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Tesis sobre el tema "Insomnio"

Autor: Grafiati
Publicado: 4 de junio de 2021
Última modificación: 25 de enero de 2023

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1

Lizarzaburu, Pinchi Alexis André. "Insomnio en internos de medicina humana del año 2014 de la facultad de medicina de San Fernando". Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2015. https://hdl.handle.net/20.500.12672/4005.

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El insomnio es un padecimiento frecuente en la población general. Ha sido asociado a diversos problemas de salud y tiene un impacto socieconómico y laboral importante. Se ha visto que en estudiantes de medicina la frecuencia de insomnio es, por lo general, superior a la población general aunque esto no se ha reflejado en estudios peruanos. Objetivo: Determinar la frecuencia de insomnio en internos de medicina del año 2014 de la Facultad de Medicina de San Fernando y conocer la frecuencia de insomnio entre los internos de medicina en relación a su sede hospitalaria. Diseño: Estudio descriptivo de corte transversal. Lugar: Facultad de Medicina de San Fernando. Participantes: Internos de medicina del año 2014. Intervenciones: Se utilizó una encuesta virtual auto administrada a los participantes que indagaba sobre aspectos relacionados al sueño en el último mes de internado. Para describir los hallazgos se utilizó promedios y porcentajes. Principales medidas de resultados: Frecuencia de insomnio y su distribución según características personales y según sede y rotación hospitalaria. Resultados: Se incluyeron 109 participantes. La frecuencia de insomnio fue de 35,8. No hubo diferencias entre las medias de las edades de los que presentaron insomnio y la población total. La frecuencia de insomnio fue similar en ambos sexos. Se encontró mayor frecuencia de insomnio en las sedes hospitalarias de mayor nivel de atención, sobre todo en sedes del MINSA. Hubo mayor frecuencia de insomnio en las rotaciones de Medicina seguido de Pediatría. Conclusiones: La frecuencia de insomnio obtenida en este estudio es similar a la población general y comparable a lo reportado en estudiantes de medicina peruanos, pero menor a las frecuencias de insomnio reportada en estudios foráneos.
Tesis
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Hoyo, García Mario César y Servin Héctor Ocaña. "CORRELACION ENTRE INSOMNIO Y NEUROPATIA DIABETICA EN PACIENTES DE LA CONSULTA EXTERNA DEL CENTRO DE SALUD SANTA ANA YENSHU MEDIANTE APLICACIÓN DE CUESTIONARIO DE INDICE DE SEVERIDAD DE INSOMNIO". Tesis de Licenciatura, Medicina-Quimica, 2013. http://hdl.handle.net/20.500.11799/14357.

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In Mexico, Diabetes is the first cause of death, and it is estimated that the rate of mortality elevates 3% every year, and this consumes between 4.7% and 6.5% of the national health budget. Diabetes Mellitus is a chronic illness that requires continuing medical care and ongoing patient selfmanagement education and support to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. In 2004, Mexico recorded 65,662 hospital discharges with DM, of which 12,681 were due to Diabetic Feet hospitalizations, with 5,327 amputations. In 2008, 6,223 amputations took place in private health institutions. Diabetic Feet hospital discharges increased in 10% between 2004 and 2005, amputations due to DM also increased in 4%. With all this information we put in evidence the importance of the nervous affectation in DM. Studies done to look at the association of DM as an etiologic factor for sleep apnea have suggested that autonomic neuropathy may be a responsible for dysfunction of central respiratory control of the diaphragm and decreased upper airway tone. Somers et al. found that sleep disturbance negatively affects glucose metabolism and endocrine function. Other reports showed that 25% of diabetic individuals with autonomic neuropathy have sleep apnea, a proportion greater than in diabetic subjects without autonomic neuropathy. Diabetes may be a cause or consequence of SDB, or possibly both. One study showed that experimentally 6 induced acute sleep deprivation could cause a state of glucose intolerance. Other studies demonstrated crosssectional relationships between sleep apnea and both fasting insulin and insulin resistance and between sleep apnea and overt diabetes. Snoring, which is a common symptom of SDB, has also been shown to predict the onset of diabetes in both men and women. Based on all of the above, this study is made in search of an association between the clinical manifestation of Diabetic Neuropathy and the disturbance of sleep quality, speculating that sleep disorders in diabetic patients are generated by damage to the nervous tissue, which pathophysiologic mechanism shares similarity with that of the Diabetic Neuropathy. Having at the same time correlation with the degree of peripheral neural damage or perhaps suggesting different mechanisms.
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3

Ródenas, Cantero Gabriel. "Jim Jarmusch: Lecturas sobre el insomnio americano (1980-1991)". Doctoral thesis, Universidad de Murcia, 2009. http://hdl.handle.net/10803/10835.

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La presente tesis doctoral aborda el primer periodo de la filmografía de Jim Jarmusch. La tesis principal es que su cine supone una respuesta cinematográfica al estado de las cosas durante el denominado "Periodo Reagan" y una relectura de la tradición fílmica anterior.
The present Ph.D. tackles the first period in Jim Jarmusch´s Filmography. The main Thesis is that his Cinema is a reaction to the Status Quo during the so-called "Reagan in-office Period" and a relecture of the previous Filmic Tradiction
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4

Murillo, Fernández Sandra Elizabeth y Fernández Sandra Elizabeth Murillo. "Mecanismos de afrontamiento de los adultos mayores con insomnio, Asilo de Ancianos San José, Chiclayo 2011". Bachelor's thesis, Universidad Católica Santo Toribio de Mogrovejo, 2013. http://tesis.usat.edu.pe/handle/usat/400.

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La presente investigación es de naturaleza cualitativa con abordaje metodológico de estudio de caso, se conoció a través de sus relatos los diferentes mecanismos de afrontamiento que optan los adultos mayores para lidiar el insomnio, partiendo de la interrogante. El referencial teórico estuvo basado para mecanismos de afrontamiento, adulto mayor, los modos de afrontamiento en la etapa del adulto mayor por Stefani y Papalia, la etapa y/o proceso de envejecimiento fueron respaldados por el Manual CTO de Enfermería y sobre el sueño e insomnio se citó a Cathy, Craig, Cruz. Se utilizó la entrevista semiestructurada como técnica para la recolección de datos, y para el procesamiento de los datos el análisis temático, fue aplicado a ocho adultos mayores, emergiendo tres categorías: El Sueño: Una necesidad para recuperar mis energías, Dificultades para Conciliar el Sueño, Estrategias para conciliar el sueño. En todo momento de la investigación se tuvo en cuenta los criterios éticos de Elio Sgreccia y el rigor científico de Polit.
Tesis
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Murillo, Fernández Sandra Elizabeth. "Mecanismos de afrontamiento de los adultos mayores con insomnio, Asilo de Ancianos San José, Chiclayo 2011". Thesis, Universidad Católica Santo Toribio de Mogrovejo, 2013. http://tesis.usat.edu.pe/jspui/handle/123456789/195.

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La presente investigación es de naturaleza cualitativa con abordaje metodológico de estudio de caso, se conoció a través de sus relatos los diferentes mecanismos de afrontamiento que optan los adultos mayores para lidiar el insomnio, partiendo de la interrogante. El referencial teórico estuvo basado para mecanismos de afrontamiento, adulto mayor, los modos de afrontamiento en la etapa del adulto mayor por Stefani y Papalia, la etapa y/o proceso de envejecimiento fueron respaldados por el Manual CTO de Enfermería y sobre el sueño e insomnio se citó a Cathy, Craig, Cruz. Se utilizó la entrevista semiestructurada como técnica para la recolección de datos, y para el procesamiento de los datos el análisis temático, fue aplicado a ocho adultos mayores, emergiendo tres categorías: El Sueño: Una necesidad para recuperar mis energías, Dificultades para Conciliar el Sueño, Estrategias para conciliar el sueño. En todo momento de la investigación se tuvo en cuenta los criterios éticos de Elio Sgreccia y el rigor científico de Polit.
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Buira, Morell Irma. "Caracterització farmacològica de moduladors gabaèrgics per al tractament de l’insomni primari". Doctoral thesis, Universitat de Barcelona, 2011. http://hdl.handle.net/10803/35857.

