Scholars@Duke
Andrew Darrell Krystal

Andrew Darrell Krystal

Professor Emeritus of Psychiatry and Behavioral Sciences
Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences
andrew.krystal@duke.edu
Box 3309 Med Ctr, Durham, NC 27710
54221 Hosp South, Durham, NC 27710

Scholarly Works - Journal articles

Cognitive-behavioural therapy for insomnia in adults to decrease cannabis use: study protocol for a randomised controlled trial in a community sample of adults with frequent cannabis use.

Journal article BMJ Open · June 17, 2026 INTRODUCTION: Cannabis use is common in the USA and is associated with adverse outcomes across many domains, including sleep difficulties. Targeting insomnia with an evidence-based treatment could improve sleep and reduce frequent cannabis use. This random ... Full text Link to item Cite

Simulated Reasoning and Self-Verification for Psychiatric Diagnosis in Generalist Large Language Models: Comparative Evaluation.

Journal article JMIR AI · June 8, 2026 BACKGROUND: Large language models (LLMs) and, more recently, large reasoning models (LRMs) have rapidly garnered significant interest for application in psychiatry and behavioral health. However, recent studies have identified significant shortcomings and ... Full text Link to item Cite

Design and Recruitment for the Comparative Effectiveness of Zolpidem/Trazodone and Cognitive Behavioral Therapy for Insomnia (COZI) Study in Rural Adults.

Journal article Behav Sleep Med · June 5, 2026 OBJECTIVES: Cognitive behavioral therapy for insomnia (CBT-I) is widely recommended, but access remains limited, particularly among rural adults. Medications to treat insomnia, including zolpidem and trazodone, are widely used but can have significant side ... Full text Link to item Cite

Stereo-encephalography-guided multi-lead deep brain stimulation for treatment-refractory obsessive compulsive disorder - Study design and individualized surgical targeting approach.

Journal article J Affect Disord · June 1, 2026 INTRODUCTION: Treatment-refractory obsessive-compulsive disorder (trOCD) is a complex network disorder that may require personalized treatment strategies due to disease heterogeneity. A multi-site, multi-stage, double-blinded, randomized crossover clinical ... Full text Link to item Cite

Sleep physiology associated with cognitive disengagement syndrome in adolescents with and without ADHD.

Journal article Sleep Med · June 2026 OBJECTIVE: Cognitive disengagement syndrome (CDS) is an attentional phenotype characterized by excessive daydreaming and hypoactivity that is distinct from attention-deficit/hyperactivity disorder (ADHD). Emerging research finds poorer sleep functioning to ... Full text Link to item Cite

Anhedonia in patients with major depressive disorder (MDD): State-of-the-art consensus review.

Journal article Psychiatry Res · May 12, 2026 Anhedonia is a highly prevalent core pathognomonic symptom of a major depressive episode seen in major depressive disorder (MDD) and bipolar disorder. The symptom is associated with functional impairment, increased suicidality, psychiatric and somatic como ... Full text Link to item Cite

Scalable biomarkers of Parkinson's disease: insights from mobile EEG in Peru.

Journal article Sci Rep · April 22, 2026 Mobile electroencephalography (EEG) may offer a scalable, cost-effective way to capture neural signatures of Parkinson’s disease (PD) in low-resource settings. In a cross-sectional cohort of 44 individuals with PD in Lima, Peru evaluated “off-medication”, ... Full text Link to item Cite

Toward Individualized Deep Brain Stimulation: A Stereoelectroencephalography-Based Workflow for Neurostimulation Target Identification.

Journal article Neuromodulation · April 2026 OBJECTIVES: Deep brain stimulation (DBS) is increasingly being used to treat a variety of neuropsychiatric conditions, many of which exhibit idiosyncratic symptom presentations and neural correlates across individuals. Thus, we have used inpatient stereoel ... Full text Link to item Cite

Pharmacologic treatment data from chronic insomnia studies and the application to individuals with acute insomnia, a narrative review.

Journal article Sleep Med Rev · April 2026 A variety of pharmacologic treatments are approved for insomnia, encompassing a range of mechanisms of action, including some treatments with published data in models of acute insomnia. However, most studies are conducted in individuals with chronic insomn ... Full text Link to item Cite

Rapid homotopic communication between human orbitofrontal subregions.

Journal article Curr Biol · March 23, 2026 The orbitofrontal cortex (OFC) is a nexus for decision-making computations,1 emotion,2 and pain processing,3 with dissociable roles for its subfields: medial and anterior OFC are thought to represent economic value,4,5,6 whereas lateral OFC receives predom ... Full text Link to item Cite

Detecting racial and ethnic disparities in study exclusion: screening outcomes from a RCT for pregnant women with insomnia.

Journal article Trials · January 13, 2026 BACKGROUND: Eligibility criteria are a critical component of a well-designed clinical trial, enhancing trial safety and internal validity. Yet, data suggest that exclusion rates based on these criteria often vary by participant race/ethnicity. METHOD: This ... Full text Link to item Cite

Integrating expert knowledge into large language models improves performance for psychiatric reasoning and diagnosis.

Journal article Psychiatry Res · January 2026 BACKGROUND AND METHODS: The authors sought to evaluate the performance of common large language models (LLMs) in psychiatric diagnosis, and the impact of integrating expert-derived reasoning on their performance. Clinical case vignettes and associated diag ... Full text Link to item Cite

Empirical limitations of current low-intensity focused ultrasound simulation platforms.

Journal article Brain Stimul · 2026 BACKGROUND: Transcranial low-intensity focused ultrasound (LIFU) is an emerging tool for noninvasive neuromodulation, with potential therapeutic applications across a range of neuropsychiatric disorders. As the field advances toward clinical translation, i ... Full text Link to item Cite

Toward a transcriptomic framework for ultrasound neuromodulation: A perspective on gene expression and regional brain sensitivity.

Journal article Imaging Neurosci (Camb) · 2026 Non-invasive transcranial ultrasound stimulation (TUS) enables deep brain therapeutic exploration at unprecedented scale. However, its optimal use is limited by the uncertainty surrounding ultrasound sensitivity across brain regions and cell types. This un ... Full text Link to item Cite

The Effectiveness of Digital Cognitive Behavioral Therapy to Treat Insomnia Disorder in US Adults: Nationwide Decentralized Randomized Controlled Trial.

Journal article JMIR Ment Health · December 4, 2025 BACKGROUND: Cognitive behavioral therapy (CBT) is recommended as the first-line treatment for insomnia; however, few patients have access to it. A new class of Food and Drug Administration (FDA)-regulated digital CBT treatments has the potential to address ... Full text Link to item Cite

Computationally Informed Insights Into Anhedonia and Treatment by Kappa Opioid Receptor Antagonism.

Journal article Biol Psychiatry Cogn Neurosci Neuroimaging · November 2025 BACKGROUND: Anhedonia, the loss of pleasure, is prevalent and impairing. Parsing its computational basis promises to explain its transdiagnostic character. One manifestation of anhedonia, reward insensitivity, may be linked to limited memory. Furthermore, ... Full text Link to item Cite

Development of a core outcome set for clinical trials of interventions to improve sleep in people with cognitive impairment-the Sleep in Cognitive Impairment Core Outcome Set (SCICOS).

Journal article Alzheimers Dement · November 2025 INTRODUCTION: Sleep disturbances are common in older people with cognitive impairment, potentially contributing to negative outcomes. A core outcome set (COS) is required to reduce heterogeneity in clinical trials and promote the development of high-qualit ... Full text Link to item Cite

Invasive brain mapping identifies personalized therapeutic neuromodulation targets that suppress OCD network activity.

Journal article Transl Psychiatry · October 31, 2025 Deep brain stimulation has been used to treat severe, refractory obsessive-compulsive disorder (OCD) with variable outcomes across multiple anatomical targets. To overcome these limitations, we developed an invasive brain mapping paradigm in which electrod ... Full text Link to item Cite

Combining plasma neurofilament light chain and frontotemporal atrophy improves differentiation of bvFTD from primary psychiatric disorders.

Journal article Alzheimers Dement · October 2025 INTRODUCTION: Distinguishing behavioral variant frontotemporal dementia (bvFTD) from primary psychiatric disorders (PPDs) remains challenging due to overlapping clinical presentation. Neurofilament light chain (NfL) is a biomarker of neuronal damage that i ... Full text Link to item Cite

Individualized functional brain mapping machine learning prediction of symptom-change resulting from selective kappa-opioid antagonism in an anhedonic sample from a Fast-Fail trial.

Journal article J Mood Anxiety Disord · September 2025 BACKGROUND: Anhedonia remains a difficult-to-treat symptom and has been associated with poor clinical course transdiagnostically. Here, we applied machine learning models to individualized neural patches derived from fMRI data during the Monetary Incentive ... Full text Link to item Cite

A Phase 2 Randomized Trial of NBI-1065846 (TAK-041) in Patients With Anhedonia Associated With Major Depressive Disorder: Results of the TERPSIS Study.

Journal article J Clin Psychopharmacol · September 2025 BACKGROUND: Anhedonia is a core symptom of major depressive disorder (MDD) that may result from aberrant lateral habenula hyperactivity. Targeting G-protein coupled receptor 139 (GPR139) may improve anhedonia by modulating lateral habenula activity. NBI-10 ... Full text Link to item Cite

Efficacy and Safety of Seltorexant in Insomnia Disorder: A Randomized Clinical Trial.

Journal article JAMA Psychiatry · August 13, 2025 IMPORTANCE: Existing pharmacological treatments for insomnia have significant limitations. OBJECTIVE: To assess the effective dose range, safety, and tolerability of the novel selective orexin-2 receptor antagonist seltorexant in insomnia disorder. DESIGN, ... Full text Link to item Cite

Selective KOR antagonist alters functional patch sizes in individualized brain system: results from the Fast-fail Trial in Mood and Anxiety Spectrum Disorders (FAST-MAS).

Journal article Neuropsychopharmacology · August 2025 In our prior study involving a transdiagnostic sample of individuals with anhedonia, we showed that an 8-week administration of a selective κ-opioid receptor (KOR) antagonist enhanced fMRI ventral striatal activation during reward anticipation in the Monet ... Full text Link to item Cite

Idiopathic Hypersomnia: Recognition and Management in Psychiatric Practice.

Journal article J Clin Psychiatry · June 2, 2025 Objective: This review of the relationship between idiopathic hypersomnia and psychiatric disorders describes considerations in recognizing and managing complaints of excessive daytime sleepiness (EDS) in patients in psychiatric clinical practice. Data Sou ... Full text Link to item Cite

Assessing the Accuracy and Reliability of Large Language Models in Psychiatry Using Standardized Multiple-Choice Questions: Cross-Sectional Study.

Journal article J Med Internet Res · May 20, 2025 BACKGROUND: Large language models (LLMs), such as OpenAI's GPT-3.5, GPT-4, and GPT-4o, have garnered early and significant enthusiasm for their potential applications within mental health, ranging from documentation support to chat-bot therapy. Understandi ... Full text Link to item Cite

Rapid resolution of depression and epilepsy following resection of a septal region tumor: illustrative case.

Journal article J Neurosurg Case Lessons · April 14, 2025 BACKGROUND: The authors present a case of a young patient who presented with depression symptoms and epilepsy. She was found to have a low-grade glioneuronal tumor located in the septal region, a critical limbic area involved in neuropsychiatric disorders. ... Full text Link to item Cite

The effect of doxepin 3 mg on sleep latency: a pooled analysis of two phase 3 trials.

Journal article Sleep Breath · April 14, 2025 INTRODUCTION: Most pharmacologic treatments with clinical data for insomnia symptoms are controlled substances. An exception is doxepin, an antihistamine that has shown efficacy for the treatment of difficulties with sleep maintenance. This analysis assess ... Full text Link to item Cite

Efficacy and safety of lemborexant in subjects with insomnia disorder receiving medications for depression or anxiety symptoms.

Journal article Neuropsychopharmacol Rep · March 2025 AIM: Individuals with insomnia frequently have comorbid depression or anxiety. This study sought to provide a preliminary indication of the effects of lemborexant (LEM) in subjects treated for mild depression/anxiety symptoms. METHODS: E2006-G000-303 (NCT0 ... Full text Link to item Cite

Advancing precision psychiatry and targeted treatments: Insights from immunopsychiatry.

Journal article Brain Behav Immun · March 2025 Despite tremendous advancements in neuroscience, there has been limited impact on patient care. Current psychiatric treatments are largely non-specific, and drug development is hindered by outdated, overinclusive diagnostic categories and a "one-size-fits- ... Full text Link to item Cite

Sleep Physiology and Neurocognition Among Adolescents With Attention-Deficit/Hyperactivity Disorder.

Journal article J Am Acad Child Adolesc Psychiatry · February 2025 OBJECTIVE: Few studies have characterized the nature of sleep problems among adolescents with attention-deficit/hyperactivity disorder (ADHD) using polysomnography (PSG). Additionally, although adolescents with ADHD and adolescents with sleep disturbances ... Full text Link to item Cite

Hyperarousal features in the sleep architecture of individuals with and without insomnia.

Journal article J Sleep Res · February 2025 Sleep architecture encodes relevant information on the structure of sleep and has been used to assess hyperarousal in insomnia. This study investigated whether polysomnography-derived sleep architecture displays signs of hyperarousal in individuals with in ... Full text Link to item Cite

Effects of Recruitment Messaging on Ethnic/Racial Minority Screening in a RCT for Prenatal Insomnia: An Experimental Approach.

Journal article Behav Sleep Med · 2025 OBJECTIVE: Using data from a nationwide recruitment campaign for an RCT evaluating digital cognitive behavioral therapy for prenatal insomnia, we tested whether a recruitment message that identified a racial/ethnic disparity in sleep quality (sleep dispari ... Full text Link to item Cite

Best practices for clinical trials of deep brain stimulation for neuropsychiatric indications.

Journal article Front Hum Neurosci · 2025 Deep brain stimulation (DBS) is well suited to target disorders with network dysregulation, as is the case in many neuropsychiatric diseases. While DBS is a well-established therapy for Parkinson's disease, essential tremor, dystonia, and medically refract ... Full text Link to item Cite

Therapeutic DBS for OCD Suppresses the Default Mode Network.

Journal article Hum Brain Mapp · December 15, 2024 Deep brain stimulation (DBS) of the anterior limb of the internal capsule (ALIC) is a circuit-based treatment for severe, refractory obsessive-compulsive disorder (OCD). The therapeutic effects of DBS are hypothesized to be mediated by direct modulation of ... Full text Link to item Cite

Clinical Manifestations

Journal article Alzheimer's & dementia : the journal of the Alzheimer's Association · December 1, 2024 Those with neurodegenerative conditions have an increased risk of developing delirium and there is some evidence that delirium may be a risk factor for neurodegenerative disorders. Similar to the interactions between sleep and neurodegenerative conditions, ... Full text Cite

Effect of daridorexant on sleep architecture in patients with chronic insomnia disorder: a pooled post hoc analysis of two randomized phase 3 clinical studies.

