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Brown AD, Dowling J, Verma S, Gibson R, Valenta T, Piestch A, Cavuoto MG, McCurry SM, Bei B, Woodward M, Jackson ML, Varma P. Integrating lived experience to develop a tailored sleep intervention for people living with dementia and carepartners. DEMENTIA 2024:14713012241282769. [PMID: 39251415 DOI: 10.1177/14713012241282769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
OBJECTIVES Sleep disturbances are highly prevalent and have adverse health consequences for both people living with dementia and their carepartners. Despite this, they are under-addressed caregiving settings. This study aimed to explore these sleep disturbances and co-design a multimodal sleep intervention for people living with dementia and their carepartners. METHODS We conducted two focus groups and five semi-structured interviews (n = 4 people living with dementia, n = 6 carepartners). Active involvement of community advisors was sought throughout the design, development, and facilitation phases. Reflexive thematic analysis was used to explore sleep-related experiences and receive feedback to shape intervention development. FINDINGS People living with dementia reported disruptions to sleep and circadian rhythms, including sleep disturbances and confusion between day and night. Multiple sleep challenges were encountered by carepartners including insomnia, hypervigilance, and daytime impairment. The proposed sleep intervention was received positively, with significant insights emphasising the need for a multimodal toolkit approach, adaptation of the intervention across different dementia stages, and a focus on tailoring the program to carepartners. CONCLUSION Sleep interventions for caregivers and care-recipients should target both sleep and daytime functioning to ensure holistic support. Participants were receptive towards time-friendly, online, multimodal sleep interventions that combine cognitive behaviour therapies, light therapy, mindfulness, and exercise elements.
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Affiliation(s)
- Aimee D Brown
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Australia
| | - Jasmine Dowling
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Australia
| | - Sumedha Verma
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Australia
| | - Rosemary Gibson
- Health and Ageing Research Team, School of Psychology, Massey University, New Zealand
| | | | | | - Marina G Cavuoto
- School of Psychological Science, Faculty of Medicines, Turner Institute for Brain and Mental Health, Monash University, Australia; National Ageing Research Institute, Australia
| | | | - Bei Bei
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Australia
| | | | - Melinda L Jackson
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Australia
| | - Prerna Varma
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Australia
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Luo X, Zhang A, Li H, Li Y, Ying F, Wang X, Yang Q, Zhang Z, Huang G. The role of arts therapies in mitigating Sleep Initiation and Maintenance Disorders: a systematic review. Front Psychiatry 2024; 15:1386529. [PMID: 38818021 PMCID: PMC11137235 DOI: 10.3389/fpsyt.2024.1386529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/01/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction Arts therapies offer effective non-pharmacological intervention for Sleep Initiation and Maintenance Disorders (SIMDs), encompassing both passive and active modalities. This review assesses their effectiveness and ethical considerations, focusing on music therapy, meditation, and Tai Chi. Methods Following PRISMA guidelines, a detailed search across PubMed, the Cochrane Library, Web of Science, and CNKI identified 17 relevant RCTs. Utilizing the Joanna Briggs Institute (JBI) quality criteria and the PICO(S) framework for data extraction ensured methodological integrity. Results Analysis shows arts therapies significantly improve sleep quality. Music therapy and meditation yield immediate benefits, while Tai Chi and Qigong require longer commitment for significant outcomes. Discussion The link between SIMDs and mental health issues like anxiety, stress, and depression suggests arts therapies not only enhance sleep quality but also address underlying mental health conditions. The evidence supports a wider adoption of arts therapies in treating SIMDs due to their dual benefits. Systematic review registration PROSPERO, ID: CRD42024506393.
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Affiliation(s)
- Xuexing Luo
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Aijia Zhang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Hong Li
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Yu Li
- State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macao, Macao SAR, China
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Fangtian Ying
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macao, Macao SAR, China
- College of Computer Science and Technology Zhejiang University, Hangzhou, Zhejiang, China
- Operation Management Centre, Guangzhou Wanqu Cooperative Institute of Design, Guangzhou, Guangdong, China
| | - Xiaoli Wang
- Qinghai Province Cardiovascular and Cerebrovascdular Disease Specialist Hospital, Xining, Qinghai, China
| | - Qianxu Yang
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Zheyu Zhang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Guanghui Huang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macao, Macao SAR, China
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Yang N, Shi L, Xu P, Ren F, Lv S, Li C, Qi X. Identification of potential drug targets for insomnia by Mendelian randomization analysis based on plasma proteomics. Front Neurol 2024; 15:1380321. [PMID: 38725646 PMCID: PMC11079244 DOI: 10.3389/fneur.2024.1380321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/12/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Insomnia, a common clinical disorder, significantly impacts the physical and mental well-being of patients. Currently, available hypnotic medications are unsatisfactory due to adverse reactions and dependency, necessitating the identification of new drug targets for the treatment of insomnia. Methods In this study, we utilized 734 plasma proteins as genetic instruments obtained from genome-wide association studies to conduct a Mendelian randomization analysis, with insomnia as the outcome variable, to identify potential drug targets for insomnia. Additionally, we validated our results externally using other datasets. Sensitivity analyses entailed reverse Mendelian randomization analysis, Bayesian co-localization analysis, and phenotype scanning. Furthermore, we constructed a protein-protein interaction network to elucidate potential correlations between the identified proteins and existing targets. Results Mendelian randomization analysis indicated that elevated levels of TGFBI (OR = 1.01; 95% CI, 1.01-1.02) and PAM ((OR = 1.01; 95% CI, 1.01-1.02) in plasma are associated with an increased risk of insomnia, with external validation supporting these findings. Moreover, there was no evidence of reverse causality for these two proteins. Co-localization analysis confirmed that PAM (coloc.abf-PPH4 = 0.823) shared the same variant with insomnia, further substantiating its potential role as a therapeutic target. There are interactive relationships between the potential proteins and existing targets of insomnia. Conclusion Overall, our findings suggested that elevated plasma levels of TGFBI and PAM are connected with an increased risk of insomnia and might be promising therapeutic targets, particularly PAM. However, further exploration is necessary to fully understand the underlying mechanisms involved.
