Search

Introduction : La prévalence de la démence au sein de la population mondiale est en constante évolution, et aucun traitement curatif n’existe à ce jour. L’un des seuls moyens de protection reste la prévention de cette maladie, passant par l’identification de facteurs potentiellement modifiables. Les benzodiazépines (BZD) sont prescrites contre les troubles anxieux et les troubles de l’alternance veille-sommeil. L’un de leurs effets indésirables est l’amnésie antérograde. Certaines études observationnelles ont noté une éventuelle association entre l’exposition à des benzodiazépines et l’augmentation du risque de développer une démence. Toutefois, ces écrits souffrent d’un biais de causalité inverse relié à la phase prodromique précédant le diagnostic. Objectifs : L’objectif principal de cette étude est d’étudier l’association entre les BZD et l’apparition de démence. Les objectifs secondaires visent à brosser un portrait d’utilisation des BZD dans notre échantillon, d’examiner la relation entre les caractéristiques pharmacocinétiques des BZD et l’augmentation du risque de développer une démence, et enfin d’explorer l’influence de la phase prodromique sur cette association. Méthodologie : Cette étude cas-témoin (n=5 344) est une analyse de données secondaires issue de la cohorte enrichie TorSaDE, elle-même obtenue par le jumelage des données de l’Enquête sur la Santé dans les Collectivités Canadiennes (ESCC), et des banques de données médico-administratives de la Régie de l’assurance maladie du Québec (RAMQ). Les cas étaient des participants âgés de plus de 50 ans avec un diagnostic de démence. Les témoins étaient appariés (1:4) sur des caractéristiques sociodémographiques. Les variables d’utilisation, de demi-vie d’élimination et de durée d’exposition aux BZD ont été analysées dans des régressions logistiques conditionnelles multivariées afin de déterminer le risque de démence en lumière de la littérature recensée. Ensuite, une étude annuelle (1 à 10 ans en amont du

Excessive daytime sleepiness (EDS) is highly prevalent in the general population; however little is known about its evolution and predictors. Our objectives were to document its natural history, provide estimates of its prevalence, incidence and persistence rates, and to identify predictors of increased daytime sleepiness (DS) in a longitudinal community study of 2157 adults over 5 years. Participants completed postal assessment at baseline and at each yearly follow-up. DS was evaluated by the Epworth Sleepiness scale (ESS). At baseline, 33% reported EDS (ESS > 10) with 33% of them reported persistent EDS. Of those without EDS at baseline, 28% developed incident EDS (15% were persistent) and 31% increased DS (augmentation ≥4-points between two consecutive evaluations). Younger age and depression were independent predictors of incident EDS and DS increase while lower coffee consumption, smoking, insomnia, tiredness and chronic pain were associated with incident EDS, and living alone with DS increase only. Persistent vs transient EDS or DS showed association with poor general health including metabolic diseases. Thus, sleepiness fluctuated over time and it was predicted by common lifestyle and psychological factors potentially modifiable. However, persistent sleepiness was associated with chronic medical diseases thus highlighting a homogeneous group at risk requiring a dedicated management.