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L’insomni és un trastorn caracteritzat per la insatisfacció en la qualitat i/o quantitat del son, que persisteix durant un considerable període de temps. És un son no reparador, amb conseqüències diürnes com la fatiga, la irritabilitat o la disminució de l’alerta, que afecta tant la vida social com laboral de l’individu. Dels diferents trastorns primaris del son, l’etiologia dels quals no és deguda a una malaltia mental, mèdica o a cap substància, l’insomni primari té una prevalença mitjana a la població del 30%. Històricament el tractament farmacològic de l’insomni ha tingut com a principal diana el receptor GABA(A). L’evolució dels hipnòtics que actuen sobre aquest receptor, ha aportat una millora en la seva eficàcia i seguretat. Tot i així, encara tenen efectes no desitjats com l’insomni de rebot, la dependència, l’amnèsia anterògrada o la tolerància. El nostre objectiu és trobar un candidat que millori els inconvenients dels hipnòtics actuals. Seguint una estratègia de cribratge, seleccionar un compost amb: 1) major selectivitat in vitro per la subunitat 1 del receptor GABA(A), implicada en el son, 2) activitat hipnòtica in vivo que no alteri l’arquitectura del son i 3) una absorció oral ràpida i vida mitjana adequada. Dels 1214 compostos que es van cribrar en total, dos van presentar una elevada selectivitat in vitro per la subunitat alfa-1 del receptor GABA(A) major que la del zolpidem, el fàrmac de referència més selectiu que hi ha actualment al mercat. Aquesta selectivitat in vitro dels compostos, es correlaciona amb la selectivitat in vivo, de manera que els compostos més selectius per la subunitat alfa-1 in vitro, són també els que indueixen sedació in vivo sense efectes no desitjats com la relaxació muscular associada a la subunitat alfa-2 del receptor GABA(A) Però l’efecte in vivo no depèn només de l’afinitat del compost pel receptor, sinó també del nombre de receptors que el compost ocupa al teixit diana i de la seva eficàcia intrínseca per activar-los i generar una resposta biològica. L’ocupació de receptors s’ha analitzat en estudis ex-vivo i s’ha relacionat amb l’efecte observat en els assaigs de comportament in vivo. Quan es determina l’ocupació ex-vivo del receptor GABA(A) per part dels compostos en determinades àrees del cervell, on predomina una determinada subunitat del receptor, els compostos amb més afinitat per la subunitat alfa-1 que indueixen sedació a dosi més baixa, també són els que per norma general requereixen menys dosi per assolir el 50% d’ocupació ex-vivo dels receptors a cerebel (on predomina la subunitat alfa-1 implicada en sedació). En el mateix sentit, els compostos menys afins per alfa-2 que requereixen una dosi més alta per induir relaxació muscular, són també els que per norma general assoleixen el 50% d’ocupació ex-vivo a medul•la (on predomina la subunitat alfa-2) a una dosi més gran. Les dades d’ocupació ex-vivo a cerebel corroboren l’afinitat dels compostos in vitro per la subunitat alfa-1 del receptor GABA(A). En base als resultats presentats en la present Tesi Doctoral, es conclou que s’ha generat i seleccionat un candidat que podria millorar els inconvenients dels hipnòtics actuals en els estudis preclínics.
Insomnia is defined as a condition of unsatisfactory quantity and/or quality of sleep, which persists for a considerable period of time, including difficulty falling asleep, difficulty staying asleep, or early final wakening. Is a non-restorative sleep which cause diurnal dysfunction and a decrease in the quality of life. Traditionally, insomnia therapy is focused on GABAA receptor. Hypnotic treatment based on GABAA receptor has experienced significant improvements in efficacy and safety. Nevertheless, it still causes side effects such as rebound insomnia, dependence and tolerance. Our goal is to identify a new therapeutic drug that improves the disadvantages of current hypnotics. We designed a screening strategy that allowed us to select a compound with: 1) greater in vitro  1 subunit-GABAA receptor selectivity, implicated in hypnosis, 2) hypnotic activity in vivo without modifying sleep architecture and 3) fast oral absorption and adequate half-life. Two compounds screened of a total of 1214 showed higher selectivity than zolpidem to the alpha-1 subunit of GABAA receptor. Nowadays, zolpidem is the most selective reference drug in the market. In vitro selectivity was well-correlated with in vivo selectivity, so the most selective 1-subunit compounds in vitro were those that also induced sedation in vivo without side effects, related to the GABAA receptor alpha -2 subunit, like muscle relaxation. Drug effect in vivo depends on its receptor affinity as well as the binding extent to its target (occupancy). Moreover, drug effect also depends on its intrinsic efficacy to activate the receptor and induce a biological response. An ex-vivo binding protocol was performed to assess receptor occupancy. The results of cerebellum ex-vivo occupancy corroborate the in vitro affinity of the compounds to the alpha -1 subunit of GABAA receptor. Based on these results, we concluded that we synthesized and selected a compound with a suitable profile to improve the disadvantages of current hypnotics in clinical use.
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Grau-López, Lara. "Factores predictores de recaída en pacientes adictos y la importancia de la evaluación y tratamiento del insomnio para mantener la abstinencia". Doctoral thesis, Universitat Autònoma de Barcelona, 2014. http://hdl.handle.net/10803/283644.

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Introducción: La recaída de pacientes drogodependendientes es frecuente tras períodos de abstinencia. Es importante identificar factores relacionados con la recaída que puedan ser tratados, ya que la corrección de los mismos se podría relacionar con una mayor probabilidad de abstinencia a largo plazo. La prevalencia del insomnio, su importancia y su tratamiento han sido poco estudiados en la población adicta, a pesar de que les preocupa a los pacientes y afecta a su calidad de vida. Objetivos: Los objetivos del presente trabajo son: a) analizar los factores relacionados con la recaída a los 3 y 6 meses; b) estimar la prevalencia del insomnio y los factores relacionados con el mismo y c) analizar si la corrección del insomnio con un tratamiento farmacológico adecuado se relaciona con una menor probabilidad de recaída. Material y Métodos: Se incluyeron pacientes dependientes de sustancias que ingresaron en la unidad de desintoxicación hospitalaria del Hospital de Vall Hebron desde junio 2008 hasta mayo 2013. Se realizó seguimiento ambulatorio durante seis meses tras el alta. Se recogieron variables sociodemográficas, clínicas referidas al consumo, clínicas relacionadas con la comorbilidad médica y psiquiátricas y variables terapeúticas. Para el diagnóstico se utilizaron cuestionarios y entrevistas semiestructuradas (SCID-I y II y CAADID). Para estudiar el insomnio se utilizó la escala COS y la agenda de sueño nocturno. Para el primer y segundo objetivo se realizó un estudio de cohortes y prospectivo. Para el tercer objetivo se realizó un estudio cuasiexperimental en el que los pacientes con insomnio recibieron fármacos con función hipnótica (antidepresivos, antipsicóticos, antiepilépticos). Resultados: Se incluyeron 481 pacientes. El 48,4% recayeron a los 3 meses y el 66,7% a los 6 meses tras el ingreso de desintoxicación. El 84,3% presentó insomnio en el consumo activo de la sustancia y el 66,5% en las fases iniciales de la abstinencia. Los pacientes con insomnio tuvieron mayor probabilidad de recaída precoz, a los 3 meses tras el ingreso hospitalario, tanto durante el consumo activo (71,7% vs 61,3%, p=0,01) como en las fases iniciales de la abstinencia (71,7% vs 61,7%, p=0,02). Los pacientes con corrección del insomnio tras tratamiento farmacológico tuvieron una probabilidad de recaída significativamente menor que aquellos con insomnio no corregido (62% vs 75%, p=0,04), igualando el porcentaje de recaída de los pacientes sin insomnio. Conclusiones: La recaída en el consumo de sustancias es frecuente. El insomnio en pacientes adictos se relaciona con la probabilidad de recaída a corto plazo y la corrección del insomnio con un tratamiento eficaz, se relaciona con una mejor evolución de la adicción.
Introduction: Addict patients relapsed frequently after periods of abstinence. It is important to identify factors for relapse to be treated, since the correction of the same could be related to an increased likelihood of long-term abstinence. The prevalence of insomnia, its important and its treatment have not been studied extensively in the addicted population, although they care to patients and affect their quality of life. Objectives: The objectives of this work are: a) to evaluate factors associated with relapse at 3 and 6 months; b) estimate the prevalence of insomnia and related factors; c) consider whether the correction of insomnia with appropriate drug therapy is associated to a lower probability of relapse. Material and Methods: Substance dependent patients admitted to the inpatient detoxification unit Vall Hebron Hospital from June 2008 to May 2013 were included. Outpatient follow was carried out for six months after discharge. Sociodemographic, clinical factors referred to consumption, clinical related to medical clinics and psychiatric comorbidity and therapeutic variables were collected. To diagnostic questionnaires and semi-structured interviews (SCID-I and II and CAADID) were used. To study the insomnia, COS scale was used and the schedule of nighttime sleep. For the first and second targets a prospective cohort study was performed. For the third objective, a quasi-experimental study in which patients received drugs with hypnotic insomnia function (antidepressants, antipsychotics, antiepileptics) was performed. Results: 481 patients were included. 48.4% relapsed at 3 months and 66.7% at 6 months after admission for detoxification. 84.3% had insomnia in the active substance use and 66.5% in the initial phases of abstinence. Patients with insomnia were more likely to relapse early, at 3 months after hospital admission, both during active use (71.7% vs 61.3%, p = 0.01) and during the initial phases of abstinence (71.7% vs 61.7%, p = 0.02). Patients with insomnia correction after pharmacological treatment had a significantly lower probability of relapse than those with uncorrected insomnia (62% vs 75%, p = 0.04), equaling the relapse rate of patients without insomnia. Conclusions: The relapse into substance use is common. Insomnia addicted patients is related to the probability of relapse in the short term and the correction of insomnia with effective treatment, is associated with better outcomes of addiction.
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Garcia, Leguia Maria Del Mar y Infante Kevin Ruiz. "Propuesta de guion de cortometraje de ficción basado en el perfil arrojado por los estudiantes que sufren de insomnio no orgánico del quinto al octavo ciclo de la carrera de comunicación de la Universidad Católica Santo Toribio de Mogrovejo del semestre 2018 – II". Bachelor's thesis, Universidad Católica Santo Toribio de Mogrovejo, 2020. http://hdl.handle.net/20.500.12423/3623.

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La presente tesis titulada “Propuesta de guion de cortometraje de ficción basado en el perfil arrojado por los estudiantes que sufren de insomnio no orgánico del quinto al octavo ciclo de la carrera de Comunicación de la Universidad Católica Santo Toribio de Mogrovejo del semestre 2018 - II”, pretende profundizar en el estudio del guion a partir de un perfil y sus requisitos necesarios pues este es la base para generar un producto audiovisual que nos permita contar una historia, específicamente, la del insomnio no orgánico en estudiantes universitarios. Esta investigación tuvo como objetivos específicos identificar los casos de insomnio no orgánico en los estudiantes del quinto al octavo ciclo de la carrera de Comunicación de la Universidad Católica Santo Toribio de Mogrovejo. Luego, se procedió a entrevistar a expertos en psicología y psiquiatría con el fin de saber las características en común de los casos y así, posteriormente, elaboraron un perfil con la información recopilada a los estudiantes. Con toda esa información se escribió un guion basado en la estructura dada por los aspectos teóricos y el perfil. Por último, se consultó a guionistas del medio para las posibles correcciones en la propuesta de guion. Los instrumentos aplicados fueron: entrevistas a expertos de insomnio no orgánico, además de un test insomnio otorgado por ellos mismos para realizarlo a los estudiantes y cuestionarios de opinión.
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Ekberg, Rebecca y Vi-An Diep. "Att leva med insomni : Patienters upplevelser". Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-32895.

