Background:Insomnia is a prevalent clinical condition and Shangxia Liangji formula(SXLJF)is a well-established method of treatment.Nevertheless,the specific mechanism of action of SXLJF remains unclear.Methods:The mou...Background:Insomnia is a prevalent clinical condition and Shangxia Liangji formula(SXLJF)is a well-established method of treatment.Nevertheless,the specific mechanism of action of SXLJF remains unclear.Methods:The mouse model of insomnia was established by intraperitoneal injection of para-chlorophenylalanine.Forty-two mice were randomly divided into a negative control group,model group,SXLJF group(18.72 g/kg/day),and positive control group(diazepam,2 mg/kg)and treated with the corresponding drugs for 7 consecutive days.The open field test and pentobarbital-induced sleeping test were conducted.LC-MS-based untargeted metabolomics and network pharmacology were applied to explore the potential targets of SXLJF for treating insomnia.Finally,key targets were validated using RT-qPCR.Results:Behavioral tests demonstrated that SXLJF reduced the total distance,average velocity,central distance,and sleep latency,and prolonged sleep duration.Metabolomics and network pharmacology revealed potential targets,signaling pathways,metabolic pathways,and metabolites associated with the anti-insomnia effects of SXLJF.Specifically,tyrosine hydroxylase(TH)and tyrosine metabolism emerged as crucial metabolic pathways and targets,respectively.RT-qPCR results supported the role of TH in the mechanism of SXLJF in treating insomnia.Conclusion:In conclusion,TH and tyrosine metabolism may represent significant targets and pathways for SXLJF in treating insomnia.展开更多
In this commentary,we respond to Zhao et al’s recent paper which focuses on mechanisms underlying insomnia sufferers’engagement with acupuncture.Insomnia,a prevalent condition characterized by difficulty falling asl...In this commentary,we respond to Zhao et al’s recent paper which focuses on mechanisms underlying insomnia sufferers’engagement with acupuncture.Insomnia,a prevalent condition characterized by difficulty falling asleep and poor sleep quality,is associated with increased risk of cardiovascular disease,diabetes,and psychiatric illness.Acupuncture,a method involving the therapeutic placement of needles,has been widely accepted as a treatment for insomnia with minimal side effects.In fact,clinical trials suggest auricular acupuncture may improve sleep duration more than cognitive behavioral therapy.However,responses to acupuncture vary.Some patients find it extremely beneficial,while others view it as a routine treatment—or avoid it altogether due to needle phobia.Patient engagement is influenced by cultural beliefs,encouragement,motivation,prior experiences,and recommendations from peers or clinicians.Trust in the physician and testimonials from recovered patients are particularly important facilitators.Looking ahead,a holistic approach-integrating acupuncture with meditation,pranayama,yoga,and other restorative practices-may enhance treatment effectiveness and help patients achieve restorative sleep.展开更多
Insomnia,anxiety,and depression have emerged as significant public mental health concerns,particularly during the coronavirus disease 2019(COVID-19)pandemic.Early recognition and intervention,addressing COVID-19's...Insomnia,anxiety,and depression have emerged as significant public mental health concerns,particularly during the coronavirus disease 2019(COVID-19)pandemic.Early recognition and intervention,addressing COVID-19's health effects before diverse symptoms appear,will expedite recovery and significantly enhance public mental health.Li et al conducted a cross-sectional online survey to assess neuroticism,cognitive function,insomnia,and emotional disorders in adult participants,examining how these factors correlate with mental health.The study revealed that a substantial number of participants reported experiencing varying degrees of anxiety,depression,and insomnia,most of which were classified as mild.Neuroticism was found closely associated with cognitive failure and poor mental health.Furthermore,moderated mediation analysis indicated that cognitive failure mediated the relationship between insomnia and anxiety and depression,whereas neuroticism moderated the pathway.These findings suggest that improving the subjective cognitive function and emotional stability can significantly improve mental health.However,this study has several limitations,including a limited sample size,cross-sectional design,and a focus on behavioral-level data.Future research should broaden its scope to include multiple hospitals at various levels to enhance the representativeness of the study population,adopt longitudinal designs,and integrate advanced technologies such as neuroimaging to explore the neural mechanisms underlying these conditions.展开更多
[Objectives]To systematically evaluate the clinical efficacy of head massage combined with Chinese herbal bath in treating insomnia and analyze its herbal medication patterns.[Methods]Clinical data of 200 chronic inso...[Objectives]To systematically evaluate the clinical efficacy of head massage combined with Chinese herbal bath in treating insomnia and analyze its herbal medication patterns.[Methods]Clinical data of 200 chronic insomnia patients treated at the Sleep Disorder Center of Taihe Hospital from January 2020 to December 2024 were retrospectively analyzed.Patients were randomly divided into observation group and control group(n=100 each).The observation group received head massage combined with Chinese herbal bath therapy,while the control group received Chinese herbal bath alone.The Pittsburgh Sleep Quality Index(PSQI)was used for efficacy evaluation,and statistical analysis was performed on the frequency of herbal medications in herbal herbal bath formulas.[Results]The PSQI score improvement in the observation group(8.44±1.87)was significantly better than that in the control group(5.74±1.93)(P<0.01).Herbal formulas for external bath primarily contained mind-calming and heart-nourishing herbs(fried Ziziphi Spinosae Semen,Concha Margaritifera)and heat-clearing herbs(Rhizoma Coptidis,Radix Scutellariae).[Conclusions]The combination of head massage and Chinese herbal bath can significantly improve sleep quality in insomnia patients,demonstrating superior clinical efficacy compared with Chinese herbal bath alone.This combined therapy shows good safety and operability,warranting promotion in primary and specialized medical institutions.展开更多
Insomnia,anxiety,and depression have become critical mental health issues exacerbated by the coronavirus disease 2019 pandemic,highlighting the importance of understanding their interrelationships.This article evaluat...Insomnia,anxiety,and depression have become critical mental health issues exacerbated by the coronavirus disease 2019 pandemic,highlighting the importance of understanding their interrelationships.This article evaluates the study by Li et al,which investigates the links between insomnia,anxiety,and depression while examining the mediating role of cognitive failures and the moderating effect of neuroticism.The study employed a cross-sectional design with 1011 participants,using validated scales to measure insomnia severity,neuroticism,cognitive failures,and mental health indicators.Li et al found that approximately 40%of participants exhibited symptoms of anxiety,depression,and insomnia,with most cases being mild.The results demonstrated that cognitive failures play a mediating role in the relationship between insomnia and both anxiety and depression.Furthermore,neuroticism moderated the relationship between insomnia and cognitive failures,with a stronger effect observed in individuals with lower levels of neuroticism.These findings underscore the importance of considering personality traits and cognitive processes in understanding mental health outcomes.This study emphasizes the critical need for interventions aimed at reducing cognitive failures and enhancing emotional stability to mitigate the impact of insomnia on mental health.Strategies to improve sleep quality,boost cognitive resilience,and regulate emotional responses could significantly enhance individuals’mental well-being.Moreover,integrating personality assessments into mental health services could facilitate more effective and personalized interventions.This article provides an original perspective on the effects of the coronavirus disease 2019 pandemic on global mental health.The content of the article addresses the complex relationships between sleep disorders,cognitive function losses,and neuroticism in light of data compiled from existing literature and current research.In addition,how these relationships have deepened during the pandemic and the effectiveness of proposed treatment methods for these phenomena are discussed in comparison with previous studies.The arguments in the article offer new perspectives and suggestions aimed at filling gaps in the literature,and make an important contribution to both clinical practice and public health policies.Li et al’s study provides a comprehensive framework for understanding the connections between insom-nia,cognitive failures,and neuroticism,as well as their influence on anxiety and depression.The findings offer valuable implications for public health strategies,emphasizing the necessity of holistic approaches to address post-pandemic mental health challenges.展开更多
BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in iden...BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in identifying solutions to improve public mental health.AIM To investigate the prevalence of anxiety,depression,and insomnia and explore the relationship among neuroticism,cognitive failures,and mental health.METHODS A cross-sectional survey was conducted in December 2023 using an online platform to recruit adult participants.The neuroticism,subjective cognitive function,and mental health of the participants were assessed using the neuroticism subscale of the Chinese Big Five Personality Inventory Brief Version,cognitive failures questionnaire,generalized anxiety disorder-7,patient health questionnaire-9,and insomnia severity index.Pearson's correlation analysis,independent samples t-tests,one-way analysis of variance,and structural equation model were used to examine the relationship between mental health indicators.RESULTS A total of 1011 valid questionnaires were collected,of which 343 were completed by male(33.93%)respondents and 668 were completed by female(66.07%)respondents.The rates of anxiety,depression,and insomnia were 41.3%,44.6%,and 36.3%,respectively,most cases of which were mild.Among the mental health indicators,there were significant differences by age and between those with siblings and those who were only children.Neuroticism and cognitive failures were significantly positively correlated with mental health indicators.Further moderated mediation analysis showed that cognitive failures mediated the relationship between insomnia and anxiety and between insomnia and depression,with neuroticism moderating the first half of this pathway and the effect being greater in the low-neuroticism group.CONCLUSION Cognitive failures and neuroticism play important roles in mental health.Therefore,enhancing subjective cognitive function and regulating emotional stability may contribute to the improvement of mental health.展开更多
BACKGROUND Insomnia is a common sleep disorder that negatively impacts quality of life and is frequently comorbid with depression and anxiety.Chronic insomnia affects approximately 15%of the global population,with hig...BACKGROUND Insomnia is a common sleep disorder that negatively impacts quality of life and is frequently comorbid with depression and anxiety.Chronic insomnia affects approximately 15%of the global population,with higher prevalence among females and the elderly.While existing research suggests a bidirectional relationship between insomnia and emotional disorders,the specific impact of insomnia severity on depression,anxiety,and quality of life remains unclear.This study investigates the correlation between insomnia severity and these factors in psychiatric outpatients,hypothesizing that greater insomnia severity is associated with higher levels of depression and anxiety,as well as poorer quality of life.AIM To explore the correlation between insomnia severity and depression,anxiety,and quality of life in primary chronic insomnia patients.METHODS From June to December 2023,345 patients with primary insomnia in Chifeng city were recruited and divided into three groups based on Pittsburgh sleep quality index(PSQI)scores:Mild(n=137),moderate(n=162),and severe(n=46).Demographic data were collected via questionnaires.Self-rating depression scale(SDS),self-rating anxiety scale(SAS),PSQI,and short form 36(SF-36)scores were compared,and Pearson and partial correlation analyses were performed.RESULTS The greater the degree of insomnia,the greater the symptoms of depression and anxiety(P<0.001).The more severe the insomnia,the lower the SF-36 score(excluding body pain),and the difference between the three groups was statist ically significant(P<0.001).Pearson correlation analysis and partial correlation analysis depicted the SDS score and SAS score were apparently positively correlated with the severity of insomnia(P<0.001).Pearson correlation analysis and partial correlation analysis depicted the SF-36 scores were apparently positively correlated with the severity of insomnia(P<0.05).CONCLUSION Depression and anxiety are independent factors influencing insomnia severity in primary chronic insomnia patients.Higher depression/anxiety levels correlate with worse insomnia,impacting quality of life.展开更多
A recent study of patient-centered perspectives by Zhao et al,published in the World Journal of Psychiatry,identified key facilitators and barriers that influence insomnia patients’choice of acupuncture therapy,offer...A recent study of patient-centered perspectives by Zhao et al,published in the World Journal of Psychiatry,identified key facilitators and barriers that influence insomnia patients’choice of acupuncture therapy,offering insights for clinical practice and policy-making to enhance the integration of acupuncture therapy into comprehensive insomnia management.While acupuncture demonstrates unique advantages as a complementary medical approach,its broader adoption is hindered by complex multidimensional factors.This paper proposes a“dynamic balance model”encompassing the cultural,economic,and patient-provider trust dimensions,and emphasizes the need for synergistic optimization through cultural narrative transformation,institutional innovation,and digital empowerment.These strategies aim to facilitate the promotion of acupuncture for insomnia treatment and its global expansion.展开更多
BACKGROUND Depression,anxiety,and insomnia were found out that were significant relevance to the mental health impact of the coronavirus disease 2019(COVID-19)lock-down.AIM To examine the interrelationships among perc...BACKGROUND Depression,anxiety,and insomnia were found out that were significant relevance to the mental health impact of the coronavirus disease 2019(COVID-19)lock-down.AIM To examine the interrelationships among perceived severity,anxiety,depression,insomnia,and sense of security in Chinese community residents during the COVID-19 lockdown period.METHODS Participants were selected using simple random sampling from four large gated communities in Chengdu,China.All participants were invited to complete a survey that included the Perceived Severity Questionnaire,Security Question-naire,Patient Health Questionnaire-9,Generalized Anxiety Disorder 7-item,and Insomnia Severity Index-7.In total,568 valid questionnaires were gathered.Co-rrelation analysis and structural equation models were used to explore the rela-RESULTS The observed prevalence rates of anxiety,depression,and insomnia among residents during lockdown were 27.5%,17.6%,and 16.0%,respectively.Correlation analysis showed that both perceived severity and sense of security were positively correlated with anxiety,depression,and insomnia[Pearson’s r was perceived severity and anxiety r=0.44(P<0.01);with depression r=0.48(P<0.01);with insomnia r=0.43(P<0.01);security with anxiety r=-0.65(P<0.01);with depression r=-0.65(P<0.01);with insomnia r=-0.53(P<0.01)].Structural equation modeling and bootstrap tests revealed that sense of security acted as a significant mediator in the relationship between perceived severity and emotional and sleep disorders(anxiety,depression,and insomnia).CONCLUSION This study demonstrates that sense of security is a significant predictor of emotional and sleep disorders(namely,depression,anxiety,and insomnia)among residents during the COVID-19 lockdown,with sense of security acting as a mediating factor.These findings suggest that mental health interventions for Chinese community residents during lockdowns may benefit from developing community-based educational programs to reduce perceived severity and ensuring the stable supply of essential resources and promoting social support networks to enhance the sense of security.展开更多