Cet article discute de l’importance du sommeil dans un contexte de santé publique, particulièrement en période de crise sanitaire comme celle de la COVID-19, et offre quelques recommandations pratiques et appuyées de données probantes pour gérer les difficultés de sommeil durant cette pandémie. La COVID-19 et l’isolement imposé pendant la pandémie ont produit stress, anxiété et inquiétudes en lien avec la santé et la peur d’être infecté du virus, la perte d’emploi et problèmes financiers, et l’incertitude quant au futur. L’incidence des difficultés de sommeil a également augmenté de manière exponentielle durant cette crise. Outre le stress et l’anxiété causés par la pandémie, au moins deux autres facteurs contribuent à exacerber les problèmes de sommeil. Premièrement, plusieurs routines quotidiennes ont été altérées, notamment celles de se lever à la même heure chaque matin, de se présenter au travail, de manger, s’entraîner, avoir des contacts sociaux et pratiquer des loisirs à des heures relativement fixes; ces activités représentent des marqueurs de temps qui synchronisent nos cycles de veille-sommeil avec les cycles des jours et des nuits. La perte de ces repères, combinée à une réduction de l’exposition à la lumière du jour, essentiel à la synchronisation de l’horloge biologique, contribuent à perturber le sommeil et les rythmes circadiens. Le sommeil joue un rôle fondamental pour la santé mentale et physique; une durée et une qualité adéquate de sommeil permettent de développer une meilleure résilience afin de composer avec des événements de vie majeurs comme la COVID-19. L’éducation grand public est donc nécessaire pour sensibiliser la population à l’importance du sommeil et aux bonnes pratiques d’hygiène du sommeil et ainsi minimiser les conséquences à long terme de la pandémie sur la santé mentale et physique., This commentary highlights the critical role of sleep as a public health issue, particularly during a stressful life period such as the COVID-19 pandemic, and provides evidence-based practical guidelines to manage sleep disturbances during this crisis. The COVID-19 pandemic and the imposed social confinement have produced significant stress, anxiety, and worries about health and the fear of being infected, jobs and financial problems, and uncertainty about the future. The incidence of sleep disturbances has also increased dramatically during this period. Aside from stress and anxiety, two other factors are likely to contribute to increased sleep disturbances during this crisis. First, alterations of our daily routines such as arising at a specific time, showing up at work, eating, exercising, and engaging in social and leisure activities at relatively fixed times are all important timekeepers for our sleep-wake cycles to remain synchronized with the day (light) and night (dark) cycles. Alterations of these timekeepers, combined with reduced daylight exposure, also essential to keep our biological clock synchronized, are likely to disrupt sleep and circadian rhythms. Sleep plays a fundamental role for mental and physical health, and adequate sleep duration and quality are essential for coping with major life events such as the COVID-19 pandemic. Public health education is warranted to keep the population well informed about the importance of sleep and healthy sleep practices in order to cope with the pandemic and prevent or minimize long-term adverse outcomes.

Cet article discute de l’importance du sommeil dans un contexte de santé publique, particulièrement en période de crise sanitaire comme celle de la COVID-19, et offre quelques recommandations pratiques et appuyées de données probantes pour gérer les difficultés de sommeil durant cette pandémie. La COVID-19 et l’isolement imposé pendant la pandémie ont produit stress, anxiété et inquiétudes en lien avec la santé et la peur d’être infecté du virus, la perte d’emploi et problèmes financiers, et l’incertitude quant au futur. L’incidence des difficultés de sommeil a également augmenté de manière exponentielle durant cette crise. Outre le stress et l’anxiété causés par la pandémie, au moins deux autres facteurs contribuent à exacerber les problèmes de sommeil. Premièrement, plusieurs routines quotidiennes ont été altérées, notamment celles de se lever à la même heure chaque matin, de se présenter au travail, de manger, s’entraîner, avoir des contacts sociaux et pratiquer des loisirs à des heures relativement fixes; ces activités représentent des marqueurs de temps qui synchronisent nos cycles de veille-sommeil avec les cycles des jours et des nuits. La perte de ces repères, combinée à une réduction de l’exposition à la lumière du jour, essentiel à la synchronisation de l’horloge biologique, contribuent à perturber le sommeil et les rythmes circadiens. Le sommeil joue un rôle fondamental pour la santé mentale et physique; une durée et une qualité adéquate de sommeil permettent de développer une meilleure résilience afin de composer avec des événements de vie majeurs comme la COVID-19. L’éducation grand public est donc nécessaire pour sensibiliser la population à l’importance du sommeil et aux bonnes pratiques d’hygiène du sommeil et ainsi minimiser les conséquences à long terme de la pandémie sur la santé mentale et physique., This commentary highlights the critical role of sleep as a public health issue, particularly during a stressful life period such as the COVID-19 pandemic, and provides evidence-based practical guidelines to manage sleep disturbances during this crisis. The COVID-19 pandemic and the imposed social confinement have produced significant stress, anxiety, and worries about health and the fear of being infected, jobs and financial problems, and uncertainty about the future. The incidence of sleep disturbances has also increased dramatically during this period. Aside from stress and anxiety, two other factors are likely to contribute to increased sleep disturbances during this crisis. First, alterations of our daily routines such as arising at a specific time, showing up at work, eating, exercising, and engaging in social and leisure activities at relatively fixed times are all important timekeepers for our sleep-wake cycles to remain synchronized with the day (light) and night (dark) cycles. Alterations of these timekeepers, combined with reduced daylight exposure, also essential to keep our biological clock synchronized, are likely to disrupt sleep and circadian rhythms. Sleep plays a fundamental role for mental and physical health, and adequate sleep duration and quality are essential for coping with major life events such as the COVID-19 pandemic. Public health education is warranted to keep the population well informed about the importance of sleep and healthy sleep practices in order to cope with the pandemic and prevent or minimize long-term adverse outcomes.