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Affiliation(s)
- Ni Yang
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Liangyuan Shi
- Qingdao Traditional Chinese Medicine Hospital (Qingdao Hiser Hospital) Qingdao Hiser Hospital Affiliated of Qingdao University, Qingdao, China
| | - Pengfei Xu
- Qingdao Traditional Chinese Medicine Hospital (Qingdao Hiser Hospital) Qingdao Hiser Hospital Affiliated of Qingdao University, Qingdao, China
| | - Fang Ren
- Department of Laboratory, Jimo District Qingdao Hospital of Traditional Chinese Medicine, Qingdao, China
| | - Shimeng Lv
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Chunlin Li
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xianghua Qi
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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Wang LX, Zhao Q, Zhang Y, Xue R, Li S, Li Y, Yu JJ, Li JC, Zhang YZ. Network pharmacology and pharmacological evaluation for deciphering novel indication of Sishen Wan in insomnia treatment. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2023; 108:154500. [PMID: 36288650 DOI: 10.1016/j.phymed.2022.154500] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/02/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Insomnia is the most frequent sleep disorder worldwide and is a prominent risk factor for mental and physical health deterioration. The clinical application of common pharmacological treatments for insomnia is far from satisfactory due to their various adverse effects. In recent years, drugs developed from natural herbs have become potential alternative therapies for insomnia. Sishen Wan (SSW), a traditional Chinese medicine (TCM) used for centuries to treat diarrheal disease, consists of multiple neurologically active herbs with sleep-regulating potential that may have therapeutic effects on insomnia. However, its hypnotic and sleep-regulating effects have not been evaluated in clinical practice or laboratory experiments. PURPOSE To investigate the anti-insomnia effects of SSW and explore its possible mechanisms using preclinical models. STUDY DESIGN AND METHODS The sedative effect of the SSW formula was investigated using network pharmacology analysis that was validated using various pharmacological approaches, including the evaluation of locomotor activity (LMA), pentobarbital-induced sleep time, and electroencephalography/electromyogram (EEG/EMG)-based sleep profiling in normal rats. Several animal models of insomnia, including sleep deprivation, serotonin depletion, and cage-changing models, have been used to further assess the anti-insomnia effects of SSW. Furthermore, the potential underlying mechanisms of action of SSW were predicted using bioinformatics methods and verified using in vivo and in silico experiments. RESULTS The results showed that SSW reduced LMA and prolonged pentobarbital-induced sleep time in a dose-dependent manner, which was consistent with the increase in non-rapid eye movement (NREM) sleep in normal rats, indicating a solid sedative effect. In animal models of insomnia, SSW alleviated sleep disturbance by increasing NREM sleep time, shortening NREM sleep latency, and inhibiting sleep fragmentation, suggesting a possible curative effect of SSW on insomnia. Finally, through functional enrichment analysis and in vivo and in silico experiments, 5-HT1A was identified as the key target of the anti-insomnia effect of SSW. Moreover, (S)-propranolol, nuciferine, zizyphusine, and N,N-dimethyl-5-methoxytryptamine may be the active compounds of SSW responsible for its anti-insomnia effect. CONCLUSION This study extended the possible indication scope for SSW, which provides a potential therapeutic TCM that may be used for insomnia treatment, as well as a reference scheme for the discovery of novel indications of TCM.
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Affiliation(s)
- Luo-Xuan Wang
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing, China
| | - Qian Zhao
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing, China; Guangzhou University of Traditional Chinese Medicine, Center for Animal Experiment, Guangzhou, China
| | - Yang Zhang
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing, China
| | - Rui Xue
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing, China
| | - Shuo Li
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing, China
| | - Ying Li
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing, China
| | - Ji-Jun Yu
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Therapeutic Gene Engineering Antibody, Beijing, China
| | - Jing-Cao Li
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing, China.
| | - You-Zhi Zhang
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing, China.
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Ziemichód W, Grabowska K, Kurowska A, Biała G. A Comprehensive Review of Daridorexant, a Dual-Orexin Receptor Antagonist as New Approach for the Treatment of Insomnia. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27186041. [PMID: 36144776 PMCID: PMC9502995 DOI: 10.3390/molecules27186041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022]
Abstract
Insomnia affects 4.4-4.8% of the world's population, but because the effect of hypnotic drugs is limited and may cause harmful side-effects, scientists are turning their attention to developing drugs that act on the orexin system. Daridorexant, a selective dual-orexin receptor antagonist (DORA), has exhibited promising results in both animal and human studies. Its activity was evaluated based on the physiology-based pharmacodynamic and pharmacokinetic model. The use of daridorexant is considered safe, with no clinically significant side-effects including deprivation of next-morning residual effects. In this manuscript we conducted a comprehensive review of daridorexant including pharmacodynamics, animal and human research, pharmacokinetics and safety.
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6
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Melatonin regulates Aβ production/clearance balance and Aβ neurotoxicity: A potential therapeutic molecule for Alzheimer's disease. Biomed Pharmacother 2020; 132:110887. [PMID: 33254429 DOI: 10.1016/j.biopha.2020.110887] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/07/2020] [Accepted: 10/12/2020] [Indexed: 02/06/2023] Open
Abstract
Alzheimer's disease (AD) is an age-related neurodegenerative disease with multiple predisposing factors and complicated pathogenesis. Aβ peptide is one of the most important pathogenic factors in the etiology of AD. Accumulating evidence indicates that the imbalance of Aβ production and Aβ clearance in the brain of AD patients leads to Aβ deposition and neurotoxic Aβ oligomer formation. Melatonin shows a potent neuroprotective effect and can prevent or slow down the progression of AD, supporting the view that melatonin is a potential therapeutic molecule for AD. Melatonin modulates the regulatory network of secretase expression and affects the function of secretase, thereby inhibiting amyloidogenic APP processing and Aβ production. Additionally, melatonin ameliorates Aβ-induced neurotoxicity and probably promotes Aβ clearance through glymphatic-lymphatic drainage, BBB transportation and degradation pathways. In this review, we summarize and discuss the role of melatonin against Aβ-dependent AD pathogenesis. We explore the potential cellular and molecular mechanisms of melatonin on Aβ production and assembly, Aβ clearance, Aβ neurotoxicity and circadian cycle disruption. We summarize multiple clinical trials of melatonin treatment in AD patients, showing that melatonin has a promising effect on improving sleep quality and cognitive function. This review aims to stimulate further research on melatonin as a potential therapeutic agent for AD.