Journal article Sleep · November 8, 2024 STUDY OBJECTIVES: Post hoc analysis to evaluate the effect of daridorexant on sleep architecture in people with insomnia, focusing on features associated with hyperarousal. METHODS: We studied sleep architecture in adults with chronic insomnia disorder fro ... Full text Link to item Cite

Stereoelectroencephalography Electrode Implantation for Inpatient Workup of Treatment-Resistant Depression.

Journal article Neurosurgery · October 1, 2024 BACKGROUND AND OBJECTIVES: Treatment-resistant depression is a leading cause of disability. Our center's trial for neurosurgical intervention for treatment-resistant depression involves a staged workup for implantation of a personalized, closed-loop neurom ... Full text Link to item Cite

Insomnia and the effect of zolpidem-extended-release on the sleep items of the Hamilton Rating Scale for Depression in outpatients with depression, insomnia, and suicidal ideation: Relationship to patient age.

Journal article J Psychopharmacol · September 2024 BACKGROUND: There are limited data regarding gamma-aminobutyric acid (GABA) allosteric modulator sleep-aid medications in persons with depression, insomnia, and suicidal ideation (SI). AIMS: This secondary analysis examined the relationship of age to insom ... Full text Link to item Cite

Comparative short-term safety and efficacy of hypnotics: A quantitative risk-benefit analysis.

Journal article J Sleep Res · August 2024 Several professional societies have provided recommendations for prescribing medications for insomnia. None has provided an integrative analysis that concurrently quantifies safety and efficacy (e.g., risk-benefit ratios). This represents an important gap ... Full text Link to item Cite

Association of Biomarkers of Neuronal Injury and Inflammation With Insomnia Trajectories After Traumatic Brain Injury: A TRACK-TBI Study.

Journal article Neurology · April 23, 2024 BACKGROUND AND OBJECTIVES: Insomnia affects about one-third of patients with traumatic brain injury and is associated with worsened outcomes after injury. We hypothesized that higher levels of plasma neuroinflammation biomarkers at the time of TBI would be ... Full text Link to item Cite

Cognitive behavioural therapy for insomnia reduces actigraphy and diary measured sleep discrepancy for individuals with comorbid insomnia and major depressive disorder: A report from the TRIAD study.

Journal article Sleep Med · February 2024 OBJECTIVE/BACKGROUND: Discrepancies between sleep diaries and actigraphy occur among individuals with insomnia. Cognitive behavioural therapy for insomnia (CBT-I) improves insomnia but the impact on discrepancy is unclear. This study examined CBT-I's effec ... Full text Link to item Cite

Closed-loop neurostimulation for the treatment of psychiatric disorders.

Journal article Neuropsychopharmacology · January 2024 Despite increasing prevalence and huge personal and societal burden, psychiatric diseases still lack treatments which can control symptoms for a large fraction of patients. Increasing insight into the neurobiology underlying these diseases has demonstrated ... Full text Link to item Cite

Proceedings of the 11th Annual Deep Brain Stimulation Think Tank: pushing the forefront of neuromodulation with functional network mapping, biomarkers for adaptive DBS, bioethical dilemmas, AI-guided neuromodulation, and translational advancements.

Journal article Front Hum Neurosci · 2024 The Deep Brain Stimulation (DBS) Think Tank XI was held on August 9-11, 2023 in Gainesville, Florida with the theme of "Pushing the Forefront of Neuromodulation". The keynote speaker was Dr. Nico Dosenbach from Washington University in St. Louis, Missouri. ... Full text Link to item Cite

Feasibility and Acceptability of Mindfulness-based Stress Reduction and Prenatal Sleep Classes for Poor Prenatal Sleep Quality: Pilot Randomized Controlled Trial.

Journal article Behav Sleep Med · 2024 OBJECTIVES: The main objectives of the current paper were to examine the feasibility, acceptability, and adherence of a remotely delivered intervention consisting of mindfulness-based stress reduction plus prenatal sleep classes (MBSR+PS) compared with tre ... Full text Link to item Cite

The effect of zolpidem-CR on the suicide item of the Hamilton Rating Scale for Depression in outpatients with depression, insomnia and suicidal ideation: Lessons learned.

Journal article Psychiatry Res · December 2023 The REST-IT study found the addition of zolpidem-controlled release (CR) provided a significant reduction in observer-rated measurement of suicidal ideation (the Columbia Suicide Severity Rating Scale) in 103 depressed outpatients with insomnia and suicida ... Full text Link to item Cite

Insomnia medications: History, characteristics, and guidelines for optimal use in clinical practice.

Journal article J Sleep Res · December 2023 This article reviews the history of insomnia pharmacotherapy, documenting the evolution that has occurred over time in the increasing availability of medications with novel mechanisms of action that more specifically target the neural systems that modulate ... Full text Link to item Cite

Effect of Psychological and Medication Therapies for Insomnia on Daytime Functions: A Randomized Clinical Trial.

Journal article JAMA Netw Open · December 1, 2023 IMPORTANCE: Daytime functional impairments are the primary reasons for patients with insomnia to seek treatment, yet little is known about what the optimal treatment is for improving daytime functions and how best to proceed with treatment for patients who ... Full text Link to item Cite

Cortical Synchrony and Information Flow during Transition from Wakefulness to Light Non-Rapid Eye Movement Sleep.

Journal article J Neurosci · November 29, 2023 Sleep is a highly stereotyped phenomenon, requiring robust spatiotemporal coordination of neural activity. Understanding how the brain coordinates neural activity with sleep onset can provide insights into the physiological functions subserved by sleep and ... Full text Link to item Cite

Association Between Insomnia and Mental Health and Neurocognitive Outcomes Following Traumatic Brain Injury.

Journal article J Neurotrauma · November 2023 We previously described five trajectories of insomnia (each defined by a distinct pattern of insomnia severity over 12 months following traumatic brain injury [TBI]). Our objective in the present study was to estimate the association between insomnia traje ... Full text Link to item Cite

Using latent profile analyses to classify subjects with anhedonia based on reward-related measures obtained in the FAST-MAS study.

Journal article J Affect Disord · October 15, 2023 BACKGROUND: Growing evidence indicates that anhedonia is a multifaceted construct. This study examined the possibility of identifying subgroups of people with anhedonia using multiple reward-related measures to provide greater understanding the Research Do ... Full text Link to item Cite

Closed-Loop Neurostimulation for Biomarker-Driven, Personalized Treatment of Major Depressive Disorder.

Journal article J Vis Exp · July 7, 2023 Deep brain stimulation involves the administration of electrical stimulation to targeted brain regions for therapeutic benefit. In the context of major depressive disorder (MDD), most studies to date have administered continuous or open-loop stimulation wi ... Full text Link to item Cite

International Consensus Statement on Obstructive Sleep Apnea.

Journal article Int Forum Allergy Rhinol · July 2023 BACKGROUND: Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collab ... Full text Link to item Cite

Objective sleep duration and response to combined pharmacotherapy and cognitive behavioral insomnia therapy among patients with comorbid depression and insomnia: a report from the TRIAD study.

Journal article J Clin Sleep Med · June 1, 2023 STUDY OBJECTIVES: Several studies have shown that patients with short sleep duration show a poor response to cognitive behavioral therapy for insomnia (CBT-I), but such studies have not included patients with comorbid conditions. The current study was cond ... Full text Link to item Cite

Do Insomnia Treatments Improve Daytime Function?

Journal article J Clin Med · April 24, 2023 A scientific advisory panel of seven U.S. and Canadian sleep experts performed a clinical appraisal by comparing general medical opinion, assessed via a survey of practicing clinicians, regarding insomnia treatment, with the available scientific evidence. ... Full text Link to item Cite

Should Trazodone Be First-Line Therapy for Insomnia? A Clinical Suitability Appraisal.

Journal article J Clin Med · April 18, 2023 Trazodone is one of the most commonly used prescription medications for insomnia; however, some recent clinical guidelines do not recommend its use for treating insomnia. This clinical appraisal critically reviews the scientific literature on trazodone as ... Full text Link to item Cite

Alliance for Sleep Clinical Practice Guideline on Switching or Deprescribing Hypnotic Medications for Insomnia.

Journal article J Clin Med · March 25, 2023 Determining the most effective insomnia medication for patients may require therapeutic trials of different medications. In addition, medication side effects, interactions with co-administered medications, and declining therapeutic efficacy can necessitate ... Full text Link to item Cite

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

Journal article J Clin Med · March 25, 2023 While both patients and physicians consider sleep to be important, sleep health may not receive appropriate consideration during patient visits with health care professionals (HCPs). We completed the first large-scale survey of people with trouble sleeping ... Full text Link to item Cite

What Should Be the Focus of Treatment When Insomnia Disorder Is Comorbid with Depression or Anxiety Disorder?

Journal article J Clin Med · March 2, 2023 Insomnia is a significant, highly prevalent, persistent public health problem but often remains undiagnosed and untreated. Current treatment practices are not always evidence-based. When insomnia is comorbid with anxiety or depression, treatment often targ ... Full text Link to item Cite

Long-Term Use of Insomnia Medications: An Appraisal of the Current Clinical and Scientific Evidence.

Journal article J Clin Med · February 17, 2023 While evidence supports the benefits of medications for the treatment of chronic insomnia, there is ongoing debate regarding their appropriate duration of use. A panel of sleep experts conducted a clinical appraisal regarding the use of insomnia medication ... Full text Link to item Cite

Recognition and Management of Obstructive Sleep Apnea in Psychiatric Practice.

Journal article J Clin Psychiatry · January 23, 2023 Objective: The aims of this review were to describe the relationship between obstructive sleep apnea (OSA) and psychiatric disorders and provide an overview of how to recognize/manage OSA in psychiatric practice. Data Sources: A literature search of PubMed ... Full text Link to item Cite

Longitudinal study to assess antidepressant treatment patterns and outcomes in individuals with depression in the general population.

Journal article J Affect Disord · January 15, 2023 BACKGROUND: Major depressive disorder (MDD) is largely managed in primary care, but physicians vary widely in their understanding of symptoms and treatments. This study aims to better understand the evolution of depression from initial diagnosis over a 3-y ... Full text Link to item Cite

Effect of brexanolone on depressive symptoms, anxiety, and insomnia in women with postpartum depression: Pooled analyses from 3 double-blind, randomized, placebo-controlled clinical trials in the HUMMINGBIRD clinical program.

Journal article J Affect Disord · January 1, 2023 BACKGROUND: Brexanolone is currently the only treatment specifically approved for postpartum depression (PPD) in the United States, based on the results from one Phase 2 and two Phase 3 double-blind, randomized, controlled trials in the HUMMINGBIRD program ... Full text Link to item Cite

Intracranial electrical stimulation of corticolimbic sites modulates arousal in humans.

Journal article Brain Stimul · 2023 BACKGROUND: Humans routinely shift their sleepiness and wakefulness levels in response to emotional factors. The diversity of emotional factors that modulates sleep-wake levels suggests that the ascending arousal network may be intimately linked with netwo ... Full text Link to item Cite

Solriamfetol treatment of excessive daytime sleepiness in participants with narcolepsy or obstructive sleep apnea with a history of depression.

Journal article J Psychiatr Res · November 2022 Given the high rate of depression associated with narcolepsy or obstructive sleep apnea (OSA), this analysis compared effects of solriamfetol treatment of excessive daytime sleepiness (EDS) in participants with/without a history of depression (DHx+/DHx-). ... Full text Link to item Cite

Post Hoc Analysis of the Impact of Lemborexant on Patient-Reported Sleep and Insomnia Severity in Adults with Insomnia and Depression Histories.

Journal article CNS Spectr · April 2022 INTRODUCTION: The dual orexin receptor antagonist lemborexant (LEM) is approved in multiple countries including the United States, Japan, Canada, and Australia for insomnia treatment in adults. In phase 3 study E2006-G000-303 (Study 303; SUNRISE-2; NCT0295 ... Full text Link to item Cite

Examining Experiences of Poor Sleep During Pregnancy: A Qualitative Study to Inform the Development of a Prenatal Sleep Intervention

Journal article Global Advances in Health and Medicine · March 16, 2022 Background: Poor sleep is common during pregnancy and is associated with increased risk of negative health outcomes. Research indicates that physical discomfort and having an active mind are primary factors for prenatal sleep disturbances. Mindfulness-base ... Full text Cite

A Delphi-method-based consensus guideline for definition of treatment-resistant depression for clinical trials.

Journal article Mol Psychiatry · March 2022 Criteria for treatment-resistant depression (TRD) and partially responsive depression (PRD) as subtypes of major depressive disorder (MDD) are not unequivocally defined. In the present document we used a Delphi-method-based consensus approach to define TRD ... Full text Link to item Cite

Links between the brain and body during sleep: implications for memory processing.

Journal article Trends Neurosci · March 2022 Sleep is intimately related to memory processes. The established view is that the transformation of experiences into long-term memories is linked to sleep-related CNS function. However, there is increasing evidence that the autonomic nervous system (ANS), ... Full text Link to item Cite

Randomized controlled trial of digital cognitive behavior therapy for prenatal insomnia symptoms: effects on postpartum insomnia and mental health.

Journal article Sleep · February 14, 2022 STUDY OBJECTIVES: To evaluate the effects of digital cognitive behavior therapy for insomnia (dCBT-I) delivered during pregnancy on subjective sleep outcomes, depressive symptoms, and anxiety symptoms through 6 months postpartum. METHODS: People up to 28 w ... Full text Link to item Cite

Telemedicine-delivered cognitive-behavioral therapy for insomnia in alcohol use disorder (AUD): study protocol for a randomized controlled trial.

Journal article Trials · January 20, 2022 BACKGROUND: Alcohol use disorder (AUD) is a leading preventable cause of morbidity and mortality, but relapse rates are high even with available treatments. Insomnia is a robust predictor of relapse and pilot studies have shown that CBT for insomnia improv ... Full text Link to item Cite

Trajectories of Insomnia in Adults After Traumatic Brain Injury.

Journal article JAMA Netw Open · January 4, 2022 IMPORTANCE: Insomnia is common after traumatic brain injury (TBI) and contributes to morbidity and long-term sequelae. OBJECTIVE: To identify unique trajectories of insomnia in the 12 months after TBI. DESIGN, SETTING, AND PARTICIPANTS: In this prospective ... Full text Link to item Cite

Overnight Delta Dynamics Associated with Daytime Psychomotor Performance in Adults with Insomnia and Healthy Controls.

