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Sleep Science
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Glenn S. Brassington, Glenn T. Brassington
To assess how much physiological drive a person has to sleep, patients are given 4–6 opportunities to take naps during the day and record the amount of time it takes them to fall asleep (Carskadon et al., 1986). Sleep latency in normal adults is from 10 to 20 minutes with pathological sleepiness as a mean sleep latency of 5–6 minutes. This shorter latency to sleep onset suggests that the participant is experiencing a very strong drive to sleep during the day and indicates insufficient quality nighttime sleep (Carskadon & Dement, 2017).
Sleep–Wake Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Margaret Kay-Stacey, Eunice Torres-Rivera, Phyllis C. Zee
Multiple drugs such as hypnotics, sedatives, stimulants, and antidepressants, or withdrawal from these agents, may affect sleep latency and/or REM latency. Ideally, these drugs should be discontinued at least 2 weeks prior to the MSLT, although the situation can be complicated due to factors such as risk of exacerbation of depression during withdrawal from antidepressant medication. Urine drug screening may be useful if the medication history is unclear.
The Sleeping Brain
Published in Hanno W. Kirk, Restoring the Brain, 2020
Somatic arousal probably reflects hyperactivity of the sympathetic nervous system as manifested in elevated heart rate, cortisol levels, body temperature and whole-body metabolic rate described in PI.27,28,29 Cognitive arousal is characterized by intrusive, repetitive and often negative thought patterns. When such patterns are induced experimentally, normal sleepers who are partially sleep-deprived demonstrate significant increases in sleep latency.30
Sleep and Rest-Activity Rhythms in Recovering Patients with Severe Concurrent Mental and Substance Use Disorder: A Pilot Study
Published in Journal of Dual Diagnosis, 2023
Myriam Juda, Joanna Pater, Ralph E. Mistlberger, Christian G. Schütz
The observed advanced rest-activity rhythm may reflect a heightened homeostatic sleep drive as a result of high sedative load from medications. Consistently, earlier sleep phase was associated with a higher sedative load. However, self-reported fatigue did not correlate with rest-activity phase. Also, sleep latency was comparable to that of healthy adults, which typically ranges between 10 and 20 min (Anderson & Bradley, 2013). Midsleep time derived from the actigraphy data was earlier (∼1 hours) compared to midsleep derived from the questionnaire (MCTQ) data. This is likely due to differences in schedule restrictions inside the treatment center (actigraphy data) vs. outside the treatment center (MCTQ data). Consistently, sleep timing from the actigraphy data showed less variance in midsleep than self-reported midsleep on weekends outside the treatment center. Also, midsleep from actigraphy, but not from MCTQ, was associated with a longer stay at the treatment center. The morningness tendency may reflect adherence to daily regimens, such as morning activities (Antúnez et al., 2016) and pharmacological treatment.
Network meta-analysis comparing the effectiveness of a prescription digital therapeutic for chronic insomnia to medications and face-to-face cognitive behavioral therapy in adults
Published in Current Medical Research and Opinion, 2022
Felicia Forma, Ramya Pratiwadi, Fadoua El-Moustaid, Nathaniel Smith, Frances Thorndike, Fulton Velez
Although several systematic reviews and network meta-analyses of treatments for chronic insomnia have been conducted23,52–55, to our knowledge none include PDTs in their network comparisons. However, several analyses have performed direct meta-analyses on trials of digital therapeutics and have found that they provide a meaningful improvement in insomnia severity, sleep efficiency, subjective sleep quality, WASO, SOL, and total sleep time, consistent with our NMA findings of significantly improved efficacy in reducing insomnia for the PDT compared to placebo56,57. A recent network meta-analysis including 45 studies found Lemborexant to be the highest ranked pharmacologic agent at four weeks for total sleep time, latency to persistent sleep, and sleep efficiency58. However, only pharmacologic agents were included in the network. Another systematic review compared CBT-I to pharmacologic agents and found low to moderate grade evidence that CBT-I was superior to benzodiazepine and non-benzodiazepine drugs in the long term, while benzodiazepines may be marginally more effective in the short term at reducing sleep latency59. In a review of 64 published systematic reviews and meta-analyses, CBT-I was found to be effective for chronic insomnia across multiple outcomes60, supporting the recommendation that CBT-I be used as first-line therapy in preference to pharmacologic agents11,13. However, digital therapeutics were not specifically examined in the comparisons.
The Association between Sleep Problems and Neuropsychological Deficits in Medication-naïve Children with ADHD
Published in Behavioral Sleep Medicine, 2022
Rikke Lambek, Per Hove Thomsen, Edmund J. S. Sonuga-Barke, Poul Jennum, Anne Virring Sørensen
In the present study, an association was found between sleep onset latency and objectively measured neuropsychological function in children with ADHD. Specifically, longer nighttime sleep latencies (on the PSG) were associated with poorer executive function, whereas shorter daytime mean sleep latency (on the MSLT) was associated with more delay aversion. Longer sleep latency during the night has been suggested to interfere with sleep quantity and quality and thereby compromise executive functioning (Holanda & De Almondes, 2016), albeit it is also possible that executive dysfunction results in longer latencies, e.g., mediated by poorer sleep hygiene (Cortese et al., 2009). In the case of delay aversion, it is possible that shorter sleep latencies indicate daytime sleepiness and that sleepiness influences choice impulsivity (e.g., exacerbates the tendency to choose immediate over delayed rewards). Overall, we speculate whether a dysregulated sleep-wake regulation interferes with neuropsychological function.