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7
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Vecchierini MF, Kilic-Huck U, Quera-Salva MA. Melatonin (MEL) and its use in neurological diseases and insomnia: Recommendations of the French Medical and Research Sleep Society (SFRMS). Rev Neurol (Paris) 2020; 177:245-259. [PMID: 32921425 DOI: 10.1016/j.neurol.2020.06.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 12/29/2022]
Abstract
The French Medicine and Research Sleep Society had organized a consensus conference about sleep/wake circadian rhythms and their disorders. During this conference a subgroup of 11 sleep doctors/researchers looked specifically at the use of MEL in different pathologies. This article gives a summary of the main results of MEL therapy in some neurological diseases and insomnia approved by this consensus group. Exogenous MEL, which crosses the blood-brain barrier, has been used as a treatment in its two available forms: an immediate release form that principally shows a chronobiotic action and a long release form that mimics the physiological MEL secretion rhythm and is used to replace reduced physiological secretion. MEL secretion decreases frequently with age, mostly in elderly insomniacs and dementia patients. Results of level A studies show that MEL therapy, used as an add-on treatment, has beneficial effects in mild cognitive impairment (MCI) and Alzheimer patients with sleep disorders in improving sleep quality and in regulating the sleep/wake rhythm. MEL has to be prescribed as early as possible and for a long period, at a dose of 2 to 5 or 10 mg. It may have a beneficial effect on cognitive function in MCI but shows no effect in moderate to severe Alzheimer's disease. It should be emphasized that there are no serious side effects with MEL treatment. In these diseases, light therapy used 12 hours before melatonin treatment has a positive synergic effect. In REM sleep behavior disorder, immediate release MEL should be prescribed first as its side effect profile is much better than clonazepam shortly before bedtime. MEL has a good efficacy on clinical symptoms and PSG REM sleep without atonia episodes and is well tolerated. In Parkinson disease with sleep disorders and without REM sleep behavior disorder, MEL seems to improve subjective sleep quality but no conclusions can be drawn. There is insufficient scientific proof for using MEL as a prophylactic treatment in primary headache, migraine and cluster headache. In epileptic patients, MEL can be safely used to regulate the sleep/wake rhythm and to improve insomnia but more randomized controlled studies are necessary. In primary or no-comorbid insomnia, only a 2 mg dose of slow release MEL, 1 to 2 hours before bedtime, over a period of 3 to 12 weeks, is recommended. It decreases sleep onset latency, improves quality of sleep, morning alertness and quality of life without serious side effects and without withdrawal symptoms.
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Affiliation(s)
- M F Vecchierini
- Sleep Center, Hôtel-Dieu, Paris-Descartes University, 1, place du parvis Jean-Paul II, 75004 Paris, France.
| | - U Kilic-Huck
- Sleep Disorders Center Hôpitaux Universitaires de Strasbourg: Institut des neurosciences cellulaires et intégratives, CNRS-UPR 3212, 5, rue Blaise-Pascal, 67000 Strasbourg, France
| | - M A Quera-Salva
- Sleep disorders Unit, Departement of Physiology, Hôpital Raymond-Poincaré, université de Saclay, EA 4047 AP-HP Saclay University, 92380 Garches, France
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8
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Bruni O, Angriman M, Melegari MG, Ferri R. Pharmacotherapeutic management of sleep disorders in children with neurodevelopmental disorders. Expert Opin Pharmacother 2019; 20:2257-2271. [DOI: 10.1080/14656566.2019.1674283] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy
| | - Marco Angriman
- Department of Pediatrics, Child Neurology and Neurorehabilitation Unit, Central Hospital of Bolzano, Bolzano, Italy
| | | | - Raffaele Ferri
- Sleep Research Centre; Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy
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9
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Juneau ZC, Stonemetz JM, Toma RF, Possidente DR, Heins RC, Vecsey CG. Optogenetic activation of short neuropeptide F (sNPF) neurons induces sleep in Drosophila melanogaster. Physiol Behav 2019; 206:143-156. [PMID: 30935941 PMCID: PMC6520144 DOI: 10.1016/j.physbeh.2019.03.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/18/2019] [Accepted: 03/28/2019] [Indexed: 01/31/2023]
Abstract
Sleep abnormalities have widespread and costly public health consequences, yet we have only a rudimentary understanding of the events occurring at the cellular level in the brain that regulate sleep. Several key signaling molecules that regulate sleep across taxa come from the family of neuropeptide transmitters. For example, in Drosophila melanogaster, the neuropeptide Y (NPY)-related transmitter short neuropeptide F (sNPF) appears to promote sleep. In this study, we utilized optogenetic activation of neuronal populations expressing sNPF to determine the causal effects of precisely timed activity in these cells on sleep behavior. Combining sNPF-GAL4 and UAS-Chrimson transgenes allowed us to activate sNPF neurons using red light. We found that activating sNPF neurons for as little as 3 s at a time of day when most flies were awake caused a rapid transition to sleep that persisted for another 2+ hours following the stimulation. Changing the timing of red light stimulation to times of day when flies were already asleep caused the control flies to wake up (due to the pulse of light), but the flies in which sNPF neurons were activated stayed asleep through the light pulse, and then showed further increases in sleep at later points when they would have normally been waking up. Video recording of individual fly responses to short-term (0.5-20 s) activation of sNPF neurons demonstrated a clear light duration-dependent decrease in movement during the subsequent 4-min period. These results provide supportive evidence that sNPF-producing neurons promote long-lasting increases in sleep, and show for the first time that even brief periods of activation of these neurons can cause changes in behavior that persist after cessation of activation. We have also presented evidence that sNPF neuron activation produces a homeostatic sleep drive that can be dissipated at times long after the neurons were stimulated. Future studies will determine the specific roles of sub-populations of sNPF-producing neurons, and will also assess how sNPF neurons act in concert with other neuronal circuits to control sleep.
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Affiliation(s)
- Zoe Claire Juneau
- Neuroscience Program, Skidmore College, 815 N. Broadway, Saratoga Springs, NY 12866, United States of America
| | - Jamie M Stonemetz
- Neuroscience Program, Skidmore College, 815 N. Broadway, Saratoga Springs, NY 12866, United States of America
| | - Ryan F Toma
- Neuroscience Program, Skidmore College, 815 N. Broadway, Saratoga Springs, NY 12866, United States of America
| | - Debra R Possidente
- Neuroscience Program, Skidmore College, 815 N. Broadway, Saratoga Springs, NY 12866, United States of America
| | - R Conor Heins
- Biology Department, Swarthmore College, 500 College Avenue, Swarthmore, PA 19081, United States of America
| | - Christopher G Vecsey
- Neuroscience Program, Skidmore College, 815 N. Broadway, Saratoga Springs, NY 12866, United States of America; Biology Department, Swarthmore College, 500 College Avenue, Swarthmore, PA 19081, United States of America.
