HOME PRODUCTS SERVICES COMPANY CONTACT FAQ

Sleep Initiation and Maintenance Disorders (Insomnia)

Subscribe to New Research on Sleep Initiation and Maintenance Disorders

Disorders characterized by impairment of the ability to initiate or maintain sleep. This may occur as a primary disorder or in association with another medical or psychiatric condition.

Also Known As:

Insomnia; Sleeplessness; Chronic Insomnia; Primary Insomnia; Nonorganic Insomnia; Insomnias; Disorders of Initiating and Maintaining Sleep; DIMS (Disorders of Initiating and Maintaining Sleep); Early Awakening; Insomnia Disorder; Psychophysiological Insomnia; Rebound Insomnia; Secondary Insomnia; Sleep Initiation Dysfunction; Transient Insomnia; Awakening, Early; Dysfunction, Sleep Initiation; Dysfunctions, Sleep Initiation; Insomnia Disorders; Insomnia, Chronic; Insomnia, Nonorganic; Insomnia, Primary; Insomnia, Psychophysiological; Insomnia, Rebound; Insomnia, Secondary; Insomnia, Transient; Sleep Initiation Dysfunctions

Networked: 4362 relevant articles (512 outcomes, 717 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Pain (Aches)
2.	Sleep Initiation and Maintenance Disorders (Insomnia)
3.	Fatigue
4.	Nausea
5.	Neoplasms (Cancer)

Experts

1.	Roth, Thomas: 78 articles (01/2016 - 01/2002)
2.	Walsh, James K: 28 articles (01/2016 - 10/2002)
3.	Krystal, Andrew D: 27 articles (01/2016 - 11/2003)
4.	Renger, John J: 26 articles (11/2015 - 08/2007)
5.	Coleman, Paul J: 23 articles (11/2015 - 01/2008)
6.	Morin, Charles M: 23 articles (05/2015 - 01/2003)
7.	Winrow, Christopher J: 21 articles (11/2015 - 07/2009)
8.	Riemann, Dieter: 19 articles (05/2015 - 03/2002)
9.	Zisapel, Nava: 19 articles (03/2015 - 12/2003)
10.	Buysse, Daniel J: 18 articles (06/2015 - 01/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Sleep Initiation and Maintenance Disorders:

