Dual Orexin Receptor Antagonist, Almorexant, in Elderly Patients With Primary Insomnia: A Randomized, Controlled Study.

Objective: Sleep laboratory study to determine the dose-related efficacy and safety of almorexant in elderly patients with primary chronic insomnia.

Methods: Patients aged ≥65 years with primary insomnia were enrolled into a prospective, randomized, double-blind, placebo-controlled, multicenter dose-finding study with a five-period, five-way Latin square cross-over design. Patients were randomized to one of 10 unique sequences of two-night treatment with oral almorexant 25, 50, 100, or 200 mg capsules, or matching placebo.

Field study on the impact of nocturnal road traffic noise on sleep: the importance of in- and outdoor noise assessment, the bedroom location and nighttime noise disturbances.

The aim of this field study is to gain more insight into the way nocturnal road traffic noise impacts the sleep of inhabitants living in noisy regions, by taking into account several modifying variables. Participants were tested during five consecutive nights in their homes and comparisons between effective indoor and outdoor noise levels (LAeq, LAmax, number of noise events), sleep (actigraphy and sleep logs) and aspects of well-being (questionnaires) were made. Also, we investigated into what extent nocturnal noise exposure - objectively measured as well as perceived - directly relates to sleep outcomes and how the bedroom location influenced our measurements.

Sleepiness phenomics: modeling individual differences in subjective sleepiness profiles.

The present study investigates individual differences in subjective sleepiness profiles during 36 h of sustained wakefulness in a modified constant routine protocol. Twenty-three volunteers (11 females), aged between 18 and 47 yrs (M age = 30.41, SD = 10.

Excitatory versus inhibitory impairments in insomnia patients: an ERP study.

According to the neurocognitive perspective on insomnia, conditioned arousal results in impairment of information processing, as such interfering with normal sleep processes. In the present study, evening event-related potentials N100 and P200 were evaluated to assess hyperarousal in patients with insomnia and controls. 13 patients (mean age = 40.

Effects of pre-sleep simulated on-call instructions on subsequent sleep.

Nightly interventions, prevalent to on-call situations, can have negative consequences for those involved. We investigated if intervention-free-on-call-nights would also mean disturbance-free-sleep for people on-call. 16 healthy sleepers spent three nights in the laboratory: after a habituation night, reference and on-call night were counterbalanced.

Effects of pre-sleep media use on sleep/wake patterns and daytime functioning among adolescents: the moderating role of parental control.

The aim of this cross-sectional study was to investigate the influence of media use in the hour before bedtime on sleep/wake patterns and daytime functioning among adolescents and to examine the moderating role of parental control. A total of 1,926 Belgian students, 55% girls and 45% boys, with a mean age of 16.9 ± 1.

The influence of pre-sleep cognitive arousal on sleep onset processes.

Cognitive hyperarousal, resulting in enhanced cognitive activation, has been cited as an important contributor to the development and preservation of insomnia. To further understand this process, our study examined the effects of acutely-induced pre-sleep cognitive hyperarousal on sleep onset processes in healthy volunteers. Following an adaptation night, 15 subjects slept two nights in our sleep laboratory: one reference night and another one with cognitive arousal induction, in a counterbalanced order.

Comparing real-life and laboratory-induced stress reactivity on cardio-respiratory parameters: differentiation of a tonic and a phasic component.

To recreate stress in laboratory conditions, the nature of the elicited physiological reactions to the presentation of mental tasks has been extensively studied. However, whether this experimental response is equivalent to real-life stress reactivity is still under debate. We investigated cardio-respiratory reactivity to a sequential protocol of different mental tasks of varying difficulties, some of them involving emotional material, and repeated the measures in a baseline and in a real-life stress situation.

Nocturnal road traffic noise: A review on its assessment and consequences on sleep and health.

Research on the impact of nocturnal road traffic noise on sleep and the consequences on daytime functioning demonstrates detrimental effects that cannot be ignored. The physiological reactions due to continuing noise processing during night time lead to primary sleep disturbances, which in turn impair daytime functioning. This review focuses on noise processing in general and in relation to sleep, as well as methodological aspects in the study of noise and sleep.

The emotional brain and sleep: an intimate relationship.

Research findings confirm our own experiences in life where daytime events and especially emotionally stressful events have an impact on sleep quality and well-being. Obviously, daytime emotional stress may have a differentiated effect on sleep by influencing sleep physiology and dream patterns, dream content and the emotion within a dream, although its exact role is still unclear. Other effects that have been found are the exaggerated startle response, decreased dream recall and elevated awakening thresholds from rapid eye movement (REM)-sleep, increased or decreased latency to REM-sleep, increased REM-density, REM-sleep duration and the occurrence of arousals in sleep as a marker of sleep disruption.

An exploratory study on the effects of tele-neurofeedback and tele-biofeedback on objective and subjective sleep in patients with primary insomnia.

Insomnia is a sleeping disorder, usually studied from a behavioural perspective, with a focus on somatic and cognitive arousal. Recent studies have suggested that an impairment of information processes due to the presence of cortical hyperarousal might interfere with normal sleep onset and/or consolidation. As such, a treatment modality focussing on CNS arousal, and thus influencing information processing, might be of interest.

Comparative sensitivity of outcome variables of a software-based Behavioral Sleep Resistance Task.

Unintentional sleep and performance impairment due to extended wakefulness are often the cause of traffic and work accidents. Therefore, large-scale screening instruments assessing the ability to resist falling asleep during monotonous tasks are needed. The current widespread computer use in industrial and home settings offers the possibility to use software-based instruments as an alternative for expensive hardware interfaces to assess sleep resistance.