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Shariq AS, Rosenblat JD, Alageel A, Mansur RB, Rong C, Ho RC, Ragguett RM, Pan Z, Brietzke E, McIntyre RS. Evaluating the role of orexins in the pathophysiology and treatment of depression: A comprehensive review. Prog Neuropsychopharmacol Biol Psychiatry 2019; 92:1-7. [PMID: 30576764 DOI: 10.1016/j.pnpbp.2018.12.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 10/27/2022]
Abstract
Orexins are neuropeptides that are postulated to play a central role in the regulation of the sleep-wake cycle, appetite, affect, and reward circuitry. The objectives of the current review are to comprehensively evaluate (1) the potential role of orexins in the pathophysiology of major depressive disorders (MDD) and (2) the orexin system as a novel target in the treatment of MDD. Dysfunction of the sleep-wake cycle is observed as a central feature of MDD pathophysiology. Orexin system disturbances produce sleep-wake dysfunction, as observed in MDD. Orexin antagonists have been shown to treat insomnia effectively without disrupting normal sleep architecture in both preclinical (e.g., animal models) and clinical studies. Orexin antagonists are generally safe, well-tolerated, and associated with an acceptable long-term adverse effect profile with relatively low propensity for tolerance or dependence. Orexin antagonists have also been shown to possess antidepressant-like properties in some animal models of MDD. Extant evidence indicates that orexin-modulating treatments exert pleiotropic effects on multiple neural systems implicated in the phenomenology of mood disorders and suggests orexins as a promising target for investigation and intervention in mood disorders. To date, no human clinical trials evaluating the antidepressant effects of orexin antagonists in MDD have been completed. Given the promising results from preclinical studies, clinical trials are merited to evaluate the antidepressant effects of orexin antagonists in MDD.
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Affiliation(s)
- Aisha S Shariq
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5T 2S8, Canada; Department of Psychiatry, Texas Tech University Health Science Center, Paul L. Foster SOM, El Paso, TX 79905, USA
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5T 2S8, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Asem Alageel
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5T 2S8, Canada; Department of Psychiatry, College of Medicine, Imam University, Riyadh, Saudi Arabia
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5T 2S8, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Carola Rong
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5T 2S8, Canada
| | - Roger C Ho
- National University of Singapore, 119077, Singapore; National University of Hong Kong, 999077, Hong Kong
| | - Renee-Marie Ragguett
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5T 2S8, Canada
| | - Zihang Pan
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5T 2S8, Canada; Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Elisa Brietzke
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5T 2S8, Canada; Research Group in Molecular and Behavioral Neuroscience of Bipolar Disorder, Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo 14021-001, Brazil
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5T 2S8, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada; Department of Pharmacology, University of Toronto, Toronto, ON M5S 1A1, Canada; Brain and Cognition Discovery Foundation (BCDF), Toronto, ON M5T 2S8, Canada.
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Sedative and hypnotic effects of Vaccinium bracteatum Thunb. through the regulation of serotonegic and GABAA-ergic systems: Involvement of 5-HT1A receptor agonistic activity. Biomed Pharmacother 2019; 109:2218-2227. [DOI: 10.1016/j.biopha.2018.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/01/2018] [Accepted: 10/02/2018] [Indexed: 01/04/2023] Open
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Zisapel N. New perspectives on the role of melatonin in human sleep, circadian rhythms and their regulation. Br J Pharmacol 2018; 175:3190-3199. [PMID: 29318587 PMCID: PMC6057895 DOI: 10.1111/bph.14116] [Citation(s) in RCA: 387] [Impact Index Per Article: 64.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/13/2017] [Accepted: 11/20/2017] [Indexed: 02/06/2023] Open
Abstract
In mammals, a central circadian clock, located in the suprachiasmatic nuclei (SCN) of the hypothalamus, tunes the innate circadian physiological rhythms to the ambient 24 h light-dark cycle to invigorate and optimize the internal temporal order. The SCN-activated, light-inhibited production of melatonin conveys the message of darkness to the clock and induces night-state physiological functions, for example, sleep/wake blood pressure and metabolism. Clinically meaningful effects of melatonin treatment have been demonstrated in placebo-controlled trials in humans, particularly in disorders associated with diminished or misaligned melatonin rhythms, for example, circadian rhythm-related sleep disorders, jet lag and shift work, insomnia in children with neurodevelopmental disorders, poor (non-restorative) sleep quality, non-dipping nocturnal blood pressure (nocturnal hypertension) and Alzheimer's disease (AD). The diminished production of melatonin at the very early stages of AD, the role of melatonin in the restorative value of sleep (perceived sleep quality) and its sleep-anticipating effects resulting in attenuated activation of certain brain networks are gaining a new perspective as the role of poor sleep quality in the build-up of β amyloid, particularly in the precuneus, is unravelled. As a result of the recently discovered relationship between circadian clock, sleep and neurodegeneration, new prospects of using melatonin for early intervention, to promote healthy physical and mental ageing, are of prime interest in view of the emerging link to the aetiology of Alzheimer's disease. LINKED ARTICLES: This article is part of a themed section on Recent Developments in Research of Melatonin and its Potential Therapeutic Applications. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.16/issuetoc.
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Affiliation(s)
- Nava Zisapel
- Department of Neurobiology, Faculty of Life SciencesTel‐Aviv University and Neurim PharmaceuticalsTel AvivIsrael
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13
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Bruni O, Angriman M, Calisti F, Comandini A, Esposito G, Cortese S, Ferri R. Practitioner Review: Treatment of chronic insomnia in children and adolescents with neurodevelopmental disabilities. J Child Psychol Psychiatry 2018; 59:489-508. [PMID: 28921528 DOI: 10.1111/jcpp.12812] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND Sleep disturbances, in particular insomnia, represent a common problem in children with neurodevelopmental disabilities (NDDs). Currently, there are no approved medications for insomnia in children by the US Food and Drug Administration or European Medicines Agency and therefore they are prescribed off-label. We critically reviewed pediatric literature on drugs as well as nonpharmacological (behavioral) interventions used for sleep disturbances in children with NDDs. METHODS PubMed, Ovid (including PsycINFO, Ovid MEDLINE® , and Embase), and Web of Knowledge databases were searched through February 12, 2017, with no language restrictions. Two authors independently and blindly performed the screening. RESULTS Good sleep practices and behavioral interventions, supported by moderate-to-low level evidence, are the first recommended treatments for pediatric insomnia but they are often challenging to implement. Antihistamine agents, such as hydroxyzine or diphenhydramine, are the most widely prescribed sedatives in the pediatric practice but evidence supporting their use is still limited. An increasing body of evidence supports melatonin as the safest choice for children with NDDs. Benzodiazepines are not recommended in children and should only be used for transient insomnia, especially if daytime anxiety is present. Only few studies have been carried out in children's and adolescents' zolpidem, zaleplon, and eszopiclone, with contrasting results. Limited evidence supports the use of alpha-agonists such as clonidine to improve sleep onset latency, especially in attention deficit/hyperactivity disorder subjects. Tricyclic antidepressants, used in adults with insomnia, are not recommended in children because of their safety profile. Trazodone and mirtazapine hold promise but require further studies. CONCLUSIONS Here, we provided a tentative guide for the use of drugs for insomnia in children with NDDs. Well-controlled studies employing both objective polysomnography and subjective sleep measures are needed to determine the efficacy, effectiveness, and safety of the currently prescribed pediatric sleep medicines in children with NDDs.