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Sömn är en livsviktig funktion för människans välmående och en tredjedel av livet spenderas till att sova. Sömnproblem är ett växande folkhälsoproblem som påverkar det dagliga livet för miljontals människor i världen. Insomni är den vanligaste sömnstörningen och definieras som svårigheter att initiera eller upprätthålla sömn, en icke-rogivande sömn, tidigt uppvaknande, eller en kombination av dessa upplevelser. Syftet med denna litteraturstudie var att beskriva patienters upplevelser av insomni. Resultatet uppkom efter kategorisering av elva vetenskapliga artiklar. Tre teman framkom: försämrat välbefinnande, maktlöshet, och en kamp. Tio kategorier uppstod: att uppleva fatigue, att känna sig ur funktion, att känna oro och ångest, att känna sig fysiskt sjuk, att känna sig utanför, att känna frustration, att känna sig kontrollerad, att inte förstå, att ej vara betrodd och att längta efter bot. I resultatet framkommer det att insomni upplevs som en kamp mot fatigue och ohälsa. Besvär med insomni styrde det dagliga livet samt begränsade möjligheten till uppnådd livskvalité. Upplevelsen av att inte känna sig betrodd av sjukvården var framträdande hos patienter med insomni. Ökad kunskap om hur insomni kan upplevas, identifieras och behandlas bör belysas i sjuksköterskans profession för att främja en bättre hälsa hos patienter med insomni.
Sleep is a vital function for peoples’ well-being and one third of life is spent sleeping. Sleep issues are a growing public health problem that affects the daily lives of millions of people worldwide. Insomnia is the most common sleep disorder and is defined as difficulty initiating or maintaining sleep, a non-restful sleep, early awakening, or a combination of these experiences. The purpose of this study was to describe patients' experiences of insomnia. The result arose after a categorizing of eleven scientific articles. Tree themes emerged: impaired well-being, powerless, and a struggle. Ten categories appeared: to experience fatigue, to feel out of function, to feel concern and anxiety, to feel physically ill, feeling like an outsider, to feel frustrated, feeling controlled, not understanding, not being trusted and to long for cure. The result shows that insomnia is experienced as a struggle against fatigue and illness. Trouble with insomnia ruled the daily life and limited the possibility of attaining quality of life. The experience of not being trusted by healthcare was common in patients with insomnia. Increased knowledge of how insomnia can be experienced, identified and treated should be developed in the nursing profession in order to promote better health in patients with insomnia.
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Desrochers, Stéphanie. "Expériences du Nouveau Monde - étude de la relation entre essai et narrativité dans les recueils «Intérieurs du nouveau monde» de Pierre Nepveu et «El insomnio de Bolivar» de Jorge Volpi". Thesis, Université Laval, 2014. http://www.theses.ulaval.ca/2014/30442/30442.pdf.

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Dans les années 1980, l’essayiste québécois André Belleau émet l’hypothèse que l’essai, fruit d’un « artiste de la narrativité des idées », n’est autre chose qu’un « récit idéel » dans lequel le contenu idéel et la tension argumentative se substituent respectivement aux personnages et à l’action d’une œuvre narrative. L’idée que l’essai puisse être rapproché du genre narratif est lancée, mais elle reste peu approfondie. Prenant le relais de la réflexion menée par Belleau, ce mémoire propose d’explorer la dimension narrative de l’essai et du recueil d’essais à partir d’Intérieurs du Nouveau Monde, de Pierre Nepveu, et de El insomnio de Bolívar, de Jorge Volpi. Ces deux recueils ont en commun d’opposer l’expérience personnelle des auteurs à un récit collectif ayant structuré le devenir identitaire américain et latino-américain. Mais, plus que cette commune volonté qu’elles ont de questionner un imaginaire construit de l’Amérique et de l’Amérique latine, les œuvres de Pierre Nepveu et Jorge Volpi partagent une semblable ambition : celle de proposer un récit alternatif, qui prête au recueil une progression linéaire, voire narrative. Deux approches théoriques sont convoquées pour mener à bien l’analyse : la sociocritique, dans un premier temps, et la poétique narrative, dans un deuxième temps.
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Desrochers, Stéphanie. "Expériences du Nouveau Monde : étude de la relation entre essai et narrativité dans les recueils Intérieurs du nouveau monde de Pierre Nepveu et El insomnio de Bolívar de Jorge Volpi". Master's thesis, Université Laval, 2014. http://hdl.handle.net/20.500.11794/24866.

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Tableau d’honneur de la Faculté des études supérieures et postdoctorales, 2013-2014.
Dans les années 1980, l’essayiste québécois André Belleau émet l’hypothèse que l’essai, fruit d’un « artiste de la narrativité des idées », n’est autre chose qu’un « récit idéel » dans lequel le contenu idéel et la tension argumentative se substituent respectivement aux personnages et à l’action d’une œuvre narrative. L’idée que l’essai puisse être rapproché du genre narratif est lancée, mais elle reste peu approfondie. Prenant le relais de la réflexion menée par Belleau, ce mémoire propose d’explorer la dimension narrative de l’essai et du recueil d’essais à partir d’Intérieurs du Nouveau Monde, de Pierre Nepveu, et de El insomnio de Bolívar, de Jorge Volpi. Ces deux recueils ont en commun d’opposer l’expérience personnelle des auteurs à un récit collectif ayant structuré le devenir identitaire américain et latino-américain. Mais, plus que cette commune volonté qu’elles ont de questionner un imaginaire construit de l’Amérique et de l’Amérique latine, les œuvres de Pierre Nepveu et Jorge Volpi partagent une semblable ambition : celle de proposer un récit alternatif, qui prête au recueil une progression linéaire, voire narrative. Deux approches théoriques sont convoquées pour mener à bien l’analyse : la sociocritique, dans un premier temps, et la poétique narrative, dans un deuxième temps.
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Wittchen, Hans-Ulrich, Petra Krause, Michael Höfler, Susanne Winter, Barbara Spiegel, Göran Hajak, Dieter Riemann, David Pittrow, Axel Steiger y Hildegard Pfister. "NISAS-2000 - die "Nationwide Insomnia Screening and Awareness Study": Insomnien und Schlafstörungen in der allgemeinärztlichen Versorgung". Schattauer GmbH, 2001. https://tud.qucosa.de/id/qucosa%3A26392.

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ZIEL: Ermittlung der Stichtagsprävalenz von Insomnie und anderen Schlafstörungen in deutschen Allgemeinarztpraxen sowie Bestimmung hausärztlicher Erkennensraten. METHODIK: Bundesweite Zufallsauswahl von 539 Arztpraxen. Charakterisierung der Arzt- und Praxismerkmale mittels initialer Vorstudie. Darauf folgend eine Stichtagsbefragung aller Hausarzt-Patienten mittels Schlaffragebogen (PSQI) und klinischen Fragen (N = 19155 Fälle) sowie klinisch-ärztliche Beurteilung durch den behandelnden Artz mittels CGI und Fragebogen. ERGEBNISSE: 1. Trotz nur moderater Kompetenzeinschätzungen hinsichtlich Diagnose und Therapie behandeln Hausärzte Insomnien und andere Schlafstörungen vorwiegend selbst, auch wenn diese einen hohen Behandlungsaufwand erfordern. 2. Die Stichprobe kann als typisch für die Hausarzt-Klientel angesehen werden. 3. Schlafstörungen sind der dritthäufigste Konsultationsanlass. Nahezu jeder zweite Patient berichtete, in den vergangenen 2 Wochen unter Schlafbeschwerden gelitten zu haben, 26,5% erfüllten aufgrund der subjektiven Angaben die Studienkriterien (DSM-IV) für Insomnie. 4. Auch die Ärzte beurteilten 46,4% aller ihrer Patienten mittels CGI zumindest als Grenzfälle einer Schlafstörung, 85,6% wurden als chronisch eingeordnet. Die ärtzlich beurteilte Insomnieprävalenz betrug 25,9%, die anderer Schlafstörungen 13,7%. 5. Nur 54,3% aller Insomniepatienten wurden auch als solche vom Hausarzt diagnostiziert. DISKUSSION: Die Studie liefert erstmals bundesrepräsentative, differenzierte epidemiologische Daten zu der Prävalenz, dem Schweregrad, den Einschränkungen und den Verlaufsmustern von Insomnien und Schlafstörungen. Die außerordentlich große Häufigkeit und die zum Teil markanten Defizite hinsichtlich Erkennen und Diagnostik in der primärärztlichen Versorgungen werden diskutiert.
AIM: To estimate the point prevalence of insomnia, recognition and prescription behavior in primary care. METHODS: Nationwide sample of 539 primary care settings along with their characterization (stage 1). Standardized assessment of all attenders (N = 19.155 patients) on the NISAS target day using a sleep questionnaire (PSQI) and additional questions to cover psychosocial and additional clinical variables. All patients were evaluated by the primary care doctors using a standardized clinical appraisal questionnaire, including a CGI-rating. RESULTS: Prevalence insomnia according to DSM-IV was 26.5%. Recognition of presence of any clinically significant sleep disorder was 72%, recognition of insomnia was poor 54.3%. 85.6% of insomnia patients were rated as chronic. Close to 50% of all insomnia cases did not receive a specific insomnia therapy. Herbals, followed by hypnotics and sedatives and antidepressants were the three most frequent treatments applied, psychotherapy was only seldomly indicated. DISCUSSION: NISAS provides for the first time nationally representative estimates of interventions for insomnia in primary care. The relatively low treatment rates and the high proportion of chronic patients receiving longterm prescription of benzodiazepines seem to be critical. Priorities for future agenda to improve this situation are discussed.
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Segerström, Karen y Annika Uvebrant. "Sömnhygien - en uppgift för sjuksköterskan". Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-22506.

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Människors allmänna välbefinnande och livskvalitet påverkas av deras sömn.    Sömnproblemen ökar och resulterar i ökade kostnader för den enskilde, arbetsgivarna och samhället. Syftet med litteraturstudien var att beskriva effekter av sömnhygieniska åtgärder riktade till individer inom hälsovården med primär insomni. Resultatet visade att en kombination av åtgärder utifrån personliga behov gav bäst resultat men också att det rådde begreppsförvirring runt sömnhygieniska åtgärder och deras effektivitet. Fördjupad kunskap behövs vad det gäller de enskilda sömnhygieniska rådens effektivitet. Vidare forskning föreslås för att komma fram till gemensamma internationella sömnhygieniska råd för att effektivt kunna vidareutveckla de sömnhygieniska råden och hur dessa ska användas.
People's general well-being and quality of life is affected by their sleep. Costs referring to sleeping disorders increase for individuals, employers as well as society as a whole. The aim of this literature review was to describe the effects of sleep hygiene measures regarding individuals in the healthcare system with primary insomnia. The results from this study showed that a combination of interventions based on personal needs gave the best results furthermore that there was a confusion regarding concepts of sleep hygiene interventions and their effectiveness. Deeper knowledge is needed to evaluate the efficiency of each of the sleep hygiene advice. Future research is suggested in order to achieve common and unified international sleep hygiene advice to effectively enable further development to the sleep hygiene advice and guidelines.
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MacLeod, Mary Annet Krista. "Attitudes and beliefs about insomnia and insomnia treatment among older adults with chronic insomnia". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0020/MQ49638.pdf.

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Poe, Rachel. "Architectural insomnia". Thesis, University of Iowa, 2017. https://ir.uiowa.edu/etd/5603.

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My artistic practice addresses issues of how memory shapes our identity and how to use memory in order to better understand our perspective. Through the construction of liminal space I reflect upon the subconscious and conscious mind. These images address issues of identity and how longing and nostalgia affect the human psyche. Through photographs of sculptures, paintings and light installations I address the architectural spaces in the world around me as catalysts.
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Gómez, Juanes Rocío. "Eficacia y coste-efectividad de la investigación estilo de vida saludable aplicada por medio de TICS para el tratamiento de la depresión en atención primaria: un estudio controlado". Doctoral thesis, Universitat de les Illes Balears, 2019. http://hdl.handle.net/10803/666968.

