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Cognitive behavioral therapy: Can it improve outcomes for individuals with insomnia?

Counting Sheep

How can cognitive behavioral therapy improve outcomes for individuals with insomnia?

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.

A number of studies have found decreased scores on quality-of-life scales in persons with insomnia, which is associated with a wide assortment of daytime impairments, some intuitive and some startling.

A variety of conditions may account for the sleep difficulties experienced by many older adults, including specific sleep disorders, circadian rhythm disturbances, and medical and psychiatric comorbidities.

It is a widely known fact that Fyodor Dostoevsky, the famous 19th-century Russian novelist, suffered from epilepsy for most of his life. However, not too many persons are aware that Dostoevsky also had a sleep disorder called delayed sleep phase syndrome, which may have contributed to his seizures.1 Although no one knows for certain, it is quite conceivable that Dostoevsky's sleep disorder worsened his epilepsy, according to Carl Bazil, MD, PhD, director of Clinical Anticonvulsant Drug Trials and director of the Neurology Division, Columbia Comprehensive Sleep Center, Columbia University, New York.

Patients who experience seizure 24 hours after stroke onset may be at increased risk for death, according to Angela Rackley, MD, a clinical neurophysiology fellow in epilepsy, and coresearchers at the University of Cincinnati. Rackley presented an abstract on the incidence of seizures within 24 hours after acute stroke at the annual meeting of the American Epilepsy Society in San Diego this past December. She and colleagues found a higher 30- day mortality rate among patients who had a seizure within hours of stroke compared with patients who did not experience poststroke seizure.