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Affiliation(s)
- Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy
| | - Marco Angriman
- Department of Pediatrics, Child Neurology and Neurorehabilitation Unit, Central Hospital of Bolzano, Bolzano, Italy
| | | | | | | | - Samuele Cortese
- Academic Unit of Psychology, Developmental Brain-Behavior Laboratory, University of Southampton, Southampton, UK.,New York University Child Study Center, New York, NY, USA.,Solent NHS Trust, Southampton, UK
| | - Raffaele Ferri
- Sleep Research Centre; Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy
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14
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Sil’kis IG. A Neurochemical Approach to the Search for Drugs for the Treatment of Symptoms of Alzheimer’s Disease. NEUROCHEM J+ 2018. [DOI: 10.1134/s1819712418010130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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15
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Liu Z, Yang Y, Sheng L, Li Y. Interspecies Variation of In Vitro Stability and Metabolic Diversity of YZG-331, a Promising Sedative-Hypnotic Compound. Front Pharmacol 2017; 8:527. [PMID: 28848441 PMCID: PMC5554529 DOI: 10.3389/fphar.2017.00527] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 07/26/2017] [Indexed: 01/08/2023] Open
Abstract
YZG-331, a synthetic adenosine derivative, express the sedative and hypnotic effects via binding to the adenosine receptor. The current study was taken to investigate the metabolic pathway of YZG-331 as well as species-specific differences in vitro. YZG-331 was reduced by 14, 11, 6, 46, and 11% within 120 min incubation in human, monkey, dog, rat, and mouse liver microsomes (LMs), respectively. However, YZG-331 was stable in human, monkey, dog, rat, and mouse liver cytoplasm. In addition, YZG-331 was unstable in rat or mouse gut microbiota with more than 50% of prototype drug degraded within 120 min incubation. Interestingly, the systemic exposure of M2 and M3 in rats and mice treated with antibiotics were significantly decreased in the pseudo germ-free group. YZG-331 could be metabolized in rat and human liver under the catalysis of CYP enzymes, and the metabolism showed species variation. In addition, 3 phase I metabolites were identified via hydroxyl (M1), hydrolysis (M2), or hydrolysis/ hydroxyl (M3) pathway. Flavin-containing monooxygenase 1 (FMO1) and FMO3 participated in the conversion of YZG-331 in rat LMs. Nevertheless, YZG-331 expressed stability with recombinant human FMOs, which further confirmed the species variation in the metabolism. Overall, these studies suggested that YZG-331 is not stable in LMs and gut microbiota. CYP450 enzymes and FMOs mediated the metabolism of YZG-331, and the metabolic pathway showed species difference. Special attention must be paid when extrapolating data from other species to humans.
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Affiliation(s)
- Zhihao Liu
- Department of Drug Metabolism, Key Laboratory of Active Substances Discovery and Drug Ability Evaluation, State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing, China.,Department of Clinical Pharmacology, College of Pharmacy, Dalian Medical UniversityDalian, China
| | - Yakun Yang
- Department of Drug Metabolism, Key Laboratory of Active Substances Discovery and Drug Ability Evaluation, State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing, China
| | - Li Sheng
- Department of Drug Metabolism, Key Laboratory of Active Substances Discovery and Drug Ability Evaluation, State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing, China
| | - Yan Li
- Department of Drug Metabolism, Key Laboratory of Active Substances Discovery and Drug Ability Evaluation, State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing, China
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16
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Stallman HM, Kohler M, White J. Medication induced sleepwalking: A systematic review. Sleep Med Rev 2017; 37:105-113. [PMID: 28363449 DOI: 10.1016/j.smrv.2017.01.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 01/13/2017] [Accepted: 01/20/2017] [Indexed: 10/20/2022]
Abstract
Medications that trigger sleepwalking may inadvertently put the patient at risk of injury to themselves and/or others, and contribute to poor treatment adherence. The aim of this study was to systematically review the literature to identify drugs that may increase the risk of sleepwalking. A search of CINAHL, EMBASE, PsycINFO, PubMed, and ScienceDirect was conducted with the keywords 'sleepwalking' OR 'somnambulism'. Of the original 83 sourced papers, 62 met the inclusion criteria and were subsequently included for review. Twenty-nine drugs, primarily in four classes-benzodiazepine receptor agonists and other gamma aminobutyric acid (GABA) modulators, antidepressants and other serotonergic agents, antipsychotics, and β-blockers-were identified as possible triggers for sleepwalking. The strongest evidence for medication-induced sleepwalking was for zolpidem and sodium oxybate. All other associations were based on case reports. This research highlights the importance of considering sleepwalking in risk profiles in clinical trials, particularly for drugs that enhance GABA activity at the GABAA receptor, enhance serotonergic activity, or block the activity of noradrenaline at β receptors. The results also have implications for prescribers to consider sleepwalking as a potential adverse effect and ensure that: 1) the patient is educated about a safe sleep environment; 2) they are encouraged to report the onset or exacerbation of sleepwalking, and 3) alternative treatments are considered if sleepwalking occurs.
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Affiliation(s)
- Helen M Stallman
- Centre for Sleep Research, University of South Australia, Australia.
| | - Mark Kohler
- Centre for Sleep Research, University of South Australia, Australia
| | - Jason White
- School of Pharmacy and Medical Sciences, University of South Australia, Australia
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17
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Qiu MH, Chen MC, Fuller PM, Lu J. Stimulation of the Pontine Parabrachial Nucleus Promotes Wakefulness via Extra-thalamic Forebrain Circuit Nodes. Curr Biol 2016; 26:2301-12. [PMID: 27546576 DOI: 10.1016/j.cub.2016.07.054] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/09/2016] [Accepted: 07/20/2016] [Indexed: 01/08/2023]
Abstract
Human and animal studies have identified an especially critical role for the brainstem parabrachial (PB) complex in regulating electrocortical (electroencephalogram [EEG]) and behavioral arousal: lesions of the PB complex produce a monotonous high-voltage, slow-wave EEG and eliminate spontaneous behaviors. We report here that targeted chemogenetic activation of the PB complex produces sustained EEG and behavioral arousal in the rat. We further establish, using viral-mediated retrograde activation, that PB projections to the preoptic-basal forebrain and lateral hypothalamus, but not to the thalamus, mediate PB-driven wakefulness. We exploited this novel and noninvasive model of induced wakefulness to explore the EEG and metabolic consequences of extended wakefulness. Repeated (daily) chemogenetic activation of the PB was highly effective in extending wakefulness over 4 days, although subsequent PB activation produced progressively lesser wake amounts. Curiously, no EEG or behavioral sleep rebound was observed, even after 4 days of induced wakefulness. Following the last of the four daily induced wake bouts, we examined the brains and observed a chimeric pattern of c-Fos expression, with c-Fos expressed in subsets of both arousal- and sleep-promoting nuclei. From a metabolic standpoint, induced extended wakefulness significantly reduced body weight and leptin but was without significant effect on cholesterol, triglyceride, or insulin levels, suggesting that high sleep pressure or sleep debt per se does not, as previously implicated, result in a deleterious metabolic phenotype.