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[spa] ANTECEDENTES: Las intervenciones psicológicas de baja intensidad aplicadas mediante tecnologías de la información y la comunicación (TICs) constituyen una alternativa terapéutica eficaz y coste-efectiva en el tratamiento de la depresión. OBJETIVO: Evaluar la eficacia en Atención Primaria de una intervención de baja intensidad de estilo de vida saludable aplicada a través de TICs que ha mostrado previamente mejoras significativas en el tratamiento de la depresión leve y moderada en contextos clínicos especializados. MÉTODO: Ensayo clínico pragmático multicéntrico aleatorizado en 2 grupos paralelos. Se diseñó la intervención y se adaptó a dispositivos online y posteriormente se realizó el ensayo clínico controlado aleatorizado; se estudió a una muestra de N=120 pacientes con depresión leve a moderada reclutados en AP. Se les asignó aleatoriamente a a) programa psicoeducativo de estilo de vida saludable + Tratamiento Habitual mejorado (Improved Treatment As Usual, ITAU) o b) ITAU. El formato de las intervenciones fue de 1 sesión presencial y 4 módulos online. El diagnóstico de depresión se realizó con la entrevista psiquiátrica MINI. La variable principal de resultado fue la puntuación en el PHQ-9. También se administró el PANAS, (escala de afecto Positivo y Negativo), EuroQol (calidad de vida) y SF-12 Health Survey (estado de salud percibido). Los pacientes fueron evaluados en el momento basal, post, a los 6 y 12 meses post-tratamiento. Se realizó un análisis por protocolo y otro análisis por intención de tratar. RESULTADO: Valoramos la posible inclusión de 120 pacientes que estarían asignados aleatoriamente a una de las dos ramas de este estudio (estilo de vida vs. ITAU). Fueron reclutados 111. Se asignaron de forma aleatoria 54 pacientes (48.6% de la muestra) al grupo de estilo de vida y 57 al grupo control (51.4%). Incluimos únicamente quienes accedieron al programa y completaron los cuestionarios; 46 y 27 participantes respectivamente (65.77% del total). Tras acabar el tratamiento, continuaron en el estudio 58 de los 73 (79.46%). A los 6 meses eran 49 (67.1%), concluyendo el estudio a los 12 meses 46 participantes (63.02%). El perfil de la muestra fue de mujer (71.23% de casos) con una edad media de 45 años (desviación estándar 11.21), casada o emparejada (52.1%), viviendo en domicilio propio con su pareja y/o sus hijos (39.7%), con estudios secundarios completados (31.5%) y situación laboral de empleada (42.5%). Únicamente existió diferencia estadísticamente significativa en el estado civil. En el análisis por protocolo únicamente se obtuvieron diferencias estadísticamente significativas entre ambos grupos en el PHQ-9 tras concluir el estudio (p= 0,012). En el análisis por intención de tratar se obtuvo diferencia estadísticamente significativa tras concluir el estudio en el PHQ-9 (p=0,00), PANAS afecto negativo (p=0,049) y en el SF-12 componente físico (p=0,029), no encontrando diferencias estadísticamente significativas transcurridos 6 y 12 meses. DISCUSION: Una aportación relevante hallada en el análisis es que, al existir mejoría clínica de los síntomas depresivos tras acabar la intervención, conseguimos acelerar el proceso de recuperación en relación al grupo control. Este hallazgo implicaría disminuir el notable impacto en la calidad de vida del paciente y de su entorno, así como el coste económico al reducir su productividad y actividad laboral. Sin embargo, no se puede obviar que una de las mayores dificultades para vincularse a la intervención en estos pacientes es la sintomatología que presentan. Por eso parece fundamental seguir motivándoles para que sean constantes en el cambio y reciban un feedback positivo que puede realizarse a través de los auto-registros o disponer de apoyo social, algo de lo que nuestro estudio carece. El estudio presenta varias limitaciones: mejora solo a corto plazo, escaso tamaño de la muestra estudiada, elevada tasa de abandonos y ausencia de registro de situación basal del paciente en relación a su estilo de vida, así como de qué forma ésta se ha podido implantar a lo largo del tiempo. CONCLUSIONES: Realizar una intervención de baja intensidad sobre el estilo de vida saludable a través de las TICs mejora más rápidamente los síntomas depresivos, disminuye el afecto negativo y acelera la mejora el estado de salud percibido al acabar la intervención. Sin embargo, la diferencia en la disminución de la sintomatología depresiva entre el grupo de intervención y el grupo control no se ha mantenido en el tiempo. Será necesario considerar para futuras investigaciones cómo favorecer la adherencia al tratamiento y disminuir la tasa de abandonos para poder beneficiar a un mayor número de pacientes.
[eng] BACKGROUND: Low intensity psychological interventions applied through information and communication technologies (ICTs) are an effective and cost-effective therapeutic alternative in the treatment of depression. OBJECTIVE: To evaluate the efficacy in Primary Care of a low intensity intervention of healthy lifestyle applied through ICTs that has previously shown significant improvements in the treatment of mild and moderate depression in specialized clinical contexts. METHOD: Multicentric pragmatic randomized clinical trial in 2 parallel groups: a) healthy lifestyle + Improved Habitual Treatment (ITAU) or b) ITAU. The intervention was designed and adapted to be online and then the randomized controlled clinical trial was carried out. A sample of N = 120 patients with mild to moderate depression was recruited in Primary Care Settings. The diagnosis of depression was made with the MINI psychiatric interview. The main outcome variable was the score on the PHQ-9. PANAS was also administered (Positive and Negative Affect Schedule), EuroQol (quality of life) and SF-12 Health Survey (perceived health status). The patients were evaluated at baseline, post, at 6 and 12 months after treatment finished. An analysis by protocol and another analysis by intent to treat was performed. RESULTS: A total of 111 patients were recruited and randomly assigned to one of the two branches of this study. We include only those who accessed the program and completed the questionnaire. In the analysis by protocol, only statistically significant differences were obtained between both groups in the PHQ-9 after concluding the study (p = 0.012). In the intention-to-treat analysis, a statistically significant difference was obtained after concluding the study in the PHQ-9 (p = 0.00), PANAS negative affect (p = 0.049) and in the SF-12 physical component (p = 0.029), finding no statistically significant differences after 6 and 12 months. CONCLUSIONS: Performing a low intensity intervention on healthy lifestyle through ICTs improves the symptoms of depression more quickly. However, this difference has not been maintained over time. It will be necessary to consider for future investigations how to improve the adherence to treatment and decrease the dropout rate in order to benefit a greater number of patients.
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Wittchen, Hans-Ulrich, Petra Krause, Michael Höfler, Susanne Winter, Barbara Spiegel, Göran Hajak, Dieter Riemann, David Pittrow, Axel Steiger y Hildegard Pfister. "NISAS-2000 - die "Nationwide Insomnia Screening and Awareness Study"". Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-102912.

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ZIEL: Ermittlung der Stichtagsprävalenz von Insomnie und anderen Schlafstörungen in deutschen Allgemeinarztpraxen sowie Bestimmung hausärztlicher Erkennensraten. METHODIK: Bundesweite Zufallsauswahl von 539 Arztpraxen. Charakterisierung der Arzt- und Praxismerkmale mittels initialer Vorstudie. Darauf folgend eine Stichtagsbefragung aller Hausarzt-Patienten mittels Schlaffragebogen (PSQI) und klinischen Fragen (N = 19155 Fälle) sowie klinisch-ärztliche Beurteilung durch den behandelnden Artz mittels CGI und Fragebogen. ERGEBNISSE: 1. Trotz nur moderater Kompetenzeinschätzungen hinsichtlich Diagnose und Therapie behandeln Hausärzte Insomnien und andere Schlafstörungen vorwiegend selbst, auch wenn diese einen hohen Behandlungsaufwand erfordern. 2. Die Stichprobe kann als typisch für die Hausarzt-Klientel angesehen werden. 3. Schlafstörungen sind der dritthäufigste Konsultationsanlass. Nahezu jeder zweite Patient berichtete, in den vergangenen 2 Wochen unter Schlafbeschwerden gelitten zu haben, 26,5% erfüllten aufgrund der subjektiven Angaben die Studienkriterien (DSM-IV) für Insomnie. 4. Auch die Ärzte beurteilten 46,4% aller ihrer Patienten mittels CGI zumindest als Grenzfälle einer Schlafstörung, 85,6% wurden als chronisch eingeordnet. Die ärtzlich beurteilte Insomnieprävalenz betrug 25,9%, die anderer Schlafstörungen 13,7%. 5. Nur 54,3% aller Insomniepatienten wurden auch als solche vom Hausarzt diagnostiziert. DISKUSSION: Die Studie liefert erstmals bundesrepräsentative, differenzierte epidemiologische Daten zu der Prävalenz, dem Schweregrad, den Einschränkungen und den Verlaufsmustern von Insomnien und Schlafstörungen. Die außerordentlich große Häufigkeit und die zum Teil markanten Defizite hinsichtlich Erkennen und Diagnostik in der primärärztlichen Versorgungen werden diskutiert
AIM: To estimate the point prevalence of insomnia, recognition and prescription behavior in primary care. METHODS: Nationwide sample of 539 primary care settings along with their characterization (stage 1). Standardized assessment of all attenders (N = 19.155 patients) on the NISAS target day using a sleep questionnaire (PSQI) and additional questions to cover psychosocial and additional clinical variables. All patients were evaluated by the primary care doctors using a standardized clinical appraisal questionnaire, including a CGI-rating. RESULTS: Prevalence insomnia according to DSM-IV was 26.5%. Recognition of presence of any clinically significant sleep disorder was 72%, recognition of insomnia was poor 54.3%. 85.6% of insomnia patients were rated as chronic. Close to 50% of all insomnia cases did not receive a specific insomnia therapy. Herbals, followed by hypnotics and sedatives and antidepressants were the three most frequent treatments applied, psychotherapy was only seldomly indicated. DISCUSSION: NISAS provides for the first time nationally representative estimates of interventions for insomnia in primary care. The relatively low treatment rates and the high proportion of chronic patients receiving longterm prescription of benzodiazepines seem to be critical. Priorities for future agenda to improve this situation are discussed
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18

Maroti, Daniel y Pär Folkeson. "Kan behandling av insomni förbättra komorbid ångest och depression?" Thesis, Örebro University, Department of Behavioural, Social and Legal Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-2103.

