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Sleep Initiation and Maintenance Disorders: HELP
Articles from Amsterdam
Based on 64 articles published since 2008
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These are the 64 published articles about Sleep Initiation and Maintenance Disorders that originated from Amsterdam during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Review A lack of consistent brain alterations in insomnia disorder: An activation likelihood estimation meta-analysis. 2018

Tahmasian, Masoud / Noori, Khadijeh / Samea, Fateme / Zarei, Mojtaba / Spiegelhalder, Kai / Eickhoff, Simon B / Van Someren, Eus / Khazaie, Habibolah / Eickhoff, Claudia R. ·Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran. · Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. · Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran. · Department of Psychiatry and Psychotherapy, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. · Institute of Systems Neuroscience, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany; Institute of Neuroscience and Medicine (INM-1; INM-7), Research Center Jülich, Jülich, Germany. · Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 Amsterdam BA, The Netherlands; Department of Psychiatry and Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Neuroscience Campus Amsterdam, VU University and Medical Center, De Boelelaan 1187, 1081 Amsterdam HV, The Netherlands. · Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Electronic address: hakhazaie@gmail.com. · Institute of Neuroscience and Medicine (INM-1; INM-7), Research Center Jülich, Jülich, Germany; Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany. ·Sleep Med Rev · Pubmed #30093361.

ABSTRACT: Insomnia disorder is a prevalent sleep disorder, which affects about 10% of general population. However, its neural mechanisms are poorly understood. Recently, several structural and functional neuroimaging studies have been conducted in patients with insomnia disorder, but these studies have yielded diverse findings. Here, we aimed to identify consistent patterns of abnormal brain alterations in insomnia disorder by performing a quantitative coordinate-based meta-analysis. Following the preferred reporting for systematic reviews and meta-analyses statement, we searched PubMed database and used reference tracking and finally retrieved 19 eligible studies (six task-based functional magnetic resonance imaging, eight resting-state functional magnetic resonance imaging, three voxel-based morphometry, and two positron emission tomography). We extracted peak coordinates from these studies and tested for convergence using the activation likelihood estimation method. Using this method, we found no significant convergent evidence for combination of structural atrophy and functional disturbances across previous studies (p = 0.914). Inconsistencies across these studies might be related to heterogonous clinical populations, the explorative nature of these studies in combination with small sample sizes, different experimental designs, and various preprocessing and statistical approaches. Future neuroimaging studies on insomnia disorder should include larger well-characterized samples, as well as standard imaging and analysis protocols.

2 Review Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis. 2018

van Straten, Annemieke / van der Zweerde, Tanja / Kleiboer, Annet / Cuijpers, Pim / Morin, Charles M / Lancee, Jaap. ·Department of Clinical Psychology & EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands. Electronic address: a.van.straten@vu.nl. · Department of Clinical Psychology & EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands. · Université Laval, École de Psychologie, Québec City, QC, Canada. · Department of Clinical Psychology, University of Amsterdam, The Netherlands. ·Sleep Med Rev · Pubmed #28392168.

ABSTRACT: Insomnia is a major public health problem considering its high prevalence, impact on daily life, co-morbidity with other disorders and societal costs. Cognitive behavioral treatment for insomnia (CBTI) is currently considered to be the preferred treatment. However, no meta-analysis exists of all studies using at least one component of CBTI for insomnia, which also uses modern techniques to pool data and to analyze subgroups of patients. We included 87 randomized controlled trials, comparing 118 treatments (3724 patients) to non-treated controls (2579 patients). Overall, the interventions had significant effects on: insomnia severity index (g = 0.98), sleep efficiency (g = 0.71), Pittsburgh sleep quality index (g = 0.65), wake after sleep onset (g = 0.63) and sleep onset latency (SOL; g = 0.57), number of awakenings (g = 0.29) and sleep quality (g = 0.40). The smallest effect was on total sleep time (g = 0.16). Face-to-face treatments of at least four sessions seem to be more effective than self-help interventions or face-to-face interventions with fewer sessions. Otherwise the results seem to be quite robust (similar for patients with or without comorbid disease, younger or older patients, using or not using sleep medication). We conclude that CBTI, either its components or the full package, is effective in the treatment of insomnia.

3 Review Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Insomnia: an Update of the Literature. 2017

Wynchank, Dora / Bijlenga, Denise / Beekman, Aartjan T / Kooij, J J Sandra / Penninx, Brenda W. ·PsyQ Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, The Netherlands. d.wynchank@parnassiagroep.nl. · PsyQ Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, The Netherlands. · Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands. ·Curr Psychiatry Rep · Pubmed #29086065.

ABSTRACT: PURPOSE OF REVIEW: Insomnia is diagnosed when there is dissatisfaction with sleep quantity or quality. It has a prevalence in the general population ranging from 31 to 56%. Insomnia has previously been associated with adult attention-deficit/hyperactivity disorder (ADHD). In this review, we address three topics: (1) the cross-sectional relationship between ADHD and insomnia in adulthood, (2) the longitudinal relationship between ADHD and insomnia, and (3) insomnia as a side effect of pharmacological treatments for adult ADHD. RECENT FINDINGS: Three cross-sectional, clinical, and population studies report a prevalence of insomnia in ADHD adults ranging from 43 to 80%. Longitudinal evidence for a link between childhood-onset ADHD and insomnia at later age is mixed, with one study confirming and another study not supporting such a longitudinal association. In randomized, placebo-controlled trials, insomnia is reported significantly more often in the treatment arm than in the placebo arm. In varying percentages of trial participants, insomnia is a treatment-emergent adverse effect in triple-bead mixed amphetamine salts (40-45%), dasotraline (35-45%), lisdexamfetamine (10-19%), and extended-release methylphenidate (11%). Ten to seventeen percent of subjects in placebo-controlled trials of atomoxetine report insomnia, possibly related to poor metabolizer status. The mechanisms explaining the relationship between ADHD and sleep problems are incompletely understood, but both genetic and non-shared environmental influences may be involved. Adults with ADHD should be assessed for insomnia, which is frequently comorbid, and both conditions should be treated.

4 Review Insomnia heterogeneity: Characteristics to consider for data-driven multivariate subtyping. 2017

Benjamins, Jeroen S / Migliorati, Filippo / Dekker, Kim / Wassing, Rick / Moens, Sarah / Blanken, Tessa F / Te Lindert, Bart H W / Sjauw Mook, Jeffrey / Van Someren, Eus J W. ·Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands; Department of Social, Health and Organizational Psychology, Utrecht University, Utrecht, The Netherlands; Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands. · Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands; Social Brain Lab, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands. · Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands. · Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands; Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Neuroscience Amsterdam, VU University, Amsterdam, The Netherlands; Department of Psychiatry, Neuroscience Amsterdam, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: e.van.someren@nin.knaw.nl. ·Sleep Med Rev · Pubmed #29066053.