Study Objectives: The study objectives were to examine accidental risks associated with insomnia or hypnotic medications, and how these risk factors interact with sex and age. Methods: A population-based sample of 3,413 adults (Mage = 49.0 years old; 61.5% female), with or without insomnia, were surveyed annually for five consecutive years about their sleep patterns, sleep medication usage, and road collisions. Results: There was a significant risk of reporting road collisions associated with insomnia (hazard ratio [HR] = 1.20; 95% confidence interval [CI] = 1.00–1.45) and daytime fatigue (HR = 1.21; 95% CI = 1.01–1.47). Insomnia and its daytime consequences were perceived to have played some contributory role in 40% of the reported collisions. Both chronic (HR = 1.50; 95% CI = 1.17–1.91) and regular use of sleep medications (HR = 1.58; 95% CI = 1.16–2.14) were associated with higher accidental risks, as well as being young female with insomnia and reporting excessive daytime sleepiness. Conclusions: Both insomnia and use of sleep medications are associated with significant risks of road collisions, possibly because of or in association with some of their residual daytime consequences (i.e. fatigue and poor concentration). The findings also highlight a new group of at-risk patients, i.e. young women reporting insomnia and excessive daytime sleepiness.

Study Objectives The study objectives were to examine accidental risks associated with insomnia or hypnotic medications, and how these risk factors interact with sex and age. Methods A population-based sample of 3,413 adults (Mage = 49.0 years old; 61.5% female), with or without insomnia, were surveyed annually for five consecutive years about their sleep patterns, sleep medication usage, and road collisions. Results There was a significant risk of reporting road collisions associated with insomnia (hazard ratio [HR] = 1.20; 95% confidence interval [CI] = 1.00–1.45) and daytime fatigue (HR = 1.21; 95% CI = 1.01–1.47). Insomnia and its daytime consequences were perceived to have played some contributory role in 40% of the reported collisions. Both chronic (HR = 1.50; 95% CI = 1.17–1.91) and regular use of sleep medications (HR = 1.58; 95% CI = 1.16–2.14) were associated with higher accidental risks, as well as being young female with insomnia and reporting excessive daytime sleepiness. Conclusions Both insomnia and use of sleep medications are associated with significant risks of road collisions, possibly because of or in association with some of their residual daytime consequences (i.e. fatigue and poor concentration). The findings also highlight a new group of at-risk patients, i.e. young women reporting insomnia and excessive daytime sleepiness.