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This study investigated the efficacy of a multicomponent cognitive–behavioral intervention of insomnia, CBT-I, for patients suffering from an anxiety disorder and/or a major depressive episode together with comorbid insomnia. In particular, the aim of the study was to evaluate whether anxiety and depressive symptoms declined as a function of

treatment for insomnia. After rigorous diagnostic procedures, 8 patients were treated in a multiple baseline design. Patients experienced clinically significant reductions in insomnia-, (57 %) depressive- (75 %) and anxiety symptoms (40 %). A three week follow-up measurement

demonstrated retained effects. These findings suggest that CBT-I is a feasible treatment for comorbid insomnia. It also provides partial support for insomnia as a possible causal agent of depression and anxiety. Further, a schematic model of transdiagnostic processes common to insomnia, anxiety and depression, is presented. More research is warranted to render better treatment for patients with anxiety

and/or depression and comorbid insomnia.


Denna studie undersökte effekten av en Kognitiv- Beteende Terapeutisk behandling mot insomni, KBT-I, för patienter som lider av ångeststörning och/eller egentlig depression samt komorbid insomni. Studiens syfte var framförallt att utvärdera om ångestsymtom och depressiva symtom reducerades som en följd av behandlingen mot insomni. En minutiös diagnostisk procedur tillämpades, varefter 8 patienter inkluderades i en multipel-baslinjes design. Deltagarna erhöll kliniskt signifikanta förbättringar på insomni-, (57 %) depressions- (75 %) och ångestsymtom

(40 %). Resultaten kvarhölls vid uppföljning tre veckor efter avslutad behandling. Resultaten tyder på att KBT-I är en tillämpbar behandling för patienter med komorbid insomni. Resultaten bidrar även med visst stöd för en kausal länk från insomni över till depression och ångest. Vidare

presenteras en teoretisk modell över transdiagnostiska processer som förekommer vid insomni, ångest och depression. Ytterligare forskning behövs för att åstadkomma effektivare behandling för patienter med ångest och/eller depression och komorbid insomni.

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Warensjö, Anna. "Finns ett samband mellan kvarstående insomni efter avslutad KBT-behandling för depression och återfall vid uppföljningsmätningen?" Thesis, Stockholms universitet, Psykologiska institutionen, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-122466.

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Personer som drabbats av depression återfaller/återinsjuknar ofta en eller flera gånger i livet. Forskning har visat att b la demografiska faktorer, residualsymtom och insomni är prediktorer för återfall. Syftet med studien var därför att undersöka betydelsen av demografiska faktorer, residualsymtom och insomni för nivån av depression 6-12 månader efter avslutad behandling på en psykiatrisk specialistmottagning. Urvalet var alla patienter som diagnosticerats med depression eller recidiverande depression och genomgått KBT-terapi under perioden 2008 – september 2013, och som hade uppföljningsdata vid sex eller tolv-månader, vilket sammanlagt var 111 patienter. Beroendevariabel var resultat på formuläret Patient Health Questionnaire (PHQ-9). Resultaten visade att patienter med residualsymtom inte försämrades signifikant mellan eftermätningen och uppföjningsmätningen, ett fynd som inte överensstämmer med forskning på området. Regressionsanalyser visade ingen signifikant påverkan av kön, ålder och utbildningsnivå på senare nivå av depression vid uppföljningsmätning. Däremot visade regressionsanalyser att sömnbesvär, mätt med formuläret Insomnia Severity Index (ISI), vid framför allt eftermätning hade ett samband med senare nivå av depression vid uppföljningsmätningen. Resultaten indikerade att kvarstående sömnbesvär då behandlingen avslutades predicerade senare nivå av depression. Slutsatsen är att ett tillägg av en sömnintervention för de patienter som har insomni då behandlingen avslutas kan minska sannolikheten för återfall i depression. Då många patienter saknade uppföljningsdata kunde inga säkra slutsatser dras.
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Wilmenius, Lina. "Kognitivbeteendeterapi för insomni i en grupp med samsjuklig insomni och depression: Grad av insomni medierar sambandet mellan behandling och grad av depression". Thesis, Örebro universitet, Institutionen för juridik, psykologi och socialt arbete, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-51773.

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Lindegren, Andreas. "Produktdesign för insomni". Thesis, KTH, Maskinkonstruktion (Inst.), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-201037.

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Rapporten beskriver en produktutvecklingsprocess från ett givet behov; produktutveckling för insomni, till en fungerande prototyp av en konsumentprodukt. Designprocessen spänner forskning, idégenerering, mekanisk konstruktion och framställning i en Rapid Prototyping (RP) miljö genom upprepade iterationer. Forskningen innefattar litteraturstudie, enkäter för att samla data på beteenden och inställningar runt sömn, kontextuella intervjuer hos yrkesmän på området för att erbjuda ett sammanhang, semistrukturerade intervjuer för att studera problemet djupare samt workshops för att testa koncept och prototyper. Stimuli är valt som angreppsätt efter kvalitativa intervjuer då det bedöms ha mest potential på marknaden samt vara en unik approach på problemet. Sedan genereras idéer och en lösningsprincip väljs ut; taktil och auditiv stimuli. Dessa principer används för att generera koncept och visar potential som enkla prototyper. Två koncept är väljs ut och utvecklas genom metoden Tjänsteresa. Ett koncept väljs ut och testas i fem försök med kvalitativa intervjuer om upplevelsen. Resultatet är en taktil enhet som lugnar användaren genom taktil stimuli. Studien kan användas som utgångspunkt för upplevelsedriven produktutveckling, produktutveckling inom det medicinska området eller för användning av verktyg för tjänstedesign inom mekanisk produktutveckling.
This paper describes a product development process from a given need of innovation in the field of insomnia to test of a working prototype of a product. The design process spans research, ideation, configuration and realisation through multiple iterations. The research consisted of a literature study, online forms to gather data on sleep behaviours and attitudes toward sleep, contextual interviews to learn from professionals working with sleep treatment, semi-structured interviews to understand the problem at depth and workshops to try different ideas and concepts. Stimuli is chosen as means for soothing a user after initial interviews because it was judged to have the most potential on the market and being an unique apprach.. Then multiple concepts are generated and a principle of solution selected; tactical and autitive stimuli. Both showed potential when tried in a rapid prototype environment. The priciple is used to generate ideas for koncepts, and among them two is chosen. These are developed with the help of a customer journey map and one is selected for further development and testing. The final concept was tested in five qualitative inteviews and the result is a soothing device for home use. The conclusions is drawn that there is still a lot to discover in the field of human-product-interaction, that techonogy can advance from its now display-dependent state. The results can be used for further product development in the field of medical product development, human-product interaction and the use of service design tools in mechanical product development.
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22

Forgan, Grant S. "Psychophysiological insomnia and idiopathic insomnia : the role of self-regulatory behaviour systems". Thesis, University of Glasgow, 2010. http://theses.gla.ac.uk/2211/.

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Further research into identifying the mechanisms that underlie the development and maintenance of insomnia and its different subtypes is required. Neurobiological motivational systems are thought to mediate our experiences of negative and positive affect and are implicated in the etiology of psychiatric disorders, but their role in insomnia is unknown. The present study aimed to compare self-reported sensitivity to these systems across Psychophysiological Insomnia (PI) and Idiopathic Insomnia (IdI). Sixty one adults with PI (n = 20) and IdI (n = 20), and Good Sleepers (n = 21), completed measures of sleep characteristics, Behavioural Inhibition Sensitivity (BIS), Behavioural Activation Sensitivity (BAS), Sleep Effort, Depression and Anxiety. As predicted the PI group reported significantly greater BIS sensitivity compared with the IdI and GS groups. However, no significant differences were found between groups on BAS sensitivity. Post-hoc analysis revealed significant differences between the insomnia groups on sleep effort when age was included as a covariate. Depression and anxiety did not moderate the relationships between the other outcome variables. The findings support the notion that PI is associated with a specific tendency toward threat sensitivity, a tendency absent in IdI. This is consistent with contemporary thinking on PI that this group exhibits greater vulnerability to stress-related sleep disturbance, whereas IdI is a more stable insomnia subtype that may be less reactive to circumstances. Accordingly, this suggests that different psychological treatment approaches are indicated for these subtypes with PI requiring re-conditioning forms of CBT and IdI requiring a more acceptance based approach.
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Killgren, Jenny y Ella Thiblin. "Preferens, förväntan och trovärdighet i relation till behandlingsutfall vid internetförmedlad insomnibehandling". Thesis, Stockholms universitet, Psykologiska institutionen, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-144748.

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Hur preferens påverkar behandlingsutfall är ett ämne som diskuteras och undersöks allt mer. Tidigare forskning indikerar en liten till moderat effekt av preferens på behandlingsutfall. Syftet i den här studien var att undersöka preferens, preferensstyrka och de närliggande begreppen förväntan och trovärdighet i relation till behandlingsutfall för två internetbaserade behandlingar för insomni, kognitiv terapi och beteendeterapi. 112 deltagare randomiserades till en av de två behandlingarna eller till att få välja behandling. Signifikant fler deltagare valde kognitiv terapi. Preferens för typ av behandling påverkade inte behandlingsutfallet. Det fanns heller inget samband mellan preferensstyrka och utfall, men deltagarna skattade det som viktigt att få välja. Det fanns en svag signifikant korrelation mellan förväntans- och trovärdighetsskattningarna och utfall. På grund av små och ojämna grupper är det svårt att dra några vidare slutsatser om hur preferens påverkar behandlingsutfall.
Behandling via Internet av Sömnproblem (BIS)
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SYLVAIN, AGATHE. "Activite onirique et insomnie". Aix-Marseille 2, 1993. http://www.theses.fr/1993AIX20190.

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Bergdahl, Lena. "Auricular acupuncture for insomnia". Doctoral thesis, Uppsala universitet, Psykiatri, Akademiska sjukhuset, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-320045.

