Sleep Initiation and Maintenance Disorders: Broch L

Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M. · Penn Sleep Centers, University of Pennsylvania Health System, Philadelphia, PA 19104, USA. · J Clin Sleep Med. · Pubmed #18853708 links to  free full text

Abstract: Insomnia is the most prevalent sleep disorder in the general population, and is commonly encountered in medical practices. Insomnia is defined as the subjective perception of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and that results in some form of daytime impairment.1 Insomnia may present with a variety of specific complaints and etiologies, making the evaluation and management of chronic insomnia demanding on a clinician's time. The purpose of this clinical guideline is to provide clinicians with a practical framework for the assessment and disease management of chronic adult insomnia, using existing evidence-based insomnia practice parameters where available, and consensus-based recommendations to bridge areas where such parameters do not exist. Unless otherwise stated, "insomnia" refers to chronic insomnia, which is present for at least a month, as opposed to acute or transient insomnia, which may last days to weeks.

Moline ML, Broch L, Zak R, Gross V. · Department of Psychiatry, Weill Medical College of Cornell University, New York Presbyterian Hospital, 21 Bloomingdale Road, White Plains, New York, 10605, USA. · Sleep Med Rev. · Pubmed #12628216 No free full text.

Abstract: Studies of sleep across the life cycle in women have utilized both survey and polysomnographic techniques, but have tended to be of small sample size with diverse methodology. As a result, definitive conclusions about the impact of the menstrual cycle and use of oral contraceptives on sleep parameters cannot yet be made. Sleep disruption during pregnancy and postpartum is nearly universal, but effective and practical countermeasures are still needed. Longitudinal studies of sleep in the postpartum period are also lacking. Menopause is associated with insomnia due to several factors including hot flashes, mood disorders and increased sleep-disordered breathing. The use of hormone replacement therapy to treat sleep and other variables is an active area of investigation. In summary, much research is required to fully elucidate the impact of the life cycle on sleep parameters in women.