ABSTRACT: Meta-analyses and systematic reviews have reported surprisingly few consistent insomnia-characteristics with respect to cognitions, mood, traits, history of life events and family history. One interpretation of this limited consistency is that different subtypes of insomnia exist, each with its own specific multivariate profile of characteristics. Because previously unrecognized subtypes will be differentially represented in individual studies and dilute effect sizes of subtype-dependent characteristics of importance, they are unlikely to be reported consistently in individual studies, let alone in meta-analyses. This review therefore aims to complement meta-analyses by listing previously reported psychometric characteristics of insomnia, irrespective of the degree of consistency over studies. The review clearly indicates that characteristics of insomnia may not be limited to sleep. Reports suggest that at least some individuals with insomnia may deviate from people without sleep complaints with respect to demographics, mental and physical health, childhood trauma, life events, fatigue, sleepiness, hyperarousal, hyperactivity, other sleep disorders, lifetime sleep history, chronotype, depression, anxiety, mood, quality of life, personality, happiness, worry, rumination, self-consciousness, sensitivity, dysfunctional beliefs, self-conscious emotion regulation, coping, nocturnal mentation, wake resting-state mentation, physical activity, food intake, temperature perception and hedonic evaluation. The value of this list of characteristics is that 1) internet has now made it feasible to asses them all in a large sample of people suffering from insomnia, and 2) statistical methods like latent class analysis and community detection can utilize them for a truly bottom-up data-driven search for subtypes. The supplement to this review provides a blueprint of this multivariate approach as implemented in the Sleep registry platform (www.sleepregistry.nl), that allows for bottom-up subtyping and fosters cross-cultural comparison and worldwide collaboration on insomnia subtype finding - and beyond.

5 Review Neuropsychological long-term sequelae of Ebola virus disease survivors - A systematic review. 2017

Lötsch, Felix / Schnyder, Jenny / Goorhuis, Abraham / Grobusch, Martin P. ·Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, The Netherlands. · Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, The Netherlands. Electronic address: m.p.grobusch@amc.uva.nl. ·Travel Med Infect Dis · Pubmed #28478336.

ABSTRACT: BACKGROUND: The recent West African Ebola virus disease (EVD) outbreak had catastrophic impact on populations, health care systems and economies of the affected countries. Somatic symptoms have been reported to persist long beyond the acute infection. This review was conducted to provide an overview on neuro- and socio-psychological long-term sequelae of EVD survivors. METHODS: Utilizing Pubmed and PsycInfo databases, a systematic review prepared according to PRISMA guidelines. Only studies reporting quantitative data on neuropsychological sequelae three weeks or later after discharge from the Ebola-treating unit were included. Pooled proportions of common outcomes were calculated. RESULTS: In total, 224 papers were identified, of which 10 were included. Depression, insomnia, fatigue, anxiety and post-traumatic stress were common sequelae in EVD survivors. However, data from high-quality studies were scarce. CONCLUSIONS: EVD survivors have been thought to commonly face neuropsychological long-term sequelae. Methodological drawbacks and heterogeneity of current studies limit conclusions of the impact and magnitude of such sequelae. We advocate the preparation of a prospective, controlled cohort study protocol in preparation for a future outbreak.

6 Review The effects of light therapy on sleep problems: A systematic review and meta-analysis. 2016

van Maanen, Annette / Meijer, Anne Marie / van der Heijden, Kristiaan B / Oort, Frans J. ·Research Institute of Child Development and Education, University of Amsterdam, The Netherlands. Electronic address: A.vanMaanen@uva.nl. · Research Institute of Child Development and Education, University of Amsterdam, The Netherlands. · Department of Clinical Child and Adolescent Studies, Leiden University, The Netherlands. ·Sleep Med Rev · Pubmed #26606319.

ABSTRACT: Although bright light therapy seems a promising treatment for sleep problems, research shows inconclusive results. This meta-analysis is the first to systematically review the effect of light therapy on sleep problems in general and on specific types of sleep problems in particular (circadian rhythm sleep disorders, insomnia, sleep problems related to Alzheimer's disease and dementia). Fifty-three studies with a total of 1154 participants were included. Overall effects and effects on separate circadian and sleep outcomes were examined. We calculated Hedges' g effect sizes and we investigated the effects of twelve moderators (design-related, treatment-related, participant-related). Light therapy was found effective in the treatment of sleep problems in general (g = 0.39), and for circadian rhythm sleep disorders (g = 0.41), insomnia (g = 0.47), and sleep problems related to Alzheimer's disease/dementia (g = 0.30) specifically. For circadian rhythm sleep disorders, effects were smaller for randomised controlled trials. For insomnia, we found larger effects for studies using a higher light intensity, and for sleep problems related to Alzheimer's disease/dementia larger effects were found for studies with more female participants. There was indication of publication bias. To conclude, light therapy is effective for sleep problems in general, particularly for circadian outcomes and insomnia symptoms. However, most effect sizes are small to medium.

7 Review Recommended patient-reported core set of symptoms to measure in adult cancer treatment trials. 2014

Reeve, Bryce B / Mitchell, Sandra A / Dueck, Amylou C / Basch, Ethan / Cella, David / Reilly, Carolyn Miller / Minasian, Lori M / Denicoff, Andrea M / O'Mara, Ann M / Fisch, Michael J / Chauhan, Cynthia / Aaronson, Neil K / Coens, Corneel / Bruner, Deborah Watkins. ·Affiliations of authors: Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC (BBR, EB) · Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD (SAM) · Division of Cancer Prevention, National Cancer Institute, Bethesda, MD (LMM and AMO) · Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD (AMD) · Division of Health Sciences Research, Mayo Clinic, Scottsdale, AZ (ACD) · Feinberg School of Medicine, Northwestern University, Chicago, IL (DC) · Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA (CMR, DWB) · Department of General Oncology, MD Anderson Cancer Center, Houston, TX (MJF) · Mayo Clinic Breast SPORE, Rochester, MN (CCh) · Department of Psychological Research, The Netherlands Cancer Institute, Amsterdam, The Netherlands (NKA) · Quality of Life Department, European Organization for the Research and Treatment of Cancer, Brussels, Belgium (CCo). ·J Natl Cancer Inst · Pubmed #25006191.

