Summary: Insomnia is a condition which affects millions of individuals, giving rise to emotional distress, daytime fatigue, and loss of productivity. Despite its prevalence, it has received scant clinical attention. An adequate evaluation of persistent insomnia requires detailed historical information as well as medical, psychological and psychiatric assessment. Use of a classification system for sleep disorders and familiarity with major diagnostic groups will facilitate the clinician's evaluation and treatment. Thorough assessment also requires attention to the unique aspects of presentation and specific set of etiologies which are associated with particular age groups.

An American Academy of Sleep Medicine Review

OBJECTIVES: Chronic low back pain (CLBP) adversely affects many quality of life components, and is reported to impair sleep. The aim of this review was to determine the association between CLBP and sleep. METHODS: This review comprised 3 phases: an electronic database search (PubMed, Cinahl Plus, EMBASE, PsychInfo, Pedro, and Cochrane Library) identified potential articles; these were screened for inclusion criteria by 2 independent reviewers; extraction of data from accepted articles; and rating of internal validity by 2 independent reviewers and strength of the evidence using valid and reliable scales. RESULTS: The search generated 17 articles that fulfilled the inclusion criteria (quantitative n=14 and qualitative n=3). CLBP was found to relate to several dimensions of sleep including: sleep disturbance and duration (n=15), sleep affecting day-time function (n=5), sleep quality (n=4), sleep satisfaction and distress (n=4), sleep efficiency (n=4), ability to fall asleep (n=3), and activity during sleep (n=3). Consistent evidence found that CLBP was associated with greater sleep disturbance; reduced sleep duration and sleep quality; increased time taken to fall asleep; poor day-time function; and greater sleep dissatisfaction and distress. Inconsistent evidence was found that sleep efficiency and activity were adversely associated with CLBP. DISCUSSION: Many dimensions of sleep are adversely associated with CLBP. Management strategies for CLBP need to address these to maximize quality of life in this patient cohort. Language: en

The association between chronic low back pain and sleep: a systematic review.

Sleep disorders, medical conditions, and road accident risk

Two sets of contributory factors to depression among patients with rheumatoid arthritis (RA) are generally examined – the social context of the individual and the biologic disease state of that person’s RA. This article will review the evidence for both. RA affects patients both physically and psychologically. Comorbid depression is common with RA and leads to worse health outcomes. Low socioeconomic status, gender, age, race/ethnicity, functional limitation, pain and poor clinical status have all been linked to depression among persons with RA. Systemic inflammation may also be associated with, cause, or contribute to depression in RA. Understanding the socioeconomic factors, individual patient characteristics and biologic causes of depression in RA can lead to a more comprehensive paradigm for targeting interventions to eliminate depression in RA.

Depression in patients with rheumatoid arthritis: description, causes and mechanisms.

There is argument over the benefits and risks of drugs for treating chronic musculoskeletal pain. This study compared the efficacy, safety, and tolerability of diclofenac, ibuprofen, naproxen, celecoxib, and etoricoxib for patients with pain caused by osteoarthritis (OA) or rheumatoid arthritis (RA). A systematic literature review used Medline and EMBASE to identify randomised controlled trials. Efficacy outcomes assessed included: pain relief measured by visual analogue scale (VAS); Western Ontario McMaster Universities Arthritis Index (WOMAC) VAS or WOMAC Likert scale; physical functioning measured by WOMAC VAS or Likert scale; and patient global assessment (PGA) of disease severity measured on VAS or 5-point Likert scale. Safety outcomes included: Antiplatelet Trialists’ Collaboration (APTC), major cardiovascular (CV) and major upper gastrointestinal (GI) events, and withdrawals. Data for each outcome were synthesized by a Bayesian network meta-analysis (NMA). For efficacy assessments, labelled doses for OA treatment were used for the base case while labelled doses for RA treatment were also included in the sensitivity analysis. Pooled data across dose ranges were used for safety. Efficacy, safety, and tolerability data were found for 146,524 patients in 176 studies included in the NMA. Diclofenac (150 mg/day) was likely to be more effective in alleviating pain than celecoxib (200 mg/day), naproxen (1000 mg/day), and ibuprofen (2400 mg/day), and similar to etoricoxib (60 mg/day); a lower dose of diclofenac (100 mg/day) was comparable to all other treatments in alleviating pain. Improved physical function with diclofenac (100 and 150 mg/day) was mostly comparable to all other treatments. PGA with diclofenac (100 and 150 mg/day) was likely to be more effective or comparable to all other treatments. All active treatments were similar for APTC and major CV events. Major upper GI events with diclofenac were lower compared to naproxen and ibuprofen, comparable to celecoxib, and higher than etoricoxib. Risk of withdrawal with diclofenac was lower compared to ibuprofen, similar to celecoxib and naproxen, and higher than etoricoxib. The benefit-risk profile of diclofenac was comparable to other treatments used for pain relief in OA and RA; benefits and risks vary in individuals and need consideration when making treatment decisions.

https://link.springer.com/content/pdf/10.1186%2Fs13075-015-0554-0.pdf

Relative benefit-risk comparing diclofenac to other traditional non-steroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors in patients with osteoarthritis or rheumatoid arthritis: a network meta-analysis

Actigraphic recordings during sleep were carried out in patients with rheumatoid arthritis (RA), in patients with chronic low back pain, and in healthy controls for 4 consecutive nights. All derived measures of sleep quality showed that the sleep of patients with RA was significantly poorer than controls, while patients with chronic low back pain had sleep quality not significantly different from either group. Polysomnographically defined periodic movements in sleep were significantly related to sleep efficiency in patients with RA. Clinical status in these patients was significantly related to several actigraphic sleep measures.

Actigraphic measurements of sleep in rheumatoid arthritis: comparison of patients with low back pain and healthy controls.

Thirteen patients with rheumatoid arthritis (mean +/- SD age 55.8 +/- 10.5 years) received 20 mg of tenoxicam daily for 90 days following a 3-7 day "washout" period and 4 days of placebo treatment. Clinical evaluations were conducted at the end of the washout period and at monthly intervals thereafter. All-night polysomnography was performed in a sleep laboratory during the last 2 days of placebo treatment and on days 13, 14, 89, and 90 of tenoxicam treatment. Although there was improvement in the patients' clinical condition, there were no treatment-related changes in any of the sleep parameters. Eight of the 13 patients, however, were found to have primary sleep disorders. Four had periodic leg movements during sleep, 3 had sleep apneas, and 1 had a combination of both disorders. The implications of these findings in the treatment of sleep disorders in patients with rheumatoid arthritis are discussed.

Nonsteroidal antiinflammatory drug therapy in rheumatoid arthritis patients. Lack of association between clinical improvement and effects on sleep.

A comparative study of naproxen with diclofenac sodium in osteoathrosis of the knees

Severe myalgia is an uncommon feature of familial Mediterranean fever (FMF). A patient is presented in whom acute myalgia and high fever were the sole clinical findings during an FMF attack. The ultrastructural picture of the muscle tissue during the acute stage was characterised by a large deposition of collagen fibrils. The myalgia subsided during colchicine treatment. The clinical and ultrastructural features of myalgia in FMF are discussed in the light of the relevant literature.

https://ard.bmj.com/content/annrheumdis/47/1/80.full.pdf

Severe myalgia in familial Mediterranean fever: clinical and ultrastructural aspects.

Severe myalgia infamilial Mediterranean fever: clinical andultrastructural aspects

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

M. Lorber

Author Tools

Chat about Author