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      Clinical Spectrum and Trajectory of Innovative Therapeutic Interventions for Insomnia: A Perspective

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          Abstract

          Increasing incidences of insomnia in adults, as well as the aging population, have been reported for their negative impact on the quality of life. Insomnia episodes may be associated with neurocognitive, musculoskeletal, cardiovascular, gastrointestinal, renal, hepatic, and metabolic disorders. Epidemiological evidence also revealed the association of insomnia with oncologic and asthmatic complications, which has been indicated as bidirectional. Two therapeutic approaches including cognitive behavioral therapy (CBT) and drugs-based therapies are being practiced for a long time. However, the adverse events associated with drugs limit their wide and long-term application. Further, Traditional Chinese medicine, acupressure, and pulsed magnetic field therapy may also provide therapeutic relief. Notably, the recently introduced cryotherapy has been demonstrated as a potential candidate for insomnia which could reduce pain, by suppressing oxidative stress and inflammation. It seems that the synergistic therapeutic approach of cryotherapy and the above-mentioned approaches might offer promising prospects to further improve efficacy and safety. Considering these facts, this perspective presents a comprehensive summary of recent advances in pathological aetiologies of insomnia including COVID-19, and its therapeutic management with a greater emphasis on cryotherapy.

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          Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies.

          In many patients with depression, symptoms of insomnia herald the onset of the disorder and may persist into remission or recovery, even after adequate treatment. Several studies have raised the question whether insomniac symptoms may constitute an independent clinical predictor of depression. This meta-analysis is aimed at evaluating quantitatively if insomnia constitutes a predictor of depression. PubMed, Medline, PsycInfo, and PsycArticles databases were searched from 1980 until 2010 to identify longitudinal epidemiological studies simultaneously investigating insomniac complaints and depressed psychopathology. Effects were summarized using the logarithms of the odds ratios for insomnia at baseline to predict depression at follow-up. Studies were pooled with both fixed- and random-effects meta-analytic models in order to evaluate the concordance. Heterogeneity test and sensitivity analysis were computed. Twenty-one studies met inclusion criteria. Considering all studies together, heterogeneity was found. The random-effects model showed an overall odds ratio for insomnia to predict depression of 2.60 (confidence interval [CI]: 1.98-3.42). When the analysis was adjusted for outliers, the studies were not longer heterogeneous. The fixed-effects model showed an overall odds ratio of 2.10 (CI: 1.86-2.38). The main limit is that included studies did not always consider the role of other intervening variables. Non-depressed people with insomnia have a twofold risk to develop depression, compared to people with no sleep difficulties. Thus, early treatment programs for insomnia might reduce the risk for developing depression in the general population and be considered a helpful general preventive strategy in the area of mental health care. Copyright © 2011 Elsevier B.V. All rights reserved.
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            The Sleep-Immune Crosstalk in Health and Disease

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              The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses.

              Cognitive behavioral therapy (CBT) refers to a popular therapeutic approach that has been applied to a variety of problems. The goal of this review was to provide a comprehensive survey of meta-analyses examining the efficacy of CBT. We identified 269 meta-analytic studies and reviewed of those a representative sample of 106 meta-analyses examining CBT for the following problems: substance use disorder, schizophrenia and other psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, personality disorders, anger and aggression, criminal behaviors, general stress, distress due to general medical conditions, chronic pain and fatigue, distress related to pregnancy complications and female hormonal conditions. Additional meta-analytic reviews examined the efficacy of CBT for various problems in children and elderly adults. The strongest support exists for CBT of anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress. Eleven studies compared response rates between CBT and other treatments or control conditions. CBT showed higher response rates than the comparison conditions in 7 of these reviews and only one review reported that CBT had lower response rates than comparison treatments. In general, the evidence-base of CBT is very strong. However, additional research is needed to examine the efficacy of CBT for randomized-controlled studies. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on specific subgroups, such as ethnic minorities and low income samples.
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                Author and article information

                Journal
                Aging Dis
                Aging Dis
                Aging and Disease
                JKL International LLC
                2152-5250
                1 August 2023
                1 August 2023
                : 14
                : 4
                : 1038-1069
                Affiliations
                [1-ad-14-4-1038] 1EUDA Wellness, Taipei 114, Taiwan.
                [2-ad-14-4-1038] 2Biosource Tech, Ambala 133101, Haryana, India.
                [3-ad-14-4-1038] 3Victory Biotechnology Co., Ltd., Taipei 114757, Taiwan.
                [4-ad-14-4-1038] 4ShiNeo Technology Co., Ltd., New Taipei City 24262, Taiwan.
                [5-ad-14-4-1038] 5Department of Surgery, Division of Neurosurgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
                [6-ad-14-4-1038] 6 Department of Neurosurgery, Taipei Medical University Hospital, Taipei 11031, Taiwan.
                [7-ad-14-4-1038] 7Taipei Neuroscience Institute, Taipei Medical University, Taipei 11031, Taiwan.
                Author notes
                [* ]Correspondence should be addressed to: Dr. Wen-Cheng Lo, Department of Surgery, Division of Neurosurgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan. Email: drlons@ 123456h.tmu.edu.tw. Dr. Navneet Kumar Dubey, Victory Biotechnology Co., Ltd., Taipei 114757, Taiwan. Email: nkd@ 123456victorybio.com.tw.
                Article
                ad-14-4-1038
                10.14336/AD.2022.1203
                10389812
                37163444
                9ed60bb7-8d33-428b-9e5a-567aacab0fc8
                Copyright: © 2023 Lo et al.

                this is an open access article distributed under the terms of the creative commons attribution license, which permits unrestricted use, distribution and reproduction in any medium provided that the original work is properly attributed.

                History
                : 4 October 2022
                : 3 December 2022
                : 3 December 2022
                Categories
                Perspectives

                insomnia,cognitive behavioral therapy,whole-body cryotherapy,traditional chinese medicine,pulsed magnetic field therapy,acupressure

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