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Affiliation(s)
- Mei Hong Qiu
- Department of Neurobiology, School of Basic Medical Science, Fudan University, Shanghai 200032, China; Department of Pharmacology, School of Basic Medical Science, Fudan University, Shanghai 200032, China; Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02115, USA.
| | - Michael C Chen
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02115, USA
| | - Patrick M Fuller
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02115, USA
| | - Jun Lu
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02115, USA.
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18
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Taylor L, Chrismas BCR, Dascombe B, Chamari K, Fowler PM. Sleep Medication and Athletic Performance-The Evidence for Practitioners and Future Research Directions. Front Physiol 2016; 7:83. [PMID: 27014084 PMCID: PMC4779957 DOI: 10.3389/fphys.2016.00083] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 02/19/2016] [Indexed: 12/03/2022] Open
Affiliation(s)
- Lee Taylor
- Qatar Orthopedic and Sports Medicine Hospital, Athlete Health and Performance Research Centre Aspire Zone ASPETAR, Doha, Qatar
| | - Bryna C R Chrismas
- Sport Science Program, College of Arts and Sciences, Qatar University Doha, Qatar
| | - Ben Dascombe
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, LaTrobe University Melbourne, VIC, Australia
| | - Karim Chamari
- Qatar Orthopedic and Sports Medicine Hospital, Athlete Health and Performance Research Centre Aspire Zone ASPETAR, Doha, Qatar
| | - Peter M Fowler
- Qatar Orthopedic and Sports Medicine Hospital, Athlete Health and Performance Research Centre Aspire Zone ASPETAR, Doha, Qatar
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19
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Fishbein AB, Vitaterna O, Haugh IM, Bavishi AA, Zee PC, Turek FW, Sheldon SH, Silverberg JI, Paller AS. Nocturnal eczema: Review of sleep and circadian rhythms in children with atopic dermatitis and future research directions. J Allergy Clin Immunol 2015; 136:1170-7. [DOI: 10.1016/j.jaci.2015.08.028] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 08/07/2015] [Accepted: 08/11/2015] [Indexed: 01/25/2023]
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20
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Kumar MBA, Gao Y, Shen W, He L. Valorisation of protein waste: An enzymatic approach to make commodity chemicals. Front Chem Sci Eng 2015. [DOI: 10.1007/s11705-015-1532-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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21
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Zheng Y, Wu J, Feng X, Jia Y, Huang J, Hao Z, Zhao S, Wang J. In silico Analysis and Experimental Validation of Lignan Extracts from Kadsura longipedunculata for Potential 5-HT1AR Agonists. PLoS One 2015; 10:e0130055. [PMID: 26076134 PMCID: PMC4468062 DOI: 10.1371/journal.pone.0130055] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 05/15/2015] [Indexed: 12/03/2022] Open
Abstract
Objectives Kadsura longipedunculata (KL) has been widely used for the treatment of insomnia in traditional Chinese medicine. The aim of this study was to explore the mechanism of the sedative and hypnotic effects of KL. Materials and Methods The content of KL was evaluated by HPLC-TOF-MS, and a potential target was found and used to construct its 3D structure to screen for potential ligands among the compounds in KL by using bioinformatics analysis, including similarity ensemble approach (SEA) docking, homology modeling, molecular docking and ligand-based pharmacophore. The PCPA-induced insomnia rat model was then applied to confirm the potential targets related to the sedative effects of KL by performing the forced swimming test (FST), the tail suspension test (TST) and the measurement of target-related proteins using western blotting and immunofluorescence. Results Bioinformatics analysis showed that most of lignan compounds in KL were optimal ligands for the 5-HT1A receptor (5-HT1AR), and they were found to be potential targets related to sedative effects; the main lignan content of KL extracts was characterized by HPLC-TOF-MS, with 7 proposed lignans detected. Administration of KL could significantly reduce FST and TST immobility time in the PCPA-induced 5HT-depleted insomnia rat model. The expressions of proteins related to the 5-HT1AR pathway were regulated by extracts of KL in a concentration-dependent manner, indicating that extracts of KL had 5-HT1AR agonist-like effects. Conclusion In silico analysis and experimental validation together demonstrated that lignan extracts from KL can target 5-HT1AR in insomniac rats, which could shed light on its use as a potential 5-HT1AR agonist drug.
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Affiliation(s)
- Yaxin Zheng
- Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Jiming Wu
- Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Xuesong Feng
- School of Pharmacy, China Medical University, Shenyang, 110122, China
| | - Ying Jia
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Jian Huang
- Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Zhihui Hao
- Animal Center, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Songyan Zhao
- School of Life Science, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Jinhui Wang
- Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang, 110016, China
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22
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Ma Y, Dong M, Mita C, Sun S, Peng CK, Yang AC. Publication analysis on insomnia: how much has been done in the past two decades? Sleep Med 2015; 16:820-6. [PMID: 25979182 DOI: 10.1016/j.sleep.2014.12.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/07/2014] [Accepted: 12/29/2014] [Indexed: 12/19/2022]
Abstract
Insomnia has been a rising public concern in recent years. As one example of a multidisciplinary topic, the theme of insomnia research has gradually shifted over time; however, there is very little quantitative characterization of the research trends in insomnia. The current study aims to quantitatively analyze trends in insomnia publications for the past 20 years. We retrospectively analyzed insomnia-related publications retrieved from PubMed and Google Scholar between 1994 and from a number of different perspectives. We investigated the major areas of research focus for insomnia, journal characteristics, as well as trends in clinical management and treatment modalities. The resulting 5841 publications presented an exponential growth trend over the past two decades, with mean annual growth rates at nearly 10% for each publication type. Analysis of major research focuses indicated that depression, hypnotics and sedatives, questionnaires, and polysomnography are the most common topics at present. Furthermore, we found that while studies on drug therapy and adverse effects decreased in the most recent five years, the greatest expansion of insomnia publications were in the areas of cognitive behavioral therapy for insomnia (CBT-I) and alternative therapies. Collectively, insomnia publications present a continuous trend of increase. While sedative and hypnotic drugs dominated the treatment of insomnia, non-pharmacological therapies may have great potential for advancement in future years. Future research effort is warranted for novel tools and clinical trials, especially on insomnia treatments with inadequate evidence or not-yet-clear efficacy and side effects.
