1.The Intricacies of Insomnia: A Comprehensive Exploration
Nimit KHARA ; Anagha APTE ; Yagnang VYAS ; Dhaval PRAJAPATI ; Ravish KSHATRIYA ; Sateesh PATEL
Journal of Sleep Medicine 2024;21(2):65-72
Insomnia is a pervasive and often debilitating sleep disorder that profoundly affects health and overall wellbeing. This comprehensive review focuses on the historical context, clinical significance, diagnostic criteria, investigative methods, and global treatment guidelines for insomnia. Historically, references to insomnia have appeared in ancient Egyptian and Greek texts, but it was not until the 19th century that they were rigorously studied and classified. Notable individuals, including Vincent van Gogh, Franz Kafka, and Marilyn Monroe, have struggled publicly with insomnia, underscoring its widespread nature. The pathophysiology of insomnia is multifactorial, involving physiological, psychological, and environmental factors. Hyperarousal, dysregulation of the sleep-wake cycle, and neurotransmitter imbalances are central to its development. Insomnia can be categorized into acute, chronic, comorbid, idiopathic, and behavioral types. Epidemiological studies have revealed that up to 30% of adults experience insomnia, with a higher prevalence among women, older adults, and those with a lower socioeconomic status. Insomnia is associated with adverse health outcomes, including cardiovascular diseases, metabolic disorders, cognitive impairment, and increased mortality risk. The COVID-19 pandemic has exacerbated insomnia owing to stress and lifestyle changes. Diagnosis involves a comprehensive assessment, including sleep history, physical examination, and objective evaluations, such as polysomnography. Treatment combines pharmacological and non-pharmacological interventions with cognitive behavioral therapy for insomnia as the first-line approach. Pharmacotherapy includes benzodiazepines, non-benzodiazepine hypnotics, antidepressants, melatonin, and orexin receptor antagonists. Guidelines from the American Academy of Sleep Medicine and the European Sleep Research Society emphasize individualized, evidence-based treatment plans to improve sleep quality and overall health.
2.The Intricacies of Insomnia: A Comprehensive Exploration
Nimit KHARA ; Anagha APTE ; Yagnang VYAS ; Dhaval PRAJAPATI ; Ravish KSHATRIYA ; Sateesh PATEL
Journal of Sleep Medicine 2024;21(2):65-72
Insomnia is a pervasive and often debilitating sleep disorder that profoundly affects health and overall wellbeing. This comprehensive review focuses on the historical context, clinical significance, diagnostic criteria, investigative methods, and global treatment guidelines for insomnia. Historically, references to insomnia have appeared in ancient Egyptian and Greek texts, but it was not until the 19th century that they were rigorously studied and classified. Notable individuals, including Vincent van Gogh, Franz Kafka, and Marilyn Monroe, have struggled publicly with insomnia, underscoring its widespread nature. The pathophysiology of insomnia is multifactorial, involving physiological, psychological, and environmental factors. Hyperarousal, dysregulation of the sleep-wake cycle, and neurotransmitter imbalances are central to its development. Insomnia can be categorized into acute, chronic, comorbid, idiopathic, and behavioral types. Epidemiological studies have revealed that up to 30% of adults experience insomnia, with a higher prevalence among women, older adults, and those with a lower socioeconomic status. Insomnia is associated with adverse health outcomes, including cardiovascular diseases, metabolic disorders, cognitive impairment, and increased mortality risk. The COVID-19 pandemic has exacerbated insomnia owing to stress and lifestyle changes. Diagnosis involves a comprehensive assessment, including sleep history, physical examination, and objective evaluations, such as polysomnography. Treatment combines pharmacological and non-pharmacological interventions with cognitive behavioral therapy for insomnia as the first-line approach. Pharmacotherapy includes benzodiazepines, non-benzodiazepine hypnotics, antidepressants, melatonin, and orexin receptor antagonists. Guidelines from the American Academy of Sleep Medicine and the European Sleep Research Society emphasize individualized, evidence-based treatment plans to improve sleep quality and overall health.