We previously investigated the capacity of the original version of the Edmonton Symptom Assessment System-Revised (ESAS-r) and the Canadian Problem Checklist (CPP) to screen for clinical levels of insomnia in cancer patients. The original ESAS-r includes an item assessing drowsiness and an “other symptom” item, both of which are rated on a scale from 0 to 10, while the CPC has a sleep item, a box which is checked when this problem is present. Because none of these items showed an optimal screening capacity, we concluded that it would be best to add a specific 0–10 sleep item to the ESAS-r. This study assessed the capacity of this ESAS-r-sleep item to screen for clinical insomnia in patients with various cancer types. Methods A total of 392 patients with mixed cancer sites completed the ESAS-r as part of a routine screening procedure implemented in the radio-oncology department of L’Hôtel-Dieu de Québec (CHU de Québec-Université Laval). They also filled out the Insomnia Severity Index (ISI). Results Using a score of 8 or greater on the ISI as the standard criterion for clinical insomnia, a score of 2 or higher on the ESAS-r-sleep item (50.8% of the patients) was the one that showed the best screening indices: sensitivity of 86.7%, specificity of 75.3%, positive predictive value of 71.9%, and negative predictive value of 88.6%. An area under the curve of 0.89 was found, which is excellent. Conclusions Adding a sleep item to the ESAS significantly improves screening of clinical insomnia in cancer patients.

Objectives : High rates of sleep difficulties have been found in patients with advanced cancer. However, not much is known about factors that are associated with sleep impairments in this population and that could constitute their potential risk factors or consequences. This study conducted in patients with cancer receiving palliative care aimed to evaluate the relationships of subjective (sleep diary; Insomnia Severity Index, ISI) and objective (actigraphy) sleep–wake variables with several physical and psychological symptoms, maladaptive sleep behaviours, erroneous beliefs about sleep, quality of life, time to death and environmental factors. Methods : The sample was composed of 57 community-dwelling patients with cancer receiving palliative care and with an Eastern Cooperative Oncology Group Scale score of 2 or 3. Actigraphic, light and sound recording and a daily sleep and pain diary were completed for seven consecutive days. A battery of self-report scales was also administered. Results : Greater disruptions of subjective and objective sleep–wake variables were more consistently associated with worse physical symptoms than with psychological variables. Disrupted objective sleep–wake parameters were also associated with a greater frequency of maladaptive sleep behaviours. Finally, a greater nocturnal noise in the bedroom was correlated with more impairments in subjective and objective sleep–wake variables while a lower 24-hour light exposure was associated with more disruption of subjectively assessed sleep only. Conclusions : Although longitudinal studies are needed to establish the etiology of sleep–wake difficulties in patients with advanced cancer, our findings suggest that physical symptoms, maladaptive sleep behaviours and environmental factors can contribute to their development or their persistence and need to be adequately addressed.

We previously investigated the capacity of the original version of the Edmonton Symptom Assessment System-Revised (ESAS-r) and the Canadian Problem Checklist (CPP) to screen for clinical levels of insomnia in cancer patients. The original ESAS-r includes an item assessing drowsiness and an “other symptom” item, both of which are rated on a scale from 0 to 10, while the CPC has a sleep item, a box which is checked when this problem is present. Because none of these items showed an optimal screening capacity, we concluded that it would be best to add a specific 0–10 sleep item to the ESAS-r. This study assessed the capacity of this ESAS-r-sleep item to screen for clinical insomnia in patients with various cancer types. Methods A total of 392 patients with mixed cancer sites completed the ESAS-r as part of a routine screening procedure implemented in the radio-oncology department of L’Hôtel-Dieu de Québec (CHU de Québec-Université Laval). They also filled out the Insomnia Severity Index (ISI). Results Using a score of 8 or greater on the ISI as the standard criterion for clinical insomnia, a score of 2 or higher on the ESAS-r-sleep item (50.8% of the patients) was the one that showed the best screening indices: sensitivity of 86.7%, specificity of 75.3%, positive predictive value of 71.9%, and negative predictive value of 88.6%. An area under the curve of 0.89 was found, which is excellent. Conclusions Adding a sleep item to the ESAS significantly improves screening of clinical insomnia in cancer patients.