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Affiliation(s)
- Yan Ma
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA; Sleep Center, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ming Dong
- IBM, Software Development Lab, Littleton, Massachusetts, USA
| | - Carol Mita
- Reference & Education Services, Countway Library of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Shuchen Sun
- Department of Otolaryngology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chung-Kang Peng
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Albert C Yang
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA; Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Psychiatry, Taipei Veterans General Hospital, Taipei City, Taiwan.
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Hu LL, Zhang X, Liu WJ, Li M, Zhang YH. Suan zao ren tang in combination with zhi zi chi tang as a treatment protocol for insomniacs with anxiety: a randomized parallel-controlled trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:913252. [PMID: 25793006 PMCID: PMC4352487 DOI: 10.1155/2015/913252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 01/19/2015] [Accepted: 01/21/2015] [Indexed: 11/17/2022]
Abstract
Insomnia is a serious worldwide health problem that is often comorbid with anxiety. The purpose of the present study was to evaluate the efficacy of a Chinese formula containing Suan Zao Ren Tang (SZRT) and Zhi Zi Chi Tang (ZZCT; SZR-ZZC) for improving sleep quality and anxiety states with four indices of Polysomnography (PSG), the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), and the Self Rating Anxiety Scale (SAS). Methods. A randomized, parallel-controlled trial compared SZR-ZZC to lorazepam tablet in insomniacs with anxiety. Patients were randomized to the SZR-ZZC treatment group (n = 60) and the lorazepam tablet treatment group (n = 59). Results. SZR-ZZC significantly improved scores on all four treatment indices. Compared with lorazepam, treatment with SZR-ZZC resulted in a significant reduction in the ISI (P = 0.029), the PSQI (P = 0.017), and wake after sleep onset (WASO; P = 0.008) scores and improved sleep architecture (P = 0.000-0.003) after a 4-week treatment period. Only one subject in the SZR-ZZC group experienced adverse side effects. Conclusion. Treatment with SZR-ZZC for 4 weeks appears to be a relatively safe and effective complementary therapeutic option when aiming to improve sleep quality and anxiety in insomniacs with anxiety.
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Affiliation(s)
- Lin-lin Hu
- School of Traditional Chinese Medicine, Zhejiang Chinese Medicine University, Zhejiang 310053, China
| | - Xin Zhang
- School of Traditional Chinese Medicine, Heilongjiang University of Chinese Medicine, Heilongjiang 150040, China
| | - Wen-juan Liu
- Department of Medicine, The Seventh Hospital of Hangzhou, Mental Health Care of Hangzhou, Zhejiang 310013, China
| | - Mei Li
- School of Medicine, Anhui Medical University, Anhui 230032, China
| | - Yong-hua Zhang
- Department of Medicine, The Seventh Hospital of Hangzhou, Mental Health Care of Hangzhou, Zhejiang 310013, China
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Lavreysen H, Ahnaou A, Drinkenburg W, Langlois X, Mackie C, Pype S, Lütjens R, Le Poul E, Trabanco AA, Nuñez JMC. Pharmacological and pharmacokinetic properties of JNJ-40411813, a positive allosteric modulator of the mGlu2 receptor. Pharmacol Res Perspect 2015; 3:e00096. [PMID: 25692015 PMCID: PMC4317228 DOI: 10.1002/prp2.96] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 09/08/2014] [Indexed: 01/26/2023] Open
Abstract
Compounds modulating metabotropic glutamate type 2 (mGlu2) receptor activity may have therapeutic benefits in treating psychiatric disorders like schizophrenia and anxiety. The pharmacological and pharmacokinetic properties of a novel mGlu2 receptor-positive allosteric modulator (PAM), 1-butyl-3-chloro-4-(4-phenyl-1-piperidinyl)-2(1H)-pyridinone (JNJ-40411813/ADX71149) are described here. JNJ-40411813 acts as a PAM at the cloned mGlu2 receptor: EC50 = 147 ± 42 nmol/L in a [(35)S]GTPγS binding assay with human metabotropic glutamate type 2 (hmGlu2) CHO cells and EC50 = 64 ± 29 nmol/L in a Ca(2+) mobilization assay with hmGlu2 G α16 cotransfected HEK293 cells. [(35)S]GTPγS autoradiography on rat brain slices confirmed PAM activity of JNJ-40411813 on native mGlu2 receptor. JNJ-40411813 displaced [(3)H]JNJ-40068782 and [(3)H]JNJ-46281222 (mGlu2 receptor PAMs), while it failed to displace [(3)H]LY341495 (a competitive mGlu2/3 receptor antagonist). In rats, JNJ-40411813 showed ex vivo mGlu2 receptor occupancy using [(3)H]JNJ-46281222 with ED50 of 16 mg/kg (p.o.). PK-PD modeling using the same radioligand resulted in an EC50 of 1032 ng/mL. While JNJ-40411813 demonstrated moderate affinity for human 5HT2A receptor in vitro (K b = 1.1 μmol/L), higher than expected 5HT2A occupancy was observed in vivo (in rats, ED50 = 17 mg/kg p.o.) due to a metabolite. JNJ-40411813 dose dependently suppressed REM sleep (LAD, 3 mg/kg p.o.), and promoted and consolidated deep sleep. In fed rats, JNJ-40411813 (10 mg/kg p.o.) was rapidly absorbed (C max 938 ng/mL at 0.5 h) with an absolute oral bioavailability of 31%. Collectively, our data show that JNJ-40411813 is an interesting candidate to explore the therapeutic potential of mGlu2 PAMs, in in vivo rodents experiments as well as in clinical studies.
