Wake Up America: National Survey of Patients’ and Physicians’ Views and Attitudes on Insomnia Care

Sleep disorders and risk of alzheimer's disease: A two-way road

Substantial sleep impairment in patients with Alzheimer's disease (AD) is one of the emerging points for continued efforts to better understand the disease. Individuals without cognitive decline, an important marker of the clinical phase of AD, may show early alterations in the sleep-wake cycle. The objective of this critical narrative review is to explore the bidirectional pathophysiological correlation between sleep disturbances and Alzheimer's Disease. Specifically, it examines how the disruption of sleep homeostasis in individuals without dementia could contribute to the pathogenesis of AD, and conversely, how neurodegeneration in individuals with Alzheimer's Disease might lead to dysregulation of the sleep-wake cycle. Recent scientific results indicate that sleep disturbances, particularly those related to impaired glymphatic clearance, may act as an important mechanism associated with the genesis of Alzheimer's Disease. Additionally, amyloid deposition and tau protein hyperphosphorylation, along with astrocytic hyperactivation, appear to trigger changes in neurotransmission dynamics in areas related to sleep, which may explain the onset of sleep disturbances in individuals with AD. Disruption of sleep homeostasis appears to be a modifiable risk factor in Alzheimer's disease. Whenever possible, the use of non-pharmacological strategies becomes important in this context. From a different perspective, additional research is needed to understand and treat the dysfunction of the sleep-wake cycle in individuals already affected by AD. Early recognition and correction of sleep disturbances in this population could potentially mitigate the progression of dementia and improve the quality of life for those with AD.

Knowledge, attitude, and practice of chronic insomnia management among general practitioners in China: a cross-sectional survey

BACKGROUND

Chronic insomnia is a common yet often overlooked issue in primary health care. This study investigated the knowledge, attitude, and practices of chronic insomnia management among general practitioners (GPs).

METHODS

A cross-sectional online survey was conducted among GPs providing routine care to adults with insomnia in health facilities at all levels in Sichuan Province, China. Additionally, we designed an online questionnaire that included basic information and knowledge, attitudes, and practices regarding chronic insomnia management.

RESULTS

We included 420 GPs, 66.2% of whom were female and 58.1% were from community health service centers. Total 198 (47.1%) GPs had received specific training and only 2 GPs (0.5%) correctly answered the knowledge-related questions. Furthermore, only 44 GPs (10.5%) demonstrated excellent practice behaviors, while most GPs (70.2%) expressed high demand for training in insomnia management. Insomnia training experience was associated with higher practice scores (β = 3.318, p < 0.001).

CONCLUSION

This study established an association and correlation between knowledge, attitude, and practice scores in treating insomnia and the sociodemographic characteristics of GPs in China. Although knowledge and practice performance in this field need to be improved, they mostly displayed a positive attitude towards insomnia management. Thus, offering continuing education opportunities to GPs would be highly beneficial.

The relationship between dizziness and sleep: a review of the literature

Background

The relation between vestibular disorders and (quality of) sleep is underexplored scientifically and the complex interactions between vestibular and sleep disorders are far from being well understood. Some studies have been conducted on the association between patients with vestibular disorders and (the occurrence of) sleep disorders, other studies have been published on the prevalence of dizziness complaints in patients with sleep disorders. The quality of sleep in patients with vestibular disorders generally receives little attention in clinical practice.

Objective

To establish what is currently known about the mutual relationship between dizziness and sleep, and to assess whether or not there is evidence of causality with regard to this relationship.

Methods

After systematically searching four literature database up until 1 April 2024, selected studies were summarized and evaluated through a (critical) review.

Results

Ultimately, 42 studies were selected and evaluated. Patients with dizziness in general and patients with a specific vestibular disorder like Benign Paroxysmal Positional Vertigo, Vestibular Migraine, Meniere's disease, and vestibular hypofunction were significantly more likely to have sleep disorders than control groups. A causal relationship is not supported due to the nature of the studies. In patients with obstructive sleep apnea syndrome there were significantly more vestibular complaints, and more disorders in the vestibular system were identified.

Conclusion

Dizziness complaints often co-exist with a sleep disorder. To what extent this sleep disorder influences dizziness is not clear. Paying attention to the quality of sleep in patients with a vestibular disorder seems to be important. In patients with OSAS, consideration should be given to vestibular complaints and dysfunction.

[Effectiveness of Anvifen in the treatment of insomnia in elderly patients]

OBJECTIVE

Purpose of the study to determine the effectiveness of Anvifen in the case of insomnia and meteosensitivity as comorbid stress-induced disorders.

MATERIAL AND METHODS

67 patients aged 60-70 years were examined, who were randomly divided into two groups: group 1 - 33 patients (20 men, 13 women), group 2 - 34 patients (19 men, 15 women). The average age of group 1 was 62.7 [61; 65] years, group 2 was 63.1 [60; 66] years (p=0.28). Research methods: questionnaire for scoring subjective characteristics of sleep, assessing the influence of meteosensitivity on daily activity using a numerical rank scale (NRS) for the previous three months. Patients in group 1 took Anvifen 250 mg (capsules) in the morning and afternoon, 500 mg (2 capsules) in the evening at 10 p.m., and upon awakening at night - an additional 250 mg of the drug per capsule. Patients in group 2 took Anvifen powder (extracting it from the capsule) 250 mg in the morning and afternoon, 500 mg in the evening at 10 p.m., and upon awakening at night - an additional 250 mg of the drug. The time from the nightly intake of Anvifen to the onset of sleep was also assessed on a three-degree scale: «fast», «long», «very long». The duration of treatment was 4 weeks.

RESULTS

Baseline results of measured parameters did not differ significantly between groups. After completion of treatment, the total score of subjective sleep characteristics improved in 1st (p=0.00001) and 2nd (p=0.000001) groups. Significant differences from group 1 for the better in group 2 were in «quality of sleep» (p=0.00027) and «quality of awakening» (p=0.00001). Weather sensitivity decreased in 1st (p=0.00001) and 2nd (p=0.000001) groups.

CONCLUSION

Anvifen showed good effectiveness in the treatment of two comorbid conditions of elderly people - insomnia and meteosensitivity. Using the drug in powder form allows you to get a faster and better effect without side-effects.