1.	zolpidem (Ambien)FDA LinkGeneric 01/01/2010 - "Zolpidem is clinically very effective in treating insomnia. " 05/18/2007 - "Zolpidem has been known as a very safe and effective hypnotic drug used to treat a variety of patients with insomnia. " 08/01/2004 - "Over a period of 12 weeks of intermittent treatment with zolpidem, sleep continuity was significantly improved, the clinical gains were sustained, and there was no evidence of subjective rebound insomnia between doses or increases in the amount of medication used during the study interval." 10/01/2008 - "Employed adults with chronic insomnia treated with zolpidem extended-release 12.5 mg experienced significantly improved work performance over 24 weeks." 12/15/2000 - "In agreement with previous findings obtained in patients with chronic primary insomnia, zolpidem significantly improved sleep induction and maintenance. "
2.	MelatoninIBA 02/01/2005 - "However, existing studies on the soporific efficacy of melatonin have been highly heterogeneous in regard to inclusion and exclusion criteria, measures to evaluate insomnia, doses of the medication, and routes of administration. " 05/01/2006 - "Analysis of the trial data able to be evaluated showed a significant reduction in initial insomnia of 16 minutes with melatonin relative to placebo, with an effect size of 0.6. " 01/01/2007 - "There are data indicating that, in affected individuals, melatonin therapy may be beneficial for ameliorating insomnia symptoms. " 02/01/2001 - "The results show that melatonin, 5 mg at 6 PM, was relatively safe to take in the short term and significantly more effective than placebo in advancing sleep onset and dim light melatonin onset and increasing sleep duration in elementary school children with chronic sleep onset insomnia. " 02/01/2001 - "To establish the efficacy of melatonin treatment in childhood sleep onset insomnia, 40 elementary school children, 6 to 12 years of age, who suffered more than 1 year from chronic sleep onset insomnia, were studied in a double-blind, placebo-controlled study. "
3.	BenzodiazepinesIBA 12/01/2012 - "Benzodiazepines (BZDs) are effective in the short term against anxiety and insomnia. " 12/01/2008 - "Until few years ago benzodiazepines were the only drugs effective in the treatment of insomnia. " 09/01/2007 - "Benzodiazepines and non-benzodiazepines are effective treatments in the management of chronic insomnia, although they pose a risk of harm. " 06/01/1992 - "Therefore, careful evaluation of the dose of a benzodiazepine hypnotic is the key to effective treatment of insomnia without inducement of adverse effects. " 08/01/1988 - "Benzodiazepines effective for treatment of anxiety and insomnia."
4.	eszopiclone (Lunesta)FDA Link 04/01/2011 - "In this post hoc analysis of patients with insomnia and comorbid anxious depression derived from 2 trials, 8 weeks of eszopiclone therapy coadministered with an SSRI resulted in significantly greater improvements in insomnia, significantly greater reductions in HDRS-17 total score, and significantly greater HDRS-17 response rates compared with placebo coadministration. " 02/01/2010 - "In this Phase IV trial of older adults with insomnia, eszopiclone significantly improved patient-reported sleep and daytime function relative to placebo. " 01/01/2007 - "A decision analytical model was developed based on the reanalysis of a 6-month placebo-controlled trial, which demonstrated that eszopiclone 3mg significantly improved sleep and daytime function measures versus placebo in adults with primary insomnia. " 02/01/2006 - "In clinical trials, eszopiclone 3 mg significantly improved objective and subjective sleep measures in transient and chronic insomnia in adults. " 12/01/2012 - "In Japanese patients with primary insomnia, eszopiclone 2mg and 3mg significantly improved PSG-determined and patient-reported sleep latency and sleep maintenance relative to placebo."
5.	Hypnotics and Sedatives (Sedatives)IBA 05/01/2015 - "The present study suggested that usage of multiple hypnotics is not beneficial for relieving insomnia or for keeping better QOL in shift work nurses. " 11/01/2002 - "Good evidence exists for the efficacy of hypnotics for short term insomnia but long term data is currently lacking. " 01/01/1993 - "More than half of the patients reported a daily use of the hypnotics for 1-5 years or longer, but only 22% of the severely insomniac patients reported at the time of the third inquiry a significant improvement of insomnia due to the administration of sleeping pills. " 12/01/2004 - "There is now an overwhelming preponderance of evidence that cognitive behavioural therapy for insomnia (CBT-I) is effective, as effective as sedative hypnotics during acute treatment (4-8 weeks), and is more effective in long term (following treatment). " 12/24/1997 - "Relative to the chronic and recurring course of insomnia, both the limited duration of treatments studied and the lack of follow-up data from controlled trials represent challenges for developing evidence-based guidelines for the use of hypnotics in the management of chronic insomnia."