Insomnia is associated with neurotransmitters and intestinal dysbiosis.Though studies have demonstrated the ameliorative effects of milk hydrolysates on insomnia,the underlying mechanisms require further exploration.I...Insomnia is associated with neurotransmitters and intestinal dysbiosis.Though studies have demonstrated the ameliorative effects of milk hydrolysates on insomnia,the underlying mechanisms require further exploration.In this study,we investigated how papain hydrolysates of goat casein(CPH)and whey protein(WPH)affected mice's sleeplessness.Here,we show that CPH effectively improved the total sleep time in 12 h and restoring neurotransmitters(5-hydroxytryptamine(5-HT),γ-aminobutyric acid(GABA),dopamine(DA),and norepinephrine(NE))in mice.Further gut microbiota analysis revealed a significant increase in the relative abundance of Helicobacter and Escherichia-Shigella and a decrease in the relative abundance of Lactobacillus in the insomnia model mice(Model).Compared to the Model group,both CPH and WPH significantly increased the relative abundance of Akkermansia and Lactobacillus while lowering the relative abundance of Helicobacter and Escherichia-Shigella.Notably,while diazepam(DZP)increased mouse sleep duration,it also increased the relative abundance of Colidextribacter,Parasutterella,Muribaculaceae,and Prevotella.Additionally,the gene expression and protein expression of GABA_A receptor,cAMP-response element binding protein(CREB),and brain-derived neurotrophic factor(BDNF)were upregulated in the hypothalamus.We also discovered a link between intestinal gut microbiota and neurotransmitters.Overall,our results suggest that goat milk hydrolysates,especially CPH,can effectively improve insomnia,providing a theoretical basis for further experimentation and individualized designs.展开更多
Objective:The concept of constitution in traditional Chinese medicine(TCM)has been increasingly recognized as a crucial factor in both the prevention and treatment of insomnia.However,rigorous statistical evidence on ...Objective:The concept of constitution in traditional Chinese medicine(TCM)has been increasingly recognized as a crucial factor in both the prevention and treatment of insomnia.However,rigorous statistical evidence on the correlation between TCM constitutions—particularly mixed constitutions—and insomnia disorder remains limited.This study aimed to investigate the association between specific TCM constitutions and insomnia disorder.Methods:A cross-sectional study was conducted at the Department of Preventive Medicine,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai,from November 2022 to December 2023.TCM constitutions were assessed using the Constitution in Chinese Medicine Questionnaire.Insomnia disorder was diagnosed by experienced internal medicine physicians according to the criteria of the International Classification of Sleep Disorders,Third Edition.A total of 1065 eligible participants(242 with insomnia disorder and 823 controls)were included in the final analysis.Results:Among the participants,862(80.94%)exhibited biased constitutions,with 75.30%of these having mixed constitutions.Logistic regression analysis revealed a negative association between the gentleness constitution and insomnia disorder,whereas qi-deficiency,yang-deficiency,phlegm-dampness and qidepression constitutions were positively associated with insomnia disorder.These associations remained significant after adjusting for potential confounders and were further validated through sensitivity analysis using propensity score matching.Conclusion:Significant associations between TCM constitutions and insomnia disorder were demonstrated.Future research should further investigate these relationships and explore the underlying mechanisms through rigorous longitudinal and interventional studies to improve understanding and clinical applications.展开更多
BACKGROUND As a substitute for traditional drug therapy,digital cognitive-behavioral therapy positively impacts the regulation of brain function,which can improve insomnia.However,there is currently a paucity of studi...BACKGROUND As a substitute for traditional drug therapy,digital cognitive-behavioral therapy positively impacts the regulation of brain function,which can improve insomnia.However,there is currently a paucity of studies on digital cognitive behavioral therapy as a treatment for insomnia.AIM To assess digital cognitive behavioral therapy for insomnia regarding its positive impact on brain function.METHODS Participants were randomly assigned to either a go/no-go group or a dot-probe group.The primary outcome was quality of sleep as assessed by the actigraphy sleep monitoring bracelet,Pittsburgh sleep quality index(PSQI),insomnia severity index(ISI),and depression anxiety and stress scale(DASS-21).RESULTS Eighty patients were included in the analysis(go/no-go group:n=40;dot-probe group:n=40).We combined the total scale scores of the two groups before and after the intervention in the analysis of covariance.Our study explored whether insomnia symptoms in both groups can be improved by using digital cognitive behavioral therapy instead of trying to compare the two trials;therefore,only one P value is listed.In both groups,we found a short-term time effect on insomnia symptom severity(PSQI:P<0.001,η^(2)=0.336;ISI:P<0.001,η^(2)=0.667;DASS-depression:P<0.001,η^(2)=0.582;DASS-anxiety:P<0.001,η^(2)=0.337;DASS-stress:P<0.001,η^(2)=0.443)and some effect on sleep efficiency(but it was not significant,P=0.585,η^(2)=0.004).CONCLUSION Go/no-go task training of inhibitory function had a short-term positive effect on sleep efficiency,whereas dotprobe task training had a positive short-term effect on emotion regulation.展开更多
This paper conducts an in-depth analysis of the theory and methods for differentiating and treating insomnia in Bu Ju Ji by Wu Cheng,a physician of the Qing Dynasty.By systematically sorting out the origin of Wu Cheng...This paper conducts an in-depth analysis of the theory and methods for differentiating and treating insomnia in Bu Ju Ji by Wu Cheng,a physician of the Qing Dynasty.By systematically sorting out the origin of Wu Cheng’s academic thoughts,this study explores his unique perspective on differentiating and treating insomnia,analyzes the compatibility rules of his core formulas and herbs,and reveals the characteristics of his medication use as well as its guiding value for later clinical practice.Research shows that Wu Cheng integrated the principles of the I Ching(Book of Changes)with medical theories to construct a theoretical system for consumptive diseases.In the differentiation and treatment of insomnia,he emphasized the dynamic balance of zang-fu organs,Qi,blood,Yin and Yang,with special attention to the impact of spleen-Yin deficiency on insomnia.He thus formed distinctive academic features,including treating both deficiency and excess,taking into account both Qi and blood,and regulating the spleen to protect the body’s defense system.In terms of medication,he was skilled in using herbs that are sweet and warm in nature for tonification,harmonizing Qi and blood,and invigorating the spleen to nourish Yin.These insights hold significant reference value for modern TCM(Traditional Chinese Medicine)in the treatment of insomnia.展开更多
Research background and Objectives: Cognitive Behavioral Therapy for Insomnia (CBT-I) is recognized as the preferred non-pharmaceutical treatment for Insomnia. This pilot study aims to test the efficacy of an extended...Research background and Objectives: Cognitive Behavioral Therapy for Insomnia (CBT-I) is recognized as the preferred non-pharmaceutical treatment for Insomnia. This pilot study aims to test the efficacy of an extended version of CBT-I called Integrative Therapy for Insomnia (IT-I). The traditional CBT-I is complemented with exercises that are expected to enhance relearning to sleep by providing different stimuli, and access options for the retrieval and application of the acquired information, cognition, and skills. Method: The efficacy of the IT-I is measured by comparing the participants’ scores on the Insomnia Severity Index at baseline and post-treatment. In total 29 people, with a wide range of ages, participated in the 8 sessions’ treatment of one hour 45 minutes per session, in mixed groups of age, gender, and primary or comorbid insomnia. Results: Comparing the ISI baseline and post-treatment scores, results show a mean improvement of 7.2 points and a p r = −0.43. Conclusions: The integration of exercises that generate sensory-motor stimuli, and address the mirror neuron system fitting with the Mental Contrasting as a metacognitive strategy seems to facilitate re-learning to sleep in cases of primary insomnia as well as for comorbid insomnia. Further studies will be needed to arrive at more firm conclusions.展开更多