ABSTRACT: BACKGROUND: The National Cancer Institute's Symptom Management and Health-Related Quality of Life Steering Committee held a clinical trials planning meeting (September 2011) to identify a core symptom set to be assessed across oncology trials for the purposes of better understanding treatment efficacy and toxicity and to facilitate cross-study comparisons. We report the results of an evidence-synthesis and consensus-building effort that culminated in recommendations for core symptoms to be measured in adult cancer clinical trials that include a patient-reported outcome (PRO). METHODS: We used a data-driven, consensus-building process. A panel of experts, including patient representatives, conducted a systematic review of the literature (2001-2011) and analyzed six large datasets. Results were reviewed at a multistakeholder meeting, and a final set was derived emphasizing symptom prevalence across diverse cancer populations, impact on health outcomes and quality of life, and attribution to either disease or anticancer treatment. RESULTS: We recommend that a core set of 12 symptoms--specifically fatigue, insomnia, pain, anorexia (appetite loss), dyspnea, cognitive problems, anxiety (includes worry), nausea, depression (includes sadness), sensory neuropathy, constipation, and diarrhea--be considered for inclusion in clinical trials where a PRO is measured. Inclusion of symptoms and other patient-reported endpoints should be well justified, hypothesis driven, and meaningful to patients. CONCLUSIONS: This core set will promote consistent assessment of common and clinically relevant disease- and treatment-related symptoms across cancer trials. As such, it provides a foundation to support data harmonization and continued efforts to enhance measurement of patient-centered outcomes in cancer clinical trials and observational studies.

8 Review Optimal dosages for melatonin supplementation therapy in older adults: a systematic review of current literature. 2014

Vural, Esmée M S / van Munster, Barbara C / de Rooij, Sophia E. ·Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, e.vural@vumc.nl. ·Drugs Aging · Pubmed #24802882.

ABSTRACT: BACKGROUND: Melatonin is a hormone that regulates circadian rhythm, and its levels decline with age. As melatonin levels decrease, older adults are prone to develop disorders related to an altered circadian rhythm. The effective dose of melatonin supplementation in these disorders remains unclear. OBJECTIVES: Our objective was to define the optimal dosage of exogenous melatonin administration in disorders related to altered melatonin levels in older adults aged 55 years and above by determining the dose-response effect of exogenous administered melatonin on endogenous levels. METHODS: We conducted a systematic review through PubMed/MEDLINE and Embase, both from 1980 until November 2013. Included articles studied the effect of exogenous melatonin administration on endogenous melatonin levels in either serum, urine, or saliva in humans aged 55 years and above. RESULTS: We included 16 articles, nine of which were randomized controlled trials (RCTs). The mean age varied from 55.3 to 77.6 years. Melatonin dosage varied from 0.1 mg to 50 mg/kg and was administered orally in all studies. Pre- and post-intervention levels revealed a significant elevation of the post-intervention melatonin levels in a dose-dependent fashion. The maximum concentrations measured in serum and urine were all elevated compared with placebo, and a higher elevation in older adults than in younger adults was demonstrated. Even though there were no differences between times to reach maximum concentration in serum and urine, melatonin levels with higher doses were maintained longer above a certain threshold than were lower doses. CONCLUSION: In older adults, we advise the use of the lowest possible dose of immediate-release formulation melatonin to best mimic the normal physiological circadian rhythm of melatonin and to avoid prolonged, supra-physiological blood levels.

9 Review Sleep, vigilance, and thermosensitivity. 2012

Romeijn, Nico / Raymann, Roy J E M / Møst, Els / Te Lindert, Bart / Van Der Meijden, Wisse P / Fronczek, Rolf / Gomez-Herrero, German / Van Someren, Eus J W. ·Department of Sleep & Cognition, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands. ·Pflugers Arch · Pubmed #22048563.

ABSTRACT: The regulation of sleep and wakefulness is well modeled with two underlying processes: a circadian and a homeostatic one. So far, the parameters and mechanisms of additional sleep-permissive and wake-promoting conditions have been largely overlooked. The present overview focuses on one of these conditions: the effect of skin temperature on the onset and maintenance of sleep, and alertness. Skin temperature is quite well suited to provide the brain with information on sleep-permissive and wake-promoting conditions because it changes with most if not all of them. Skin temperature changes with environmental heat and cold, but also with posture, environmental light, danger, nutritional status, pain, and stress. Its effect on the brain may thus moderate the efficacy by which the clock and homeostat manage to initiate or maintain sleep or wakefulness. The review provides a brief overview of the neuroanatomical pathways and physiological mechanisms by which skin temperature can affect the regulation of sleep and vigilance. In addition, current pitfalls and possibilities of practical applications for sleep enhancement are discussed, including the recent finding of impaired thermal comfort perception in insomniacs.

10 Clinical Trial Sleep Stage Transition Dynamics Reveal Specific Stage 2 Vulnerability in Insomnia. 2017

Wei, Yishul / Colombo, Michele A / Ramautar, Jennifer R / Blanken, Tessa F / van der Werf, Ysbrand D / Spiegelhalder, Kai / Feige, Bernd / Riemann, Dieter / Van Someren, Eus J W. ·Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands. · Bernstein Center Freiburg and Faculty of Biology, University of Freiburg, Freiburg, Germany. · Centre for Chronobiology, Psychiatric Hospital of the University of Basel (UPK), Basel, Switzerland. · Departments of Psychiatry and Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University and Medical Center, Amsterdam, The Netherlands. · Department of Anatomy and Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands. · Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. ·Sleep · Pubmed #28934523.

ABSTRACT: Study Objectives: Objective sleep impairments in insomnia disorder (ID) are insufficiently understood. The present study evaluated whether whole-night sleep stage dynamics derived from polysomnography (PSG) differ between people with ID and matched controls and whether sleep stage dynamic features discriminate them better than conventional sleep parameters. Methods: Eighty-eight participants aged 21-70 years, including 46 with ID and 42 age- and sex-matched controls without sleep complaints, were recruited through www.sleepregistry.nl and completed two nights of laboratory PSG. Data of 100 people with ID and 100 age- and sex-matched controls from a previously reported study were used to validate the generalizability of findings. The second night was used to obtain, in addition to conventional sleep parameters, probabilities of transitions between stages and bout duration distributions of each stage. Group differences were evaluated with nonparametric tests. Results: People with ID showed higher empirical probabilities to transition from stage N2 to the lighter sleep stage N1 or wakefulness and a faster decaying stage N2 bout survival function. The increased transition probability from stage N2 to stage N1 discriminated people with ID better than any of their deviations in conventional sleep parameters, including less total sleep time, less sleep efficiency, more stage N1, and more wake after sleep onset. Moreover, adding this transition probability significantly improved the discriminating power of a multiple logistic regression model based on conventional sleep parameters. Conclusions: Quantification of sleep stage dynamics revealed a particular vulnerability of stage N2 in insomnia. The feature characterizes insomnia better than-and independently of-any conventional sleep parameter.