3.The Intricacies of Insomnia: A Comprehensive Exploration
Nimit KHARA ; Anagha APTE ; Yagnang VYAS ; Dhaval PRAJAPATI ; Ravish KSHATRIYA ; Sateesh PATEL
Journal of Sleep Medicine 2024;21(2):65-72
Insomnia is a pervasive and often debilitating sleep disorder that profoundly affects health and overall wellbeing. This comprehensive review focuses on the historical context, clinical significance, diagnostic criteria, investigative methods, and global treatment guidelines for insomnia. Historically, references to insomnia have appeared in ancient Egyptian and Greek texts, but it was not until the 19th century that they were rigorously studied and classified. Notable individuals, including Vincent van Gogh, Franz Kafka, and Marilyn Monroe, have struggled publicly with insomnia, underscoring its widespread nature. The pathophysiology of insomnia is multifactorial, involving physiological, psychological, and environmental factors. Hyperarousal, dysregulation of the sleep-wake cycle, and neurotransmitter imbalances are central to its development. Insomnia can be categorized into acute, chronic, comorbid, idiopathic, and behavioral types. Epidemiological studies have revealed that up to 30% of adults experience insomnia, with a higher prevalence among women, older adults, and those with a lower socioeconomic status. Insomnia is associated with adverse health outcomes, including cardiovascular diseases, metabolic disorders, cognitive impairment, and increased mortality risk. The COVID-19 pandemic has exacerbated insomnia owing to stress and lifestyle changes. Diagnosis involves a comprehensive assessment, including sleep history, physical examination, and objective evaluations, such as polysomnography. Treatment combines pharmacological and non-pharmacological interventions with cognitive behavioral therapy for insomnia as the first-line approach. Pharmacotherapy includes benzodiazepines, non-benzodiazepine hypnotics, antidepressants, melatonin, and orexin receptor antagonists. Guidelines from the American Academy of Sleep Medicine and the European Sleep Research Society emphasize individualized, evidence-based treatment plans to improve sleep quality and overall health.
4. Aloin attenuates chronic constriction injury-induced neuropathic pain in rats by inhibiting inflammatory cytokines and oxidative stress
Aarti KALE ; Avinash WADKAR ; Umesh MAHAJAN ; Lalit BIRARI ; Chandragouda PATIL ; Kalpesh PATIL ; Sateesh BELEMKAR ; Sameer GOYAL ; Shreesh OJHA ; Sanjay SURANA
Asian Pacific Journal of Tropical Biomedicine 2021;11(5):205-213
Objective: To investigate the effect of aloin against chronic constriction injury (CCI)-induced neuropathic pain in rats. Methods: Rats were randomly divided into 7 groups: Group I (normal control), Group II (sham-operated), Group III (CCI control) and Group IV, V, VI, and VII, which underwent CCI surgery and then were administered with aloin (5 mg/kg, p.o.; 25 mg/kg, p.o.; 125 mg/kg, p.o.) and gabapentin (50 mg/kg, p.o.), respectively for 14 days. Peripheral neuropathy was induced by silk ligatures (4-0) loosely placed around the sciatic nerve. Nociceptive thresholds against mechanical stimuli (Von-Frey filaments) and thermal stimuli (12 °C and 40 °C) were measured at mid-plantar paw region ipsilateral to the compressed nerve on day-3, 7, 11, and 14. The concentration of cytokines including tumor necrosis factor-α (TNF-α), interleukin-6, and interleukin-1β was estimated at day-7. At day 14, motor nerve conduction velocity was determined under urethane anesthesia (1.25 g/kg). Oxidative stress parameters (malondiadehyde, glutathione, catalase, and superoxide dismutase) were estimated in sciatic nerve homogenates at day 14. Representative nerve samples were processed for histological investigations. Results: Aloin significantly reduced CCI-induced mechanical and thermal allodynia. It also improved motor nerve conduction velocity and decreased oxidative stress in nerve tissues. In addition, it decreased pro-inflammatory cytokine levels and restored the histoarchitecture of compressed sciatic nerve. Conclusions: Aloin mitigates CCI-induced neuropathic pain in rats by inhibiting oxidative stress and pro-inflammatory cytokines in the afflicted sciatic nerve.