Background:Electroacupuncture is often used to treat insomnia.Objective:To evaluate the efficacy and safety of electroacupuncture for insomnia.Search strategy:Databases including PubMed,Cochrane Library,Embase,Web of ...Background:Electroacupuncture is often used to treat insomnia.Objective:To evaluate the efficacy and safety of electroacupuncture for insomnia.Search strategy:Databases including PubMed,Cochrane Library,Embase,Web of Science,Chinese Biomedical Literature Database,China National Knowledge Infrastructure,Wanfang Data and VIP Fulltext e-Journals Database were searched up to January 15,2023.Inclusion criteria:Randomized clinical trials were included if they compared the clinical efficacy and safety of electroacupuncture with sham acupuncture,no treatment or usual care (UC) and general acupuncture.Data extraction and analysis:The full texts of the studies were reviewed to remove ineligible literature.The extracted data included authors,publication year,diagnostic criteria,sample size,population characteristics,interventions and outcomes.The above steps were performed independently by two reviewers and the data were cross checked.Stata15.0 software was used to analyze the extracted outcome data.For continuous data (Pittsburgh Sleep Quality Index[PSQI]score and Insomnia Severity Index score),weighted mean difference (WMD) was calculated and 95% confidence interval (CI) was reported when the same scale was applied.For dichotomous variables (clinical response rate and adverse events),a meta-analysis was performed using risk ratio (RR) as the effect indicator.Results:Thirty-one trials with 2226 subjects were included.The meta-analysis suggested that electroacupuncture was more effective in improving insomnia compared with the control group (sham acupuncture,no treatment,UC and general acupuncture)(RR=1.21;95 CI:[1.16,1.27]),significantly reducing the PSQI score in insomnia patients after treatment and at follow-up (WMD=-3.23;95%CI:[-4.29,-2.17];P<0.001).There was no significant difference in the incidence of adverse events between the EA and control groups (sham acupuncture and no treatment or UC.RR=1.48;95%CI:[0.91,2.40];P=0.117).In addition,the regression results revealed that receiving electroacupuncture for seven to nine weeks provided the best efficacy (P<0.05). Conclusion:Electroacupuncture can significantly promote better sleep quality in insomnia patients and is suitable for the treatment of various types of insomnia.However,the articles included were single-center trials with small sample sizes,and some articles were of poor quality.Therefore,further research is still needed to confirm these findings.展开更多
Insomnia,as one of the emotional diseases,has been increasing in recent years,which has a great impact on people's life and work.Therefore,researchers are eager to find a more perfect treatment.The microbiome-gut-...Insomnia,as one of the emotional diseases,has been increasing in recent years,which has a great impact on people's life and work.Therefore,researchers are eager to find a more perfect treatment.The microbiome-gut-brain axis is a new theory that has gradually become popular abroad in recent years and has a profound impact in the field of insomnia.In recent years,traditional Chinese medicine(TCM)has played an increasingly important role in the treatment of insomnia,especially acupuncture and Chinese herbal medicine.It is the main method of TCM in the treatment of insomnia.This paper mainly reviews the combination degree of"microorganism-gut-brain axis"theory with TCM and acupuncture under the system of TCM.To explore the mechanism of TCM and acupuncture in the treatment of insomnia under the guidance of"microorganismgut-brain axis"theory,in order to provide a new idea for the diagnosis and treatment of insomnia.展开更多
In recent years,insomnia has gradually become a common disease in society,which seriously affects people's quality of life.At present,with the deepening of research on intestinal microbiota-gut-brain axis in Weste...In recent years,insomnia has gradually become a common disease in society,which seriously affects people's quality of life.At present,with the deepening of research on intestinal microbiota-gut-brain axis in Western medicine,many studies suggest that regulating the gastrointestinal tract can treat brain-related diseases.It is found that brain-gut-bacteria axis plays an important role in the prevention and treatment of primary insomnia.At present,although the clinical treatment of insomnia with Western medicine can improve the insomnia symptoms of patients to a certain extent,there are still obvious adverse reactions,such as anxiety and depression,drug addiction,etc.,so long-term oral drug therapy cannot be carried out.Traditional Chinese medicine(TCM)and acu-puncture techniques have certain therapeutic effects on insomnia.TCM believes that the brain and gastrointestinal system are connected through the meridian,and the pathophysiology is closely related.This paper will discuss the theory and feasibility of TCM for the treatment of insomnia from the pathological relation-ship between brain-gut axis,intestinal flora and insomnia.展开更多
BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even afte...BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.展开更多
BACKGROUND The treatment of adolescent patients with anxiety,depression and insomnia is challenging,and there is no ideal treatment method.AIM To evaluate the clinical efficacy of Wuling capsule combined with sertrali...BACKGROUND The treatment of adolescent patients with anxiety,depression and insomnia is challenging,and there is no ideal treatment method.AIM To evaluate the clinical efficacy of Wuling capsule combined with sertraline in the treatment of adolescent anxiety,depression and insomnia.METHODS Eighty adolescent patients with anxiety,depression with insomnia who were admitted to our hospital from April 1,2022 to March 30,2024.And the subjects were randomly classified into the control group(n=40)and the observational group(n=40).The control group was treated with a combination of sertraline and placebo.The observation group was treated with Wuling capsule in addition to sertraline.The two groups were cured continuously for 8 weeks.Insomnia severity index(ISI),Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)were used to evaluate the clinical symptoms before treatment and at 2,4,6 and 8 weeks after treatment.The Treatment Emergent Symptom Scale(TESS)was used to evaluate adverse reactions during treatment.RESULTS There was no obvious difference in HAMD,HAMA and ISI scores between the two groups before treatment(P>0.05).After treatment,the HAMD,HAMA and ISI scores of patients in both groups decreased compared with before treatment,and HAMD,HAMA and ISI scores of patients in the observation group were remarkedly lower than those in the control group at each time point after treatment(P<0.05).Compared with the control group,the TESS score of the study group were sharply lower(t=18.239,P<0.001).CONCLUSION Wuling capsule can further alleviate the insomnia symptoms of adolescents with anxiety and depression,and the efficacy and safety are high.It is recommended to promote the application.展开更多
Insomnia is among the most common sleep disorders worldwide.Insomnia in older adults is a social and public health problem.Insomnia affects the physical and mental health of elderly hospitalized patients and can aggra...Insomnia is among the most common sleep disorders worldwide.Insomnia in older adults is a social and public health problem.Insomnia affects the physical and mental health of elderly hospitalized patients and can aggravate or induce physical illnesses.Understanding subjective feelings and providing reasonable and standardized care for elderly hospitalized patients with insomnia are urgent issues.AIM To explore the differences in self-reported outcomes associated with insomnia among elderly hospitalized patients.METHODS One hundred patients admitted to the geriatric unit of our hospital between June 2021 and December 2021 were included in this study.Self-reported symptoms were assessed using the Athens Insomnia Scale(AIS),Generalized Anxiety Disorder Scale-7(GAD-7),Geriatric Depression Scale-15(GDS-15),Memorial University of Newfoundland Scale of Happiness(MUNSH),Barthel Index Evaluation(BI),Morse Fall Scale(MFS),Mini-Mental State Examination,and the Short Form 36 Health Survey Questionnaire(SF-36).Correlation coefficients were used to analyze the correlation between sleep quality and self-reported symptoms.Effects of insomnia was analyzed using Logistic regression analysis.RESULTS Nineteen patients with AIS≥6 were included in the insomnia group,and the incidence of insomnia was 19%(19/100).The remaining 81 patients were assigned to the non-insomnia group.There were significant differences between the two groups in the GDA-7,GDS-15,MUNSH,BI,MFS,and SF-36 items(P<0.05).Patients in the insomnia group were more likely to experience anxiety,depression,and other mental illnesses,as well as difficulties with everyday tasks and a greater risk of falling(P<0.05).Subjective well-being and quality of life were poorer in the insomnia group than in the control group.The AIS scores positively correlated with the GAD-7,GDS-15,and MFS scores in elderly hospitalized patients with insomnia(P<0.05).Logistic regression analysis showed that GDS-15≥5 was an independent risk factor for insomnia in elderly hospitalized patients(P<0.05).CONCLUSION The number of self-reported symptoms was higher among elderly hospitalized patients with insomnia.Therefore,we should focus on the main complaints of patients to meet their care needs.展开更多
基金Science Foundation of Hunan Province(2021JJ40510)General Guidance Project of Hunan Health Commission(202203074169)+1 种基金Clinical Medical Technology Innovation Guidance Project of Hunan Province(2021SK51901)and Key Guiding Projects of Hunan Health Commission(20201918)for supporting this study.