11 Article Biological and clinical insights from genetics of insomnia symptoms. 2019

Lane, Jacqueline M / Jones, Samuel E / Dashti, Hassan S / Wood, Andrew R / Aragam, Krishna G / van Hees, Vincent T / Strand, Linn B / Winsvold, Bendik S / Wang, Heming / Bowden, Jack / Song, Yanwei / Patel, Krunal / Anderson, Simon G / Beaumont, Robin N / Bechtold, David A / Cade, Brian E / Haas, Mary / Kathiresan, Sekar / Little, Max A / Luik, Annemarie I / Loudon, Andrew S / Purcell, Shaun / Richmond, Rebecca C / Scheer, Frank A J L / Schormair, Barbara / Tyrrell, Jessica / Winkelman, John W / Winkelmann, Juliane / Anonymous4031133 / Hveem, Kristian / Zhao, Chen / Nielsen, Jonas B / Willer, Cristen J / Redline, Susan / Spiegelhalder, Kai / Kyle, Simon D / Ray, David W / Zwart, John-Anker / Brumpton, Ben / Frayling, Timothy M / Lawlor, Deborah A / Rutter, Martin K / Weedon, Michael N / Saxena, Richa. ·Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA. · Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. · Broad Institute, Cambridge, MA, USA. · Genetics of Complex Traits, University of Exeter Medical School, Exeter, UK. · Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. · Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA. · Netherlands eScience Center, Amsterdam, the Netherlands. · K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway. · FORMI and Department of Neurology, Oslo University Hospital, Oslo, Norway. · Division of Clinical Neuroscience, Oslo University Hospital and University of Oslo, Oslo, Norway. · Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA. · Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA. · MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK. · Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. · College of Science, Northeastern University, Boston, MA, USA. · Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. · Farr Institute of Health Informatics Research, University College London, London, UK. · Division of Endocrinology, Diabetes & Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. · Department of Mathematics, Aston University, Birmingham, UK. · Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA. · Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK. · Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands. · Department of Psychiatry, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA. · School of Social and Community Medicine, University of Bristol, Bristol, UK. · Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK. · Institute of Neurogenomics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany. · Departments of Psychiatry and Neurology, Massachusetts General Hospital, Boston, MA, USA. · Cluster for Systems Neurology (SyNergy), Munich, Germany. · Institute of Human Genetics, Technische Universität München, Munich, Germany. · Neurogenetics, Technische Universität München, Munich, Germany. · Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. · Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA. · Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA. · Departments of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. · Clinic for Psychiatry and Psychotherapy, Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. · Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, OX37LE/NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK. · Department of Thoracic and Occupational Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. · Manchester Diabetes Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK. · Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA. rsaxena@partners.org. · Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. rsaxena@partners.org. · Broad Institute, Cambridge, MA, USA. rsaxena@partners.org. ·Nat Genet · Pubmed #30804566.

ABSTRACT: Insomnia is a common disorder linked with adverse long-term medical and psychiatric outcomes. The underlying pathophysiological processes and causal relationships of insomnia with disease are poorly understood. Here we identified 57 loci for self-reported insomnia symptoms in the UK Biobank (n = 453,379) and confirmed their effects on self-reported insomnia symptoms in the HUNT Study (n = 14,923 cases and 47,610 controls), physician-diagnosed insomnia in the Partners Biobank (n = 2,217 cases and 14,240 controls), and accelerometer-derived measures of sleep efficiency and sleep duration in the UK Biobank (n = 83,726). Our results suggest enrichment of genes involved in ubiquitin-mediated proteolysis and of genes expressed in multiple brain regions, skeletal muscle, and adrenal glands. Evidence of shared genetic factors was found between frequent insomnia symptoms and restless legs syndrome, aging, and cardiometabolic, behavioral, psychiatric, and reproductive traits. Evidence was found for a possible causal link between insomnia symptoms and coronary artery disease, depressive symptoms, and subjective well-being.

12 Article Genome-wide analysis of insomnia in 1,331,010 individuals identifies new risk loci and functional pathways. 2019

Jansen, Philip R / Watanabe, Kyoko / Stringer, Sven / Skene, Nathan / Bryois, Julien / Hammerschlag, Anke R / de Leeuw, Christiaan A / Benjamins, Jeroen S / Muñoz-Manchado, Ana B / Nagel, Mats / Savage, Jeanne E / Tiemeier, Henning / White, Tonya / Anonymous3951133 / Tung, Joyce Y / Hinds, David A / Vacic, Vladimir / Wang, Xin / Sullivan, Patrick F / van der Sluis, Sophie / Polderman, Tinca J C / Smit, August B / Hjerling-Leffler, Jens / Van Someren, Eus J W / Posthuma, Danielle. ·Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, the Netherlands. · Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands. · Laboratory of Molecular Neurobiology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden. · UCL Institute of Neurology, Queen Square, London, UK. · Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. · Department of Social, Health and Organisational Psychology, Utrecht University, Utrecht, the Netherlands. · Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands. · Department of Clinical Genetics, Section of Complex Trait Genetics, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands. · Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands. · 23andMe, Inc., Mountain View, CA, USA. · Department of Genetics, University of North Carolina, Chapel Hill, NC, USA. · Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA. · Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, The Netherlands. · Department of Sleep and Cognition, Netherlands Institute for Neuroscience (an institute of the Royal Netherlands Academy of Arts and Sciences), Amsterdam, The Netherlands. · Departments of Psychiatry and Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University, Amsterdam University Medical Center, Amsterdam, The Netherlands. · Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, the Netherlands. d.posthuma@vu.nl. · Department of Clinical Genetics, Section of Complex Trait Genetics, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands. d.posthuma@vu.nl. ·Nat Genet · Pubmed #30804565.

ABSTRACT: Insomnia is the second most prevalent mental disorder, with no sufficient treatment available. Despite substantial heritability, insight into the associated genes and neurobiological pathways remains limited. Here, we use a large genetic association sample (n = 1,331,010) to detect novel loci and gain insight into the pathways, tissue and cell types involved in insomnia complaints. We identify 202 loci implicating 956 genes through positional, expression quantitative trait loci, and chromatin mapping. The meta-analysis explained 2.6% of the variance. We show gene set enrichments for the axonal part of neurons, cortical and subcortical tissues, and specific cell types, including striatal, hypothalamic, and claustrum neurons. We found considerable genetic correlations with psychiatric traits and sleep duration, and modest correlations with other sleep-related traits. Mendelian randomization identified the causal effects of insomnia on depression, diabetes, and cardiovascular disease, and the protective effects of educational attainment and intracranial volume. Our findings highlight key brain areas and cell types implicated in insomnia, and provide new treatment targets.