Journal article Nat Sci Sleep · 2022 PURPOSE: Sleep is vital to cognition, yet underlying mechanisms remain unclear. Although sleep duration and continuity are two well-established contributors, additional factors-including homeostatic sleep drive processes-may also underlie cognition-related ... Full text Link to item Cite

What Is Insomnia?

Journal article JAMA · December 21, 2021 Full text Link to item Cite

Examining suicide assessment measures for research use: Using item response theory to optimize psychometric assessment for research on suicidal ideation in major depressive disorder.

Journal article Suicide Life Threat Behav · December 2021 INTRODUCTION: Progress reducing suicide death will require randomized clinical trials (RCTs) specifically targeting suicide risk. Even large RCTs may not stipulate suicide death as the primary outcome, as suicide death is relatively uncommon. Therefore, RC ... Full text Link to item Cite

Design of the National Adaptive Trial for PTSD-related Insomnia (NAP Study), VA Cooperative Study Program (CSP) #2016.

Journal article Contemp Clin Trials · October 2021 There are currently no validated pharmacotherapies for posttraumatic stress disorder (PTSD)-related insomnia. The purpose of the National Adaptive Trial for PTSD-Related Insomnia (NAP Study) is to efficiently compare to placebo the effects of three insomni ... Full text Link to item Cite

Closed-loop neuromodulation in an individual with treatment-resistant depression.

Journal article Nat Med · October 2021 Deep brain stimulation is a promising treatment for neuropsychiatric conditions such as major depression. It could be optimized by identifying neural biomarkers that trigger therapy selectively when symptom severity is elevated. We developed an approach th ... Full text Link to item Cite

Diagnosing and Treating Insomnia in Adults and Older Adults.

Journal article J Clin Psychiatry · September 28, 2021 Insomnia, the most prevalent sleep-wake disorder, affects 6% to 10% of adults. It may result in interpersonal and occupational problems and has a deleterious effect on quality of life. Patients may experience difficulty with sleep onset, sleep maintenance, ... Full text Link to item Cite

Optimizing Treatment for Insomnia.

Journal article J Clin Psychiatry · July 13, 2021 By tailoring the mechanism of action and effects of therapy to the specific nature of each patient's insomnia and other conditions, clinicians can offer personalized care in an attempt to achieve an improved risk-benefit ratio compared to that of a "one-si ... Full text Link to item Cite

Evaluating lemborexant for the treatment of insomnia.

Journal article Expert Opin Pharmacother · July 2021 INTRODUCTION: Insomnia is a complex sleep disorder that compromises quality of life and affects approximately 10% of the general population. Insomnia, defined as trouble initiating or maintaining sleep associated with impaired daytime function or distress, ... Full text Link to item Cite

Association of Sleep and β-Amyloid Pathology Among Older Cognitively Unimpaired Adults.

Journal article JAMA Netw Open · July 1, 2021 IMPORTANCE: Disrupted sleep commonly occurs with progressing neurodegenerative disease. Large, well-characterized neuroimaging studies of cognitively unimpaired adults are warranted to clarify the magnitude and onset of the association between sleep and em ... Full text Link to item Cite

Challenges in Managing Insomnia in Older People.

Journal article J Clin Psychiatry · June 29, 2021 Older people often experience insomnia, whether it is difficulty initiating or maintaining sleep. These sleep disturbances have a negative impact on quality of life and functioning. This report offers general considerations as well as specific data related ... Full text Link to item Cite

Cost-effectiveness of digital cognitive behavioral therapy (Sleepio) for insomnia: a Markov simulation model in the United States.

Journal article Sleep · April 9, 2021 STUDY OBJECTIVES: To examine the cost-effectiveness and potential net monetary benefit (NMB) of a fully automated digital cognitive behavioral therapy (CBT) intervention for insomnia compared with no insomnia treatment in the United States (US). Similar re ... Full text Link to item Cite

A Longitudinal Study to Assess Antidepressant Treatment Patterns and Outcomes in Individuals with Depression in the General Population.

Journal article CNS Spectr · April 2021 STUDY OBJECTIVES: Depression is an important cause of disability in the United States (US). The care experience of major depressive disorder (MDD) is highly variable and has only been documented to a limited degree. This study examines the prevalence incid ... Full text Link to item Cite

State-dependent responses to intracranial brain stimulation in a patient with depression.

Journal article Nat Med · February 2021 Deep brain stimulation is a promising treatment for severe depression, but lack of efficacy in randomized trials raises questions regarding anatomical targeting. We implanted multi-site intracranial electrodes in a severely depressed patient and systematic ... Full text Link to item Cite

Optimizing computation of overnight decline in delta power: Evidence for slower rate of decline in delta power in insomnia patients.

Journal article Clin Neurophysiol · February 2021 OBJECTIVE: To determine the best of commonly used methods for computing the rate of decline in non-rapid eye movement (NREM) sleep EEG delta power overnight (Delta Decline) in terms of vulnerability to missing data and to evaluate whether this rate is slow ... Full text Link to item Cite

Mutations in Metabotropic Glutamate Receptor 1 Contribute to Natural Short Sleep Trait.

Journal article Curr Biol · January 11, 2021 Sufficient and efficient sleep is crucial for our health. Natural short sleepers can sleep significantly shorter than the average population without a desire for more sleep and without any obvious negative health consequences. In searching for genetic vari ... Full text Link to item Cite

Blinding and bias in a hypnotic clinical trial.

Journal article Hum Psychopharmacol · January 2021 OBJECTIVES: Information is lacking regarding how commonly unblinding of treatment assignment occurs in hypnotic randomized clinic trials (RCTs). We now report the "best guesses" of clinical trial participants, versus study coordinators, versus study physic ... Full text Link to item Cite

Chronobiologic parameter changes in patients with major depressive disorder and sleep disturbance treated with adjunctive brexpiprazole: An open-label, flexible-dose, exploratory substudy.

Journal article J Affect Disord · January 1, 2021 BACKGROUND: Circadian rhythm disturbances have been reported in patients with major depressive disorder (MDD). Among these is an increased phase angle between peak cortisol concentration and dim-light melatonin onset (DLMO). The aim of this study was to ev ... Full text Link to item Cite

Distributed Subnetworks of Depression Defined by Direct Intracranial Neurophysiology.

Journal article Front Hum Neurosci · 2021 Major depressive disorder is a common and disabling disorder with high rates of treatment resistance. Evidence suggests it is characterized by distributed network dysfunction that may be variable across patients, challenging the identification of quantitat ... Full text Link to item Cite

Is cellular energy monitoring more responsive to hypoxia than pulse oximetry?

Journal article Sleep Breath · December 2020 PURPOSE: Pulse oximetry is the current standard for detecting drops in arterial blood oxygen saturation (SpO2) associated with obstructive sleep apnea and hypopnea events in polysomnographic (PSG) testing. However, cellular energy monitoring (CE monitoring ... Full text Link to item Cite

Content validity of a sleep numerical rating scale and a sleep diary in adults and adolescents with moderate-to-severe atopic dermatitis

Journal article Journal of Patient Reported Outcomes · December 1, 2020 Background: The intense itching associated with atopic dermatitis (AD) often causes patients to experience severe sleep disturbance. Here, we describe the results of a two-phase concept elicitation and cognitive interview study to establish the content val ... Full text Cite

Effectiveness of Sequential Psychological and Medication Therapies for Insomnia Disorder: A Randomized Clinical Trial.

Journal article JAMA Psychiatry · November 1, 2020 IMPORTANCE: Despite evidence of efficacious psychological and pharmacologic therapies for insomnia, there is little information about what first-line treatment should be and how best to proceed when initial treatment fails. OBJECTIVE: To evaluate the compa ... Full text Link to item Cite

Feasibility and Acceptability of Wearable Sleep Electroencephalogram Device Use in Adolescents: Observational Study.

Journal article JMIR Mhealth Uhealth · October 1, 2020 BACKGROUND: Adolescence is an important life stage for the development of healthy behaviors, which have a long-lasting impact on health across the lifespan. Sleep undergoes significant changes during adolescence and is linked to physical and psychiatric he ... Full text Link to item Cite

Selective kappa-opioid antagonism ameliorates anhedonic behavior: evidence from the Fast-fail Trial in Mood and Anxiety Spectrum Disorders (FAST-MAS).

Journal article Neuropsychopharmacology · September 2020 Anhedonia remains a major clinical issue for which there is few effective interventions. Untreated or poorly controlled anhedonia has been linked to worse disease course and increased suicidal behavior across disorders. Taking a proof-of-mechanism approach ... Full text Link to item Cite

An exploratory analysis of the association of circadian rhythm dysregulation and insomnia with suicidal ideation over the course of treatment in individuals with depression, insomnia, and suicidal ideation.

Journal article J Clin Sleep Med · August 15, 2020 STUDY OBJECTIVES: Sleep disturbance is significantly associated with suicidal ideation. However, the majority of past research has examined the relationship between insomnia and suicidality. The current exploratory study examined the relationship of circad ... Full text Link to item Cite

Omitted Conflict of Interest Disclosures.

Journal article JAMA Psychiatry · July 1, 2020 Full text Link to item Cite

Feasibility and Acceptability of Wearable Sleep Electroencephalogram Device Use in Adolescents: Observational Study (Preprint)

Journal article · May 25, 2020 BACKGROUNDAdolescence is an important life stage for the development of healthy behaviors, which have a long-lasting impact on health across the lifespan. Sleep undergoes significant chan ... Full text Cite

Efficacy of Digital Cognitive Behavioral Therapy for the Treatment of Insomnia Symptoms Among Pregnant Women: A Randomized Clinical Trial.

Journal article JAMA Psychiatry · May 1, 2020 IMPORTANCE: Despite the prevalence and adverse consequences of prenatal insomnia, a paucity of research is available regarding interventions to improve insomnia symptoms during pregnancy. OBJECTIVE: To test the efficacy of digital cognitive behavioral ther ... Full text Link to item Cite

A randomized proof-of-mechanism trial applying the 'fast-fail' approach to evaluating κ-opioid antagonism as a treatment for anhedonia.

Journal article Nat Med · May 2020 The National Institute of Mental Health (NIMH) 'fast-fail' approach seeks to improve too-often-misleading early-phase drug development methods by incorporating biomarker-based proof-of-mechanism (POM) testing in phase 2a. This first comprehensive applicati ... Full text Link to item Cite

142 Withdrawal Symptom Assessment in an Esketamine Safety Study in Patients with Treatment-resistant Depression.

Journal article CNS Spectr · April 2020 BACKGROUND: SUSTAIN-2 (NCT02497287) was an open-label, phase III trial evaluating the safety of esketamine (ESK) nasal spray plus a newly initiated oral antidepressant (AD) for up to 1 year in adults with treatment-resistant depression (TRD). ESK is a sche ... Full text Link to item Cite

Sleep therapeutics and neuropsychiatric illness.

Journal article Neuropsychopharmacology · January 2020 Alterations in sleep are extremely common in patients with neuropsychiatric illness. In addition, sleep disorders such as insomnia, obstructive sleep apnea, rapid eye movement sleep behavior disorder, and circadian rhythm disorders commonly occur at a rate ... Full text Link to item Cite

Genetics of the human circadian clock and sleep homeostat.

Journal article Neuropsychopharmacology · January 2020 Timing and duration of sleep are controlled by the circadian system, which keeps an ~24-h internal rhythm that entrains to environmental stimuli, and the sleep homeostat, which rises as a function of time awake. There is a normal distribution across the po ... Full text Link to item Cite

Pilot Study of An Intracranial Electroencephalography Biomarker of Depressive Symptoms in Epilepsy.

Journal article J Neuropsychiatry Clin Neurosci · 2020 OBJECTIVES: Adult patients with epilepsy have an increased prevalence of major depressive disorder (MDD). Intracranial EEG (iEEG) captured during extended inpatient monitoring of patients with treatment-resistant epilepsy offers a particularly promising me ... Full text Link to item Cite

Reducing Suicidal Ideation Through Insomnia Treatment (REST-IT): A Randomized Clinical Trial.

Journal article Am J Psychiatry · November 1, 2019 OBJECTIVE: The authors sought to determine whether targeted treatment of insomnia with controlled-release zolpidem (zolpidem-CR) in suicidal adults with insomnia would provide a reduction in suicidal ideation superior to placebo. METHODS: Reducing Suicidal ... Full text Link to item Cite

The assessment and management of insomnia: an update.

Journal article World Psychiatry · October 2019 Insomnia poses significant challenges to public health. It is a common condition associated with marked impairment in function and quality of life, psychiatric and physical morbidity, and accidents. As such, it is important that effective treatment is prov ... Full text Link to item Cite

A Rare Mutation of β1-Adrenergic Receptor Affects Sleep/Wake Behaviors.

Journal article Neuron · September 25, 2019 Sleep is crucial for our survival, and many diseases are linked to long-term poor sleep quality. Before we can use sleep to enhance our health and performance and alleviate diseases associated with poor sleep, a greater understanding of sleep regulation is ... Full text Link to item Cite

Sleep Pharmacogenetics: The Promise of Precision Medicine.

Journal article Sleep Med Clin · September 2019 Pharmacogenetics is the branch of personalized medicine concerned with the variability in drug response occurring because of heredity. Advances in genetics research, and decreasing costs of gene sequencing, are promoting tremendous growth in pharmacogeneti ... Full text Link to item Cite

Prevalence of obstructive sleep apnea in suicidal patients with major depressive disorder.

Journal article J Psychiatr Res · September 2019 In this paper, we report the rate of previously undiagnosed obstructive sleep apnea (OSA) in a randomized clinical trial (RCT) of suicidal patients with major depressive disorder (MDD). One hundred and twenty-five suicidal adults with MDD were recruited in ... Full text Link to item Cite

British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update.

Journal article J Psychopharmacol · August 2019 This British Association for Psychopharmacology guideline replaces the original version published in 2010, and contains updated information and recommendations. A consensus meeting was held in London in October 2017 attended by recognised experts and advoc ... Full text Link to item Cite

An Electrophysiological Biomarker That May Predict Treatment Response to ECT.

Journal article J ECT · June 2019 OBJECTIVE: Electroconvulsive therapy (ECT) is the most effective treatment for major depression but also carries risk of cognitive side effects. The ability to predict whether treatment will be effective before initiation of treatment could significantly i ... Full text Link to item Cite

Circadian Preference as a Moderator of Depression Outcome Following Cognitive Behavioral Therapy for Insomnia Plus Antidepressant Medications: A Report From the TRIAD Study.