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Affiliation(s)
- Hilde Lavreysen
- Janssen Research & Development, Janssen Pharmaceutica NVBeerse, Belgium
| | - Abdellah Ahnaou
- Janssen Research & Development, Janssen Pharmaceutica NVBeerse, Belgium
| | | | - Xavier Langlois
- Janssen Research & Development, Janssen Pharmaceutica NVBeerse, Belgium
| | - Claire Mackie
- Janssen Research & Development, Janssen Pharmaceutica NVBeerse, Belgium
| | - Stefan Pype
- Janssen Research & Development, Janssen Pharmaceutica NVBeerse, Belgium
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Scalo J, Desai P, Rascati K. Insomnia, hypnotic use, and health-related quality of life in a nationally representative sample. Qual Life Res 2014; 24:1223-33. [PMID: 25432884 DOI: 10.1007/s11136-014-0842-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To assess health-related quality of life (HRQoL) associated with insomnia and prescription hypnotic use. METHODS Primary outcomes were mental component summary (MCS) and physical component summary (PCS) scores from the 12-item Short-Form Health Survey. Using multiple regression, subjects in the 2005 through 2009 Medical Expenditure Panel Survey with diagnosed insomnia were compared against those without that diagnosis. Among subjects with diagnosed insomnia, users of prescription hypnotics were compared against nonusers. RESULTS Of 104,274 adults, 1.3 % (n = 1,401) had an insomnia diagnosis. Of those, 45.6 % (n = 639) used prescription hypnotics. For subjects with insomnia, mean PCS and MCS scores were 9.2 and 7.0 points lower (p < 0.001), respectively. After controlling for demographic and clinical covariates, differences remained significant (PCS:5.1; MCS 6.2; p < 0.001). Among subjects with insomnia, HRQoL scores were not different between prescription hypnotic users (n = 639) and nonusers (n = 762). Analysis by drug class revealed lower PCS scores (difference: 7.5, p < 0.001) with benzodiazepine use (n = 129) versus benzodiazepine receptor agonist use (n = 493), but the adjusted difference was not significant (difference: 3.8, p = .018). CONCLUSIONS Diagnosed insomnia was associated with consistent decreases in both physical and mental HRQoL scores, regardless of whether prescription hypnotics were used. Benzodiazepine use may be associated with a further decrease in physical HRQoL scores. Although limited by its retrospective design, this study provides a first look at real-world hypnotic use outcomes at a national level. Important next steps include studies with patients serving as their own controls, and further evaluation of the sensitivity of HRQoL instruments to the effects of insomnia treatments.
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Affiliation(s)
- Julieta Scalo
- College of Pharmacy, The University of Texas at Austin, 2409 University Avenue A1930, Austin, TX, 78712, USA,
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Shi Y, Dong J, Tang L, Kang R, Shi J, Zhang J. N6-(3-methoxyl-4-hydroxybenzyl) adenine riboside induces sedative and hypnotic effects via GAD enzyme activation in mice. Pharmacol Biochem Behav 2014; 126:146-51. [DOI: 10.1016/j.pbb.2014.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 08/24/2014] [Accepted: 09/06/2014] [Indexed: 12/24/2022]
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MacFarlane J, Morin CM, Montplaisir J. Hypnotics in Insomnia: The Experience of Zolpidem. Clin Ther 2014; 36:1676-701. [DOI: 10.1016/j.clinthera.2014.09.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 09/16/2014] [Accepted: 09/24/2014] [Indexed: 02/01/2023]
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Shi Y, Dong JW, Zhao JH, Tang LN, Zhang JJ. Herbal Insomnia Medications that Target GABAergic Systems: A Review of the Psychopharmacological Evidence. Curr Neuropharmacol 2014; 12:289-302. [PMID: 24851093 PMCID: PMC4023459 DOI: 10.2174/1570159x11666131227001243] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Revised: 11/02/2013] [Accepted: 12/24/2013] [Indexed: 12/24/2022] Open
Abstract
Insomnia is a common sleep
disorder which is prevalent in women and the elderly. Current insomnia drugs
mainly target the γ-aminobutyric acid (GABA) receptor, melatonin receptor,
histamine receptor, orexin, and serotonin receptor. GABAA receptor
modulators are ordinarily used to manage insomnia, but they are known to affect
sleep maintenance, including residual effects, tolerance, and dependence. In an
effort to discover new drugs that relieve insomnia symptoms while avoiding side
effects, numerous studies focusing on the neurotransmitter GABA and herbal
medicines have been conducted. Traditional herbal medicines, such as Piper
methysticum and the seed of Zizyphus jujuba Mill var. spinosa,
have been widely reported to improve sleep and other mental disorders. These
herbal medicines have been applied for many years in folk medicine, and extracts
of these medicines have been used to study their pharmacological actions and
mechanisms. Although effective and relatively safe, natural plant products have
some side effects, such as hepatotoxicity and skin reactions effects of Piper
methysticum. In addition, there are insufficient evidences to certify the
safety of most traditional herbal medicine. In this review, we provide an
overview of the current state of knowledge regarding a variety of natural plant
products that are commonly used to treat insomnia to facilitate future studies.
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Affiliation(s)
- Yuan Shi
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Jing-Wen Dong
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Jiang-He Zhao
- Department of Pharmacology, School of Marine, Shandong University, Weihai, P.R. China
| | - Li-Na Tang
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Jian-Jun Zhang
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
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Abstract
Insomnia is a common sleep disorder which has been shown to adversely affect outcomes in hospitalized patients. This article reviews the available classes of medications that may be considered in the treatment of insomnia in the hospital setting.
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Affiliation(s)
- Jennifer Kelly
- Clinical Pharmacy Specialist, Residential Rehabilitation Treatment Programs (RRTPs), (A-PRRTP, CWT/TR, DRRTP, G-PRRTP, STARR Programs), Albuquerque, NM
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Cooper CK. Orexin receptor antagonists: Novel hypnotic agents. Ment Health Clin 2014. [DOI: 10.9740/mhc.n190094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Dual acting orexin antagonists are a novel class of medications in development for the treatment of insomnia. This article reviews the available data on these agents.
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Armstrong TS, Gilbert MR. Practical strategies for management of fatigue and sleep disorders in people with brain tumors. Neuro Oncol 2013; 14 Suppl 4:iv65-72. [PMID: 23095832 DOI: 10.1093/neuonc/nos210] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Terri S Armstrong
- Department of Family Health, University of Texas Health Science Center at Houston-School of Nursing , Houston, Texas, USA.
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Lyseng-Williamson KA. Melatonin prolonged release: a guide to its use in the treatment of insomnia in patients aged ≥55 years. DRUGS & THERAPY PERSPECTIVES 2013. [DOI: 10.1007/s40267-013-0031-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dingemanse J, Hoever P, Hoch M, Treiber A, Wagner-Redeker W, Miraval T, Hopfgartner G, Shakeri-Nejad K. Elucidation of the Metabolic Pathways and the Resulting Multiple Metabolites of Almorexant, a Dual Orexin Receptor Antagonist, in Humans. Drug Metab Dispos 2013; 41:1046-59. [DOI: 10.1124/dmd.112.050120] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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