13 Article Genome-wide association analysis of insomnia complaints identifies risk genes and genetic overlap with psychiatric and metabolic traits. 2017

Hammerschlag, Anke R / Stringer, Sven / de Leeuw, Christiaan A / Sniekers, Suzanne / Taskesen, Erdogan / Watanabe, Kyoko / Blanken, Tessa F / Dekker, Kim / Te Lindert, Bart H W / Wassing, Rick / Jonsdottir, Ingileif / Thorleifsson, Gudmar / Stefansson, Hreinn / Gislason, Thorarinn / Berger, Klaus / Schormair, Barbara / Wellmann, Juergen / Winkelmann, Juliane / Stefansson, Kari / Oexle, Konrad / Van Someren, Eus J W / Posthuma, Danielle. ·Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. · Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Medical Center, Amsterdam, the Netherlands. · Department of Sleep and Cognition, Netherlands Institute for Neuroscience (an institute of the Royal Netherlands Academy of Arts and Sciences), Amsterdam, the Netherlands. · Department of Integrative Neurophysiology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. · Department of Psychiatry, Vrije Universiteit Medical Center, Amsterdam, the Netherlands. · deCODE Genetics, Amgen, Inc., Reykjavík, Iceland. · Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. · Department of Respiratory Medicine and Sleep, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland. · Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany. · Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany. · Institute of Human Genetics, Technische Universität München, Munich, Germany. · Neurologische Klinik und Poliklinik, Klinikum Rechts der Isar der Technischen Universität München, Munich, Germany. · Munich Cluster for Systems Neurology (SyNergy), Munich, Germany. · Department of Clinical Genetics, Amsterdam Neuroscience, Vrije Universiteit Medical Center, Amsterdam, the Netherlands. ·Nat Genet · Pubmed #28604731.

ABSTRACT: Persistent insomnia is among the most frequent complaints in general practice. To identify genetic factors for insomnia complaints, we performed a genome-wide association study (GWAS) and a genome-wide gene-based association study (GWGAS) in 113,006 individuals. We identify three loci and seven genes associated with insomnia complaints, with the associations for one locus and five genes supported by joint analysis with an independent sample (n = 7,565). Our top association (MEIS1, P < 5 × 10

14 Article Attentional bias modification training for insomnia: A double-blind placebo controlled randomized trial. 2017

Lancee, Jaap / Yasiney, Samya L / Brendel, Ruben S / Boffo, Marilisa / Clarke, Patrick J F / Salemink, Elske. ·Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands. · Department of Developmental Psychology, University of Amsterdam, Amsterdam, the Netherlands. · School of Psychology, University of Western Australia, Perth, Australia. · School of Psychology and Speech Pathology, Curtin University, Perth, Australia. ·PLoS One · Pubmed #28423038.

ABSTRACT: BACKGROUND: Attentional bias toward sleep-related information is believed to play a key role in insomnia. If attentional bias is indeed of importance, changing this bias should then in turn have effects on insomnia complaints. In this double-blind placebo controlled randomized trial we investigated the efficacy of attentional bias modification training in the treatment of insomnia. METHOD: We administered baseline, post-test, and one-week follow-up measurements of insomnia severity, sleep-related worry, depression, and anxiety. Participants meeting DSM-5 criteria for insomnia were randomized into an attentional bias training group (n = 67) or a placebo training group (n = 70). Both groups received eight training sessions over the course of two weeks. All participants kept a sleep diary for four consecutive weeks (one week before until one week after the training sessions). RESULTS: There was no additional benefit for the attentional bias training over the placebo training on sleep-related indices/outcome measures. CONCLUSIONS: The absence of the effect may be explained by the fact that there was neither attentional bias at baseline nor any reduction in the bias after the training. Either way, this study gives no support for attentional bias modification training as a stand-alone intervention for ameliorating insomnia complaints.

15 Article Mobile Phone-Delivered Cognitive Behavioral Therapy for Insomnia: A Randomized Waitlist Controlled Trial. 2017

Horsch, Corine Hg / Lancee, Jaap / Griffioen-Both, Fiemke / Spruit, Sandor / Fitrianie, Siska / Neerincx, Mark A / Beun, Robbert Jan / Brinkman, Willem-Paul. ·Department of Intelligent Systems, Delft University of Technology, Delft, Netherlands. · Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands. · Department of Information and Computing Sciences, Utrecht University, Utrecht, Netherlands. ·J Med Internet Res · Pubmed #28400355.

ABSTRACT: BACKGROUND: This study is one of the first randomized controlled trials investigating cognitive behavioral therapy for insomnia (CBT-I) delivered by a fully automated mobile phone app. Such an app can potentially increase the accessibility of insomnia treatment for the 10% of people who have insomnia. OBJECTIVE: The objective of our study was to investigate the efficacy of CBT-I delivered via the Sleepcare mobile phone app, compared with a waitlist control group, in a randomized controlled trial. METHODS: We recruited participants in the Netherlands with relatively mild insomnia disorder. After answering an online pretest questionnaire, they were randomly assigned to the app (n=74) or the waitlist condition (n=77). The app packaged a sleep diary, a relaxation exercise, sleep restriction exercise, and sleep hygiene and education. The app was fully automated and adjusted itself to a participant's progress. Program duration was 6 to 7 weeks, after which participants received posttest measurements and a 3-month follow-up. The participants in the waitlist condition received the app after they completed the posttest questionnaire. The measurements consisted of questionnaires and 7-day online diaries. The questionnaires measured insomnia severity, dysfunctional beliefs about sleep, and anxiety and depression symptoms. The diary measured sleep variables such as sleep efficiency. We performed multilevel analyses to study the interaction effects between time and condition. RESULTS: The results showed significant interaction effects (P<.01) favoring the app condition on the primary outcome measures of insomnia severity (d=-0.66) and sleep efficiency (d=0.71). Overall, these improvements were also retained in a 3-month follow-up. CONCLUSIONS: This study demonstrated the efficacy of a fully automated mobile phone app in the treatment of relatively mild insomnia. The effects were in the range of what is found for Web-based treatment in general. This supports the applicability of such technical tools in the treatment of insomnia. Future work should examine the generalizability to a more diverse population. Furthermore, the separate components of such an app should be investigated. It remains to be seen how this app can best be integrated into the current health regimens. TRIAL REGISTRATION: Netherlands Trial Register: NTR5560; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5560 (Archived by WebCite at http://www.webcitation.org/6noLaUdJ4).

16 Article The bidirectional longitudinal relationship between insomnia, depression and anxiety in patients with early-stage, medication-naïve Parkinson's disease. 2017

Rutten, Sonja / Vriend, Chris / van der Werf, Ysbrand D / Berendse, Henk W / Weintraub, Daniel / van den Heuvel, Odile A. ·Department of Psychiatry, VU University Medical Center (VUmc), The Netherlands; Department of Anatomy & Neurosciences, VUmc, The Netherlands. Electronic address: s.rutten@vumc.nl. · Department of Psychiatry, VU University Medical Center (VUmc), The Netherlands; Department of Anatomy & Neurosciences, VUmc, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands; Department of Neurology, VUmc, The Netherlands. · Department of Anatomy & Neurosciences, VUmc, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands. · Amsterdam Neuroscience, Amsterdam, The Netherlands; Department of Neurology, VUmc, The Netherlands. · Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, United States. · Department of Psychiatry, VU University Medical Center (VUmc), The Netherlands; Department of Anatomy & Neurosciences, VUmc, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands. ·Parkinsonism Relat Disord · Pubmed #28365203.