Journal article J Clin Sleep Med · April 15, 2019 STUDY OBJECTIVES: We previously presented results from a randomized controlled trial that examined the effects of antidepressant medication plus cognitive behavioral therapy for insomnia (CBT-I) among patients with major depressive disorder (MDD) and insom ... Full text Link to item Cite

Orexin receptor antagonists for the treatment of insomnia and potential treatment of other neuropsychiatric indications.

Journal article J Sleep Res · April 2019 In this review, we outline the role of orexin receptor antagonists in disorders of sleep/wake and other potential neuropsychiatric conditions, with a focus on suvorexant, which is currently the only approved agent in this class. The efficacy of suvorexant ... Full text Link to item Cite

Solriamfetol for the Treatment of Excessive Sleepiness in OSA: A Placebo-Controlled Randomized Withdrawal Study.

Journal article Chest · February 2019 BACKGROUND: Excessive sleepiness (ES) is a common symptom of OSA, which often persists despite primary OSA therapy. This phase III randomized withdrawal trial evaluated solriamfetol (JZP-110) for the treatment of ES in adults with OSA. METHODS: After 2 wee ... Full text Link to item Cite

Longitudinal study of narcolepsy symptoms in first, second, and third-degree relatives of simplex and multiplex narcolepsy families.

Journal article Sleep Med · January 2019 OBJECTIVE: To assess the evolution of narcolepsy symptoms in first-, second, and third-degree relatives and to compare multiplex and simplex families. METHODS: A total of 4045 family members and 362 narcoleptic individuals were entered in the study; with 3 ... Full text Link to item Cite

Long-Term Trazodone Use and Cognition: A Potential Therapeutic Role for Slow-Wave Sleep Enhancers.

Journal article J Alzheimers Dis · 2019 BACKGROUND: Recent studies reveal an association between slow-wave sleep (SWS), amyloid-β aggregation, and cognition. OBJECTIVE: This retrospective study examines whether long-term use of trazodone, an SWS enhancer, is associated with delayed cognitive dec ... Full text Link to item Cite

A review of the associations between obstructive sleep apnea and hypertensive disorders of pregnancy and possible mechanisms of disease.

Journal article Sleep Med Rev · December 2018 Obesity is prevalent among pregnant women in the United States; 15-20% of obese pregnant women have obstructive sleep apnea. The prevalence of obstructive sleep apnea increases along with body mass index, age and in the presence of other co-morbidities. Un ... Full text Link to item Cite

Screening extremely obese pregnant women for obstructive sleep apnea.

Journal article Am J Obstet Gynecol · December 2018 BACKGROUND: Obesity is prevalent among pregnant women in the United States; obstructive sleep apnea is highly comorbid with obesity and is associated with adverse pregnancy outcomes. Screening for obstructive sleep apnea in pregnant women has remained a ch ... Full text Link to item Cite

Obstructive Sleep Apnea in Pregnant Women: A Review of Pregnancy Outcomes and an Approach to Management.

Journal article Anesth Analg · November 2018 Among obese pregnant women, 15%-20% have obstructive sleep apnea (OSA) and this prevalence increases along with body mass index and in the presence of other comorbidities. Prepregnancy obesity and pregnancy-related weight gain are certainly risk factors fo ... Full text Link to item Cite

Validating functional data analysis measures from 24-h actigraphy data

Journal article Biological Rhythm Research · September 3, 2018 The timing of sleep and wakefulness are under the influence of the circadian pacemaker in the suprachiasmatic nucleus, and the set-point for the circadian pacemaker is revealed by the time of onset of the secretion of melatonin under dim light conditions ( ... Full text Cite

An Ultra-miniaturized Near Infrared Spectroscopy System to Assess Sleep Apnea in Children with Down Syndrome.

Journal article Annu Int Conf IEEE Eng Med Biol Soc · July 2018 Down syndrome is one of the health disorders that interferes with regular and healthy sleep. Most children with Down syndrome are referred to a sleep clinic for the assessment of the severity of their apnea. Regular polysomnography based assessment of apne ... Full text Link to item Cite

Treating insomnia in depression: Insomnia related factors predict long-term depression trajectories.

Journal article J Consult Clin Psychol · March 2018 OBJECTIVE: Insomnia and major depressive disorders (MDD) often co-occur, and such comorbidity has been associated with poorer outcomes for both conditions. However, individual differences in depressive symptom trajectories during and after treatment are po ... Full text Link to item Cite

The relationship of person-specific eveningness chronotype, greater seasonality, and less rhythmicity to suicidal behavior: A literature review.

Journal article J Affect Disord · February 2018 BACKGROUND: Epidemiological data have demonstrated seasonal and circadian patterns of suicidal deaths. Several reviews and meta-analyses have confirmed the relationship between sleep disturbance and suicidality. However, these reviews/meta-analyses have no ... Full text Link to item Cite

In vitro evaluation of an injectable EEG/ECG sensor for wireless monitoring of hibernation in endangered animal species

Journal article IEEE Sensors Journal · January 15, 2018 Hibernation is a unique metabolic adaptation employed by several animal species for survival where its study would further enhance our understanding of metabolic disorders, such as diabetes and obesity. As a primate animal with close genetic ties to humans ... Full text Cite

Consensus Recommendations for the Clinical Application of Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Depression.

Journal article J Clin Psychiatry · 2018 OBJECTIVE: To provide expert recommendations for the safe and effective application of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depressive disorder (MDD). PARTICIPANTS: Participants included a group of 17 expert clinici ... Full text Link to item Cite

International randomized-controlled trial of transcranial Direct Current Stimulation in depression.

Journal article Brain Stimul · 2018 BACKGROUND: Evidence suggests that transcranial Direct Current Stimulation (tDCS) has antidepressant effects in unipolar depression, but there is limited information for patients with bipolar depression. Additionally, prior research suggests that brain der ... Full text Link to item Cite

Dr McClintock and Colleagues Reply.

Journal article J Clin Psychiatry · 2018 Full text Link to item Cite

Phase II Proof-of-Concept Trial of the Orexin Receptor Antagonist Filorexant (MK-6096) in Patients with Major Depressive Disorder.

Journal article Int J Neuropsychopharmacol · August 1, 2017 BACKGROUND: We evaluated the orexin receptor antagonist filorexant (MK-6096) for treatment augmentation in patients with major depressive disorder. METHODS: We conducted a 6-week, double-blind, placebo-controlled, parallel-group, Phase II, proof-of-concept ... Full text Link to item Cite

Pilot prospective study of post-surgery sleep and EEG predictors of post-operative delirium.

Journal article Clin Neurophysiol · August 2017 OBJECTIVE: Delirium is a common post-operative complication associated with significant costs, morbidity, and mortality. We sought sleep/EEG predictors of delirium present prior to delirium symptoms to facilitate developing and targeting therapies. METHODS ... Full text Link to item Cite

Segmented sleep in a nonelectric, small-scale agricultural society in Madagascar.

Journal article Am J Hum Biol · July 8, 2017 OBJECTIVES: We studied sleep in a rural population in Madagascar to (i) characterize sleep in an equatorial small-scale agricultural population without electricity, (ii) assess whether sleep is linked to noise levels in a dense population, and (iii) examin ... Full text Link to item Cite

Suvorexant in Elderly Patients with Insomnia: Pooled Analyses of Data from Phase III Randomized Controlled Clinical Trials.

Journal article Am J Geriatr Psychiatry · July 2017 OBJECTIVE: Suvorexant is an orexin receptor antagonist approved for treating insomnia at doses of 10-20 mg. Previously reported phase III results showed that suvorexant was effective and well-tolerated in a combined-age population (elderly and nonelderly a ... Full text Link to item Cite

Adverse Effects of Hypnotic Medications.

Journal article J Clin Sleep Med · June 15, 2017 Full text Link to item Cite

A randomised trial of peri-operative positive airway pressure for postoperative delirium in patients at risk for obstructive sleep apnoea after regional anaesthesia with sedation or general anaesthesia for joint arthroplasty.

Journal article Anaesthesia · June 2017 Previous pilot work has established an association between obstructive sleep apnoea and the development of acute postoperative delirium , but it remains unclear to what extent this risk factor is modifiable in the 'real world' peri-operative setting. In a ... Full text Link to item Cite

Clinical profile of suvorexant for the treatment of insomnia over 3 months in women and men: subgroup analysis of pooled phase-3 data.

Journal article Psychopharmacology (Berl) · June 2017 RATIONALE: Sex-related differences in the clinical profiles of some insomnia medications have been previously reported. OBJECTIVE: To evaluate the clinical profile of suvorexant, a novel orexin receptor antagonist approved for treating insomnia at doses up ... Full text Link to item Cite

Cognitive Behavioral Insomnia Therapy for Those With Insomnia and Depression: A Randomized Controlled Clinical Trial.

Journal article Sleep · April 1, 2017 STUDY OBJECTIVE: To compare cognitive behavioral therapy for insomnia (CBT-I) + antidepressant medication (AD) against treatments that target solely depression or solely insomnia. DESIGN: A blinded, randomized split-plot experimental study. SETTING: Two ur ... Full text Link to item Cite

Are Patients with Childhood Onset of Insomnia and Depression More Difficult to Treat Than Are Those with Adult Onsets of These Disorders? A Report from the TRIAD Study.

Journal article J Clin Sleep Med · February 15, 2017 STUDY OBJECTIVES: To determine if patients with childhood onsets (CO) of both major depression and insomnia disorder show blunted depression and insomnia treatment responses to concurrent interventions for both disorders compared to those with adult onsets ... Full text Link to item Cite

Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline.

Journal article J Clin Sleep Med · February 15, 2017 INTRODUCTION: The purpose of this guideline is to establish clinical practice recommendations for the pharmacologic treatment of chronic insomnia in adults, when such treatment is clinically indicated. Unlike previous meta-analyses, which focused on broad ... Full text Link to item Cite

National Sleep Foundation's sleep quality recommendations: first report.

Journal article Sleep Health · February 2017 OBJECTIVES: To provide evidence-based recommendations and guidance to the public regarding indicators of good sleep quality across the life-span. METHODS: The National Sleep Foundation assembled a panel of experts from the sleep community and representativ ... Full text Link to item Cite

Hypnotic Medications and Suicide: Risk, Mechanisms, Mitigation, and the FDA.

Journal article Am J Psychiatry · January 1, 2017 OBJECTIVE: Insomnia is associated with increased risk for suicide. The Food and Drug Administration (FDA) has mandated that warnings regarding suicide be included in the prescribing information for hypnotic medications. The authors conducted a review of th ... Full text Link to item Cite

Insomnia Patients With Objective Short Sleep Duration Have a Blunted Response to Cognitive Behavioral Therapy for Insomnia.

Journal article Sleep · January 1, 2017 STUDY OBJECTIVES: This study examined whether individuals with insomnia and objective short sleep duration <6 h, a subgroup with greater risks of adverse health outcomes, differ in their response to cognitive-behavioral therapy for insomnia (CBT-I) when co ... Full text Link to item Cite

Double-Blind, Placebo-Controlled, Crossover Study of Armodafinil Treatment of Daytime Sleepiness Associated With Treated Nocturia.

Journal article Sleep · January 1, 2017 STUDY OBJECTIVES: Nocturia, voids which disturb sleep, is the most common cause of awakenings and is associated with daytime sleepiness. Because the standard treatments for the most common causes of nocturia are relatively ineffective, many treated patient ... Full text Link to item Cite

Sleep disturbances in adolescents with ADHD: A systematic review and framework for future research.

Journal article Clin Psychol Rev · December 2016 BACKGROUND: Biological mechanisms underlying symptom and prognostic heterogeneity in Attention-Deficit/Hyperactivity Disorder (ADHD) are unclear. Sleep impacts neurocognition and daytime functioning and is disrupted in ADHD, yet little is known about sleep ... Full text Link to item Cite

Sleep and Mood: Chicken or Egg?

Journal article Biol Psychiatry · December 1, 2016 Full text Link to item Cite

Sleep Medications and Women: a Review of Issues to Consider for Optimizing the Care of Women with Sleep Disorders

Journal article Current Sleep Medicine Reports · December 1, 2016 Certain medications exhibit sex-specific pharmacological profiles. It is, therefore, imperative to understand their unique pharmacokinetic properties to optimize women’s health. Two such medications that are commonly used in sleep medicine are zolpidem and ... Full text Cite

Adjunctive 5-Hydroxytryptophan Slow-Release for Treatment-Resistant Depression: Clinical and Preclinical Rationale.

Journal article Trends Pharmacol Sci · November 2016 Serotonin transporter (SERT) inhibitors treat depression by elevating brain extracellular 5-hydroxytryptamine (5-HTExt). However, only one-third of patients respond adequately. Treatment-resistant depression (TRD) is a major unmet need. Interestingly, elev ... Full text Link to item Cite

Kappa-Opioid Antagonists for Psychiatric Disorders: From Bench to Clinical Trials.

Journal article Depress Anxiety · October 2016 Kappa-opioid receptor (KOR) antagonists are currently being considered for the treatment of a variety of neuropsychiatric conditions, including depressive, anxiety, and substance abuse disorders. A general ability to mitigate the effects of stress, which c ... Full text Link to item Cite

Suvorexant in Patients with Insomnia: Pooled Analyses of Three-Month Data from Phase-3 Randomized Controlled Clinical Trials.

Journal article J Clin Sleep Med · September 15, 2016 STUDY OBJECTIVES: Suvorexant is an orexin receptor antagonist approved for treating insomnia at a maximum dose of 20 mg. Phase-3 trials evaluated two age-adjusted (non-elderly/elderly) dose-regimes of 40/30 mg and 20/15 mg with the primary focus on 40/30 m ... Full text Link to item Cite

Insomnia Patients with Objective Short Sleep Duration have a Blunted Response to Cognitive Behavioral Therapy for Insomnia.

Journal article Sleep · September 9, 2016 STUDY OBJECTIVES: This study examined whether individuals with insomnia and objective short sleep duration <6h, a subgroup with greater risks of adverse health outcomes, differ in their response to cognitive behavioral therapy for insomnia (CBT-I) when com ... Link to item Cite

DOUBLE-BLIND, PLACEBO-CONTROLLED, CROSS-OVER, STUDY OF ARMODAFINIL TREATMENT OF DAYTIME SLEEPINESS ASSOCIATED WITH TREATED NOCTURIA.