Significant disruptions in sleep–wake cycles have been found in advanced cancer patients in prior research. However, much remains to be known about specific sleep–wake cycle variables that are impaired in patients with a significantly altered performance status. More studies are also needed to explore the extent to which disrupted sleep–wake cycles are related to physical and psychological symptoms, time to death, maladaptive sleep behaviors, quality of life and 24-h light exposure. This study conducted in palliative cancer patients was aimed at characterizing patients’ sleep–wake cycles using various circadian parameters (i.e. amplitude, acrophase, mesor, up-mesor, down-mesor, rhythmicity coefficient). It also aimed to compare rest–activity rhythm variables of participants with a performance status of 2 vs. 3 on the Eastern Cooperative Oncology Group scale (ECOG) and to evaluate the relationships of sleep–wake cycle parameters with several possible correlates. The sample was composed of 55 community-dwelling cancer patients receiving palliative care with an ECOG of 2 or 3. Circadian parameters were assessed using an actigraphic device for seven consecutive 24-h periods. A light recording and a daily pain diary were completed for the same period. A battery of self-report scales was also administered. A dampened circadian rhythm, a low mean activity level, an early mean time of peak activity during the day, a late starting time of activity during the morning and an early time of decline of activity during the evening were observed. In addition, a less rhythmic sleep–wake cycle was associated with a shorter time to death (from the first home visit) and with a lower 24-h light exposure. Sleep–wake cycles are markedly disrupted in palliative cancer patients, especially, near the end of life. Effective non-pharmacological interventions are needed to improve patients’ circadian rhythms, including perhaps bright light therapy.

Objectives : High rates of sleep difficulties have been found in patients with advanced cancer. However, not much is known about factors that are associated with sleep impairments in this population and that could constitute their potential risk factors or consequences. This study conducted in patients with cancer receiving palliative care aimed to evaluate the relationships of subjective (sleep diary; Insomnia Severity Index, ISI) and objective (actigraphy) sleep–wake variables with several physical and psychological symptoms, maladaptive sleep behaviours, erroneous beliefs about sleep, quality of life, time to death and environmental factors. Methods : The sample was composed of 57 community-dwelling patients with cancer receiving palliative care and with an Eastern Cooperative Oncology Group Scale score of 2 or 3. Actigraphic, light and sound recording and a daily sleep and pain diary were completed for seven consecutive days. A battery of self-report scales was also administered. Results : Greater disruptions of subjective and objective sleep–wake variables were more consistently associated with worse physical symptoms than with psychological variables. Disrupted objective sleep–wake parameters were also associated with a greater frequency of maladaptive sleep behaviours. Finally, a greater nocturnal noise in the bedroom was correlated with more impairments in subjective and objective sleep–wake variables while a lower 24-hour light exposure was associated with more disruption of subjectively assessed sleep only. Conclusions : Although longitudinal studies are needed to establish the etiology of sleep–wake difficulties in patients with advanced cancer, our findings suggest that physical symptoms, maladaptive sleep behaviours and environmental factors can contribute to their development or their persistence and need to be adequately addressed.