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Cognitive behavioural therapy for insomnia (CBT-i) is the most effective treatment for insomnia. Studies show that auricular acupuncture (AA) may alleviate insomnia symptoms. The overall aim of the thesis was to compare treatment effects of auricular acupuncture (AA) with cognitive behavioural therapy for insomnia (CBT-i) on symptoms of insomnia, anxiety, depression, hypnotic drugs consumption and quality of life from short- and long-term perspectives. Paper I had a qualitative approach with a descriptive design. 16 participants received group-treatment with AA during their protracted withdrawal phase and were interviewed about their experiences. They participants experienced a reduction in protracted withdrawal symptoms, improved subjective sleep quality, a strong sensation of peacefulness and increased wellbeing. Paper II, III and IV present results from a randomised controlled trial in where the effects of group-treatment with AA and CBT-i were compared in short- and long-term using subjective (questionnaires and sleep diary) and objective (actigraphy) measurements. The results showed that CBT-i was superior to AA in reducing insomnia symptoms in both the short and long run. Both groups experienced significant long-term reduction of depressive symptoms. Further, both groups managed to maintain a decreased intake of hypnotic drugs at the end of the treatment when compared to baseline measurement. Short-term reduction of symptoms of anxiety and depression improved only in the AA group. The results from the objective actigraph recordings showed that the AA group slept more and the CBT-i group less after the treatment and that sleep patterns in both groups reverted to pre-treatment levels after 6 months. Conclusively: AA, as administered in this study, was not as good as CBT-i in treating insomnia symptoms, and should not be used as a stand-alone treatment for insomnia. Our results also demonstrate that prolonged sleep time does not necessarily yield better sleep, and that the perception of insomnia symptoms is not inevitably affected by sleep duration. AA was as effective as CBT-i in ending hypnotic drugs consumption. Moreover, AA was more successful than CBT-i in reducing symptoms of anxiety and depression in the short run. Further studies investigating AA for anxiety and depression are motivated.
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26

Leroy, Jean-Dominique. "L'insomnie chronique de l'adulte, facteurs étiologiques et traitements : à propos de 136 cas". Montpellier 1, 1988. http://www.theses.fr/1988MON11211.

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Mardula, Karolina y Ebba Winai. "I jakten på en god natts sömn: Ett försök till manipulering av tankar innan insomning". Thesis, Örebro universitet, Akademin för juridik, psykologi och socialt arbete, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-14493.

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I en single case experimental design (SCED) av crossover typ med fyra deltagare med insomni undersöktes möjligheten till att manipulera mängden negativa tankar innan insomning genom tillämpningen av två olika tankeexperiment, savoring och framkallad ruminering. Bland resultaten fanns signifikanta samband mellan mängd negativa tankar innan insomning och sömnkvalité, insomningslatens och antal uppvaknanden. Samband fanns även mellan mängd negativa tankar och obehag över tankarna. Dock visade det sig att experimenten inte påverkade mängden negativa tankar innan insomning då de sömnrelaterade faktorerna varierade oberoende av experiment. Variationen i de olika skattningarna på måtten gjorde att inga slutsatser kunde dras kring vad som orsakade sömnbesvären hos deltagarna eller vilken roll mängden negativa tankar hade för dessa. Resultatet diskuteras i förhållande till tidigare forskning.
The possibility of manipulating the amount of negative thoughts before sleep onset in four subjects with insomnia was investigated in a single case crossover experimental design (SCED). The attempt to change the amount of thoughts consisted of two experimental conditions, savoring and induced rumination. Significant correlations were found between the amount of negative thoughts before sleep onset and quality of sleep, sleep onset latency and number of awakenings. There were also correlations between the amount of negative thoughts and distress related to the thoughts. The experiments did, however, not influence the amount of negative thoughts before sleep onset. Conclusions concerning causal factors of the sleep difficulties and the impact of the amount of negative thoughts were made impossible by the large variability in the scores. The results are discussed in relation to previous research.
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28

Schiller, Helena. "How to work for a good night's sleep". Doctoral thesis, Stockholms universitet, Centrum för forskning om ojämlikhet i hälsa (CHESS), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-148576.

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Stress and sleep problems are common in the working population and cause considerable costs for society. Sleep is the most important part of recovery, and poor sleep has a negative impact on overall functioning, which might have important consequences for both the employee, the employer and society. In order to find strategies to alleviate this contemporary public health concern of stress and poor sleep in the working population, this thesis evaluated interventions performed at the workplace to target these issues. The first intervention is a randomized controlled trial of a 25% work time reduction for full-time workers within the public sector in Sweden. Study I evaluated the impact of work time reduction on subjective sleep quality, sleep duration, sleepiness, perceived stress, and bedtime worries. Assessments included diary data from one week at three occasions over 18 months. Study II investigated time-use patterns through activity reporting sheets used during the work time reduction by evaluating the amount of total workload, paid work, non-paid work and recovery activities. Both studies investigated workdays and days off separately as well as the importance of gender, family status and work situation (only Study II). The second randomized controlled intervention of the thesis is a group cognitive behavioral therapy (CBT) intervention at the workplace targeting sleep disturbances among employees within the retail sector in Sweden (Study III). Data were collected through questionnaires, diaries and objective sleep measurement (actigraphy) over a period of ten days before and after the intervention, as well as at a three-month follow up. The study evaluated the effects of the intervention on sleep and explored the moderating effect of burnout-levels at baseline. In our studies, an economically fully compensated reduction of work hours for full-time workers lead to long-term positive effects on sleep duration and sleep quality, sleepiness and levels of perceived stress. During this work time reduction, the total workload of both paid and non-paid work was reduced and time spent in recovery activities increased. The results indicate that a more balanced relation between effort and recovery was established. The second intervention, which targets the individual through a group CBT-intervention for insomnia at the workplace, was shown to improve insomnia symptoms in daytime workers who did not suffer from concurrent burnout. Such an intervention could support the individual in handling sleep problems and preventing the development of more severe and chronic sleep disorders, as opposed to interventions aimed at making environmental changes at the workplace. However, the CBT-intervention evaluated within this thesis will need to be further developed in order to be beneficial for more groups of employees. The positive effects of these interventions might be beneficial for public health and help improve employee’s life satisfaction, daily functioning and health development.​

At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 2: Manuscript. Paper 3: Manuscript.

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29

Kurz, Carolin. "Neuropathologische Untersuchungen zur letalen Insomnie". Diss., lmu, 2010. http://nbn-resolving.de/urn:nbn:de:bvb:19-122409.

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Baker, Louise. "Insomnia symptoms and daytime dysfunction". Thesis, University of Southampton, 2015. https://eprints.soton.ac.uk/375529/.

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31

Hicks, Jane Amanda. "Sleep in depression and insomnia". Thesis, University of Bristol, 2007. http://hdl.handle.net/1983/e0f31410-a6a8-4941-b758-08877b5b5a2d.

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This thesis explores the pharmacological and psychological treatment of both primary insomnia and insomnia secondary to depression. The first study, in a double blind placebo controlled trial, compares the effects of two anti-depressants, nefazodone and paroxetine, on the sleep of patients with moderate to severe depression. The second study described is a cross over trial that investigates whether nefazodone compared to placebo has beneficial effects on sleep in patients with primary insomnia. The final chapter explores the treatment of primary insomnia or secondary insomnia (e.g. insomnia secondary to depression) using a cognitive behaviour therapy group approach. In the first study, nefazodone was found, compared to paroxetine, to increase sleep efficiency, total sleep time and decrease number of awakenings as measured objectively by polysomnography. These effects were evident early in treatment, by day 3. In the second study nefazodone was not found, compared to placebo, to increase sleep efficiency, total sleep time or decrease number of awakenings in patients with primary insomnia. In the third study, patients with primary insomnia did report improvements in dysfunctional attitudes and beliefs about insomnia and improvements in energy/vitality and mental health, as measured by the SF36 quality of life scale, after attending group cognitive behavioural therapy (CBT). Sleep parameters were not significantly improved when compared pre and post CBT. The findings described in this thesis have led to further work to test the efficacy of trazodone (nefazodone's sister drug) in a placebo controlled trial for primary insomnia and the continued running of the CBT insomnia group with a view to supporting patients with chronic insomnia.
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32

Hendley, Debbie D. "Insomnia, Race, and Mental Wellness". Antioch University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=antioch156290885199634.

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Hamdy, Ronald C., Amber Kinser, Kara Dickerson, c. Kendall-Wilson, Audrey Depelteau, Rebecca Copeland y Kathleen Whalen. "Insomnia and Mild Cognitive Impairment". Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/2737.

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Insomnia is a common problem in older people, especially in patients with mild cognitive impairment (MCI) whose circadian rhythm is often compromised. Insomnia exerts such a toll on caregivers that it is frequently the primary reason for seeking to institutionalize their loved ones. Three different types of insomnia are recognized: sleep-onset or initial insomnia, sleep maintenance or middle insomnia, and early morning awakening or late insomnia. Nocturnal hypoglycemia, as a cause of middle insomnia, is the main focus of this case study. Other types of insomnia are also briefly reviewed. The management of insomnia is then discussed including sleep hygiene, the usefulness and potential drawbacks of dietary supplements, nonprescription over-the-counter preparations and prescription hypnotics. Sleep architecture is then briefly reviewed, emphasizing the importance of its integrity and the role of each sleep stage.
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34

Norell, Annika y EvaLotta Nyander. "Sleepless in Örebro : Effekter av kognitiv terapi med beteendeexperiment på ungdomar med primär insomni". Thesis, Örebro University, Department of Behavioural, Social and Legal Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-2104.

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Sömnsvårigheter hos ungdomar är ett växande problem i Sverige men det saknas forskning om behandlingsmetoder för åldersgruppen. Syftet med studien var att testa kognitiv terapi med beteendeexperiment (KT-I) på gymnasieungdomar med primär insomni. Studien genomfördes enligt en Single Subject design med för- och eftermätning. Tre ungdomar i åldern 16-18 genomgick en sju veckor lång behandling efter 1-2 veckors baslinjemätning. Resultatet visade att svårighetsgrad av insomni minskade, att funktionsförmågan dagtid förbättrades och behandlingsmålen uppfylldes i hög grad. Dagliga mätningar visade att förändring av sömnrelaterade symtom och dagtidssymtom varierade mellan deltagarna. Graden av vidmakthållande kognitiva processvariabler minskade. Slutsatser som kan dras är att KT-I är en lovande behandlingsmetod för ungdomar med insomni och att metoden bör testas ytterligare i randomiserade kontrollerade studier.


Sleeping difficulties are an increasing problem in Sweden for youths today, but there is a lack of research on treatments for this age group. The aim of the study was to investigate the effects from Cognitive Therapy with Behavioural Experiments (CT-I) on youths with primary insomnia in upper secondary school. The study was conducted according to a Single-Subject design with pre- and posttests. Three youths between the ages of 16-18 participated in a seven week long treatment, after 1-2 weeks of baseline measures. The results showed that the degree of insomnia decreased, that the ability to function during daytime increased, and that the treatment goals were met to a large extent. Daily measures showed that changes in sleep related symptoms and daytime symptoms varied among the participants. The degree of maintaining cognitive processes decreased. The conclusions that can be drawn are that CT-I is a promising treatment for youths with insomnia and that the method should be tested further in randomized controlled studies.