ABSTRACT: INTRODUCTION: While anxiety, depression and insomnia frequently (co-)occur in Parkinson's disease (PD) patients, little is known about their temporal relationship. In this study, we tested two hypotheses: i) insomnia predicts an increase in symptoms of depression or anxiety and ii) anxiety or depression at baseline predicts insomnia in PD patients six months later. METHODS: We used longitudinal data from a prospective cohort study of early-stage, medication-naïve PD patients. Primary outcome measures were: anxiety symptoms, measured with the State-Trait Anxiety Inventory (STAI); depressive symptoms, measured with the 15-item Geriatric Depression Scale (GDS-15); and insomnia, defined as a score ≥ 2 on item 1.7 of the Movement Disorder Society - Unified Parkinson's Disease Rating Scale. We performed linear and logistic regression analyses, correcting for baseline value of the respective outcome variable. RESULTS: Baseline insomnia was not associated with GDS-15 or STAI total score at follow-up. In a post hoc analysis, we found that insomnia predicted a higher STAI State score (B(SE) = 2.50 (1.07), p < 0.05), while the association with the STAI Trait score was not significant. Baseline STAI scores (B(SE) = 0.02 (0.01), p = 0.001) and GDS-15 score (B(SE) = 0.15 (0.05), p < 0.001) were significantly associated with insomnia at follow-up. CONCLUSION: Symptoms of anxiety and depression may constitute a risk factor for insomnia in PD. The relationship between insomnia and anxiety is bidirectional, which suggests that both anxiety and sleep disorders can start a negative spiral in PD patients, where one enhances the other. Independent clinical attention for these symptoms in PD patients is therefore warranted.

17 Article Effects of Melatonin and Bright Light Treatment in Childhood Chronic Sleep Onset Insomnia With Late Melatonin Onset: A Randomized Controlled Study. 2017

van Maanen, Annette / Meijer, Anne Marie / Smits, Marcel G / van der Heijden, Kristiaan B / Oort, Frans J. ·Research Institute of Child Development and Education, University of Amsterdam,Amsterdam,The Netherlands. · Centre of Sleep-Wake Disorders and Chronobiology, Hospital Gelderse Vallei,Ede,The Netherlands. · Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands. · Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands. ·Sleep · Pubmed #28364493.

ABSTRACT: Study Objectives: Chronic sleep onset insomnia with late melatonin onset is prevalent in childhood, and has negative daytime consequences. Melatonin treatment is known to be effective in treating these sleep problems. Bright light therapy might be an alternative treatment, with potential advantages over melatonin treatment. In this study, we compare the effects of melatonin and bright light treatment with a placebo condition in children with chronic sleep onset insomnia and late melatonin onset. Methods: Eighty-four children (mean age 10.0 years, 61% boys) first entered a baseline week, after which they received melatonin (N = 26), light (N = 30), or placebo pills (N = 28) for 3 to 4 weeks. Sleep was measured daily with sleep diaries and actigraphy. Before and after treatment children completed a questionnaire on chronic sleep reduction, and Dim Light Melatonin Onset (DLMO) was measured. Results were analyzed with linear mixed model analyses. Results: Melatonin treatment and light therapy decreased sleep latency (sleep diary) and advanced sleep onset (sleep diary and actigraphy), although for sleep onset the effects of melatonin were stronger. In addition, melatonin treatment advanced DLMO and had positive effects on sleep latency and sleep efficiency (actigraphy data), and sleep time (sleep diary and actigraphy data). However, wake after sleep onset (actigraphy) increased with melatonin treatment. No effects on chronic sleep reduction were found. Conclusions: We found positive effects of both melatonin and light treatment on various sleep outcomes, but more and stronger effects were found for melatonin treatment.

18 Article Insomnia, Sleep Duration, Depressive Symptoms, and the Onset of Chronic Multisite Musculoskeletal Pain. 2017

Generaal, Ellen / Vogelzangs, Nicole / Penninx, Brenda W J H / Dekker, Joost. ·Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands. · Department of Epidemiology, Cardiovascular Research Institute Maastricht (CARIM) and Maastricht Centre for Systems Biology (MaCSBIO), Maastricht University, Maastricht, the Netherlands. · Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, the Netherlands. ·Sleep · Pubmed #28364456.

ABSTRACT: Study objective: The temporal relationships among sleep, depressive symptoms, and pain are unclear. This longitudinal study examines whether insomnia and sleep duration predict the onset of chronic multisite musculoskeletal pain over 6 years and whether this association is mediated by depressive symptoms. Methods: 1860 subjects of the Netherlands Study of Depression and Anxiety, free from chronic multisite musculoskeletal pain at baseline, were followed up for the onset of chronic multisite musculoskeletal pain over 6 years (Chronic Pain Grade Questionnaire). We determined baseline insomnia (Women's Health Initiative Insomnia Rating Scale ≥9) and sleep duration (short: ≤6 hr, normal: 7-9 hr, long: ≥10 hr). Depressive symptoms were assessed at baseline and as a change score over time (Inventory of Depressive Symptomatology). Results: Insomnia (hazard ratio [HR] [95% confidence interval, 95%CI] = 1.60 [1.30-1.96], p < .001) and short sleep duration (HR [95%CI] = 1.52 [1.22-1.90], p < .001) were associated with chronic pain onset. Adding baseline depressive symptoms as a mediator attenuated the associations for insomnia and short sleep with chronic pain onset (∆B = 40% and 26%, respectively). Adding the change score of depressive symptoms further weakened the association for insomnia (∆B = 16%) but not for short sleep. All direct effects for sleep measures with chronic pain onset remained statistically significant (p < .05). Conclusions: This longitudinal study shows that insomnia and short sleep duration are risk factors for developing chronic pain. Depressive symptoms partially mediate the effect for insomnia and short sleep with developing chronic pain.

19 Article A case of dose escalation of quetiapine in persistent insomnia disorder. 2017

Cornelis, Claudia / Van Gastel, Ann / Dumont, Glenn / Coppens, Violette / Sabbe, Bernard / Morrens, Manuel / Van Den Eede, Filip. ·a Department of Adult Psychiatry, Collaborative Antwerp Psychiatric Research Institute , University of Antwerp , Antwerp , Belgium. · b University Department of Psychiatry , Campus Psychiatric Hospital, Duffel , Belgium. · c University Department of Psychiatry , Campus Antwerp University Hospital, Edegem , Belgium. · d Department of Clinical Pharmacology, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands. ·Acta Clin Belg · Pubmed #27960654.