文摘Background:Insomnia is a prevalent clinical condition and Shangxia Liangji formula(SXLJF)is a well-established method of treatment.Nevertheless,the specific mechanism of action of SXLJF remains unclear.Methods:The mouse model of insomnia was established by intraperitoneal injection of para-chlorophenylalanine.Forty-two mice were randomly divided into a negative control group,model group,SXLJF group(18.72 g/kg/day),and positive control group(diazepam,2 mg/kg)and treated with the corresponding drugs for 7 consecutive days.The open field test and pentobarbital-induced sleeping test were conducted.LC-MS-based untargeted metabolomics and network pharmacology were applied to explore the potential targets of SXLJF for treating insomnia.Finally,key targets were validated using RT-qPCR.Results:Behavioral tests demonstrated that SXLJF reduced the total distance,average velocity,central distance,and sleep latency,and prolonged sleep duration.Metabolomics and network pharmacology revealed potential targets,signaling pathways,metabolic pathways,and metabolites associated with the anti-insomnia effects of SXLJF.Specifically,tyrosine hydroxylase(TH)and tyrosine metabolism emerged as crucial metabolic pathways and targets,respectively.RT-qPCR results supported the role of TH in the mechanism of SXLJF in treating insomnia.Conclusion:In conclusion,TH and tyrosine metabolism may represent significant targets and pathways for SXLJF in treating insomnia.
文摘In this commentary,we respond to Zhao et al’s recent paper which focuses on mechanisms underlying insomnia sufferers’engagement with acupuncture.Insomnia,a prevalent condition characterized by difficulty falling asleep and poor sleep quality,is associated with increased risk of cardiovascular disease,diabetes,and psychiatric illness.Acupuncture,a method involving the therapeutic placement of needles,has been widely accepted as a treatment for insomnia with minimal side effects.In fact,clinical trials suggest auricular acupuncture may improve sleep duration more than cognitive behavioral therapy.However,responses to acupuncture vary.Some patients find it extremely beneficial,while others view it as a routine treatment—or avoid it altogether due to needle phobia.Patient engagement is influenced by cultural beliefs,encouragement,motivation,prior experiences,and recommendations from peers or clinicians.Trust in the physician and testimonials from recovered patients are particularly important facilitators.Looking ahead,a holistic approach-integrating acupuncture with meditation,pranayama,yoga,and other restorative practices-may enhance treatment effectiveness and help patients achieve restorative sleep.
文摘Insomnia,anxiety,and depression have emerged as significant public mental health concerns,particularly during the coronavirus disease 2019(COVID-19)pandemic.Early recognition and intervention,addressing COVID-19's health effects before diverse symptoms appear,will expedite recovery and significantly enhance public mental health.Li et al conducted a cross-sectional online survey to assess neuroticism,cognitive function,insomnia,and emotional disorders in adult participants,examining how these factors correlate with mental health.The study revealed that a substantial number of participants reported experiencing varying degrees of anxiety,depression,and insomnia,most of which were classified as mild.Neuroticism was found closely associated with cognitive failure and poor mental health.Furthermore,moderated mediation analysis indicated that cognitive failure mediated the relationship between insomnia and anxiety and depression,whereas neuroticism moderated the pathway.These findings suggest that improving the subjective cognitive function and emotional stability can significantly improve mental health.However,this study has several limitations,including a limited sample size,cross-sectional design,and a focus on behavioral-level data.Future research should broaden its scope to include multiple hospitals at various levels to enhance the representativeness of the study population,adopt longitudinal designs,and integrate advanced technologies such as neuroimaging to explore the neural mechanisms underlying these conditions.
文摘[Objectives]To systematically evaluate the clinical efficacy of head massage combined with Chinese herbal bath in treating insomnia and analyze its herbal medication patterns.[Methods]Clinical data of 200 chronic insomnia patients treated at the Sleep Disorder Center of Taihe Hospital from January 2020 to December 2024 were retrospectively analyzed.Patients were randomly divided into observation group and control group(n=100 each).The observation group received head massage combined with Chinese herbal bath therapy,while the control group received Chinese herbal bath alone.The Pittsburgh Sleep Quality Index(PSQI)was used for efficacy evaluation,and statistical analysis was performed on the frequency of herbal medications in herbal herbal bath formulas.[Results]The PSQI score improvement in the observation group(8.44±1.87)was significantly better than that in the control group(5.74±1.93)(P<0.01).Herbal formulas for external bath primarily contained mind-calming and heart-nourishing herbs(fried Ziziphi Spinosae Semen,Concha Margaritifera)and heat-clearing herbs(Rhizoma Coptidis,Radix Scutellariae).[Conclusions]The combination of head massage and Chinese herbal bath can significantly improve sleep quality in insomnia patients,demonstrating superior clinical efficacy compared with Chinese herbal bath alone.This combined therapy shows good safety and operability,warranting promotion in primary and specialized medical institutions.
文摘Insomnia,anxiety,and depression have become critical mental health issues exacerbated by the coronavirus disease 2019 pandemic,highlighting the importance of understanding their interrelationships.This article evaluates the study by Li et al,which investigates the links between insomnia,anxiety,and depression while examining the mediating role of cognitive failures and the moderating effect of neuroticism.The study employed a cross-sectional design with 1011 participants,using validated scales to measure insomnia severity,neuroticism,cognitive failures,and mental health indicators.Li et al found that approximately 40%of participants exhibited symptoms of anxiety,depression,and insomnia,with most cases being mild.The results demonstrated that cognitive failures play a mediating role in the relationship between insomnia and both anxiety and depression.Furthermore,neuroticism moderated the relationship between insomnia and cognitive failures,with a stronger effect observed in individuals with lower levels of neuroticism.These findings underscore the importance of considering personality traits and cognitive processes in understanding mental health outcomes.This study emphasizes the critical need for interventions aimed at reducing cognitive failures and enhancing emotional stability to mitigate the impact of insomnia on mental health.Strategies to improve sleep quality,boost cognitive resilience,and regulate emotional responses could significantly enhance individuals’mental well-being.Moreover,integrating personality assessments into mental health services could facilitate more effective and personalized interventions.This article provides an original perspective on the effects of the coronavirus disease 2019 pandemic on global mental health.The content of the article addresses the complex relationships between sleep disorders,cognitive function losses,and neuroticism in light of data compiled from existing literature and current research.In addition,how these relationships have deepened during the pandemic and the effectiveness of proposed treatment methods for these phenomena are discussed in comparison with previous studies.The arguments in the article offer new perspectives and suggestions aimed at filling gaps in the literature,and make an important contribution to both clinical practice and public health policies.Li et al’s study provides a comprehensive framework for understanding the connections between insom-nia,cognitive failures,and neuroticism,as well as their influence on anxiety and depression.The findings offer valuable implications for public health strategies,emphasizing the necessity of holistic approaches to address post-pandemic mental health challenges.