Journal article Sleep · September 9, 2016 STUDY OBJECTIVES: Nocturia, voids which disturb sleep, is the most common cause of awakenings and is associated with daytime sleepiness. Because the standard treatments for the most common causes of nocturia are relatively ineffective, many treated patient ... Link to item Cite

Effects of Adjunctive Brexpiprazole on Sleep Disturbances in Patients With Major Depressive Disorder: An Open-Label, Flexible-Dose, Exploratory Study.

Journal article Prim Care Companion CNS Disord · September 8, 2016 BACKGROUND: Brexpiprazole is a serotonin-dopamine activity modulator. We evaluated the effects of adjunctive treatment with brexpiprazole on sleep disturbances in patients with DSM-IV-TR major depressive disorder (MDD) and inadequate response to antidepres ... Full text Link to item Cite

Hibernation in a primate: does sleep occur?

Journal article R Soc Open Sci · August 2016 During hibernation, critical physiological processes are downregulated and thermogenically induced arousals are presumably needed periodically to fulfil those physiological demands. Among the processes incompatible with a hypome tabolic state is sleep. How ... Full text Link to item Cite

Objective but Not Subjective Short Sleep Duration Associated with Increased Risk for Hypertension in Individuals with Insomnia.

Journal article Sleep · May 1, 2016 STUDY OBJECTIVES: To examine the relationship between hypertension prevalence in individuals with insomnia who have short total sleep duration < 6 h or sleep duration ≥ 6 h, using both objective and subjective measures of total sleep duration. METHODS: Usi ... Full text Link to item Cite

The sleep effects of lurasidone: a placebo-controlled cross-over study using a 4-h phase-advance model of transient insomnia.

Journal article Hum Psychopharmacol · May 2016 BACKGROUND: Lurasidone, an atypical antipsychotic, is a potent 5-HT7 antagonist and D2 , 5-HT2A antagonist, and 5-HT1A partial agonist. As such, lurasidone would be expected to modulate sleep and circadian function but there have been no human studies of t ... Full text Link to item Cite

Sleep disturbance in chronic military-related PTSD: clinical impact and response to adjunctive risperidone in the Veterans Affairs cooperative study #504.

Journal article J Clin Psychiatry · April 2016 OBJECTIVE: Sleep disturbances are common among veterans with chronic military-related posttraumatic stress disorder (PTSD). This article reports the results of a multicenter clinical trial that explored the clinical correlates of reported sleep impairment ... Full text Link to item Cite

Recognizing and managing insomnia in primary care and specialty settings.

Journal article J Clin Psychiatry · April 2016 Insomnia is a common feature of both medical and psychiatric disorders. Whether as a symptom of an illness or as a comorbid disorder, insomnia worsens patient outcomes related to quality of life, functioning, workplace productivity, and health care expendi ... Full text Link to item Cite

Sequential psychological and pharmacological therapies for comorbid and primary insomnia: study protocol for a randomized controlled trial.

Journal article Trials · March 3, 2016 BACKGROUND: Chronic insomnia is a prevalent disorder associated with significant psychosocial, health, and economic impacts. Cognitive behavioral therapies (CBTs) and benzodiazepine receptor agonist (BzRA) medications are the most widely supported therapeu ... Full text Open Access Link to item Cite

Suvorexant in Patients With Insomnia: Results From Two 3-Month Randomized Controlled Clinical Trials.

Journal article Biol Psychiatry · January 15, 2016 BACKGROUND: Suvorexant is an orexin receptor antagonist for treatment of insomnia. We report results from two pivotal phase 3 trials. METHODS: Two randomized, double-blind, placebo-controlled, parallel-group, 3-month trials in nonelderly (18-64 years) and ... Full text Link to item Cite

Shining evolutionary light on human sleep and sleep disorders.

Journal article Evol Med Public Health · 2016 Sleep is essential to cognitive function and health in humans, yet the ultimate reasons for sleep-i.e. 'why' sleep evolved-remain mysterious. We integrate findings from human sleep studies, the ethnographic record, and the ecology and evolution of mammalia ... Full text Link to item Cite

New Developments in Insomnia Medications of Relevance to Mental Health Disorders.

Journal article Psychiatr Clin North Am · December 2015 Many insomnia medications with high specificity have become available recently. They provide a window into the clinical effects of modulating specific brain systems and establish a new guiding principal for conceptualizing insomnia medications: "mechanism ... Full text Link to item Cite

Insomnia disorder.

Journal article Nat Rev Dis Primers · September 3, 2015 Insomnia disorder affects a large proportion of the population on a situational, recurrent or chronic basis and is among the most common complaints in medical practice. The disorder is predominantly characterized by dissatisfaction with sleep duration or q ... Full text Link to item Cite

Individualized Low-Amplitude Seizure Therapy: Minimizing Current for Electroconvulsive Therapy and Magnetic Seizure Therapy.

Journal article Neuropsychopharmacology · August 2015 Electroconvulsive therapy (ECT) at conventional current amplitudes (800-900 mA) is highly effective but carries the risk of cognitive side effects. Lowering and individualizing the current amplitude may reduce side effects by virtue of a less intense and m ... Full text Link to item Cite

Current, emerging, and newly available insomnia medications.

Journal article J Clin Psychiatry · August 2015 Research into the sleep-wake cycle has provided new treatment targets for patients with insomnia as well as a better understanding of how medications affect sleep processes. Current insomnia medications, including benzodiazepines and nonbenzodiazepines, fo ... Full text Link to item Cite

Esmirtazapine in non-elderly adult patients with primary insomnia: efficacy and safety from a randomized, 6-week sleep laboratory trial.

Journal article Sleep Med · July 2015 OBJECTIVE: Esmirtazapine (Org 50081), a medication that binds with high affinity to serotonin 5-HT2A and histamine-1 receptors, was evaluated as a potential treatment for insomnia. METHODS: Adults with primary insomnia were treated with esmirtazapine (3.0 ... Full text Link to item Cite

A multi-site randomized clinical trial to reduce suicidal ideation in suicidal adult outpatients with Major Depressive Disorder: Development of a methodology to enhance safety.

Journal article Clin Trials · June 2015 BACKGROUND/AIMS: Suicide is a major public health concern, yet there are very few randomized clinical trials that have been conducted to reduce suicidal ideation in patients at risk of suicide. We describe the rationale and refinements of such a trial that ... Full text Link to item Cite

Lessons learned and potentials for improvement in cns drug development: Isctm section on designing the right series of experiments

Journal article Innovations in Clinical Neuroscience · March 1, 2015 Once a molecule has been characterized as engaging an identified target at the appropriate location (affinity and potency), the next step involves designing experiments that will determine its pharmacodynamic activities both for efficacy (on target) and sa ... Cite

Traumatic brain injury detection using electrophysiological methods

Journal article Frontiers in Human Neuroscience · February 4, 2015 Measuring neuronal activity with electrophysiological methods may be useful in detecting neurological dysfunctions, such as mild traumatic brain injury (mTBI).This approach may be particularly valuable for rapid detection in at-risk populations including m ... Full text Cite

Efficacy and Safety of Low-field Synchronized Transcranial Magnetic Stimulation (sTMS) for Treatment of Major Depression.

Journal article Brain Stimul · 2015 BACKGROUND: Transcranial Magnetic Stimulation (TMS) customarily uses high-field electromagnets to achieve therapeutic efficacy in Major Depressive Disorder (MDD). Low-field magnetic stimulation also may be useful for treatment of MDD, with fewer treatment- ... Full text Link to item Cite

The impact of eszopiclone on sleep and cognition in patients with schizophrenia and insomnia: a double-blind, randomized, placebo-controlled trial.

Journal article Schizophr Res · December 2014 BACKGROUND: Insomnia is frequent in schizophrenia and may contribute to cognitive impairment as well as overuse of weight inducing sedative antipsychotics. We investigated the effects of eszopiclone on sleep and cognition for patients with schizophrenia-re ... Full text Link to item Cite

Methodological approaches and magnitude of the clinical unmet need associated with amotivation in mood disorders.

Journal article J Affect Disord · October 2014 BACKGROUND: There is growing research interest in studying motivational deficits in different neuropsychiatric disorders because these symptoms appear to be more common than originally reported and negatively impact long-term functional outcomes. However, ... Full text Link to item Cite

Multifactorial determinants of the neurocognitive effects of electroconvulsive therapy.

Journal article J ECT · June 2014 For many patients with neuropsychiatric illnesses, standard psychiatric treatments with mono or combination pharmacotherapy, psychotherapy, and transcranial magnetic stimulation are ineffective. For these patients with treatment-resistant neuropsychiatric ... Full text Open Access Link to item Cite

A randomized, double-blind, placebo-controlled trial of eszopiclone for the treatment of insomnia in patients with chronic low back pain.

Journal article Sleep · June 1, 2014 STUDY OBJECTIVES: Insomnia, which is very common in patients with chronic low back pain (LBP), has long been viewed as a pain symptom that did not merit specific treatment. Recent data suggest that adding insomnia therapy to pain-targeted treatment should ... Full text Link to item Cite

The sleep effects of tiagabine on the first night of treatment predict post-traumatic stress disorder response at three weeks.

Journal article J Psychopharmacol · May 2014 INTRODUCTION: We sought to test the hypothesis that improvements in sleep might mediate treatment-related improvements in daytime symptoms of post-traumatic stress disorder (PTSD). We evaluated whether changes in sleep occurring on the first night of tiaga ... Full text Open Access Link to item Cite

Safety and efficacy of suvorexant during 1-year treatment of insomnia with subsequent abrupt treatment discontinuation: a phase 3 randomised, double-blind, placebo-controlled trial.

Journal article Lancet Neurol · May 2014 BACKGROUND: Suvorexant (MK-4305) is an orexin receptor antagonist shown to be efficacious for insomnia over 3 months. We aimed to assess its clinical profile during and after 1 year of treatment. METHODS: We did a randomised, placebo-controlled, parallel-g ... Full text Link to item Cite

Obstructive sleep apnea and delirium: exploring possible mechanisms.

Journal article Sleep Breath · March 2014 INTRODUCTION: Obstructive sleep apnea (OSA) is a medical disorder strongly associated with multiple comorbidities and postoperative complications. Current evidence suggests that OSA disturbs fundamental biochemical processes, leading to low-grade systemic ... Full text Link to item Cite

Effect of armodafinil on cortical activity and working memory in patients with residual excessive sleepiness associated with CPAP-Treated OSA: a multicenter fMRI study.

Journal article J Clin Sleep Med · February 15, 2014 STUDY OBJECTIVE: To assess the effect of armodafinil on task-related prefrontal cortex activation using functional magnetic resonance imaging (fMRI) in patients with obstructive sleep apnea (OSA) and excessive sleepiness despite continuous positive airway ... Full text Link to item Cite

Therapeutic approaches for shankopathies.

Journal article Dev Neurobiol · February 2014 Despite recent advances in understanding the molecular mechanisms of autism spectrum disorders (ASD), the current treatments for these disorders are mostly focused on behavioral and educational approaches. The considerable clinical and molecular heterogene ... Full text Link to item Cite

Insomnia in HIV-infected patients: pathophysiologic implications.

Journal article AIDS Rev · 2014 The prevalence of insomnia in the HIV-seropositive population is estimated to be 29-97%, far greater than the 10% general population prevalence. We carried out a systematic review to assess whether the prevalence of insomnia is indeed higher in HIV-seropos ... Link to item Cite

Optimizing the Pharmacologic Treatment of Insomnia: Current Status and Future Horizons.

Journal article Sleep Med Clin · September 1, 2013 A number of medications are available for treating patients with insomnia. These medications include agents approved as insomnia therapies by the U.S. Food and Drug Administration (FDA), agents approved by the FDA for another condition that are used "off-l ... Full text Link to item Cite

Review of the histamine system and the clinical effects of H1 antagonists: basis for a new model for understanding the effects of insomnia medications.

Journal article Sleep Med Rev · August 2013 The pharmacologic management of insomnia has long been dominated by agents that facilitate gamma amino butyric acid inhibition. These agents have served as the clinical model for understanding the pharmacodynamic effects of insomnia agents according to whi ... Full text Link to item Cite

Does physiological hyperarousal enhance error rates among insomnia sufferers?

Journal article Sleep · August 1, 2013 OBJECTIVE: To examine the association between physiological hyperarousal and response accuracy on reaction time tasks among individuals with insomnia. DESIGN AND SETTING: This study was conducted at affiliated Veterans Administration (VA) and academic medi ... Full text Link to item Cite

Comparison of diary-derived bladder and sleep measurements across OAB individuals, primary insomniacs, and healthy controls.

Journal article Int Urogynecol J · March 2013 INTRODUCTION AND HYPOTHESIS: Can diary-derived bladder and sleep measurements differentiate individuals with overactive bladder syndrome (OAB) from individuals with primary insomnia and healthy controls? METHODS: Bladder- and sleep-diary data were compared ... Full text Link to item Cite

Novel sublingual low-dose zolpidem tablet reduces latency to sleep onset following spontaneous middle-of-the-night awakening in insomnia in a randomized, double-blind, placebo-controlled, outpatient study.

Journal article Sleep · February 1, 2013 STUDY OBJECTIVES: To evaluate efficacy and safety of 3.5-mg zolpidem tartrate sublingual tablets (ZST) on latency to sleep onset after middle-of-the-night (MOTN) awakenings in patients with insomnia characterized by difficulty returning to sleep after MOTN ... Full text Link to item Cite

Left dorsolateral prefrontal transcranial magnetic stimulation (TMS): sleep factor changes during treatment in patients with pharmacoresistant major depressive disorder.

Journal article Psychiatry Res · January 30, 2013 As they alleviate major depressive disorder, antidepressant therapies may improve associated sleep disturbances, but may also have inherent sedating or activating properties. We examined sleep changes during a multicenter, sham-controlled, trial of transcr ... Full text Link to item Cite

The relationship of sleep with temperature and metabolic rate in a hibernating primate.

Journal article PLoS One · 2013 STUDY OBJECTIVES: It has long been suspected that sleep is important for regulating body temperature and metabolic-rate. Hibernation, a state of acute hypothermia and reduced metabolic-rate, offers a promising system for investigating those relationships. ... Full text Open Access Link to item Cite

Comparison of polysomnographic data in age-, sex- and Axis I psychiatric diagnosis matched HIV-seropositive and HIV-seronegative insomnia patients.

Journal article Clin Neurophysiol · December 2012 OBJECTIVE: There is a high prevalence of insomnia in HIV-seropositive patients. Insomnia is associated with poorer disease outcomes, cognitive impairment and HIV-associated dementia. However there is limited data characterizing the type of sleep disturbanc ... Full text Link to item Cite

Sleep in Mood Disorders

Journal article · December 1, 2012 Full text Cite

Psychiatric disorders and sleep.

