OBJECTIVE To evaluate efficacy and safety of ramelteon (MT1/MT2-receptor [corrected] agonist) in subjects with chronic primary insomnia. METHODS Randomized, multicenter, double-blind, placebo-controlled trial of nightly ramelteon treatment (8 mg or 16 mg) in adults (N=405) with primary chronic insomnia (DSM-IV-TR). Latency to persistent sleep (LPS), TST, sleep efficiency, wake time after slee...

CHRONIC INSOMNIA IS A WIDESPREAD HEALTH PROBLEM THAT REDUCES QUALITY OF LIFE, increases risks for psychiatric/medical disease, and enhances healthcare costs for countless millions worldwide.1-12 Most insomnia sufferers who seek treatment do so in primary care settings where their sleep complaints typically are addressed via symptom-focused pharmacotherapy. Various medications, including traditi...

An elderly patient with depression and chronic back pain presents several months of new onset agitation, insomnia, hyperhidrosis, hypertension, tachycardia, nausea, vomiting. Her quality is unchanged, basic labs imaging including cardiac echocardiography are normal.

BACKGROUND Chronic musculoskeletal pain is highly prevalent, disabling, and costly, and has many negative effects on quality of life. The aim of this study was to investigate factors associated with higher reported pain levels in patients with chronic musculoskeletal pain among demographic, clinical, and psychological factors, and to evaluate whether insomnia is independently associated with pa...

THE TRANSITION FROM WAKEFULNESS TO SLEEP IS MARKED BY A PROGRESSIVE LOSS OF CONSCIOUSNESS, REDUCTION OF STIMULUS RECEPTION, CESSATION OF BEHAVIORAL RESPONSE, AND AN ABSENCE OF MEMORY.1 Accordingly, for the sleeper, the exact point of sleep onset is elusive. One interesting finding to emerge from research on human sleep is that many people with insomnia overestimate their sleep-onset latency (SO...

PURPOSE No study to date has compared the associations of pain intensity, depression, and anxiety with insomnia among outpatients with chronic low back pain (CLBP). This study aimed to investigate this issue. PATIENTS AND METHODS A total of 225 outpatients with CLBP were enrolled from a general orthopedics clinic. The Insomnia Severity Index was used to evaluate sleep quality. Major depressiv...

INTRODUCTION Insomnia is a condition that affects nearly everyone at some point in life. Up to 40% of American adults have intermittent insomnia, and 10% to 15% have a chronic sleep problem.1 The main presentation of insomnia is difficulty with either falling asleep or maintaining sleep throughout the night. Complaints of insomnia tend to increase with age. Elderly people report trouble falling...