6.	ramelteon (Rozerem)FDA Link 06/15/2011 - "In this case series of 5 alcohol-dependent patients with insomnia who had initiated abstinence, a 4-week course of ramelteon 8 mg nightly was associated with markedly improved insomnia scores, increased total sleep time, and decreased time to fall asleep. " 01/01/2005 - "In three clinical trials in patients with chronic insomnia, ramelteon 8mg was effective in reducing sleep latency, without being associated with any significant or clinically relevant residual effects. " 02/01/2011 - "In Japanese adults with chronic insomnia, ramelteon 8 mg significantly reduced patient-reported sleep latency, increased total sleep time and improved sleep quality after 1 week of treatment. " 07/01/2008 - "In this post hoc analysis of data from patients with chronic insomnia, a significantly greater percentage experienced a > or = 50% reduction in LPS with ramelteon 8 mg/d versus placebo. " 01/01/2006 - "Ramelteon demonstrated a statistically significant reduction in LPS and a statistically significant increase in TST, with no apparent next-day residual effects, in patients with chronic primary insomnia."
7.	Trazodone (Trittico)FDA LinkGeneric 04/01/2005 - "Evidence for the efficacy of trazodone in treating insomnia is very limited; most studies are small, conducted in populations of depressed patients, raise issues of design, and often lack objective efficacy measures. " 01/01/2003 - "Evaluation of the target symptoms of trazodone by ranking the most improved symptoms identified insomnia as the most improved psychopathological item in all three scales. " 06/01/2010 - "Trazodone is an sedative antidepressant, acting quickly, efficiently, safely, with a small number of adverse reactions and proven effective in the treatment of insomnia." 01/01/2005 - "After trazodone introduction, insomnia improved and the median (interquartile range) of this item in G1 and G2 patients showed no statistically significant difference on Day 28 (G1: 0 (0-1); G2: 0 (0-2)). " 08/01/1983 - "In the subjective ratings, sleep improved in quality on trazodone, significantly so in the first and second weeks of intake, though with significant rebound insomnia on the second withdrawal night. "
8.	Flurazepam (Dalmane)FDA LinkGeneric 07/01/1982 - "The short-term hypnotic efficacy of 15 mg flurazepam was evaluated in nine patients (mean age 37.2 +/- 15.9 years) who complained of insomnia and had polysomnographic evidence of disturbed sleep. " 12/01/1979 - "Under sleep-laboratory control, the efficacy of flurazepam hydrochloride (15 mg) was evaluated in 6 women (age range, 67-82 years) with objectively verified insomnia. " 08/01/2014 - "Flurazepam 30 mg was given before bedtime for insomnia. " 06/01/1989 - "In keeping with its long elimination half-life, flurazepam (30 mg) continued to exert beneficial effects for the first 2-3 withdrawal nights, but the possibility of a mild rebound insomnia cannot be dismissed during the intermediate withdrawal period (nights 4-10) following prolonged, consecutive, nightly administration (more than 30 nights). " 01/01/1988 - "Ten patients with subjective insomnia received 30 mg flurazepam or placebo on nights in which arousal thresholds in response to electronic tones or a recording of the subjects' names were determined. "
9.	Triazolam (Halcion)FDA LinkGeneric 05/01/1983 - "Overall, triazolam is an effective and safe compound for the symptomatic treatment of insomnia complaints." 08/01/1981 - "Triazolam: a review of its pharmacological properties and therapeutic efficacy in patients with insomnia." 08/01/1993 - "The authors examined sleep improvement in subjects with primary insomnia who received triazolam plus behavioral therapy (N = 8) or triazolam plus sleep-related information (N = 7). " 11/01/1983 - "A double-blind crossover study in 53 psychiatric outpatients compared the safety and efficacy of triazolam and placebo in relieving insomnia refractory to treatment with a tricyclic antidepressant. " 01/01/2002 - "Sixty-four healthy men and women with and without insomnia (aged 21-55 years) were given an opportunity to self-administer placebo or triazolam (0.25 mg) capsules (single-choice method - available capsule or no capsule) before sleep in three separate studies. "
10.	Estazolam (ProSom)FDA LinkGeneric 08/01/1991 - "Patients treated with estazolam 2.0 mg showed significantly greater improvement in anxiety than those receiving placebo on the mean total score of HAM-A ([placebo, -3.4; estazolam, -7.1; p less than 0.001] and without the insomnia item [placebo, -2.7; estazolam, -5.5; p less than 0.001]). " 03/02/1990 - "Estazolam is an effective treatment for situational insomnia and significantly improves sleep in patients with insomnia associated with moderately severe anxiety or depression." 07/01/1992 - "A 1-mg dose of estazolam appears to be a safe and effective hypnotic for elderly patients with insomnia." 03/02/1990 - "These data, combined with the evidence for hypnotic activity, indicate that estazolam is a safe and effective treatment for insomnia." 03/01/2009 - "JXYP, combined with or without Estazolam, can improve the quality of sleep subjectively, and the combination of the two could enhance the efficacy of sleep in patients with psychological stress insomnia."