Journal article Neurol Clin · November 2012 There is growing experimental evidence that the relationship between psychiatric disorders and sleep is complex and includes bidirectional causation. This article provides the evidence that supports this point of view, reviewing data on sleep disturbances ... Full text Link to item Cite

Shift work disorder case studies: applying management principles in clinical practice.

Journal article J Clin Psychiatry · August 2012 Shift work disorder (SWD) is a circadian rhythm sleep disorder characterized by insomnia and excessive sleepiness. SWD, which is estimated to affect 10% of people who work night or rotating shifts, can have serious consequences such as accidents, loss of p ... Full text Link to item Cite

A WASO sub-group analysis of a 6-month study of eszopiclone 3 mg.

Journal article Sleep Med · June 2012 BACKGROUND: Insomnia marked by sleep maintenance difficulty is extremely prevalent. Yet, problems staying asleep have been relatively neglected as a research focus compared to problems falling asleep. Insomnia treatment studies typically have not required ... Full text Link to item Cite

Prevalence and comorbidity of nocturnal wandering in the U.S. adult general population.

Journal article Neurology · May 15, 2012 OBJECTIVE: To assess the prevalence and comorbid conditions of nocturnal wandering with abnormal state of consciousness (NW) in the American general population. METHODS: Cross-sectional study conducted with a representative sample of 19,136 noninstitutiona ... Full text Link to item Cite

Obstructive sleep apnea and incidence of postoperative delirium after elective knee replacement in the nondemented elderly.

Journal article Anesthesiology · April 2012 BACKGROUND: Postoperative delirium, a common complication in the elderly, can occur following any type of surgery and is associated with increased morbidity and mortality; it may also be associated with subsequent cognitive problems. Effective therapy for ... Full text Link to item Cite

How the circadian rhythm affects sleep, wakefulness, and overall health: background for understanding shift work disorder.

Journal article J Clin Psychiatry · February 2012 It is estimated that 15 to 25% of the U.S. labor force works night, evening, or rotating shifts. These non-traditional schedules can affect the circadian rhythm, a self-sustained rhythm of biological processes that plays an important role in modulating sle ... Full text Link to item Cite

The consensus sleep diary: standardizing prospective sleep self-monitoring.

Journal article Sleep · February 1, 2012 STUDY OBJECTIVES: To present an expert consensus, standardized, patient-informed sleep diary. METHODS AND RESULTS: Sleep diaries from the original expert panel of 25 attendees of the Pittsburgh Assessment Conference(1) were collected and reviewed. A smalle ... Full text Link to item Cite

Loop diuretics have anxiolytic effects in rat models of conditioned anxiety.

Journal article PLoS One · 2012 A number of antiepileptic medications that modulate GABA(A) mediated synaptic transmission are anxiolytic. The loop diuretics furosemide (Lasix) and bumetanide (Bumex) are thought to have antiepileptic properties. These drugs also modulate GABA(A) mediated ... Full text Link to item Cite

REM sleep bout duration and frequency in PTSD

Journal article Journal of Aggression Maltreatment and Trauma · January 1, 2012 The few pharmacological treatments shown to be effective in reducing sleep disturbance in posttraumatic stress disorder (PTSD) might work through normalization of rapid eye movement (REM). However, evidence of REM sleep disturbance in PTSD has been inconsi ... Full text Cite

Eszopiclone treatment for insomnia: effect size comparisons in patients with primary insomnia and insomnia with medical and psychiatric comorbidity.

Journal article Prim Care Companion CNS Disord · 2012 OBJECTIVE: The purpose of this post hoc analysis was to compare the treatment effect size of eszopiclone 3 mg for insomnia in patients with a diagnosis of primary insomnia and in several of the psychiatric and medical conditions that are most commonly como ... Full text Link to item Cite

Insomnia is frequent in schizophrenia and associated with night eating and obesity.

Journal article Schizophr Res · December 2011 BACKGROUND: Sleep difficulties are common in schizophrenia, however these complaints are often overshadowed by more prominent clinical concerns. The point prevalence of insomnia in this population is not well documented. Poor sleep is associated with lower ... Full text Link to item Cite

The association of fatigue with depression and insomnia in HIV-seropositive patients: a pilot study.

Journal article Sleep · December 1, 2011 OBJECTIVE: Fatigue is a pervasive symptom associated with HIV, resulting in significant functioning impairment; but little is known about its etiology or treatment. In patients with primary insomnia, data have shown improvement in fatigue following success ... Full text Link to item Cite

Repetitive transcranial magnetic stimulation of the superior frontal gyrus modulates craving for cigarettes.

Journal article Biol Psychiatry · October 15, 2011 BACKGROUND: Previous functional magnetic resonance imaging studies have shown strong correlations between cue-elicited craving for cigarettes and activation of the superior frontal gyrus (SFG). Repetitive transcranial magnetic stimulation (rTMS) offers a n ... Full text Link to item Cite

Testing the reliability and validity of DSM-IV-TR and ICSD-2 insomnia diagnoses. Results of a multitrait-multimethod analysis.

Journal article Arch Gen Psychiatry · October 2011 CONTEXT: Distinctive diagnostic classification schemes for insomnia diagnoses are available, but the optimal insomnia nosology has yet to be determined. OBJECTIVES: To test the reliability and validity of insomnia diagnoses listed in the American Psychiatr ... Full text Link to item Cite

Efficacy and safety of doxepin 3 and 6 mg in a 35-day sleep laboratory trial in adults with chronic primary insomnia.

Journal article Sleep · October 1, 2011 STUDY OBJECTIVES: To evaluate the efficacy and safety of doxepin (DXP) 3 mg and 6 mg in adults diagnosed with primary insomnia. DESIGN AND METHODS: The study was a randomized, double-blind, parallel-group, placebo-controlled trial. Patients meeting DSM-IV- ... Full text Link to item Cite

Should we be anxious when assessing anxiety using the Beck Anxiety Inventory in clinical insomnia patients?

Journal article J Psychiatr Res · September 2011 Assessing for clinical levels of anxiety is crucial, as comorbid insomnias far outnumber primary insomnias (PI). Such assessment is complex since those with Anxiety Disorders (AD) and those with PI have overlapping symptoms. Because of this overlap, we nee ... Full text Link to item Cite

Recognition and assessment of shift work disorder.

Journal article J Clin Psychiatry · February 2011 Full text Link to item Cite

Pharmacological advances in the treatment of insomnia.

Journal article Curr Pharm Des · 2011 Insomnia is a highly prevalent condition, and due to ongoing demand from patients suffering with this condition, new pharmacological treatments are actively being sought. As our neurophysiological understanding of insomnia grows, so too do the available tr ... Full text Link to item Cite

Antidepressant and Antipsychotic Drugs.

Journal article Sleep Med Clin · December 1, 2010 Full text Link to item Cite

British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders.

Journal article J Psychopharmacol · November 2010 Sleep disorders are common in the general population and even more so in clinical practice, yet are relatively poorly understood by doctors and other health care practitioners. These British Association for Psychopharmacology guidelines are designed to add ... Full text Link to item Cite

Efficacy and Safety of Doxepin 1 mg and 3 mg in a 12-week Sleep Laboratory and Outpatient Trial of Elderly Subjects with Chronic Primary Insomnia.

Journal article Sleep · November 2010 STUDY OBJECTIVES: to evaluate the efficacy and safety of doxepin 1 mg and 3 mg in elderly subjects with chronic primary insomnia. DESIGN AND METHODS: the study was a randomized, double-blind, parallel-group, placebo-controlled trial. Subjects meeting DSM-I ... Full text Link to item Cite

Sleep-wake functioning along the cancer continuum: focus group results from the Patient-Reported Outcomes Measurement Information System (PROMIS(®)).

Journal article Psychooncology · October 2010 OBJECTIVE: Cancer and its treatments disturb sleep-wake functioning; however, there is little information available on the characteristics and consequences of sleep problems associated with cancer. As part of an effort to improve measurement of sleep-wake ... Full text Link to item Cite

Durability of clinical benefit with transcranial magnetic stimulation (TMS) in the treatment of pharmacoresistant major depression: assessment of relapse during a 6-month, multisite, open-label study.

Journal article Brain Stimul · October 2010 BACKGROUND: Although transcranial magnetic stimulation (TMS) can be an effective acute antidepressant treatment, few studies systematically examine persistence of benefit. OBJECTIVE: We assessed the durability of antidepressant effect after acute response ... Full text Link to item Cite

The effect of vestibular stimulation in a four-hour sleep phase advance model of transient insomnia.

Journal article J Clin Sleep Med · August 15, 2010 STUDY OBJECTIVES: To determine if vestibular stimulation is an effective therapy for transient insomnia in a sleep phase advance model. DESIGN: Multi-site, double-blind, randomized, parallel-group, sham-controlled trial SETTING: This study was carried out ... Link to item Cite

Treatment of insomnia in depressed insomniacs: effects on health-related quality of life, objective and self-reported sleep, and depression.

Journal article J Clin Sleep Med · August 15, 2010 STUDY OBJECTIVES: Insomnia is associated with poor health related quality of life (HRQOL) in depressed patients. Prior clinical trials of hypnotic treatment of insomnia in depressed patients have shown improvement in HRQOL, but in these studies HRQOL was r ... Link to item Cite

Detrusor overactivity persisting at night and preceding nocturia in patients with overactive bladder syndrome: a nocturnal cystometrogram and polysomnogram study.

Journal article J Urol · August 2010 PURPOSE: Nocturia, a common symptom of overactive bladder syndrome, is associated with substantial adverse consequences and yet its pathophysiology has hardly been studied and the capacity to treat it remains limited. We established methods to study the ph ... Full text Link to item Cite

Sleep EEG predictors and correlates of the response to cognitive behavioral therapy for insomnia.

Journal article Sleep · May 2010 STUDY OBJECTIVES: Determine the relationship of non-rapid eye movement (NREM) electroencephalographic (EEG) spectral measures and the response to cognitive behavioral therapy (CBT) in primary insomnia (PI). DESIGN: Patients with PI were randomly assigned t ... Full text Link to item Cite

Using difficulty resuming sleep to define nocturnal awakenings.

Journal article Sleep Med · March 2010 OBJECTIVE: Nocturnal awakenings are one of the most prevalent sleep disturbances in the general population. Little is known, however, about the frequency of these episodes and how difficulty resuming sleep once awakened affects subjective sleep quality and ... Full text Link to item Cite

A 12-week, randomized, double-blind, placebo-controlled study evaluating the effect of eszopiclone 2 mg on sleep/wake function in older adults with primary and comorbid insomnia.

Journal article Sleep · February 2010 BACKGROUND: Longer-term pharmacologic studies for insomnia in older individuals are sparse. OBJECTIVE: To evaluate the efficacy and safety of 12 weeks of nightly eszopiclone in elderly outpatients with insomnia. METHODS: Participants (65-85 years) met DSM- ... Full text Link to item Cite

Insomnia: A health care (gap that is growing)

Journal article Psychiatric Times · January 1, 2010 Insomnia is a highly prevalent and costly condition. It is underdiagnosed and many patients remain untreated. All patients should be asked about their sleep-related health. If the patient has sleep difficulties accompanied by impairment in physical or cogn ... Cite

A double-blind, placebo-controlled study of armodafinil for excessive sleepiness in patients with treated obstructive sleep apnea and comorbid depression.

Journal article J Clin Psychiatry · January 2010 OBJECTIVE: Treatment of excessive sleepiness in the context of obstructive sleep apnea (OSA) may be particularly difficult in those with depression because depression and/or antidepressant medications may cause sleepiness and fatigue in addition to that du ... Full text Link to item Cite

The treatment of primary insomnia.

Journal article CNS Spectr · December 2009 Full text Link to item Cite

A compendium of placebo-controlled trials of the risks/benefits of pharmacological treatments for insomnia: the empirical basis for U.S. clinical practice.

Journal article Sleep Med Rev · August 2009 For many years practitioners have had limited data from double-blind, placebo-controlled studies to guide the types of decision-making needed to optimally manage patients with insomnia in clinical practice. However, in recent years there has been a great i ... Full text Link to item Cite

The pharmacologic management of insomnia in patients with HIV.

Journal article J Clin Sleep Med · June 15, 2009 Insomnia is common in human immunodeficiency virus (HIV) seropositive populations. Some studies have estimated as many as 70% of HIV patients experience insomnia at some point during their illness. Insomnia has been linked to reduced quality of life as wel ... Link to item Cite

Assessing depression symptoms in those with insomnia: an examination of the beck depression inventory second edition (BDI-II).

Journal article J Psychiatr Res · February 2009 BACKGROUND: Due to concerns about overlapping symptomatology between medical conditions and depression, the validity of the beck depression inventory (BDI-II) has been assessed in various medical populations. Although major depressive disorder (MDD) and pr ... Full text Link to item Cite

Daily left prefrontal repetitive transcranial magnetic stimulation in the acute treatment of major depression: clinical predictors of outcome in a multisite, randomized controlled clinical trial.

Journal article Neuropsychopharmacology · January 2009 Randomized controlled trials support the antidepressant efficacy of transcranial magnetic stimulation (TMS); however, there is individual variability in the magnitude of response. Examination of response predictors has been hampered by methodological limit ... Full text Link to item Cite

Modeling slow-wave activity dynamics: does an exponentially dampened periodic function really fit a single night of normal human sleep?

Journal article Clin Neurophysiol · December 2008 OBJECTIVE: Slow-wave activity (SWA) is believed to be a fundamental measure of sleep homeostasis and is frequently characterized as an exponentially declining periodic dynamical system. The objective of this study is to carry out the first rigorous statist ... Full text Link to item Cite

Non-REM sleep EEG spectral analysis in insomnia

Journal article Psychiatric Annals · September 1, 2008 There is a need for objective measures of insomnia that can be used in diagnosis and outcome assessment. Although PSG is a valuable outcome assessment tool in a selected subset of insomnia patients, we lack measures with diagnostic utility and that can ref ... Cite

Measuring sleep quality.

Journal article Sleep Med · September 2008 Despite being used commonly in sleep medicine, the term "sleep quality" has not been rigorously defined. The purpose of this article is to consider objective measures of the subjective "sleep quality" experience. In order to do so, it was necessary to choo ... Full text Link to item Cite

Psychomotor performance deficits and their relation to prior nights' sleep among individuals with primary insomnia.

Journal article Sleep · May 2008 OBJECTIVE: To examine psychomotor (reaction time) performance deficits and their relation to subjective and objective sleep measures among individuals with primary insomnia (PI). DESIGN AND SETTING: This study was conducted at affiliated VA and academic me ... Full text Link to item Cite

Eszopiclone coadministered with escitalopram in patients with insomnia and comorbid generalized anxiety disorder.

