Objective To investigate the current status of the diagnosis and treatment of insomnia and the clinical use of related drugs in primary medical institutions in Beijing， China through a survey. Methods A questionnaire survey and face-to-face interviews were used to conduct a stratified random sampling survey in primary medical institutions in 16 districts of Beijing. Results The primary medical institutions in Beijing played an important role in the long-term management of insomnia patients， and integrated traditional Chinese and Western medicine therapy is the main treatment paradigm for insomnia. The three most frequently used sedative-hypnotic drugs are estazolam， zolpidem tartrate. At present， there are still several issues in primary medical institutions， including a lack of training on sleep medicine and strict restrictions on the types of sedative-hypnotic drugs. Conclusion Primary medical institutions in Beijing play a significant role in the long-term management of insomnia patients. However， due to a lack of standardized and systematic training on sleep medicine and the limited types and quantities of sedative-hypnotic drugs， there are still difficulties in the standardized diagnosis and treatment of insomnia， as well as the presence of non-standardized use of sedative-hypnotic drugs.
Insomnia, Fatal Familial

Objective To investigate the potential genetic mechanisms of insomnia and anxiety and the bidirectional causal relationship between them using Linkage Disequilibrium Score Regression （LDSC） and Mendelian Randomization （MR）. Methods Based on the data from genome-wide association studies， LDSC was used to analyze the genetic correlation of insomnia with anxiety and its subtypes. The inverse variance weighted （IVW） method was used as the main analytical method， supplemented by MR-Egger regression， weighted median， the simple model method， and weighted model. The Cochran’s Q test was used for heterogeneity testing， MR-Egger was used for pleiotropy testing， and the leave-one-out method was used for sensitivity analysis. Results The LDSC analysis revealed the genetic correlation of insomnia with anxiety and its subtypes. The results of IVW analysis showed that insomnia had a causal relationship with the increased risk of anxiety （OR=1.448，95%CI 1.025‒2.045，P=0.036，PFDR=0.178） and generalized anxiety disorder （OR=2.098，95% CI 1.105‒3.986， P=0.024， PFDR=0.314）. Conversely， the reverse MR analysis showed a causal relationship between generalized anxiety disorder and the increased risk of insomnia （OR=1.010， 95% CI 1.003‒1.017， P=0.008， PFDR=0.329）. No significant horizontal pleiotropy was detected for the instrumental variables （P>0.05）， and the sensitivity analysis showed that the results of MR analysis were stable. Conclusion Insomnia may be used as a risk factor for anxiety， and there is a genetic correlation between the two diseases.
Insomnia ; Anxiety

Aged ; Asian Continental Ancestry Group ; Creutzfeldt-Jakob Syndrome ; cerebrospinal fluid ; genetics ; Female ; Genetic Predisposition to Disease ; Humans ; Insomnia, Fatal Familial ; cerebrospinal fluid ; genetics ; Male ; Middle Aged ; Mutation ; genetics

Consensus ; Humans ; Insomnia, Fatal Familial ; diagnosis ; Mutation ; Pedigree

OBJECTIVEFatal familial insomnia (FFI) is an autosomal dominant prion disease characterized clinically by inattention, sleep loss, dysautonomia, and motor signs. This study is aimed to investigate clinical and familial characteristics of ten Chinese Patients with FFI.

METHODSWe identified ten FFI cases from the surveillance network for Creutafeldt-Jakob disease (CJD) in China. Final diagnosis of FFI cases was made in accordance with the WHO criteria for CJD. The main clinical features and family histories of these ten FFI cases were analyzed.

RESULTSThe median age of ten cases at onset was 38 years (from 19 to 55). The foremost symptoms seemed to be various, including sleep disturbances, vision disorder, dizziness and anorexia. Sleep disturbances appeared in all cases and lasted in the whole clinical courses. Progressive sympathetic symptoms, memory loss, movement disturbances, myoclonus and hypertension were also frequently observed. The median duration of the disease was 9.5 months. EEG and MRI did not figure out special abnormality. 14-3-3 protein in CSF was positive in five out of eight tested patients. Clear family histories were identified in 8 patients.

CONCLUSIONThe data from our study confirm that the Chinese FFI cases have similar clinical characteristics as that of the Caucasian cases. Compared with other genetic CJD associated mutations, the genetic frequencies of D178N in PRNP are apparently high among the Chinese cases.

Adult ; Asian Continental Ancestry Group ; Female ; Humans ; Insomnia, Fatal Familial ; pathology ; physiopathology ; Male ; Middle Aged ; Young Adult

Valeriane (Valeriana officinalis L.; Valerianaceae) is a perennial herbaceous plant common in Europe, North America and North Asia. The medicinal properties of the valeriane have been recognized as far back as the early Greeks and Romans, and in medieval time it was used to treat a variety of ailments. Valerian has a direct sedative effect and interacts with neurotransmitters such as GABA. Now a day it is considered as a safe herbal choice for mild insomnia and has good tolerability. One of the potential advantages of valeriane over benzodiazepines (BZDs) is the lack of daylight sleepiness when used at recommended dosages (300 to 600mg in capsule form, taken 30 minutes to 2 hours before bedtime). It also may be helpful in weaning patients with insomnia due to BZDs.
Valeriane ; Insomnia

Dementias can be calssified into cortical, subcortical, cortical-subcortical and multifocal ones based on the major pathological distribution within the brain. The literatures of recent knowledge about clinical features of other dementias than Alzheimer's and vascular ones, which were most frequently experienced by many clinicians were reviewed. That is, cortical dementias such as Pick's disease, frontal lobe type dementia and non-Alzheimer's type lobar atrophy including fronto-temporal dementia, progressive dysphasia, fronto-temporal dementia with motor neuron disease, and alcohol-related dementia were reviewed. Subcortical dementias such as dementias accompanying Parkinson's disease, Huntington's disease and progressive supranuclear palsy, and cortical-subcortical dementias such as Lewy body dementiaq and cortical-basal degeneration were also reviewed. As multifocal dementias, prion dementias including KUru, Creutzfeldt-Jakob disease, fatal familial insomnia and Gerstmann-Strussler-Sheinker syndrone, and AIDS dementia were also reviewed.
Aphasia ; Atrophy ; Brain ; Creutzfeldt-Jakob Syndrome ; Dementia* ; Frontal Lobe ; Frontotemporal Dementia ; Huntington Disease ; Insomnia, Fatal Familial ; Kuru ; Lewy Bodies ; Lewy Body Disease ; Motor Neuron Disease ; Parkinson Disease ; Pick Disease of the Brain ; Supranuclear Palsy, Progressive