ABSTRACT: Quetiapine, an atypical antipsychotic drug, is recommended for the treatment of schizophrenia and mood disorders. In addition, given its sedative effects, a low dose of the agent is also widely used in the treatment of anxiety disorders, personality disorders, substance abuse, and sleep disturbances. In this case study, quetiapine was the first effective drug in reducing chronic insomnia in a male patient with a long treatment history. Because its effect declined over time, in the course of two years, a gradual dose increase led to a posology 50 times higher than the off-label dosage used to obtain sedation, i.e. 25-100 mg quetiapine administered once daily. This case raises awareness of the ease with which dose escalation of quetiapine occurs. The risk of side effects and, possibly, dependence and abuse underlines the importance of regular and careful patient monitoring. Given the unexpected effectiveness of the agent and the absence of side effects in the described case, we argue that in treatment-resistant insomnia, a high dose of quetiapine may be justifiable in selected cases but also urge that further research on the long-term effects and potential adverse events of quetiapine for this indication is of the utmost importance.

20 Article The impact of online therapeutic feedback on outcome measures in Internet-CBTI for adolescents with insomnia. 2017

de Bruin, Eduard Jan / Meijer, Anne Marie. ·Research Institute of Child Development and Education, University of Amsterdam, The Netherlands. Electronic address: E.J.deBruin@UvA.nl. · Research Institute of Child Development and Education, University of Amsterdam, The Netherlands. ·Sleep Med · Pubmed #27866826.

ABSTRACT: BACKGROUND: Guided Internet cognitive behavioral therapy for insomnia (CBTI) offers an effective treatment for adolescents, but little is known about the active ingredients of therapeutic feedback on outcomes. OBJECTIVE: This study aims to identify which factors can be distinguished in written therapeutic feedback in Internet CBTI, and examine whether these factors and participation in a chat session contribute to sleep outcomes. METHODS: Internet CBTI was applied to 57 adolescents (mean age 15.43 years, SD 1.74, 82.5% girls). Symptoms of insomnia and chronic sleep reduction, and total sleep time, time in bed, and sleep efficiency from seven day sleep logs were measured at baseline, post-treatment, and at two month follow-up. With a coding instrument developed for this study, two independent researchers coded transcripts of the written therapeutic feedback of the Internet CBTI sessions with an event sampling method. RESULTS: Principal component analysis of the initial 17 items from the coding instrument yielded four distinct factors of therapeutic feedback, of which only Sleep expertise seemed to contribute to improvements after Internet CBTI. The other factors, indicating forms of encouragement, and participation in a chat session seemed counterproductive. CONCLUSIONS: This first longitudinal study into effects of therapeutic feedback in adolescent Internet CBTI indicated that emphasizing knowledge about sleep might contribute to insomnia improvement. The structured nature of the preprogrammed treatment content, delay of therapeutic feedback due to standardized timing, and unintentional reinforcement of undesirable behavior by giving attention to failures might explain the negative results of encouraging behavior. Further research to identify effective therapeutic factors in Internet therapy is warranted.

21 Article When Thinking Impairs Sleep: Trait, Daytime and Nighttime Repetitive Thinking in Insomnia. 2017

Lancee, Jaap / Eisma, Maarten C / van Zanten, Kristopher B / Topper, Maurice. ·a Department of Clinical Psychology , University of Amsterdam , Amsterdam , Netherlands. · b Department of Clinical and Health Psychology , Utrecht University , Utrecht , Netherlands. ·Behav Sleep Med · Pubmed #26651373.

ABSTRACT: We performed two studies in individuals with sleep problems to investigate trait, daytime, and nighttime repetitive thinking as risk factors for insomnia. In Study 1, 139 participants completed questionnaires on worry, rumination, insomnia, anxiety, depression, and a sleep diary. Trait rumination and trait worry were not associated with sleep impairment. In Study 2, 64 participants completed similar measures and a daytime and nighttime sleep-related worry diary. Only nighttime sleep-related worry was consistently associated with sleep impairment. Overall, results indicate that nighttime sleep-related worry is important in the maintenance of insomnia, whereas effects of trait and daytime repetitive thinking are more benign. Treatment for insomnia can potentially be improved by focusing more on nighttime sleep-related worry.

22 Article Multiple phenotypes of resting-state cognition are altered in insomnia disorder. 2016

Palagini, Laura / Cellini, Nicola / Mauri, Mauro / Mazzei, Irene / Simpraga, Sonja / dell'Osso, Liliana / Linkenkaer-Hansen, Klaus / Riemann, Dieter. ·Department of Clinical Experimental Medicine, Psychiatric Unit, University of Pisa, Pisa, Italy. Electronic address: lpalagini@tiscali.it. · Department of General Psychology, University of Padova, Padova, Italy. · Department of Clinical Experimental Medicine, Psychiatric Unit, University of Pisa, Pisa, Italy. · Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Neuroscience Campus Amsterdam, Amsterdam, the Netherlands. · Department of Clinical Psychology and Psychophysiology/Sleep Medicine, Center for Mental Disorders, University of Freiburg Medical Center, Freiburg, Germany. ·Sleep Health · Pubmed #29073428.

ABSTRACT: BACKGROUND: Research has supported the role of cognitive processes in the development and maintenance of insomnia, yet a standardized characterization of mind-wandering experiences in insomniacs is lacking. OBJECTIVES: The aim was to understand the quantitative nature of thoughts and feelings during mind wandering in insomniacs and healthy controls and their relationship with sleep-related parameters. METHODS: We used the 5-minute eyes-closed wakeful rest as an experimental model condition of mind wandering. Forty-seven individuals with insomnia disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (48.66±15.62 years; 31 women) and 29 healthy controls (50.66±15.14 years; 17 women) participated in the experiments and completed the Amsterdam Resting-State Questionnaire (ARSQ) immediately after the resting session. Participants also completed the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Dysfunctional Beliefs and Attitudes About Sleep Scale (DBAS). Statistical analyses included multiple regression to elucidate the independent determinants of ARSQ phenotypes. RESULTS: Participants with insomnia presented higher ISI, PSQI, and DBAS scores than did healthy controls. Insomniacs had strikingly different scores on most dimensions of the ARSQ, in particular Discontinuity of Mind, Self, Sleepiness, and Health Concern, that correlated positively with ISI and DBAS. Multiple regressions highlighted that for insomniacs, ISI was the best predictor of both Discontinuity of Mind and Health Concern. CONCLUSIONS: Resting-state activity in insomnia is altered and it seems to be related to unhelpful beliefs and insomnia severity. Resting-state neuroimaging in combination with the ARSQ could reveal important associations between these aberrant cognitive scores and their underlying systems-level brain mechanisms.

23 Article Insomnia among current and remitted common mental disorders and the association with role functioning: results from a general population study. 2016

Ten Have, Margreet / Penninx, Brenda W J H / van Dorsselaer, Saskia / Tuithof, Marlous / Kleinjan, Marloes / de Graaf, Ron. ·Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands. Electronic address: mhave@trimbos.nl. · Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. · Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands. ·Sleep Med · Pubmed #27823713.