Journal article Arch Gen Psychiatry · May 2008 CONTEXT: Insomnia and generalized anxiety disorder (GAD) are prevalent disorders that may coexist. OBJECTIVE: To determine the efficacy of eszopiclone combined with escitalopram oxalate in treating insomnia comorbid with GAD. DESIGN: Double-blind, randomiz ... Full text Link to item Cite

Effects of antipsychotic medications on sleep in schizophrenia.

Journal article Int Clin Psychopharmacol · May 2008 Schizophrenia is often accompanied by sleep problems. Evidence exists that these sleep difficulties have significant effects on individuals with this disorder. The mainstay of treatment for this condition is the administration of medications that have effe ... Full text Link to item Cite

Report of two cases where sleep related eating behavior occurred with the extended-release formulation but not the immediate-release formulation of a sedative-hypnotic agent.

Journal article J Clin Sleep Med · April 15, 2008 We report two cases in which amnestic sleep related eating disorder (SRED) occurred with extended-release zolpidem but not with the immediate-release formulation. These cases illustrate how even relatively small differences such as formulation can affect t ... Link to item Cite

Sleep disturbance in psychiatric disorders: effects on function and quality of life in mood disorders, alcoholism, and schizophrenia.

Journal article Ann Clin Psychiatry · 2008 INTRODUCTION: While the precise role of sleep in maintaining optimal health and function remains unknown, it is clear that disturbances of sleep have a profound impact on the lives of affected individuals. In psychiatric disorders, not only is there a rela ... Full text Link to item Cite

Long-term efficacy and safety of zolpidem extended-release 12.5 mg, administered 3 to 7 nights per week for 24 weeks, in patients with chronic primary insomnia: a 6-month, randomized, double-blind, placebo-controlled, parallel-group, multicenter study.

Journal article Sleep · January 2008 STUDY OBJECTIVES: To evaluate long-term efficacy and safety of zolpidem extended-release 3 to 7 nights/week for chronic primary insomnia. DESIGN: Multicenter, 25-week, phase IIIb, randomized, double-blind, placebo-controlled, parallel-group. SETTING: Outpa ... Full text Link to item Cite

Nightly treatment of primary insomnia with eszopiclone for six months: effect on sleep, quality of life, and work limitations.

Journal article Sleep · August 2007 STUDY OBJECTIVES: To evaluate 6 months' eszopiclone treatment upon patient-reported sleep, fatigue and sleepiness, insomnia severity, quality of life, and work limitations. DESIGN: Randomized, double blind, controlled clinical trial. SETTING: 54 research s ... Full text Link to item Cite

Long-term issues in the treatment of sleep disorders.

Journal article CNS Spectr · July 2007 Insomnia is a disorder characterized by chronic sleep disturbance associated with daytime disability or distress, such as memory impairment and fatigue, that occurs despite adequate opportunity for sleep. Insomnia may present as difficulty falling/staying ... Link to item Cite

Long-term issues in the treatment of sleep disorders

Journal article Primary Psychiatry · July 1, 2007 Insomnia is a disorder characterized by chronic sleep disturbance associated with daytime disability or distress, such as memory impairment and fatigue, that occurs despite adequate opportunity for sleep. Insomnia may present as difficulty falling/staying ... Cite

Associations of a regulatory polymorphism of monoamine oxidase-A gene promoter (MAOA-uVNTR) with symptoms of depression and sleep quality.

Journal article Psychosom Med · June 2007 OBJECTIVE: To examine the relationships among the variable number of tandem repeats in the monoamine oxidase-A linked polymorphic region allelic variation (MAOA-uVNTR) and the symptoms of depression and sleep quality. The monoamine oxidase-A (MAOA) gene, w ... Full text Link to item Cite

Psychotic disorder in a patient with central and extrapontine myelinolysis.

Journal article Psychiatry Clin Neurosci · June 2007 Central pontine and extrapontine myelinolysis (CPEM) are rare conditions usually associated with rapid correction of hyponatremia. Neurologic complications are the usual sequelae although neuropsychiatric features are rare. Described herein are unusual psy ... Full text Link to item Cite

Bupropion HCL and sleep in patients with depression

Journal article Current Psychiatry Reviews · May 1, 2007 Objectives: Depressed patients often have insomnia, daytime sleepiness, and/or changes in sleep architecture. These sleep/wake changes are associated with diminished quality of life, impaired function, diminished treatment response and greater risk of rela ... Full text Cite

Treating the health, quality of life, and functional impairments in insomnia.

Journal article J Clin Sleep Med · February 15, 2007 STUDY OBJECTIVES: Impairments in health, function, and quality of life (QOL) are a central feature of insomnia, yet insomnia treatment is targeted solely to improving problems falling and staying asleep. It is not even known if the nonsleep deficits improv ... Link to item Cite

Evaluation of eszopiclone discontinuation after cotherapy with fluoxetine for insomnia with coexisting depression.

Journal article J Clin Sleep Med · February 15, 2007 BACKGROUND: Insomnia and major depressive disorder (MDD) may coexist. This study evaluated hypnotic discontinuation effects following an 8-week placebo-controlled study of eszopiclone/fluoxetine cotherapy in patients with insomnia and comorbid MDD. METHODS ... Link to item Cite

A comparison of rates of residual insomnia symptoms following pharmacotherapy or cognitive-behavioral therapy for major depressive disorder.

Journal article J Clin Psychiatry · February 2007 OBJECTIVE: A number of pharmacologic studies have documented that insomnia is among the most commonly reported residual symptoms after remission from depression. Residual symptoms after remission are particularly relevant because these symptoms confer grea ... Full text Link to item Cite

The Morbidity of Insomnia

Journal article CNS Spectrums · January 1, 2007 Insomnia is a disorder characterized by chronic sleep disturbance associated with daytime disability or distress, such as memory impairment and fatigue, that occurs despite adequate opportunity for sleep. Insomnia may present as difficulty falling/staying ... Full text Cite

Sleep quality varies as a function of 5-HTTLPR genotype and stress.

Journal article Psychosom Med · 2007 OBJECTIVE: To test the hypothesis that allelic variation in 5HTT gene-linked polymorphic region (5-HTTLPR) genotype was associated with sleep quality (Pittsburgh Sleep Quality Index, PSQI) as a main effect and as moderated by the chronic stress of caregivi ... Full text Link to item Cite

Sleep and psychiatric disorders: future directions.

Journal article Psychiatr Clin North Am · December 2006 Understanding of the relationship between co-occurring sleep and psychiatric disorders has undergone a radical change. The longstanding perspective that sleep problems invariably are a symptom of a psychiatric disorder is giving way to understanding that c ... Full text Link to item Cite

Sleep and residual sedation after administration of zaleplon, zolpidem, and placebo during experimental middle-of-the-night awakening.

Journal article J Clin Sleep Med · October 15, 2006 STUDY OBJECTIVES: To assess the efficacy of zaleplon 10 mg and zolpidem 10 mg administered during experimental middle-of-the-night awakenings in patients with sleep-maintenance insomnia using objective polysomnographic measures and to assess daytime residu ... Link to item Cite

Psychiatric Comorbidity: The Case for Treating Insomnia

Journal article Sleep Medicine Clinics · September 1, 2006 A review of studies of the treatment of insomnia occurring in association with other psychiatric disorders suggests that the secondary insomnia model fails to explain adequately the relationship between insomnia and the associated conditions and also fails ... Full text Cite

A polysomnography study of eszopiclone in elderly patients with insomnia.

Journal article Curr Med Res Opin · September 2006 OBJECTIVE: To evaluate the safety and efficacy of eszopiclone 2 mg in elderly patients (aged 64-86 years) with chronic insomnia. METHODS: This was a randomized, double-blind, placebo-controlled 2-week study. Patients meeting DSM-IV criteria for primary ins ... Full text Link to item Cite

Eszopiclone co-administered with fluoxetine in patients with insomnia coexisting with major depressive disorder.

Journal article Biol Psychiatry · June 1, 2006 BACKGROUND: Insomnia and major depressive disorder (MDD) can coexist. This study evaluated the effect of adding eszopiclone to fluoxetine. METHODS: Patients who met DSM-IV criteria for both MDD and insomnia (n = 545) received morning fluoxetine and were ra ... Full text Link to item Cite

Tiagabine increases slow-wave sleep in a dose-dependent fashion without affecting traditional efficacy measures in adults with primary insomnia.

Journal article J Clin Sleep Med · January 15, 2006 INTRODUCTION: This study evaluated dose-response effects of tiagabine on sleep in adults with primary insomnia. METHODS: Men and women with primary insomnia (DSM-IV-TR) were randomly assigned to receive tiagabine 4, 6, 8, 10 mg or placebo in a randomized, ... Link to item Cite

Long-Term Pharmacotherapy in the Management of Chronic Insomnia

Journal article Journal for Nurse Practitioners · January 1, 2006 Chronic insomnia is common among primary care patients and often necessitates long-term management. The available treatment options for the clinical care of such patients are limited. Medication management is the most common therapy for this condition; how ... Full text Cite

Response to Dr. Finucane [2]

Journal article Journal of the American Geriatrics Society · January 1, 2006 Full text Cite

Advertising the new hypnotics - Response to Dr. Finucane

Journal article JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · January 1, 2006 Link to item Cite

Behavioral insomnia therapy for fibromyalgia patients: a randomized clinical trial.

Journal article Arch Intern Med · November 28, 2005 BACKGROUND: Insomnia is common and debilitating to fibromyalgia (FM) patients. Cognitive-behavioral therapy (CBT) is effective for many types of patients with insomnia, but has yet to be tested with FM patients. This study compared CBT with an alternate be ... Full text Link to item Cite

An evaluation of the efficacy and safety of eszopiclone over 12 months in patients with chronic primary insomnia.

Journal article Sleep Med · November 2005 BACKGROUND AND PURPOSE: A double-blind placebo-controlled study of eszopiclone found significant, sustained improvement in sleep and daytime function. The 6-month open-label extension phase is described herein. PATIENTS AND METHODS: Adults (21-64) with pri ... Full text Link to item Cite

A comparison of placebo and no-treatment during a hypnotic clinical trial.

Journal article Int J Clin Pharmacol Ther · August 2005 OBJECTIVE: Sleep parameters commonly improve during placebo treatment in insomnia clinical trials. We examined whether the improvement seen with placebo was related to taking pills or other non-specific factors. METHOD: 95 insomniacs took either a placebo ... Full text Link to item Cite

The effect of insomnia definitions, terminology, and classifications on clinical practice.

Journal article J Am Geriatr Soc · July 2005 There is a need for newer, more clinically useful classifications for insomnia. Identification of specific subtypes of insomnia helps anchor research, allows for prediction of prognosis/course of the condition, and may allow for individualization of treatm ... Full text Link to item Cite

A comparison of placebo and no-treatment during a hypnotic clinical trial

Journal article International Journal of Clinical Pharmacology and Therapeutics · 2005 Objective: Sleep parameters commonly improve during placebo treatment in insomnia clinical trials. We examined whether the improvement seen with placebo was related to taking pills or other non-specific factors. Method: 95 insomniacs took either a placebo ... Cite

Definitions, measurements, and management in insomnia

Journal article Journal of Clinical Psychiatry · December 1, 2004 Cite

Long-term, non-nightly administration of zolpidem in the treatment of patients with primary insomnia.

Journal article J Clin Psychiatry · August 2004 INTRODUCTION: While it is common practice that hypnotics are used on a non-nightly basis, few investigations have been undertaken to evaluate the efficacy of the intermittent dosing strategy. The present study was designed to further evaluate this issue wi ... Full text Link to item Cite

Panel discussion: changing how we think about insomnia.

Journal article J Clin Psychiatry · 2004 Featured Publication Link to item Cite

The changing perspective on chronic insomnia management.

Journal article J Clin Psychiatry · 2004 Featured Publication A particular challenge in the treatment of insomnia is management of chronic insomnia, which occurs in a substantial portion of the population. A number of factors suggest the importance of identifying this condition as distinct from short-term insomnia in ... Link to item Cite

Depression and insomnia in women.

Journal article Clin Cornerstone · 2004 Depression and insomnia are both significantly more prevalent in women than in men. Risks appear linked to fluctuations and transitions in gonadal hormones during various phases of women's lives, with the risk of depression greatest during the period from ... Full text Link to item Cite

Changing how we think about insomnia

Journal article JOURNAL OF CLINICAL PSYCHIATRY · January 1, 2004 Link to item Cite

Sustained efficacy of eszopiclone over 6 months of nightly treatment: results of a randomized, double-blind, placebo-controlled study in adults with chronic insomnia.

Journal article Sleep · November 1, 2003 Featured Publication STUDY OBJECTIVES: To determine the long-term efficacy of eszopiclone in patients with chronic insomnia. DESIGN: Randomized, double-blind, multicenter, placebo-controlled. SETTING: Out-patient, with monthly visits. PATIENTS: Aged 21 to 69 years meeting DSM ... Full text Link to item Cite

Subtyping primary insomnia: is sleep state misperception a distinct clinical entity?

Journal article Sleep Med Rev · June 2003 Featured Publication Among the range of primary insomnia subtypes, those assigned such labels as subjective insomnia or sleep state misperception historically have been among the most intriguing yet challenging to understand and manage clinically. Such patients who produce see ... Full text Link to item Cite

Comparison of seizure duration, ictal EEG, and cognitive effects of ketamine and methohexital anesthesia with ECT.

Journal article J Neuropsychiatry Clin Neurosci · 2003 Featured Publication The authors retrospectively compared the seizure duration, ictal EEG, and cognitive side effects of ketamine and methohexital anesthesia with ECT. This comparison was carried out with data from consecutive index ECT treatments that occurred immediately bef ... Full text Link to item Cite

Insomnia in women.

Journal article Clin Cornerstone · 2003 Featured Publication Insomnia is a highly prevalent disorder that can lead to substantial impairments in quality of life and functional capacity. This condition occurs significantly more frequently in women than men. An important contributing factor is that insomnia can occur ... Full text Link to item Cite

Quantitative determination of abrupt changes in dynamical systems: Illustration via identification of seizure termination in generalized tonic-clonic seizure EEG data

Journal article International Journal of Bifurcation and Chaos in Applied Sciences and Engineering · January 1, 2003 We discuss key theoretical and practical issues related to the identification of transitions in dynamical systems in real-time. We focus on the choice of candidate measures and optimization of decision thresholds for candidate measures. To illustrate these ... Full text Cite

NREM sleep EEG frequency spectral correlates of sleep complaints in primary insomnia subtypes.