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35

Lebrun, Cindy. "L'insomnie dans la Maladie de Parkinson : de l'étude de ses facteurs psychologiques de maintien à sa prise en charge". Thesis, Montpellier 3, 2019. http://www.theses.fr/2019MON30013.

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L’objectif de cette thèse est double, d’une part, investiguer le rôle des facteurs cognitifs et comportementaux comme processus sous-jacents au maintien de l'insomnie chronique associée à la maladie de Parkinson (MP), d’autre part, évaluer l’acceptabilité et l’efficacité de la Thérapie Cognitive et Comportementale (TCC) pour la prise en charge de l’insomnie chronique comorbide de la MP. Une première étude (Étude 1) de nature psychométrique a été menée auprès d’un large échantillon de 539 individus issus de la population générale afin de proposer une adaptation et une validation en langue française d’un questionnaire anglophone, le Sleep- Related Behaviors Questionnaire (SRBQ). Ce questionnaire permet de mesurer la fréquence d’utilisation des comportements de sécurité reliés au sommeil, une composante centrale dans le maintien de l’insomnie chronique. Des analyses préliminaires ont permis de supprimer les items de la version originale du SRBQ ayant de mauvaises propriétés psychométriques, ce qui a donné lieu à une version française composée de 20 items (SRBQ-20). Nos résultats ont mis en évidence une très bonne consistance interne du SRBQ-20. L’analyse factorielle exploratoire ainsi que l’analyse parallèle suggéraient une solution à 3 facteurs : amélioration de la fatigue, amélioration du sommeil et suppression de pensées. Les analyses de corrélation démontraient une relation significative entre les croyances dysfonctionnelles, la sévérité de l’insomnie et le score total au SRBQ-20. La version française du SRBQ-20 se présente comme un instrument ayant de bonnes qualités psychométriques pour l’étude des comportements de sécurité reliés au sommeil. Une seconde étude de type cas-témoin a été conduite afin de déterminer, au regard du modèle de Harvey (2002), les relations qu’entretiennent les facteurs psychologiques de maintien de l’insomnie avec la présence d’un diagnostic d’insomnie chronique associée à la MP. Corollairement, nous avons étudié l’interaction entre ces facteurs dans leur contribution au diagnostic d’insomnie chronique associée à la MP. Soixante-huit patients porteurs d’une MP (38 avec insomnie chronique) ont été recrutés
The aim of the present thesis is twofold: on the one hand, to investigate the role of cognitive and behavioral factors as processes underlying the maintenance of chronic insomnia associated with Parkinson's disease (PD); on the other hand, to evaluate the acceptability and efficacy of Cognitive Behavioral Therapy (CBT) for the management of chronic insomnia comorbid to PD. A first psychometric study (Study 1) was conducted with a large sample of 539 individuals from the general population in order to propose an adaptation and validation of a French version of the Sleep-Related Behaviors Questionnaire (SRBQ). This questionnaire measures the frequency of use of sleep-related safety behaviors, a central component in maintaining chronic insomnia. Preliminary analyses resulted in a French version consisting of 20 items (SRBQ-20) with a very good internal consistency. The exploratory factor and parallel analyses suggested a solution with 3 factors: improvement of fatigue, improvement of sleep and suppression of thoughts. Correlation analyses showed a significant relationship between dysfunctional beliefs, insomnia severity and total SRBQ-20 score. The French version of the SRBQ-20 has good psychometric properties. A second case-control study (Study 2) was conducted to determine, using Harvey's (2002) model, the relationships between psychological factors maintaining insomnia and chronic insomnia associated with PD. In addition, we studied the interaction between these factors in their contribution to chronic insomnia diagnosis associated with PD. Sixty-eight patients with PD (38 with chronic insomnia) were enrolled
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36

Knoop, Johanna y Veronica Kovacs. "Sjuksköterskans sömnstöd till patienter med långvariga sömnproblem : En litteraturöversikt". Thesis, University of Skövde, School of Life Sciences, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-3592.

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BAKGRUND: Sömn är ett regelbundet återkommande tillstånd som är livsnödvändigt för att kroppen skall återhämta sig på ett korrekt vis. Personer med insomni och sömnapné är två patientgrupper som lider utav långvariga sömnproblem. Orsakerna till den dåliga sömnen kan vara många, och därför är det viktigt för sjuksköterskan att vara lyhörd och kunna stötta patienterna med hjälp av sina kunskaper gällande de åtgärder och behandlingar som finns att använda sig av.

SYFTE: Syftet med denna litteraturöversikt var att belysa vilka åtgärder sjuksköterskan kan tillämpa för att stödja patienter med långvariga sömnproblem.

METOD: En litteraturöversikt där 13 vetenskapliga artiklar granskades och analyserades. Fribergs (2006) modell för litteraturöversikter användes vid datainsamling och analysförfarande.

RESULTAT: Fyra kategorier framkom ur analysen av de vetenskapliga artiklarna: egenvård, akupunktur, kognitiv beteendeterapi, och stödprogram. Dessa kategorier gör det möjligt för sjuksköterskan att tillämpa stöd till patienterna. Hos patienter med långvariga sömnproblem har de stödjande åtgärderna visat sig ge ökad sömn- och livskvalitet.

SLUTSATS: Forskningen kring de långvariga sömnproblemen har ökat under de senaste åren men trots det finns det bristande kunskap om hur sjuksköterskan kan ge de behandlingar och det stödet som patienterna med insomni och sömnapné behöver.


BACKGROUND: Sleep is a periodic state which is essential for the body to recover in a proper manner. Insomnia and people with sleep apnea are two groups of patients out of long-term sleep problems. There are many causes of poor sleep, and that’s why there are so important for the nurse to be sensitive and support patients through their knowledge concerning the actions and processes that exist to use.

AIM: The purpose of this literature review was to illustrate which measures nurse can apply to support patients with long-term sleep problems.

METHOD: A literature overview, including 13 reviewed and analyzed articles. Fribergs (2006) model for literature overview were used in data collection and analysis procedure.

RESULT: Four categories emerged from the analysis of the articles: self-care, acupuncture, cognitive behavioral therapy, and support program. These categories make it enable for the nurse to apply support to patients who suffer out of prolonged sleeping problem. Patients perceive that both their sleep and quality of life improves with the help of different treatments.

CONCLUSION: Research into long-term sleep problems has increased in recent years. Despite this, there is a lack of knowledge about how nurse can provide treatment and support for patients with insomnia and sleep apnea.

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Nabb, Cajsa-Stina Matilda y Rebecca Diana Taylor. "En longitudinell studie av psykologiska riskfaktorer för depression och ångest". Thesis, Umeå universitet, Institutionen för psykologi, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-183382.

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Tidigare forskning pekar på att det kan finnas samband mellan vissa psykologiska faktorer och utveckling av depression och ångest. Därför var syftet med denna studie att undersöka huruvida olika psykologiska faktorer påverkar risken att utveckla depression samt ångest vid en uppföljning efter tre år. Studien baserades på data som insamlats vid det första (T1) och det andra (T2) mättillfället i den longitudinella populationsbaserade Miljöhälsostudien i Västerbotten. Samplen i denna undersökning bestod av deltagare som inte hade ångest (n=1930), och deltagare som inte hade depression (n=2120) vid T1. I studien undersöktes i vilken utsträckning upplevelse av utmattning, insomni, känsla av hjälp- och hopplöshet, stress, självskattad ohälsa, ångest och depression vid T1 ökade risken för depression respektive ångest vid T2. Logistiska regressionsanalyser visade på en signifikant ökad risk för att utveckla depression vid T2 (Oddskvot; OK=1.99-3.64) för samtliga riskfaktorer. Riskfaktorerna depression, utmattning, hjälp- och hopplöshet och självskattad ohälsa ökade risken för att utveckla ångest vid T2 signifikant (OK=2.37-3.78). Sammanfattningsvis visar resultaten att riskfaktorerna indikerar en i varierande grad ökad risk för att utveckla depression och ångest. Kännedom om riskfaktorer kan vara ett betydelsefullt stöd för att i ett tidigt skede sätta in interventioner och därmed förhindra senare insjuknande i depression och ångest.
Previous research suggests that there may be a link between certain psychological factors and development of depression and anxiety. The purpose of this study was therefore to investigate how different psychological factors affect the risk of developing depression and anxiety in a follow-up three years later. The study was based on data from baseline (T1) and follow-up (T2) in the Västerbotten Environmental Health Study, a longitudinal population- based study. The sample consisted of participants who did not have anxiety (n = 1930), and participants who did not have depression (n = 2120) at T1. The study examined the extent to which experience of exhaustion, insomnia, feelings of helplessness and hopelessness, stress, low self-rated health, anxiety and depression at T1 increased the risk of depression and anxiety at T2, respectively. Logistic regression analyses showed a significantly increased risk of developing depression at T2 (Odds ratio; OR = 1.99-3.64) for all risk factors. The risk factors depression, exhaustion, feelings of helplessness and hopelessness and low self-rated health significantly increased the risk of developing anxiety at T2 (OR = 2.37-3.78). In conclusion, the results show that the risk factors indicate a varying degree of increased risk of developing depression and anxiety. Knowledge of risk factors is important as support for initiating interventions at an early stage and thus preventing later onset of depression and anxiety.
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38

Rioux, Isabelle. "Time estimation in chronic insomnia sufferers". Master's thesis, Université Laval, 2003. http://proquest.umi.com/pqdweb?did=766731671&sid=9&Fmt=2&clientId=9268&RQT=309&VName=PQD.

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39

Laugsand, Lars Erik Sande. "Insomnia and risk for cardiovascular disease". Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for samfunnsmedisin, 2012. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-17010.

