Sleep Initiation and Maintenance Disorders: Neubauer DN

Neubauer DN. · Johns Hopkins Sleep Disorders Center, 4940 Eastern Ave, Box 151, Baltimore, MD 21224, USA. · Am J Manag Care. · Pubmed #19298103 links to  free full text

Abstract: Insomnia occurs predominantly in conjunction with a medical or psychiatric illness. New thinking regarding the treatment of comorbid insomnia has moved the field away from practices that called for treating the comorbid condition to resolve the coexisting insomnia to one in which the insomnia is treated as a separate condition. Although 10 medications currently are approved by the US Food and Drug Administration for the treatment of insomnia, only 2, eszopiclone and zolpidem, have been evaluated for efficacy in patients with chronic comorbid insomnia. Studies suggest clear benefits in comorbid insomnia. Nonpharmacologic treatments, such as cognitive behavioral therapy, sleep hygiene, and relaxation training, have also been investigated for comorbid insomnia, with studies suggesting these approaches may be effective either alone or in conjunction with medications. While behavioral issues should be optimized, clinicians need to customize treatments for patients with comorbid insomnia based on coexisting medical and psychiatric morbidities, age, medical history, current medications, and lifestyle issues.

Neubauer DN. · Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, USA. · Manag Care. · Pubmed #18504884 No free full text.

This publication has no abstract.

Lieberman JA, Neubauer DN. · Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA. · J Fam Pract. · Pubmed #17949603 No free full text.

This publication has no abstract.

Neubauer DN. · Sleep Disorders Center Johns Hopkins University School of Medicine, Baltimore, MD, USA. · J Clin Sleep Med. · Pubmed #17824496 links to  free full text

This publication has no abstract.

Neubauer DN. · Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224, USA. · Expert Opin Investig Drugs. · Pubmed #16185169 No free full text.

Abstract: Indiplon is a short-acting hypnotic that is currently being developed as a treatment for insomnia by Neurocrine Biosciences and Pfizer, and is expected to be marketed in mid-2006. It is a high-affinity allosteric potentiator of GABAA responses that demonstrates preference for alpha1 subunit-containing GABAA receptors. Indiplon will be an addition to the general category of newer-generation hypnotics that now includes zaleplon, zolpidem, zopiclone and eszopiclone. Clinical trials were carried out with an immediate-release capsule and a modified-release tablet and demonstrate very positive efficacy and safety profiles. The major challenge will be developing a commercial success in the crowded insomnia treatment marketplace.

Neubauer DN. · Department of Pyschiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287-7413, USA. · Prim Care. · Pubmed #15935191 No free full text.

Abstract: Insomnia is a common problem that is chronic for many individuals. Multiple processes, including psychologic, physiologic, and environmental factors, can influence insomnia, and their effects can shift over time. Accordingly, the evaluation of patients who have insomnia should be broad in scope. Insomnia represents a clinical problem with significant daytime consequences, associations, and comorbidities. Several nosologies categorize insomnia into specific diagnoses. Useful minimal criteria for an insomnia disorder include persistent nighttime symptoms with daytime distress or impairment. Specific treatments, addressing particular underlying causes,and general pharmacologic and nonpharmacologic strategies may play valuable roles in the management of insomnia patients. The effective treatment of insomnia can have further benefits in decreasing the likelihood of future psychiatric symptoms.

Neubauer DN. · The Johns Hopkins School of Medicine, Department of Psychiatry, The Johns Hopkins Sleep Disorders Center, Baltimore, Maryland 21224, USA. · Clin Cornerstone. · Pubmed #15543998 No free full text.

Abstract: Insomnia is a common problem in the general population and has a higher prevalence in persons with medical and psychiatric disorders. Although insomnia is most often transient, occurring as a result of identifiable stressors, a substantial portion of insomnia cases involve persistent sleep difficulty. This chronic form of insomnia may be associated with a wide range of adverse consequences. An understanding of the characteristics and causes of this disorder and the available therapeutic strategies will promote more effective identification and treatment of patients with chronic insomnia.

Smith MT, Neubauer DN. · Johns Hopkins School of Medicine, Department of Psychiatry, Behavioral Medicine Research Laboratory and Clinic, Baltimore, Maryland, USA. · Clin Cornerstone. · Pubmed #14626539 No free full text.

Abstract: Approximately 20% of patients presenting in general medical settings have severe and persistent insomnia. Studies consistently find that trouble initiating and maintaining sleep are independent risk factors for medical and psychiatric morbidity, but insomnia is often underdetected and undertreated in primary care settings. Cognitive-behavioral treatment approaches for chronic insomnia and related sleep disorders have been shown to be effective in various patient populations. This article reviews the most common cognitive-behavioral interventions for insomnia, and discusses their efficacy and durability. Possible adaptations for the integration of these approaches into primary care settings and a description of the emerging field of behavioral sleep medicine as a resource for health care providers treating patients with chronic insomnia are also presented.

Neubauer DN. · Johns Hopkins School of Medicine, Department of Psychiatry, Johns Hopkins Sleep Disorders Center, Baltimore, Maryland, USA. · Clin Cornerstone. · Pubmed #14626538 No free full text.

Abstract: Insomnia is a common problem that for many sufferers persists chronically and may result from a wide range of causes. Specific treatments address particular underlying medical disorders. General therapeutic approaches, including pharmacologic and behavioral strategies, may have broad applicability to insomnia patients. Many different medications and substances have been used in an attempt to improve sleep. This article reviews the advantages and disadvantages of medications and other substances employed to promote improved sleep. Special emphasis is given to the use of the newer-generation benzodiazepine receptor agonist hypnotics.