Il n’existe actuellement pas de cure pour la fibromyalgie, ce syndrome de douleur chronique, dont les symptômes clés incluent la douleur musculaire, la fatigue et des points de douleur pouvant avoir un impact nuisible sur le bien-être psychologique et physique. Les difficultés d’anxiété et de sommeil ne sont pas rares chez ceux qui en souffrent. Bien que les études scientifiques actuelles soient limitées, beaucoup de personnes avec la fibromyalgie choisissent la massothérapie comme traitement de choix. La présente étude propose de vérifier si le massage suédois est efficace pour réduire les symptômes d’anxiété et les troubles de sommeil chez des patients atteints de fibromyalgie. Les hypothèses principales postulaient la baisse de l’anxiété et de l’anxiété liée à la douleur ainsi que l’amélioration du sommeil des personnes ayant reçu un traitement de huit semaines de massage suédois comparativement à des participants ayant été placés sur une liste d’attente. Les hypothèses secondaires postulaient une amélioration de la qualité de vie et une baisse de la douleur chez les mêmes personnes. Cinquante-six personnes atteintes de fibromyalgie provenant de la région de l’Estrie au Québec, réparties en deux groupes, ont complété divers questionnaires avant et après le temps d’observation soit en traitement ou en attente de traitement de massothérapie : la partie trait du State-Trait Anxiety Scale, la version courte du Pain Anxiety Symptoms Scale, le Pittsburgh Sleep Quality Index et le Revised Fibromyalgia Impact Questionnaire. En plus des analyses statistiques descriptives, des analyses inférentielles telles que des tests de Mann-Whitney et Wilcoxon ont été effectuées pour tester les hypothèses. Il n’est pas possible de se prononcer quant aux effets du massage suédois sur les différentes variables. En effet, il s’avère que l’échantillon de cette étude paraît moins affecté négativement par cette maladie comparativement à d’autres échantillons et que ceci ne permet pas de gén

Excessive daytime sleepiness (EDS) is highly prevalent in the general population; however little is known about its evolution and predictors. Our objectives were to document its natural history, provide estimates of its prevalence, incidence and persistence rates, and to identify predictors of increased daytime sleepiness (DS) in a longitudinal community study of 2157 adults over 5 years. Participants completed postal assessment at baseline and at each yearly follow-up. DS was evaluated by the Epworth Sleepiness scale (ESS). At baseline, 33% reported EDS (ESS > 10) with 33% of them reported persistent EDS. Of those without EDS at baseline, 28% developed incident EDS (15% were persistent) and 31% increased DS (augmentation ≥4-points between two consecutive evaluations). Younger age and depression were independent predictors of incident EDS and DS increase while lower coffee consumption, smoking, insomnia, tiredness and chronic pain were associated with incident EDS, and living alone with DS increase only. Persistent vs transient EDS or DS showed association with poor general health including metabolic diseases. Thus, sleepiness fluctuated over time and it was predicted by common lifestyle and psychological factors potentially modifiable. However, persistent sleepiness was associated with chronic medical diseases thus highlighting a homogeneous group at risk requiring a dedicated management.

Significant disruptions in sleep–wake cycles have been found in advanced cancer patients in prior research. However, much remains to be known about specific sleep–wake cycle variables that are impaired in patients with a significantly altered performance status. More studies are also needed to explore the extent to which disrupted sleep–wake cycles are related to physical and psychological symptoms, time to death, maladaptive sleep behaviors, quality of life and 24-h light exposure. This study conducted in palliative cancer patients was aimed at characterizing patients’ sleep–wake cycles using various circadian parameters (i.e. amplitude, acrophase, mesor, up-mesor, down-mesor, rhythmicity coefficient). It also aimed to compare rest–activity rhythm variables of participants with a performance status of 2 vs. 3 on the Eastern Cooperative Oncology Group scale (ECOG) and to evaluate the relationships of sleep–wake cycle parameters with several possible correlates. The sample was composed of 55 community-dwelling cancer patients receiving palliative care with an ECOG of 2 or 3. Circadian parameters were assessed using an actigraphic device for seven consecutive 24-h periods. A light recording and a daily pain diary were completed for the same period. A battery of self-report scales was also administered. A dampened circadian rhythm, a low mean activity level, an early mean time of peak activity during the day, a late starting time of activity during the morning and an early time of decline of activity during the evening were observed. In addition, a less rhythmic sleep–wake cycle was associated with a shorter time to death (from the first home visit) and with a lower 24-h light exposure. Sleep–wake cycles are markedly disrupted in palliative cancer patients, especially, near the end of life. Effective non-pharmacological interventions are needed to improve patients’ circadian rhythms, including perhaps bright light therapy.