Journal article Sleep · September 15, 2002 Featured Publication STUDY OBJECTIVES: To determine whether the frequency spectrum of the sleep EEG is a physiologic correlate of 1) the degree to which individuals with persistent primary insomnia (PPI) underestimate their sleep time compared with the traditionally scored pol ... Link to item Cite

Changes in sleep architecture and the sleep EEG with aging.

Journal article AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY · March 1, 2002 Link to item Cite

The use of valerian in neuropsychiatry.

Journal article CNS Spectr · October 2001 Valerian is a medicinal agent deriving from the plant Valeriana officinalis L. We reviewed the available literature on the use of valerian preparations in the treatment of neuropsychiatric disorders. Preclinical studies suggest that valerian has sedative a ... Full text Link to item Cite

ECT failure rate among specific devices.

Journal article Am J Psychiatry · June 2001 Full text Link to item Cite

ECT failure rate among specific devices - Drs. Krystal and Weiner reply

Journal article AMERICAN JOURNAL OF PSYCHIATRY · June 1, 2001 Link to item Cite

Multichannel electroencephalographic analyses via dynamic regression models with time-varying lag-lead structure

Journal article Journal of the Royal Statistical Society Series C Applied Statistics · January 1, 2001 Multiple time series of scalp electrical potential activity are generated routinely in electroencephalographic (EEG) studies. Such recordings provide important non-invasive data about brain function in human neuropsychiatric disorders. Analyses of EEG trac ... Full text Cite

The development and retrospective testing of an electroencephalographic seizure quality-based stimulus dosing paradigm with ECT.

Journal article J ECT · December 2000 Featured Publication The optimization of electroconvulsive therapy (ECT) stimulus dosing remains uncertain. Previous work suggests the potential utility of ictal EEG models of seizure adequacy, but such models have never been tested for their ability to improve the clinical do ... Full text Link to item Cite

Prediction of the utility of a switch from unilateral to bilateral ECT in the elderly using treatment 2 ictal EEG indices.

Journal article J ECT · December 2000 Featured Publication BACKGROUND: The choice of whether to administer nondominant unilateral (UL) or bilateral (BL) ECT remains controversial. METHODS: A study in which moderately suprathreshold UL nonresponders at treatment 6 were randomized to UL or BL ECT offered the opportu ... Full text Link to item Cite

ECT stimulus intensity: are present ECT devices too limited?

Journal article Am J Psychiatry · June 2000 Featured Publication OBJECTIVE: The maximum output charge for ECT devices is limited to 576 millicoulombs in the United States, although there are no data ensuring that this limit will allow consistently effective treatments. The authors examined whether this limit has a negat ... Full text Link to item Cite

The role of the ictal EEG in ECT stimulus dosing.

Journal article JOURNAL OF ECT · March 1, 2000 Link to item Cite

EEG effects of ECT: implications for rTMS.

Journal article Depress Anxiety · 2000 Featured Publication Electroconvulsive therapy (ECT) involves the use of electrical stimulation to elicit a series of generalized tonic-clonic seizures for therapeutic purposes and is the most effective treatment known for major depression. These treatments have significant ne ... Full text Link to item Cite

Stationarity and redundancy of multichannel EEG data recorded during generalized tonic-clonic seizures.

Journal article Brain Topogr · 2000 Featured Publication To improve our understanding of the physiology of generalized tonic-clonic (GTC) seizures, we have investigated the stationarity and redundancy of 21-electrode EEG data recorded from ten patients during GTC seizures elicited by electroconvulsive therapy (E ... Full text Link to item Cite

New methods of time series analysis of non-stationary EEG data: eigenstructure decompositions of time varying autoregressions.

Journal article Clin Neurophysiol · December 1999 Featured Publication OBJECTIVE: Those who analyze EEG data require quantitative techniques that can be validly applied to time series exhibiting ranges of non-stationary behavior. Our objective is to introduce a new analysis technique based on formal non-stationary time series ... Full text Link to item Cite

Evaluation and Comparison of EEG Traces: Latent Structure in Nonstationary Time Series

Journal article Journal of the American Statistical Association · December 1, 1999 We explore and illustrate the use of time series decomposition methods for evaluating and comparing latent structure in nonstationary electroencephalographic (EEG) traces obtained from depressed patients during brain seizures induced as part of electroconv ... Full text Cite

Zolpidem for persistent insomnia in SSRI-treated depressed patients.

Journal article J Clin Psychiatry · October 1999 Featured Publication BACKGROUND: Depressed individuals effectively treated with selective serotonin reuptake inhibitors (SSRIs) often report persistent insomnia and require adjunctive sleep-promoting therapy. METHOD: Men (N = 40) and women (N = 150) with a mean age of 41.6 yea ... Full text Link to item Cite

Evaluation and Comparison of EEG Traces: Latent Structure in Nonstationary Time Series

Journal article Journal of the American Statistical Association · June 1, 1999 We explore and illustrate the use of time series decomposition methods for evaluating and comparing latent structure in nonstationary electroencephalographic (EEG) traces obtained from depressed patients during brain seizures induced as part of electroconv ... Full text Cite

EEG correlates of the response to ECT: a possible antidepressant role of brain-derived neurotrophic factor.

Journal article J ECT · March 1999 Featured Publication Studies on the relationship of electroencephalographic (EEG) data to the therapeutic response to electroconvulsive therapy (ECT) have been carried out since the 1940s, but for many years they did not yield any consistent correlates. Recent studies, however ... Link to item Cite

2. ECT and Anticonvulsant Medications

Journal article The Journal of ECT · March 1999 Full text Cite

Sleep in peri-menopausal and post-menopausal women.

Journal article Sleep Med Rev · November 1998 Despite the fact that a large number of women report sleep disturbances associated with peri-menopausal and post-menopausal periods, there is a surprising lack of literature related to this issue. In fact, there has not been enough work in this area to eve ... Full text Link to item Cite

Low-dimensional chaos in bipolar disorder [1] (multiple letters)

Journal article Archives of Internal Medicine · March 9, 1998 Cite

The use of flumazenil in the anxious and benzodiazepine-dependent ECT patient.

Journal article J ECT · March 1998 Featured Publication Many patients who receive electroconvulsive therapy (ECT) are benzodiazepine dependent or are anxious and require benzodiazepine drugs. Because these agents may diminish the therapeutic effectiveness of ECT, we explored the dosing, safety, and efficacy of ... Link to item Cite

Low-dimensional chaos in bipolar disorder?

Journal article Arch Gen Psychiatry · March 1998 Featured Publication Full text Link to item Cite

Changes in seizure threshold over the course of electroconvulsive therapy affect therapeutic response and are detected by ictal EEG ratings.

Journal article J Neuropsychiatry Clin Neurosci · 1998 Featured Publication Therapeutic effectiveness of electroconvulsive therapy is influenced by the degree to which the stimulus intensity exceeds the seizure threshold. However, the threshold rises variably over the treatment course, confounding maintenance of desired relative s ... Full text Link to item Cite

The clinical utility of ictal EEG seizure adequacy models

Journal article Psychiatric Annals · January 1, 1998 Full text Cite

The largest Lyapunov exponent of the EEG during ECT seizures as a measure of ECT seizure adequacy.

Journal article Electroencephalogr Clin Neurophysiol · December 1997 Featured Publication Attributes of the electroencephalogram (EEG) recorded during electroconvulsive therapy (ECT) seizures appear promising for decreasing the uncertainty that exists about how to define a therapeutically adequate seizure. In the present report we study whether ... Full text Link to item Cite

EEG correlates of the response to ECT

Journal article BIOLOGICAL PSYCHIATRY · April 1, 1997 Link to item Cite

Establishing an ambulatory ECT program: Different models.

Journal article CONVULSIVE THERAPY · March 1, 1997 Link to item Cite

Neuropsychiatric considerations in the use of electroconvulsive therapy.

Journal article J Neuropsychiatry Clin Neurosci · 1997 Featured Publication ECT is an effective and rapidly acting treatment for certain major psychiatric disorders, even in patients with neurologic illness. Further, in some cases the neurologic illness itself also responds to ECT. Patients with some types of neurologic illness ma ... Full text Link to item Cite

Statistical analysis of redundancy and stationarity in multi-channel EEG.

Journal article JOURNAL OF MATHEMATICAL PSYCHOLOGY · December 1, 1996 Link to item Cite

A comparison of EEG signal dynamics in waking, after anesthesia induction and during electroconvulsive therapy seizures.

Journal article Electroencephalogr Clin Neurophysiol · August 1996 Featured Publication Evidence suggests that quantitative dynamical measures of electroencephalogram (EEG) signals are more appropriate for characterizing the differences between states in an individual rather than as absolute indices. One such measure, the largest Lyapunov exp ... Full text Link to item Cite

The empirical identification of insomnia subtypes: a cluster analytic approach.

Journal article Sleep · June 1996 Featured Publication Over the past 15 years, there has been considerable debate concerning the extent to which insomnia patients can be classified into diagnostic subtypes. Despite this debate, relatively little research has been conducted to empirically determine whether natu ... Link to item Cite

Effect of ECT treatment number on the ictal EEG.

Journal article Psychiatry Res · May 17, 1996 Featured Publication Recent evidence suggests that attributes of the ictal electroencephalogram (EEG) may be clinically useful for estimating the extent to which the electroconvulsive therapy (ECT) stimulus exceeds the seizure threshold (relative stimulus intensity). Such a to ... Full text Link to item Cite

The relative ability of three ictal EEG frequency bands to differentiate ECT seizures on the basis of electrode placement, stimulus intensity, and therapeutic response.

Journal article Convuls Ther · March 1996 Featured Publication Ictal EEG indices show promise for separating individual ECT seizures on the basis of treatment electrode placement (ELPL), relative stimulus intensity (Dose), and expected therapeutic response. One factor impeding the effective clinical implementation of ... Link to item Cite

The anticonvulsant properties of ECT.

Journal article CONVULSIVE THERAPY · March 1, 1996 Link to item Cite

Cost effectiveness of maintenance ECT.

Journal article Convuls Ther · December 1995 Link to item Cite

ECT seizure duration: reliability of manual and computer-automated determinations.

Journal article Convuls Ther · September 1995 Featured Publication Reliable monitoring of electroencephalographic (EEG) and electromyographic electroconvulsive therapy (ECT) seizure duration has become important as these assessments have become a routine part of the clinical practice of ECT. In this regard, accurate autom ... Link to item Cite

Seizure threshold in electroconvulsive therapy (ECT) II. The anticonvulsant effect of ECT.

Journal article Biol Psychiatry · June 1, 1995 Featured Publication To measure the anticonvulsant effects of a course of electroconvulsive therapy (ECT), we used a flexible stimulus dosage titration procedure to estimate seizure threshold at the first and sixth ECT treatments in 62 patients with depression who were undergo ... Full text Link to item Cite

Seizure threshold in electroconvulsive therapy: I. Initial seizure threshold.

Journal article Biol Psychiatry · May 15, 1995 Featured Publication We measured initial seizure threshold by means of a structured stimulus dosage titration procedure in a clinical sample of 111 depressed patients undergoing brief-pulse, constant-current electroconvulsive therapy (ECT). Initial seizure threshold was approx ... Full text Link to item Cite

Ambulatory cassette polysomnography: findings from a large cohort of drug-free insomnia patients.

Journal article J Clin Neurophysiol · May 1995 Featured Publication Technology for conducting ambulatory polysomnography (APSG) has been available for more than a decade, but relatively few studies have used this technology to study the sleep of subjects in their usual home sleeping environments. Herein we suggest the usef ... Link to item Cite

The ictal EEG as a marker of adequate stimulus intensity with unilateral ECT.

Journal article J Neuropsychiatry Clin Neurosci · 1995 Featured Publication Relative stimulus intensity above seizure threshold has been shown to affect therapeutic outcome with unilateral ECT. The authors sought to explore whether a multivariate ictal EEG model would permit ongoing clinical assessment of this parameter. Twenty-fi ... Full text Link to item Cite

ECT seizure therapeutic adequacy.

Journal article Convuls Ther · June 1994 Featured Publication From the beginnings of convulsive therapy, the need for some way to assess the therapeutic adequacy of individual treatments has been apparent. Recent work suggests that seizure therapeutic adequacy and adverse effects are dependent on the extent to which ... Link to item Cite

The present use of electroconvulsive therapy.

Journal article Annu Rev Med · 1994 Featured Publication Physicians attempting to treat certain severe mental disorders have recently shown renewed interest in electroconvulsive therapy (ECT). A number of technical innovations have made ECT safer, as well as more effective. These innovations include oxygenation, ... Full text Link to item Cite

The effects of ECT stimulus dose and electrode placement on the ictal electroencephalogram: an intraindividual crossover study.

Journal article Biol Psychiatry · December 1, 1993 Featured Publication Recent evidence suggests that electroconvulsive therapy (ECT) efficacy depends upon both electrode placement and the degree to which stimulus dosage exceeds seizure threshold (T), and not simply on surpassing a minimum seizure duration as has been assumed. ... Full text Link to item Cite

EEG evidence of more "intense" seizure activity with bilateral ECT.

Journal article Biol Psychiatry · March 15, 1992 Featured Publication Full text Link to item Cite

Ambulatory polysomnography: technical aspects and normative values.

Journal article J Clin Neurophysiol · January 1992 Featured Publication Ambulatory polysomnographic (APSG) assessment of sleep disorders is now possible, but the technique of APSG is sufficiently different from in-laboratory PSG that normative data from in-laboratory PSG may not apply to APSG. This paper reviews the technical ... Link to item Cite

The electrophysiology of ECT: relevance to mechanism of action.

Journal article Clin Neuropharmacol · 1992 Featured Publication Full text Link to item Cite

The monitoring and management of electrically induced seizures.

Journal article Psychiatr Clin North Am · December 1991 Featured Publication Because induced seizures have such a fundamental influence on both beneficial and adverse effects associated with ECT, it is crucial that they be monitored as effectively as possible. In practice this process involves a combination of both motor and EEG mo ... Link to item Cite

Shared features of neuroleptic malignant syndrome and alcohol abuse complications.

Journal article J Clin Psychiatry · December 1990 Featured Publication Link to item Cite

Differential diagnosis and pathophysiology of Cushing's syndrome and primary affective disorder.

Journal article J Neuropsychiatry Clin Neurosci · 1990 Featured Publication Most patients with major depression have increased 24-hour urinary free cortisol and cortisol nonsuppression after dexamethasone administration, which are cornerstones of a diagnosis of Cushing's syndrome. Similarly, Cushing's syndrome patients often suffe ... Full text Link to item Cite