基金Supported by National Natural Science Foundation of China,No.82271546 and No.82301744The Shanxi Province Science and Technology Innovation Think Tank Construction Research Project,No.KXKT202317+1 种基金Fundamental Research Program of Shanxi Province,No.202303021222346 and No.202103021223224The Research Foundation of The First Hospital of Shanxi Medical University,No.YQ2208.
文摘BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in identifying solutions to improve public mental health.AIM To investigate the prevalence of anxiety,depression,and insomnia and explore the relationship among neuroticism,cognitive failures,and mental health.METHODS A cross-sectional survey was conducted in December 2023 using an online platform to recruit adult participants.The neuroticism,subjective cognitive function,and mental health of the participants were assessed using the neuroticism subscale of the Chinese Big Five Personality Inventory Brief Version,cognitive failures questionnaire,generalized anxiety disorder-7,patient health questionnaire-9,and insomnia severity index.Pearson's correlation analysis,independent samples t-tests,one-way analysis of variance,and structural equation model were used to examine the relationship between mental health indicators.RESULTS A total of 1011 valid questionnaires were collected,of which 343 were completed by male(33.93%)respondents and 668 were completed by female(66.07%)respondents.The rates of anxiety,depression,and insomnia were 41.3%,44.6%,and 36.3%,respectively,most cases of which were mild.Among the mental health indicators,there were significant differences by age and between those with siblings and those who were only children.Neuroticism and cognitive failures were significantly positively correlated with mental health indicators.Further moderated mediation analysis showed that cognitive failures mediated the relationship between insomnia and anxiety and between insomnia and depression,with neuroticism moderating the first half of this pathway and the effect being greater in the low-neuroticism group.CONCLUSION Cognitive failures and neuroticism play important roles in mental health.Therefore,enhancing subjective cognitive function and regulating emotional stability may contribute to the improvement of mental health.
文摘BACKGROUND Insomnia is a common sleep disorder that negatively impacts quality of life and is frequently comorbid with depression and anxiety.Chronic insomnia affects approximately 15%of the global population,with higher prevalence among females and the elderly.While existing research suggests a bidirectional relationship between insomnia and emotional disorders,the specific impact of insomnia severity on depression,anxiety,and quality of life remains unclear.This study investigates the correlation between insomnia severity and these factors in psychiatric outpatients,hypothesizing that greater insomnia severity is associated with higher levels of depression and anxiety,as well as poorer quality of life.AIM To explore the correlation between insomnia severity and depression,anxiety,and quality of life in primary chronic insomnia patients.METHODS From June to December 2023,345 patients with primary insomnia in Chifeng city were recruited and divided into three groups based on Pittsburgh sleep quality index(PSQI)scores:Mild(n=137),moderate(n=162),and severe(n=46).Demographic data were collected via questionnaires.Self-rating depression scale(SDS),self-rating anxiety scale(SAS),PSQI,and short form 36(SF-36)scores were compared,and Pearson and partial correlation analyses were performed.RESULTS The greater the degree of insomnia,the greater the symptoms of depression and anxiety(P<0.001).The more severe the insomnia,the lower the SF-36 score(excluding body pain),and the difference between the three groups was statist ically significant(P<0.001).Pearson correlation analysis and partial correlation analysis depicted the SDS score and SAS score were apparently positively correlated with the severity of insomnia(P<0.001).Pearson correlation analysis and partial correlation analysis depicted the SF-36 scores were apparently positively correlated with the severity of insomnia(P<0.05).CONCLUSION Depression and anxiety are independent factors influencing insomnia severity in primary chronic insomnia patients.Higher depression/anxiety levels correlate with worse insomnia,impacting quality of life.
基金Supported by the National Natural Science Foundation of China,No.82474207 and No.82405087Guangdong Basic and Applied Basic Research Foundation of China,No.2024A1515011014,No.2025A1515010371 and No.2025A1515012912+2 种基金Youth Science and Technology Talent Support Project of Jinan University Science and Technology Association,No.21624222the Fundamental Research Funds for the Central Universities,No.21624360the Research Fund Program of Guangdong Provincial Key Laboratory of Speed Capability Research,No.2023B1212010009.
文摘A recent study of patient-centered perspectives by Zhao et al,published in the World Journal of Psychiatry,identified key facilitators and barriers that influence insomnia patients’choice of acupuncture therapy,offering insights for clinical practice and policy-making to enhance the integration of acupuncture therapy into comprehensive insomnia management.While acupuncture demonstrates unique advantages as a complementary medical approach,its broader adoption is hindered by complex multidimensional factors.This paper proposes a“dynamic balance model”encompassing the cultural,economic,and patient-provider trust dimensions,and emphasizes the need for synergistic optimization through cultural narrative transformation,institutional innovation,and digital empowerment.These strategies aim to facilitate the promotion of acupuncture for insomnia treatment and its global expansion.
基金Supported by Young Talent Project of Air Force Medical Center,No.2022YXQN008and Rapid Response Project of Air Force Medical University,No.2023KXKT041.
文摘BACKGROUND Depression,anxiety,and insomnia were found out that were significant relevance to the mental health impact of the coronavirus disease 2019(COVID-19)lock-down.AIM To examine the interrelationships among perceived severity,anxiety,depression,insomnia,and sense of security in Chinese community residents during the COVID-19 lockdown period.METHODS Participants were selected using simple random sampling from four large gated communities in Chengdu,China.All participants were invited to complete a survey that included the Perceived Severity Questionnaire,Security Question-naire,Patient Health Questionnaire-9,Generalized Anxiety Disorder 7-item,and Insomnia Severity Index-7.In total,568 valid questionnaires were gathered.Co-rrelation analysis and structural equation models were used to explore the rela-RESULTS The observed prevalence rates of anxiety,depression,and insomnia among residents during lockdown were 27.5%,17.6%,and 16.0%,respectively.Correlation analysis showed that both perceived severity and sense of security were positively correlated with anxiety,depression,and insomnia[Pearson’s r was perceived severity and anxiety r=0.44(P<0.01);with depression r=0.48(P<0.01);with insomnia r=0.43(P<0.01);security with anxiety r=-0.65(P<0.01);with depression r=-0.65(P<0.01);with insomnia r=-0.53(P<0.01)].Structural equation modeling and bootstrap tests revealed that sense of security acted as a significant mediator in the relationship between perceived severity and emotional and sleep disorders(anxiety,depression,and insomnia).CONCLUSION This study demonstrates that sense of security is a significant predictor of emotional and sleep disorders(namely,depression,anxiety,and insomnia)among residents during the COVID-19 lockdown,with sense of security acting as a mediating factor.These findings suggest that mental health interventions for Chinese community residents during lockdowns may benefit from developing community-based educational programs to reduce perceived severity and ensuring the stable supply of essential resources and promoting social support networks to enhance the sense of security.