This paper summarizes recent epidemiological evidence on insomnia, including its prevalence, incidence, and risk factors, as well as its course and consequences. There is now substantial evidence that insomnia is a significant public health problem. It is a highly prevalent condition, both as a symptom and a syndrome, and is often a persistent condition over time. Its persistence is associated with increased risk for mental (major depression), physical (hypertension), and occupational health problems (disability). Chronic insomnia also carries heavy economic burden, both in terms of direct healthcare costs and, more importantly, in terms of human resources loss due to the illness and lack of treatment. These findings have direct implications for community-based prevention and intervention programs and for future research including the need for: a) longitudinal, population-based studies aimed at evaluating whether we can prevent insomnia among at-risk individuals; b) clinical studies evaluating whether the morbidity associated with chronic insomnia is reversible; and c) prospective health economic evaluations of prevention programs using different dissemination technologies.

The MC1R gene, suggested to be involved in Parkinson disease (PD) and melanoma, was sequenced in PD patients (n = 539) and controls (n = 265) from New York, and PD patients (n = 551), rapid eye movement sleep behavior disorder (RBD) patients (n = 351), and controls (n = 956) of European ancestry. Sixty-eight MC1R variants were identified, including 7 common variants with frequency > 0.01. None of the common variants was associated with PD or RBD in the different regression models. In a meta-analysis with fixed-effect model, the p.R160W variant was associated with an increased risk for PD (odds ratio = 1.22, 95% confidence interval = 1.02–1.47, p = 0.03) but with significant heterogeneity (p = 0.048). Removing one study that introduced the heterogeneity resulted in nonsignificant association (odds ratio = 1.11, 95% confidence interval, 0.92–1.35, p = 0.27, heterogeneity p = 0.57). Rare variants had similar frequencies in patients and controls (10.54% and 10.15%, respectively, p = 0.75), and no cumulative effect of carrying more than one MC1R variant was found. The present study does not support a role for the MC1R p.R160W and other variants in susceptibility for PD or RBD.

Background Shift work disorder involves insomnia and/or excessive sleepiness associated with the work schedule. The present study examined the impact of insomnia on the perceived physical and psychological health of adults working on night and rotating shift schedules compared to day workers. Methods A total of 418 adults (51% women, mean age 41.4 years), including 51 night workers, 158 rotating shift workers, and 209 day workers were selected from an epidemiological study. An algorithm was used to classify each participant of the two groups (working night or rotating shifts) according to the presence or absence of insomnia symptoms. Each of these individuals was paired with a day worker according to gender, age, and income. Participants completed several questionnaires measuring sleep, health, and psychological variables. Results Night and rotating shift workers with insomnia presented a sleep profile similar to that of day workers with insomnia. Sleep time was more strongly related to insomnia than to shift work per se. Participants with insomnia in the three groups complained of anxiety, depression, and fatigue, and reported consuming equal amounts of sleep-aid medication. Insomnia also contributed to chronic pain and otorhinolaryngology problems, especially among rotating shift workers. Work productivity and absenteeism were more strongly related to insomnia. Conclusion The present study highlights insomnia as an important component of the sleep difficulties experienced by shift workers. Insomnia may exacerbate certain physical and mental health problems of shift workers, and impair their quality of life.

The MC1R gene, suggested to be involved in Parkinson disease (PD) and melanoma, was sequenced in PD patients (n = 539) and controls (n = 265) from New York, and PD patients (n = 551), rapid eye movement sleep behavior disorder (RBD) patients (n = 351), and controls (n = 956) of European ancestry. Sixty-eight MC1R variants were identified, including 7 common variants with frequency > 0.01. None of the common variants was associated with PD or RBD in the different regression models. In a meta-analysis with fixed-effect model, the p.R160W variant was associated with an increased risk for PD (odds ratio = 1.22, 95% confidence interval = 1.02–1.47, p = 0.03) but with significant heterogeneity (p = 0.048). Removing one study that introduced the heterogeneity resulted in nonsignificant association (odds ratio = 1.11, 95% confidence interval, 0.92–1.35, p = 0.27, heterogeneity p = 0.57). Rare variants had similar frequencies in patients and controls (10.54% and 10.15%, respectively, p = 0.75), and no cumulative effect of carrying more than one MC1R variant was found. The present study does not support a role for the MC1R p.R160W and other variants in susceptibility for PD or RBD.