ABSTRACT: OBJECTIVE AND BACKGROUND: Insomnia is a neglected topic in psychiatric epidemiological studies. Despite the fact that insomnia is a common phenomenon and usually co-occurs with mental disorders, it remains to be addressed to what extent insomnia is associated with remitted and current common mental disorders and with impaired functioning in the population, after considering a wide variety of confounders. PATIENTS AND METHODS: Data were used from three waves of the Netherlands Mental Health Survey and Incidence Study-2 (N = 4618), a nationally representative face-to-face survey of the general population. Insomnia was assessed at the third wave with the Women's Health Initiative Insomnia Rating Scale. Mental disorders were assessed at all waves with the Composite International Diagnostic Interview version 3.0. Confounders included sociodemographic characteristics, physical health, and psychotropic medication use. Role functioning was assessed with the Medical Outcomes Study Short Form Health Survey and work loss with the World Health Organization Disability Assessment Schedule. RESULTS: Forty-two per cent of the population reported none to mild insomnia, 35% moderate insomnia, and 23% severe insomnia. Both current and remitted anxiety disorder and current mood disorder were significantly associated with severe insomnia with adjusted odds ratios ranging from 1.8 to 3.3. Current and remitted substance use disorders were associated with moderate insomnia (adjusted OR range: 1.3-1.8). Moderate and severe insomnia were significantly associated with impaired role functioning and work loss after adjustment for confounders. CONCLUSION: Insomnia is a prevalent problem across different categories of mental disorders, even in the remitted phase. As insomnia has a high impact on daily functioning, insomnia deserves wide clinical attention.

24 Article I Keep a Close Watch on This Heart of Mine: Increased Interoception in Insomnia. 2016

Wei, Yishul / Ramautar, Jennifer R / Colombo, Michele A / Stoffers, Diederick / Gómez-Herrero, Germán / van der Meijden, Wisse P / Te Lindert, Bart H W / van der Werf, Ysbrand D / Van Someren, Eus J W. ·Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands. · Bernstein Center Freiburg and Faculty of Biology, University of Freiburg, Freiburg, Germany. · Centre for Chronobiology, Psychiatric Hospital of the University of Basel (UPK), Basel, Switzerland. · Department of Emotion and Cognition, Netherlands Institute for Neuroscience (NIN), an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands. · Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands. · Departments of Psychiatry and Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), VU University and Medical Center, Amsterdam, The Netherlands. ·Sleep · Pubmed #27634787.

ABSTRACT: STUDY OBJECTIVES: Whereas both insomnia and altered interoception are core symptoms in affective disorders, their neural mechanisms remain insufficiently understood and have not previously been linked. Insomnia Disorder (ID) is characterized by sensory hypersensitivity during wakefulness and sleep. Previous studies on sensory processing in ID addressed external stimuli only, but not interoception. Interoceptive sensitivity can be studied quantitatively by measuring the cerebral cortical response to one's heartbeat (heartbeat-evoked potential, HEP). We here investigated whether insomnia is associated with increased interoceptive sensitivity as indexed by the HEP amplitude. METHODS: Sixty-four participants aged 21-70 years were recruited through www.sleepregistry.nl including 32 people suffering from ID and 32 age- and sex-matched controls without sleep complaints. HEPs were obtained from resting-state high-density electroencephalography (HD-EEG) recorded during evening wakeful rest in eyes-open (EO) and eyes-closed (EC) conditions of 5-minute duration each. Significance of group differences in HEP amplitude and their topographical distribution over the scalp were assessed by means of cluster-based permutation tests. RESULTS: In particular during EC, and to a lesser extent during EO, people with ID had a larger amplitude late HEP component than controls at frontal electrodes 376-500 ms after the R-wave peak. Source localization suggested increased neural activity time-locked to heartbeats in people with ID mainly in anterior cingulate/medial frontal cortices. CONCLUSIONS: People with insomnia show insufficient adaptation of their brain responses to the ever-present heartbeats. Abnormalities in the neural circuits involved in interoceptive awareness including the salience network may be of key importance to the pathophysiology of insomnia.

25 Article Internet-Based Cognitive Behavioral Therapy for Insomnia: A Health Economic Evaluation. 2016

Thiart, Hanne / Ebert, David Daniel / Lehr, Dirk / Nobis, Stephanie / Buntrock, Claudia / Berking, Matthias / Smit, Filip / Riper, Heleen. ·Innovation Incubator, Division of Health Training Online, Leuphana University Lueneburg, Lueneburg, Germany. · Department of Clinical Psychology and Psychotherapy, University Erlangen-Nuremberg, Erlangen, Germany. · Leuphana University Lueneburg, Institute of Psychology, Lueneburg, Germany. · Department of Clinical, Developmental and Neuro Psychology, Section of Clinical Psychology, Vrije Universiteit, EMGO+ Institute for Health and Care Research, VUmc, Amsterdam, The Netherlands. · Center of Economic Evaluation, Trimbos Institute (Netherlands Institute of Mental health and Addiction), Utrecht, The Netherlands. · Department of Clinical, Neuro and Developmental Psychology, VU University, Amsterdam, The Netherlands. · Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. ·Sleep · Pubmed #27450686.

ABSTRACT: STUDY OBJECTIVES: Lost productivity caused by insomnia is a common and costly problem for employers. Although evidence for the efficacy of Internet-based cognitive behavioral therapy for insomnia (iCBT-I) already exists, little is known about its economic effects. This study aims to evaluate the cost-effectiveness and cost-benefit of providing iCBT-I to symptomatic employees from the employer's perspective. METHODS: School teachers (N = 128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided iCBT-I or a waitlist-control-group, both with access to treatment as usual. Economic data were collected at baseline and 6-mo follow-up. We conducted (1) a cost-effectiveness analysis with treatment response (Reliable Change [decline of 5.01 points] and Insomnia Severity Index < 8 at 6-month follow-up) as the outcome and (2) a cost-benefit analysis. Because both analyses were performed from the employer's perspective, we focused specifically on absenteeism and presenteeism costs. Statistical uncertainty was estimated using bootstrapping. RESULTS: Assuming intervention costs of €200 ($245), cost-effectiveness analyses showed that at a willingness-to-pay of €0 for each positive treatment response, there is an 87% probability that the intervention is more cost effective than treatment as usual alone. Cost-benefit analyses led to a net benefit of €418 (95% confidence interval: -593.03 to 1,488.70) ($512) per participant and a return on investment of 208% (95% confidence interval: -296.52 to 744.35). The reduction in costs was mainly driven by the effects of the intervention on presenteeism and to a lesser degree by reduced absenteeism. CONCLUSIONS: Focusing on sleep improvement using iCBT-I may be a cost-effective strategy in occupational health care. CLINICAL TRIALS REGISTRATION: Title: Online Recovery Training for Better Sleep in Teachers with High Psychological Strain. German Clinical Trial Register (DRKS), URL: https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00004700. Identifier: DRKS00004700. COMMENTARY: A commentary on this article appears in this issue on page 1767.

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