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Lorenzo

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Analaysis on Insomnia and Related Disorders
« on: November 15, 2010, 11:24:53 PM »
General Medicine Clinical Report: Insomnia and Related Disorders

by: Lorenzo Lucino Jr.




The article that I chose is Insomnia, Depression & Aging: Assessing Sleep & Mood Interaction In Older Adults by Daniel J. Buysse, M.D. This article appeared in the Geriatrics Periodical in its 59th volume. This article is 6 years old and is 4 pages long. The purpose of this study was to identify the relationship between insomnia and depression in the aging population, and thus was initiated as an epidemiological study for the benefit of health psychology and medical science’ specialty in gerontology. The hypothesis of the study was that Insomnia and depression are related to each other on the level of epidemiology, clinical presentation, neurobiology, and treatment implications; the study notes that depression is one of the strongest risk factors for insomnia in the geriatric population (Buysse, 2004, p.47).

   This journal article was an epidemiological analytical paper in that it didn’t acquire particular subjects for the study , per say, but analyzed the trends between insomnia, depression and aging through analysis of numbers and previous articles on the said subject matter. The epidemiolical findings of the subject matter is actually quite interesting in the sense that it gives us, the reader and the rest of the medical and the psychological world an idea of the natural processes of aging and its effect on the sleep process. The article discussed the 5 risk factors for the development of insomnia and includes age, gender, and previous insomnia, chronic health condition associated with insomnias such as arthritis, chronic obstructive pulmonary disorder, and depression; the findings also noted how prevalence of insomnia was inversely proportional to socioeconomic status (Buysse, 2004, p. 48-49). The article also noted that the specific complaints that older adults experience in sleeping are how there is a change in their early sleep patterns, a change in their REM sleep, NREM sleep and REM latency, which translates into changes in napping schedules, increased sleepiness. The article notes that past epidemiological studies have noted how about 20-40% of older adults have complained of sleep disorders.

   Buysshe also notes the rising correlation between cases of depression and insomnia cases in the aging population by indicating how these two conditions rose as population groups aged. Epidemiological studies that he notes indicates that persons aged 65 years and older comprises 13% of the US population, but accounts for over 19% of the completed suicides, attributed to depression. Buysshe notes that the highest group of this are older adult men over 85 years of age, who have a suicide rate of 64.9/100,000 as compared to the overall US population that has a suicide rate of 10.6/ 100,000.

   Buysshe continues to write how the treatment of insomnia is similar for the treatment of depression and that the most effective way of treating insomnia would be to treat the underlying depression. Buysshe further elucidates the reader by discussing the different types of anti-depressive medications out there and the different combinations between tricyclic antidepressants, and trazodone, as well as using anxiolytics such as alprazolam etc. Bussye stresses the medical importance of treating the underlying depression first as the most effective means of treating the symptoms of insomnia. This, therefore, actually strengthens his claim that depression and insomnia are quite interlinked and that the former is a risk factor for the latter (Buysse, 2004, p. 47-50).

   The benefit of this journal article to the world of psychology is extensive and provides the behavioral psychologist, health psychologist etc the understanding of how many of the neuroses that older patients experience are interlinked with each other. The risk factors that Buysshe indicates also tell us how genetics, and environment, namely the stress factors, contribute to the manifestation of chronic depression and the eventual appearance of insomnias in the adult population. This is essential for us as psychologists because it allows us to be aware and ready of the possible medical problems of older patients when they come to us for medical guidance and counsel. With an interest in the psychological functions of the human mind and how this is affected by the circadian rhythm , which is itself dependent on the sleep cycle, this article truly helped me to understand the strong relationship between the changes in sleep patterns in older adults help in manifestation of sleep disorders, insomnia being one. Reading this article I am rather amazed how integrated medical science and health psychology is in treating this subset of the human population.



Reference:
Buysshe, Daniel. (2004). Insomnia , Depression & Aging: Assessing Sleep & Mood Interactions In Older Adults. Geriatrics Journal, 59(2), 47-51. Retrieved from http://geriatrics.modernmedicine.com/geriatrics/data/articlestandard/geriatrics/072004/84701/article.pdf





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Re: Analaysis on Insomnia and Related Disorders
« Reply #1 on: November 16, 2010, 01:32:07 AM »
Janjan basaha ni sha dear!!! kay mo tuo jud ko ani.
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Re: Analaysis on Insomnia and Related Disorders
« Reply #2 on: November 16, 2010, 01:35:28 AM »
Ajaw toho Jan, kay wala ka maapil sa aging population! ;D

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Re: Analaysis on Insomnia and Related Disorders
« Reply #3 on: November 16, 2010, 04:23:02 AM »
depress lang siguro ko dire  kay if mouli ko pinas wa man ko problema katulog
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Lorenzo

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Re: Analaysis on Insomnia and Related Disorders
« Reply #4 on: November 16, 2010, 07:17:38 AM »
Jan, if you are having sleep problems, then that is the underlying mechanism of your depressive episode(s). Decreased sleep patterns (REM, NREM etc) leads to an unstable circadian rythm, which produces abnormal levels of serotonin, dopamine, and melatonin. This translates into depressive episodes.

I would suggest you ask to see a neurologist to check up. If you have sleep obstruction such as apnea etc, then I would suggest you ask your GP to refer you to a pulmonologist.


All the best,
Lorenz



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