Background: Shift work disorder involves insomnia and/or excessive sleepiness associated with the work schedule. The present study examined the impact of insomnia on the perceived physical and psychological health of adults working on night and rotating shift schedules compared to day workers. Methods: A total of 418 adults (51% women, mean age 41.4 years), including 51 night workers, 158 rotating shift workers, and 209 day workers were selected from an epidemiological study. An algorithm was used to classify each participant of the two groups (working night or rotating shifts) according to the presence or absence of insomnia symptoms. Each of these individuals was paired with a day worker according to gender, age, and income. Participants completed several questionnaires measuring sleep, health, and psychological variables. Results: Night and rotating shift workers with insomnia presented a sleep profile similar to that of day workers with insomnia. Sleep time was more strongly related to insomnia than to shift work per se. Participants with insomnia in the three groups complained of anxiety, depression, and fatigue, and reported consuming equal amounts of sleep-aid medication. Insomnia also contributed to chronic pain and otorhinolaryngology problems, especially among rotating shift workers.Work productivity and absenteeism were more strongly related to insomnia. Conclusion: The present study highlights insomnia as an important component of the sleep difficulties experienced by shift workers. Insomnia may exacerbate certain physical and mental health problems of shift workers, and impair their quality of life.

This paper summarizes recent epidemiological evidence on insomnia, including its prevalence, incidence, and risk factors, as well as its course and consequences. There is now substantial evidence that insomnia is a significant public health problem. It is a highly prevalent condition, both as a symptom and a syndrome, and is often a persistent condition over time. Its persistence is associated with increased risk for mental (major depression), physical (hypertension), and occupational health problems (disability). Chronic insomnia also carries heavy economic burden, both in terms of direct healthcare costs and, more importantly, in terms of human resources loss due to the illness and lack of treatment. These findings have direct implications for community-based prevention and intervention programs and for future research including the need for: a) longitudinal, population-based studies aimed at evaluating whether we can prevent insomnia among at-risk individuals; b) clinical studies evaluating whether the morbidity associated with chronic insomnia is reversible; and c) prospective health economic evaluations of prevention programs using different dissemination technologies.

Collection : Psychiatrie ouverte. Série Nodules, Collection : Psychiatrie ouverte, Contient une table des matières, Avec mode texte

Collection : Psychiatrie ouverte. Série Nodules, Collection : Psychiatrie ouverte, Contient une table des matières, Avec mode texte

Collection : Collection Medica, Comprend : L'Hypnotisme et les états analogues au point de vue médico-légal, Contient une table des matières, Avec mode texte

Collection : Collection Medica, Comprend : L'Hypnotisme et les états analogues au point de vue médico-légal, Contient une table des matières, Avec mode texte

Appartient à l’ensemble documentaire : BibHEy, Appartient à l’ensemble documentaire : CentSev001, Contient une table des matières

Le fonctionnement de processus tertiaires à l’arrivée d’un bébé procure aux parents une opportunité pour revisiter leurs identifications. Il s’agit là d’une chance de réorganisation psychique pour eux et par répercussion pour la famille. Dans les soins donnés au bébé, les processus tertiaires favorisent l’infiltration des signifiants énigmatiques divers qui peuvent imposer à la pulsionnalité du bébé de se mettre au service de celle de l’objet. Ces processus indispensables à la survie psychique et physique peuvent mobiliser des déliaisons catastrophiques chez le bébé, voire chez les parents.