Therapies and Procedures

1.	Drug Therapy (Chemotherapy) 01/01/2011 - "These five and the one who resumed chemotherapy after 6 weeks report an improved emotional functioning and less insomnia, while several other parameters of quality of life remained stable or worsened, reflecting their very advanced disease. " 12/01/1999 - "Pharmacotherapy provides reliable and rapid relief from insomnia, whereas behavioral therapies help produce long-term improvement. " 01/01/2007 - "Management of insomnia in the elderly appears to have a better outcome when pharmacotherapy is combined with SHT rather than SHT alone. " 01/01/2005 - "Cognitive-behavioral therapy is effective in the treatment of insomnia, alone and in combination with pharmacotherapy, but finding a qualified provider can be difficult and the patient must be willing to take the time to learn the therapies and wait for them to show effect." 04/01/2012 - "The present study is a secondary analysis that examines the degree to which insomnia, objective sleep disturbances, or their combination predicts depression remission following pharmacotherapy and/or psychotherapy treatment. "
2.	Aftercare (After-Treatment) 07/15/2012 - "After treatment, significant improvement was seen for the QLQ-C15-PAL insomnia scale, as well as the QLQ-BN20+2 scales of future uncertainty, visual disorder, and concentration difficulty. " 05/01/2009 - "After treatment for 4 courses, the total effective rate was 88.2%, and the time falling asleep was significantly shortened (P < 0.05) and the sleeping time was prolonged (P < 0.05), and also the syndromes induced by insomnia were significantly improved (P < 0.01). " 05/01/2010 - "Cognitive behavioral therapy for insomnia (CBTi) is a brief and effective non-pharmacologic treatment for insomnia that is grounded in the science of sleep medicine and the science of behavior change and psychological theory, and in direct comparisons with sleep medication in randomized control trials that demonstrate that CBTi has comparable efficacy with more durable long-term maintenance of gains after treatment discontinuation. " 08/01/2015 - "Supported ICBT-i is more effective than an active control treatment in reducing insomnia severity and treatment gains remain stable one year after treatment." 07/01/2014 - "Furthermore, the Dutch ASHS was able to discriminate between normal sleepers and adolescents with insomnia, and scores of adolescents with insomnia improved after treatment. "
3.	Acupressure (Shiatsu) 01/01/2013 - "Acupressure is a noninvasive, safe, and effective method for the management of insomnia in adolescents, with good compliance and no adverse effects." 01/01/2013 - "The purpose of this study was to assess the efficacy of acupressure therapy in a sample of adolescents with insomnia using a standard polysomnographic evaluation. " 12/01/2008 - "The aim of study was to evaluate the efficacy of HT 7 point acupressure in insomnia. " 01/01/2013 - "This high-tech "teleacupuncture study" describes a neurovegetative ear acupressure effect in patients with chronic insomnia by using heart rate variability analysis. " 01/01/2013 - "Acupressure therapy for insomnia in adolescents: a polysomnographic study."
4.	Hormone Replacement Therapy (Therapy, Hormone Replacement) 03/01/1999 - "Conventional hormone replacement therapy is effective in controlling vasomotor symptoms, including insomnia, for most postmenopausal women. " 07/01/2015 - "Insomnia related to vasomotor symptoms can be improved with hormone replacement therapy. " 03/01/2009 - "While hormone replacement therapy (HRT) has historically been considered a first-line treatment for menopausal insomnia, many women are now seeking alternative treatments due to concerns about the risks and side-effects of HRT. " 01/01/2011 - "Insomnia is considered one of the climacteric symptoms of menopause, which can be controlled with hormone replacement therapy (HRT). " 04/01/2003 - "Effects of hormone replacement therapy on perceptual and cognitive event-related potentials in menopausal insomnia."
5.	Psychology Biofeedback (Biofeedback) 07/24/1996 - "Regarding insomnia, behavioral techniques, particularly relaxation and biofeedback, produce improvements in some aspects of sleep, but it is questionable whether the magnitude of the improvement in sleep onset and total sleep time are clinically significant." 10/01/1995 - "Despite the availability, relative safety and efficacy of these newer hypnotic agents, they should not be perceived as the sole treatment for insomnia and should be used in conjunction with nonpharmacological techniques (such as adherence to good sleep hygiene, sleep restriction, stimulus control and biofeedback therapy)." 07/01/1981 - "Appropriate biofeedback methods may be effective for specific types of insomnia, but these procedures offer no panacea for all poor sleep." 06/01/1982 - "The treatment of psychophysiologic insomnia with biofeedback: a replication study." 06/01/1982 - "This paper describes a study in which progressive relaxation, EMG frontalis biofeedback, and a biofeedback placebo manipulation were compared in the treatment of severe insomnia with 40 chronically sleep-disturbed adult patients. "