基金supported by the National First-class Discipline Program of Food Science and Technology(JUFSTR20180204)。
文摘Insomnia is associated with neurotransmitters and intestinal dysbiosis.Though studies have demonstrated the ameliorative effects of milk hydrolysates on insomnia,the underlying mechanisms require further exploration.In this study,we investigated how papain hydrolysates of goat casein(CPH)and whey protein(WPH)affected mice's sleeplessness.Here,we show that CPH effectively improved the total sleep time in 12 h and restoring neurotransmitters(5-hydroxytryptamine(5-HT),γ-aminobutyric acid(GABA),dopamine(DA),and norepinephrine(NE))in mice.Further gut microbiota analysis revealed a significant increase in the relative abundance of Helicobacter and Escherichia-Shigella and a decrease in the relative abundance of Lactobacillus in the insomnia model mice(Model).Compared to the Model group,both CPH and WPH significantly increased the relative abundance of Akkermansia and Lactobacillus while lowering the relative abundance of Helicobacter and Escherichia-Shigella.Notably,while diazepam(DZP)increased mouse sleep duration,it also increased the relative abundance of Colidextribacter,Parasutterella,Muribaculaceae,and Prevotella.Additionally,the gene expression and protein expression of GABA_A receptor,cAMP-response element binding protein(CREB),and brain-derived neurotrophic factor(BDNF)were upregulated in the hypothalamus.We also discovered a link between intestinal gut microbiota and neurotransmitters.Overall,our results suggest that goat milk hydrolysates,especially CPH,can effectively improve insomnia,providing a theoretical basis for further experimentation and individualized designs.
基金supported by the Special Clinical Research Project of the Health Industry by the Shanghai Municipal Health Commission(No.202240055)。
文摘Objective:The concept of constitution in traditional Chinese medicine(TCM)has been increasingly recognized as a crucial factor in both the prevention and treatment of insomnia.However,rigorous statistical evidence on the correlation between TCM constitutions—particularly mixed constitutions—and insomnia disorder remains limited.This study aimed to investigate the association between specific TCM constitutions and insomnia disorder.Methods:A cross-sectional study was conducted at the Department of Preventive Medicine,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai,from November 2022 to December 2023.TCM constitutions were assessed using the Constitution in Chinese Medicine Questionnaire.Insomnia disorder was diagnosed by experienced internal medicine physicians according to the criteria of the International Classification of Sleep Disorders,Third Edition.A total of 1065 eligible participants(242 with insomnia disorder and 823 controls)were included in the final analysis.Results:Among the participants,862(80.94%)exhibited biased constitutions,with 75.30%of these having mixed constitutions.Logistic regression analysis revealed a negative association between the gentleness constitution and insomnia disorder,whereas qi-deficiency,yang-deficiency,phlegm-dampness and qidepression constitutions were positively associated with insomnia disorder.These associations remained significant after adjusting for potential confounders and were further validated through sensitivity analysis using propensity score matching.Conclusion:Significant associations between TCM constitutions and insomnia disorder were demonstrated.Future research should further investigate these relationships and explore the underlying mechanisms through rigorous longitudinal and interventional studies to improve understanding and clinical applications.
基金Supported by the Shanghai Pujiang Program,No.2020PJC115Social Science Incubation Fund of Naval Medical University,No.2022SK027+1 种基金Scientific Research Program of Provincial Department of Education,No.Q20224105Research on the High-quality Development of Sports Talents in Hubei Province’s Universities Under the Background of Integration of Sports and Education,No.2022GA059.
文摘BACKGROUND As a substitute for traditional drug therapy,digital cognitive-behavioral therapy positively impacts the regulation of brain function,which can improve insomnia.However,there is currently a paucity of studies on digital cognitive behavioral therapy as a treatment for insomnia.AIM To assess digital cognitive behavioral therapy for insomnia regarding its positive impact on brain function.METHODS Participants were randomly assigned to either a go/no-go group or a dot-probe group.The primary outcome was quality of sleep as assessed by the actigraphy sleep monitoring bracelet,Pittsburgh sleep quality index(PSQI),insomnia severity index(ISI),and depression anxiety and stress scale(DASS-21).RESULTS Eighty patients were included in the analysis(go/no-go group:n=40;dot-probe group:n=40).We combined the total scale scores of the two groups before and after the intervention in the analysis of covariance.Our study explored whether insomnia symptoms in both groups can be improved by using digital cognitive behavioral therapy instead of trying to compare the two trials;therefore,only one P value is listed.In both groups,we found a short-term time effect on insomnia symptom severity(PSQI:P<0.001,η^(2)=0.336;ISI:P<0.001,η^(2)=0.667;DASS-depression:P<0.001,η^(2)=0.582;DASS-anxiety:P<0.001,η^(2)=0.337;DASS-stress:P<0.001,η^(2)=0.443)and some effect on sleep efficiency(but it was not significant,P=0.585,η^(2)=0.004).CONCLUSION Go/no-go task training of inhibitory function had a short-term positive effect on sleep efficiency,whereas dotprobe task training had a positive short-term effect on emotion regulation.
基金Key Scientific Research Project of Anhui Provincial Department of Education in 2021,“Literature Collation of Insomnia Syndrome in Xin’an Medical Classics and Analysis of Its Related Academic Thoughts”(Project No.:KJ2021A1282)Wanjiang Pilot Zone Project in 2021,“Modern Apprenticeship System for TCM(Traditional Chinese Medicine)Mentorship Education”(Project No.:WJ-RCPY-037)2023 Anhui Provincial-Level High-Level Vocational Colleges and High-Level Professional Groups,TCM Professional Group(Project No.:Wan Jiao Mi Gao[2023]No.5)。
文摘This paper conducts an in-depth analysis of the theory and methods for differentiating and treating insomnia in Bu Ju Ji by Wu Cheng,a physician of the Qing Dynasty.By systematically sorting out the origin of Wu Cheng’s academic thoughts,this study explores his unique perspective on differentiating and treating insomnia,analyzes the compatibility rules of his core formulas and herbs,and reveals the characteristics of his medication use as well as its guiding value for later clinical practice.Research shows that Wu Cheng integrated the principles of the I Ching(Book of Changes)with medical theories to construct a theoretical system for consumptive diseases.In the differentiation and treatment of insomnia,he emphasized the dynamic balance of zang-fu organs,Qi,blood,Yin and Yang,with special attention to the impact of spleen-Yin deficiency on insomnia.He thus formed distinctive academic features,including treating both deficiency and excess,taking into account both Qi and blood,and regulating the spleen to protect the body’s defense system.In terms of medication,he was skilled in using herbs that are sweet and warm in nature for tonification,harmonizing Qi and blood,and invigorating the spleen to nourish Yin.These insights hold significant reference value for modern TCM(Traditional Chinese Medicine)in the treatment of insomnia.
文摘Research background and Objectives: Cognitive Behavioral Therapy for Insomnia (CBT-I) is recognized as the preferred non-pharmaceutical treatment for Insomnia. This pilot study aims to test the efficacy of an extended version of CBT-I called Integrative Therapy for Insomnia (IT-I). The traditional CBT-I is complemented with exercises that are expected to enhance relearning to sleep by providing different stimuli, and access options for the retrieval and application of the acquired information, cognition, and skills. Method: The efficacy of the IT-I is measured by comparing the participants’ scores on the Insomnia Severity Index at baseline and post-treatment. In total 29 people, with a wide range of ages, participated in the 8 sessions’ treatment of one hour 45 minutes per session, in mixed groups of age, gender, and primary or comorbid insomnia. Results: Comparing the ISI baseline and post-treatment scores, results show a mean improvement of 7.2 points and a p r = −0.43. Conclusions: The integration of exercises that generate sensory-motor stimuli, and address the mirror neuron system fitting with the Mental Contrasting as a metacognitive strategy seems to facilitate re-learning to sleep in cases of primary insomnia as well as for comorbid insomnia. Further studies will be needed to arrive at more firm conclusions.