Simulator driving performance, subjective sleepiness and salivary cortisol in a fast-forward versus a slow-backward rotating shift system.

Objectives: The objectives of this study were to examine simulator driving and subjective sleepiness after morning, afternoon, and night shifts and to compare these differences, as well as objective stress, between a fast-forward and a slow-backward rotating shift system.

Methods: The participants were male volunteers working in a chemical plant, 18 in a slow-backward rotating system and 18 in a fast-forward rotating system. All of the participants performed a driving simulator test and subjectively estimated sleepiness after a night, afternoon, and morning shift.

Defining the occurrence and influence of alpha-delta sleep in chronic fatigue syndrome.

Background: Patients with chronic fatigue syndrome (CFS) present a disordered sleep pattern and frequently undergo polysomnography to exclude a primary sleep disorder. Such studies have shown reduced sleep efficiency, a reduction of deep sleep, prolonged sleep initiation, and alpha-wave intrusion during deep sleep. Deregulation of the 2-5A synthetase/RNase L antiviral pathway and a potential acquired channelopathy are also found in a subset of CFS patients and could lead to sleep disturbances.

Neurophysiological aspects of primary insomnia: implications for its treatment.

Insomnia has usually been studied from a behavioral perspective. Somatic and/or cognitive conditioned arousal was shown to play a central role in sleep complaints becoming chronic, and was used as a starting point for the development of treatment modalities. The introduction of the neurocognitive perspective, with its focus on cortical or CNS arousal, has given rise to a renewed interest in the neurophysiological characteristics of insomnia.

Individualized and time-variant model for the functional link between thermoregulation and sleep onset.

This study makes use of control system model identification techniques to examine the relationship between thermoregulation and sleep regulation. Specifically, data-based mechanistic (DBM) modelling is used to formulate and experimentally test the hypothesis, put forth by Gilbert et al., that there exists a connection between distal heat loss and sleepiness.

Multidimensional scaling of pediatric sleep breathing problems and bio-behavioral correlates.

Study Objectives: Complex relationships exist between pediatric sleep disorders and daytime behavior. Using a multidimensional scaling model, we investigated these relationships in 126 children with sleep breathing disorders (SBD).

Method: Validated questionnaires on nighttime behavior, daytime behavior, and respiratory health were administered to a large number of school children in Belgium.

Odds, prevalence and predictors of sleep problems in school-age normal children.

The objectives of the study were to describe the prevalence, odds, and predictors of 36 paediatric sleep behaviours and describe their coexistence in a school-age normal population. The design was community-based questionnaire survey of sleep-wake patterns, sleep environment, and 36 sleep behaviours indicative of six sleep disorder-subscales using the Health-Behaviour Questionnaire. A caregivers' report of 3045 children aged 6-13 years in Belgium constituted the participants.

Effect of cognitive arousal on sleep latency, somatic and cortical arousal following partial sleep deprivation.

Emerging research has shown that sleepiness, defined as the tendency to fall asleep, is not only determined by sleep pressure and time of day, but also by physiological and cognitive arousal. In this study we evaluated (i) the impact of experimentally induced cognitive arousal on electroencephalogram (EEG) defined sleep latency, and subjective, somatic and cortical arousal, and (ii) whether experimentally induced cognitive arousal enhances performance on a driving simulator test. Twelve healthy sleepers each spent three nights and the following day in the sleep laboratory: an adaptation, a cognitive arousal and a neutral testing day.

Zolpidem 'as needed': methodological issues and clinical findings.

This article introduces 'as needed' hypnotic treatment as a possible option in the psychopharmacological treatment for chronic but non-daily occurring insomnia complaints. This treatment option is a well-structured regimen designed by both patient and treating physician. It aims at providing symptomatic relief for sleepless nights and preventing the development of possible dependence on the hypnotic agent.

Executive function in sleep apnea: controlling for attentional capacity in assessing executive attention.

Study Objectives: As the effects of general slowness and decreased attentional capacity on higher executive attention have not been fully taken into account in the sleep apnea literature, we statistically controlled for basic attentional performance in evaluating executive attention per se in sleep apnea patients.

Design: A case-controlled design was used with comparison of basic and executive attentional tasks.

Participants: Thirty-six polysomnographically diagnosed patients (mean apnea-hypopnea index = 60.

Executive control of attention in sleep apnea patients: theoretical concepts and methodological considerations.

Sleep apnea patients' nocturnal breathing disturbances cause daytime sleepiness and cognitive impairments. Attentional capacity and vigilance deficits have often been observed. Moreover, some studies have suggested executive dysfunction, usually assumed to be related to (pre)frontal lobe dysfunction caused by intermittent hypoxemia.

Pediatric sleep disorders: exploratory modulation of their relationships.

Study Objectives: This study explores relationships between clinically encountered sleep problems in children.

Design: The Sleep Disturbance Scale for Children (SDSC) (Bruni et al 1996), which screens 26 sleep problems and results in 6 sleep disorder-subscales, was used as core in a larger health-behavior questionnaire (HBQ).

Participants: Caregivers of 3045 6- to 12-year-olds filled out the HBQ.

Effects of slow-release caffeine and a nap on driving simulator performance after partial sleep deprivation.

A driving simulator was used to evaluate the effectiveness of a 30-min. nap and 300-mg slow-release caffeine as countermeasures to drivers' sleepiness induced by partial sleep deprivation. 12 participants were allowed 45 hr.