Sleep-Wake Disorders

Sleep-disordered breathing is common in patients with mood and anxiety disorders. This article explores the implication for practicing psychiatrists whose patients have sleep disorders.

Melatonin has a role in psychiatric illness and the treatment of circadian rhythm sleep disorders, insomnia, and comorbid depressive disorders.

Although the purpose of sleep continues to be the subject of much debate, few would argue that a well-functioning sleep-wake cycle is essential for good health.

Knowledge of how different antidepressants are likely to affect parameters of sleep can provide an important basis for selecting an appropriate antidepressant drug among the roughly 2 dozen marketed options to meet the needs of depressed patients.

Sleep changes associated with psychotropic drugs are common enough to justify routinely obtaining a baseline sleep diary before beginning treatment, even when the initial screening for sleep disorders indicates that no further investigation is needed.

Sleep disorders - most commonly sleep apnea - are often comorbid with psychiatric disorders. Treatment of disordered sleep can result in a significant improvement in the psychiatric disorder.

This discussion focuses on approaches to improve medication adherence, particularly in reference to helping adolescents remain on recommended psychopharmacological regimens when transitioning from acute to long-term maintenance.

Recently our inpatient psychiatric unit moved into a brand new facility. In the months and weeks preceding “the move,” there was much preparation and nervous energy. We had been preparing our patients and ourselves for this day. “

Can you name an important part of good sleep hygiene? The use of which short-acting sedative-hypnotics to treat sleep disturbances in patients is associated with Alzheimer disease? These questions and more.

The plain fact is that nothing that has been claimed in the name of defending our country can justify cruel, inhuman, and degrading treatment of another man or woman. Torture, in any form-light or heavy-is not a tool of interrogation or useful for gathering good intelligence.

How often do insomnia and anxiety disorders coexist? And how best to treat patients with comorbid insomnia and anxiety? Answers here..

In Part 3 of this 3-part series, Dr Dilsaver discusses dichotomization versus a continuum model and concerns that bipolar disorders are over-diagnosed.

Several available agents in addition to methylene blue are being investigated for bipolar disorder and were in a in a recent review.

Although the foundational and antifoundational traditions differ in their language and claims, both call into question the legitimacy of psychiatric diagnosis and treatment.

Autism is demanding increased attention by professional and lay audiences; prevalence seems to be increasing. There are differing opinions about whether the increase is due to greater recognition and reporting, diagnostic expansion and substitution, or increasing acceptability.

Are a history of complicated pneumonia and possible obstructive sleep apnea part of the DSM-IV exclusionary criteria for potential participants in anesthesia-assisted opioid withdrawal? How many alcoholic drinks a week does it take for a woman to be considered an at-risk drinker? These and more in this week's quiz.

Keys to diagnosis, assessment, and management.

Available treatments are so robust that nearly one-third of patients with major depression will achieve full clinical remission with monotherapy.

During my medical training in the early 1980s, I attended a Grand Rounds on health care reform. Sleep-deprived physicians-in-training are easily conditioned to snooze upright in their auditorium seats, and economics is not an interest of choice for me, but when the speaker told us that there would be no solution to rising health care costs except to fracture the bond between patient and doctor, I found myself engaging in nightmarish fantasies that in subsequent decades have come true.

What do we know about circadian rhythms and melatonin? And what further lessons do we need about circadian rhythms, light exposure, and melatonin to help our patients with disturbed sleep/wake cycles?

Simple but powerful suggestions to get a better night's sleep.

Pediatric bipolar disorder (PBD) is a serious psychiatric illness that impairs children’s emotional, cognitive, and social development. PBD causes severe mood instability that manifests in chronic irritability, episodes of rage, tearfulness, distractibility, grandiosity or inflated self-esteem, hypersexual behavior, a decreased need for sleep, and behavioral activation coupled with poor judgment. While research in this area has accelerated during the past 15 years, there are still significant gaps in knowledge concerning the prevalence, etiology, phenomenology, assessment, and treatment for PBD.

On Monday, August 24, 2009, in response to a Freedom of Information Act lawsuit, the Central Intelligence Agency (CIA) released a “Top Secret,” highly redacted May 7, 2004, report, Counterterrorism Detention and Interrogation Activities (September 2001 – October 2003).1 The report’s opening pages concede that the activity it divulges “diverges sharply from previous Agency policy and rules that govern interrogation.”

Restless legs syndrome (RLS) is a neurosensory disorder first described by Sir Thomas Willis in 1672. As early as the 19th century, Theodor Wittmaack observed the comorbidity of RLS with depression and anxiety. He termed this condition “anxietas tibiarum” and believed it to be a form of hysteria.

Surveys show that approximately 60% of the general population has gambled within the past 12 months.1 The majority of people who gamble do so socially and do not incur lasting adverse consequences or harm. Beyond this, approximately 1% to 2% of the population currently meets criteria for pathological gambling.2 This prevalence is similar to that of schizophrenia and bipolar disorder, yet pathological gambling often goes unrecognized by most health care providers.