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Insomni og risiko for hjerte- og karsykdom Forskning som har blitt utført det siste tiåret har gitt resultater som taler for at dårlig søvn og søvnlidelser bidrar til utvikling av hjerte- og karsykdom. Insomni er definert som en subjektiv opplevelse av å ha problemer med innsoving, for tidlig oppvåkning om morgenen og/eller dårlig søvnkvalitet, og insomni ansees for å være den vanligste søvnforstyrrelsen. Forekomsten av minst ett av symptomene kan være så høy som 33% i den generelle befolkningen. Foreløpig er det få studier på sammenhengen mellom insomni og risiko for framtidig hjerte- og karsykdom. Insomni henger sammen med en ugunstig livsstil og utvikling av metabolsk syndrom, som betyr at personer med insomni ofte har høyere blodtrykk, kolesterol og høyere kroppsmasseindeks enn personer uten slike søvnplager. En annen mulighet for sammenhengen er at søvnproblemene bidrar til økt utskillelse av inflammatoriske stoffer i blodet som kan øke risikoen for hjerte- og karsykdom. Om det er en klar sammenheng mellom metabolsk syndrom og inflammasjon, er heller ikke kjent, og spesielt er dette uavklart i yngre aldersgrupper. Studiene i avhandlingen tok utgangspunkt i den andre Helseundersøkelsen i Nord-Trøndelag (HUNT-2) som foregikk i perioden 1995-97. Alle personer over 20 år i fylket ble invitert, og deltakerne fylte ut spørreskjema, gjennomgikk en klinisk undersøkelse, og det ble tatt blodprøver. I spørreskjemaet ble det blant annet spurt om søvnplager. Fra undersøkelsen startet til og med 2008 ble det fortløpende registrert førstegangs hjerteinfarkt eller hjertesvikt, hvor opplysningene enten ble hentet fra sykehusjournaler i Helse-Nord Trøndelag eller fra Dødsårsaksregisteret. I en undergruppe bestående av 10 000 deltakere ble det målt høy-sensitivt C-reaktivt protein (hsCRP) i blod, som er et mål på graden av inflammasjon i kroppen. Resultatene viste at personer med symptomer på insomni hadde en moderat økt risiko for førstegangs hjerteinfarkt og økt risiko for hjertesvikt sammenliknet med personer uten søvnproblemer. Vi fant også at sjansen for å få hjerteinfarkt eller hjertesvikt var høyere jo flere symptomer på insomni som var tilstede samtidig. Vi tok høyde for betydningen av andre faktorer som kunne påvirke resultatene, og i de statistiske analysene justerte vi for forskjeller i alder, kjønn, ekteskapsstatus, utdanningsnivå, skiftarbeid, blodtrykk, kolesterol, diabetes, vekt, fysisk aktivitet, alkohol og røyking. I tillegg justerte vi for symptomer på depresjon og angst, som begge kan medføre søvnplager. De justerte analysene viste at disse mulig konfunderende faktorene ikke påvirket resultatene i nevneverdig grad, noe som styrker sannsynligheten for at våre funn har en underliggende biologisk årsak. I en annen studie fant vi at den positive sammenhengen mellom metabolsk syndrom og hsCRP var like tydelig i alle aldersgrupper. Til tross for at personer med insomni oftere har metabolsk syndrom, fant vi ingen holdepunkter for at personer med insomni har økt utskillelse av hsCRP. Disse funnene taler imot at inflammasjon, indikert av høy hsCRP, kan forklare sammenhengen mellom insomni og framtidig hjerte- og karsykdom. Til tross for at insomni er forbundet med en moderat risikoøkning for hjerte- og karsykdom, er insomni så vanlig i befolkningen at søvnplager kan spille en viktig rolle for hjertehelse. I tillegg er insomni en lett gjenkjennbar og potensielt håndterbar tilstand. I forebygging av hjerte- og karsykdom bør derfor søvnplager tas med i vurderingen. Det kreves mer forskning på området, slik at man får en bedre forståelse av de underliggende mekanismene.
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40

Cabrera, Mendoza Laura [Verfasser] y Dieter [Akademischer Betreuer] Riemann. "Insomnie: Trauminhalte und Orientierung im Schlaf". Freiburg : Universität, 2019. http://d-nb.info/1186794488/34.

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David, Beverley Mari. "Insomnia : predisposing, precipitating and perpetuating factors". Thesis, University of Birmingham, 2014. http://etheses.bham.ac.uk//id/eprint/5341/.

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Context: The aim of this research was to identify whether the underlying cognitive mechanisms suggested to contribute to the maintenance of depression are present in a community sample of people who report insomnia. Design: In a cross section study, rumination, inhibition and set switching cognitive processes were compared in a community sample of 79 participants aged 18-59 years. The Insomnia Severity Index (ISI) was used to identify subjective ‘good’ and ‘poor sleepers’. Using Morin et al., (2011) recommendations, a cutoff score of 10 was used to differentiate between this community sample of good (n = 43) and poor(n = 36) sleepers. Measures: Assessments included: the ISI; Pittsburgh Sleep Quality Index; Epworth Sleepiness Scale; The Ruminative Response Styles questionnaire; Pre Sleep Arousal Scale; Spielberger’s State/Trait Anxiety Inventory and the Beck Depression Inventory. The task-switching paradigm described by Mayr and Keele (2000), was used to design a computer-based program to obtain an index of set shifting and an index of inhibition of previously relevant information. Main findings: Between group comparisons were made using a one-way ANOVA. Data replicated previous findings showing people with poor sleep differ significantly in their psychological makeup compared to good sleepers. Data show a distinct psychological profile that has been found in previous research when comparing a community sample of people with and without poor sleep.
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42

Skácel, Martin. "Podnikatelský plán Next generation baru Insomnia". Master's thesis, Vysoká škola ekonomická v Praze, 2008. http://www.nusl.cz/ntk/nusl-3423.

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Práce je zaměřena na poskytnutí srozumitelného a čtivého návodu k sestavení podnikatelského plánu nově vznikající společnosti. Teoretická část shrnuje obecné poznatky z dané oblasti. V praktické části je zpracován kompletní podnikatelský plán společnosti, jejímž cílem je v Čechách vytvořit a usadit se na zcela novém trhu, který bude charakteristický využitím nejnovějších zobrazovacích a ovládacích technologií v oblasti nočních zábavních podniků a barů.
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43

Prem, Martin [Verfasser] y Dieter [Akademischer Betreuer] Riemann. "Diffusion-Tensor-Imaging bei primärer Insomnie". Freiburg : Universität, 2012. http://d-nb.info/1123469768/34.

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44

Jurysta, Fabrice. "Contribution à l'étude de la relation entre l'activité cérébrale et la variabilité du rythme cardique au cours du sommeil". Doctoral thesis, Universite Libre de Bruxelles, 2010. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/210016.

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45

Emelie, Johansson y Närfors Ulrika. "Omvårdnadsåtgärder vid insomni : En litteratursammanställning av kunskap kring omvårdnadsåtgärder för att stödja vuxna personer med insomni". Thesis, Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-7838.

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46

Eriksson, Hanna y David Gryphon. "Kognitiv beteendeterapi för samsjuklig insomni och socialt ångestsyndrom: En behandlingsstudie". Thesis, Örebro universitet, Institutionen för juridik, psykologi och socialt arbete, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-55945.

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47

Herasymiuk, L. G. "Comorbidity of recurrent depressive disorder and insomnia". Thesis, БДМУ, 2021. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/18743.

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48

Genderson, Margo R. "Insomnia, cognition, aging: genetic and environmental influences". Thesis, Boston University, 2013. https://hdl.handle.net/2144/12759.

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Thesis (Ph.D.)--Boston University PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
Studying insomnia in aging populations is critical since the risk of insomnia increases with age, and insomnia is associated with numerous negative outcomes, such as cognitive impairments and co-occurring psychiatric disorders. The Vietnam Era Twin Study of Aging (VETSA) is a longitudinal study that investigates the relative contributions of genes and the environment to age-related changes in a broad range of characteristics. This thesis examined VETSA participants (n=1237; mean age=55.6) and utilized classic twin analyses, neuropsychological assessments, hormone, genotype, and structural MRI data to explore the etiology of insomnia, the relationship between insomnia and depression, and the mechanisms through which insomnia may influence cognitive decline. Results demonstrate that genetic factors are responsible for approximately 34% of the variation in individual differences in insomnia while non-shared environmental influences are responsible for the remaining 66%; shared family environmental influences are negligible. This study was the first investigation of the extent to which symptoms of insomnia and depression share a single genetic liability or independent liabilities, as these disorders often co-occur. Results demonstrate that much of the genetic influence on insomnia is also associated with depression, suggesting that the comorbidity between these disorders reflects shared genetic effects. There is an association between insomnia and poorer performance on tests of general cognitive ability, visual spatial processing and memory, short term memory, and working memory. After adjusting for depression, insomnia was significantly related to visual spatial processing and memory, suggesting that treating insomnia might be a successful intervention for individuals who demonstrate visual spatial memory and processing impairments. To explore mechanisms through which insomnia influences cognitive decline, cortisol, hippocampal volume, and the apoE genotype were examined. Insomnia was significantly related to smaller hippocampal volume; there was no association between insomnia and cortisol levels. ApoE genotype is related to deficits in recovering from neuronal insult, but insomnia did not differentially impact cognition based on apoE genotype. However, trends towards interactions were observed, particularly on memory domains. These findings have implications for the treatment of insomnia and depression and may inform prevention and intervention techniques aimed at cognitive preservation, which is of central importance in successful aging.
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49

Sharman, Rachel. "Empirically testing the neurocognitive model of insomnia". Thesis, Northumbria University, 2014. http://nrl.northumbria.ac.uk/21426/.

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The Neurocognitive Model of insomnia proposes that, through conditioned arousal, individuals with insomnia may experience heightened cortical arousal leading to increased sensory processing of external stimuli and sleep state misperception. This thesis provides a novel contribution to the literature by utilising auditory stimuli to examine the propositions of the Neurocognitive Model as a method of both eliciting and measuring the effects of cortical arousal. Firstly, the effect of noise on sleep was observed within the habituated home environment, evidencing that NREM sleep may be more susceptible to increased arousal through noise comparative to REM. Furthermore, traits typically associated with insomnia showed relationships with sleep disturbance due to noise, indicative that noise may increase cortical arousal. Secondly, the administration of novel noise in a non-habituated laboratory environment was utilised to raise cortical arousal levels in good sleepers to directly test the propositions of the Neurocognitive Model. Results demonstrated that noise altered both subjective and objective sleep along with creating a misperception of sleep onset, albeit not associated with explicit memory of noise stimuli. Finally, utilising individuals assumed to be experiencing heightened cortical arousal (insomnia) and good sleepers, words were administered during sleep onset periods to directly assess the processing and misperception components of the Neurocognitive model. Results demonstrated that both explicit and implicit recognition for words presented during sleep was greater for individuals with insomnia, yet this did not associate with a misperception of sleep. Therefore, this thesis proposes that the Neurocognitive Model could be a model of the effects of raised cortical arousal on sleep of which the two outcome pathways are the processing of auditory stimuli and sleep state misperception. Future research may wish to continue to examine the role of cortical arousal in the context of the Neurocognitive Model as a potential mechanism of sleep state misperception in those with insomnia and vulnerable good sleepers.
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50

Landry, Florentina. "Medikamentöse Behandlung der primären Insomnie mit Quetiapin". kostenfrei, 2008. http://mediatum2.ub.tum.de/doc/634726/634726.pdf.

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