文摘Background:Electroacupuncture is often used to treat insomnia.Objective:To evaluate the efficacy and safety of electroacupuncture for insomnia.Search strategy:Databases including PubMed,Cochrane Library,Embase,Web of Science,Chinese Biomedical Literature Database,China National Knowledge Infrastructure,Wanfang Data and VIP Fulltext e-Journals Database were searched up to January 15,2023.Inclusion criteria:Randomized clinical trials were included if they compared the clinical efficacy and safety of electroacupuncture with sham acupuncture,no treatment or usual care (UC) and general acupuncture.Data extraction and analysis:The full texts of the studies were reviewed to remove ineligible literature.The extracted data included authors,publication year,diagnostic criteria,sample size,population characteristics,interventions and outcomes.The above steps were performed independently by two reviewers and the data were cross checked.Stata15.0 software was used to analyze the extracted outcome data.For continuous data (Pittsburgh Sleep Quality Index[PSQI]score and Insomnia Severity Index score),weighted mean difference (WMD) was calculated and 95% confidence interval (CI) was reported when the same scale was applied.For dichotomous variables (clinical response rate and adverse events),a meta-analysis was performed using risk ratio (RR) as the effect indicator.Results:Thirty-one trials with 2226 subjects were included.The meta-analysis suggested that electroacupuncture was more effective in improving insomnia compared with the control group (sham acupuncture,no treatment,UC and general acupuncture)(RR=1.21;95 CI:[1.16,1.27]),significantly reducing the PSQI score in insomnia patients after treatment and at follow-up (WMD=-3.23;95%CI:[-4.29,-2.17];P<0.001).There was no significant difference in the incidence of adverse events between the EA and control groups (sham acupuncture and no treatment or UC.RR=1.48;95%CI:[0.91,2.40];P=0.117).In addition,the regression results revealed that receiving electroacupuncture for seven to nine weeks provided the best efficacy (P<0.05). Conclusion:Electroacupuncture can significantly promote better sleep quality in insomnia patients and is suitable for the treatment of various types of insomnia.However,the articles included were single-center trials with small sample sizes,and some articles were of poor quality.Therefore,further research is still needed to confirm these findings.
文摘Insomnia,as one of the emotional diseases,has been increasing in recent years,which has a great impact on people's life and work.Therefore,researchers are eager to find a more perfect treatment.The microbiome-gut-brain axis is a new theory that has gradually become popular abroad in recent years and has a profound impact in the field of insomnia.In recent years,traditional Chinese medicine(TCM)has played an increasingly important role in the treatment of insomnia,especially acupuncture and Chinese herbal medicine.It is the main method of TCM in the treatment of insomnia.This paper mainly reviews the combination degree of"microorganism-gut-brain axis"theory with TCM and acupuncture under the system of TCM.To explore the mechanism of TCM and acupuncture in the treatment of insomnia under the guidance of"microorganismgut-brain axis"theory,in order to provide a new idea for the diagnosis and treatment of insomnia.
基金Supported by The Science and Technology Program of Nantong Health Committee,China,No.MA2019003 and No.MA2021017The Science and Technology Program of Nantong City,China,No.KD2021JYYJYB025,No.JCZ2022040,and No.KD2022KYJJZD022.
文摘In recent years,insomnia has gradually become a common disease in society,which seriously affects people's quality of life.At present,with the deepening of research on intestinal microbiota-gut-brain axis in Western medicine,many studies suggest that regulating the gastrointestinal tract can treat brain-related diseases.It is found that brain-gut-bacteria axis plays an important role in the prevention and treatment of primary insomnia.At present,although the clinical treatment of insomnia with Western medicine can improve the insomnia symptoms of patients to a certain extent,there are still obvious adverse reactions,such as anxiety and depression,drug addiction,etc.,so long-term oral drug therapy cannot be carried out.Traditional Chinese medicine(TCM)and acu-puncture techniques have certain therapeutic effects on insomnia.TCM believes that the brain and gastrointestinal system are connected through the meridian,and the pathophysiology is closely related.This paper will discuss the theory and feasibility of TCM for the treatment of insomnia from the pathological relation-ship between brain-gut axis,intestinal flora and insomnia.
文摘BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.
文摘BACKGROUND The treatment of adolescent patients with anxiety,depression and insomnia is challenging,and there is no ideal treatment method.AIM To evaluate the clinical efficacy of Wuling capsule combined with sertraline in the treatment of adolescent anxiety,depression and insomnia.METHODS Eighty adolescent patients with anxiety,depression with insomnia who were admitted to our hospital from April 1,2022 to March 30,2024.And the subjects were randomly classified into the control group(n=40)and the observational group(n=40).The control group was treated with a combination of sertraline and placebo.The observation group was treated with Wuling capsule in addition to sertraline.The two groups were cured continuously for 8 weeks.Insomnia severity index(ISI),Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)were used to evaluate the clinical symptoms before treatment and at 2,4,6 and 8 weeks after treatment.The Treatment Emergent Symptom Scale(TESS)was used to evaluate adverse reactions during treatment.RESULTS There was no obvious difference in HAMD,HAMA and ISI scores between the two groups before treatment(P>0.05).After treatment,the HAMD,HAMA and ISI scores of patients in both groups decreased compared with before treatment,and HAMD,HAMA and ISI scores of patients in the observation group were remarkedly lower than those in the control group at each time point after treatment(P<0.05).Compared with the control group,the TESS score of the study group were sharply lower(t=18.239,P<0.001).CONCLUSION Wuling capsule can further alleviate the insomnia symptoms of adolescents with anxiety and depression,and the efficacy and safety are high.It is recommended to promote the application.
文摘Insomnia is among the most common sleep disorders worldwide.Insomnia in older adults is a social and public health problem.Insomnia affects the physical and mental health of elderly hospitalized patients and can aggravate or induce physical illnesses.Understanding subjective feelings and providing reasonable and standardized care for elderly hospitalized patients with insomnia are urgent issues.AIM To explore the differences in self-reported outcomes associated with insomnia among elderly hospitalized patients.METHODS One hundred patients admitted to the geriatric unit of our hospital between June 2021 and December 2021 were included in this study.Self-reported symptoms were assessed using the Athens Insomnia Scale(AIS),Generalized Anxiety Disorder Scale-7(GAD-7),Geriatric Depression Scale-15(GDS-15),Memorial University of Newfoundland Scale of Happiness(MUNSH),Barthel Index Evaluation(BI),Morse Fall Scale(MFS),Mini-Mental State Examination,and the Short Form 36 Health Survey Questionnaire(SF-36).Correlation coefficients were used to analyze the correlation between sleep quality and self-reported symptoms.Effects of insomnia was analyzed using Logistic regression analysis.RESULTS Nineteen patients with AIS≥6 were included in the insomnia group,and the incidence of insomnia was 19%(19/100).The remaining 81 patients were assigned to the non-insomnia group.There were significant differences between the two groups in the GDA-7,GDS-15,MUNSH,BI,MFS,and SF-36 items(P<0.05).Patients in the insomnia group were more likely to experience anxiety,depression,and other mental illnesses,as well as difficulties with everyday tasks and a greater risk of falling(P<0.05).Subjective well-being and quality of life were poorer in the insomnia group than in the control group.The AIS scores positively correlated with the GAD-7,GDS-15,and MFS scores in elderly hospitalized patients with insomnia(P<0.05).Logistic regression analysis showed that GDS-15≥5 was an independent risk factor for insomnia in elderly hospitalized patients(P<0.05).CONCLUSION The number of self-reported symptoms was higher among elderly hospitalized patients with insomnia.Therefore,we should focus on the main complaints of patients to meet their care needs.
