Insomnia historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Adnan Ezici, M.D[2]

Overview

In 1970, Sleep Disorders Clinic was founded at the Stanford University with the availability of performing nocturnal polysomnography and multiple sleep latency tests. In the same year, with the use of flurazepam, benzodiazepines were first promoted for insomnia treatment. The Association of Sleep Disorders Centers (ASDC) was launched and led by Dr. Dement in 1975. In 1984, the Clinical Sleep Society (CSS) was declared by the Association of Sleep Disorders Centers (ASDC). In 1999, the Association of Sleep Disorders Centers (ASDC) renamed the American Academy of Sleep Medicine. The association between sleep deprivation and poor outcomes (e.g., death, skin lesions, weight loss, etc.) was made by Rechtschaffen et al. in 1989. Nonbenzodiazepine hypnotics (i.e. zolpidem, zaleplon, eszopiclone) were available for the treatment of insomnia in 1990s. Ramelteon (a selective melatonin receptor agonist), which has a completely different mechanism of action from the medications that were found a couple of decades ago (e.g., benzodiazepines, nonbenzodiazepine hypnotics, etc.), was approved by the FDA in 2005. In 2017, human circadian clock gene CRY1 mutations were first implicated in the pathogenesis of delayed sleep phase disorder (DSPD).

Historical Perspective

Insomnia was classified as a separate entity since 1979/1980 (ASDC/DSM III-R), although the first records of the word insomnia existed since the 1600s.[1][2].

Discovery

In 1964, the first center for sleep disorders was founded as a narcolepsy clinic at the Stanford University.[3]

  • In 1970, Sleep Disorders Clinic was founded at the Stanford University with the availability of performing nocturnal polysomnography and multiple sleep latency tests.
  • In 1975, the Association of Sleep Disorders Centers (ASDC) was launched and led by Dr. Dement.
  • In 1984, the Clinical Sleep Society (CSS) was declared by the Association of Sleep Disorders Centers (ASDC).
  • In 1999, the Association of Sleep Disorders Centers (ASDC) renamed the American Academy of Sleep Medicine.
  • The association between sleep deprivation and poor outcomes (e.g., death, skin lesions, weight loss, etc.) was made by Rechtschaffen et al. in 1989.[4]
  • In 2017, human circadian clock gene CRY1 mutations were first implicated in the pathogenesis of delayed sleep phase disorder (DSPD).[5]

Landmark Events in the Development of Treatment Strategies

In 1970s, with the use of flurazepam, benzodiazepines were first promoted for insomnia treatment.[6]

  • Nonbenzodiazepine hypnotics (i.e. zolpidem, zaleplon, eszopiclone) were available for the treatment of insomnia in 1990s.
  • Ramelteon (a selective melatonin receptor agonist), which has a completely different mechanism of action from the medications that were found a couple of decades ago (e.g., benzodiazepines, nonbenzodiazepine hypnotics, etc.), was approved by the FDA in 2005.

Impact on Cultural History

In western culture the mention of insomnia dates back to ancient Greeks and also found in the pre-Hippocratic Epidaurian list of 70 cases, one was a patient with insomnia. The first scientific explanation of insomnia was found in the work of Aristotle back in 350 BC and the first treatment records from a Greek Physician in the first century recommended opium as the treatment of choice for insomnia [7].

References

  1. Reynolds CF 3rd, Kupfer DJ, Buysse DJ, Coble PA, Yeager A. Subtyping DSM-III-R primary insomnia: a literature review by the DSM-IV Work Group on Sleep Disorders. Am J Psychiatry. 1991 Apr;148(4):432-8. doi: 10.1176/ajp.148.4.432. PMID: 2006686.
  2. https://www.dictionary.com/browse/insomnia#:~:text=Where%20does%20insomnia%20come%20from,in%20the%20names%20of%20diseases.
  3. Shepard JW, Buysse DJ, Chesson AL, Dement WC, Goldberg R, Guilleminault C, Harris CD, Iber C, Mignot E, Mitler MM, Moore KE, Phillips BA, Quan SF, Rosenberg RS, Roth T, Schmidt HS, Silber MH, Walsh JK, White DP (January 2005). "History of the development of sleep medicine in the United States". J Clin Sleep Med. 1 (1): 61–82. PMC 2413168. PMID 17561617.
  4. Rechtschaffen A, Bergmann BM, Everson CA, Kushida CA, Gilliland MA (February 1989). "Sleep deprivation in the rat: X. Integration and discussion of the findings". Sleep. 12 (1): 68–87. PMID 2648533.
  5. Patke A, Murphy PJ, Onat OE, Krieger AC, Özçelik T, Campbell SS, Young MW (April 2017). "Mutation of the Human Circadian Clock Gene CRY1 in Familial Delayed Sleep Phase Disorder". Cell. 169 (2): 203–215.e13. doi:10.1016/j.cell.2017.03.027. PMC 5479574. PMID 28388406.
  6. Neubauer DN (August 2007). "The evolution and development of insomnia pharmacotherapies". J Clin Sleep Med. 3 (5 Suppl): S11–5. PMC 1978321. PMID 17824496.
  7. Attarian H.P., Nishith-Davis P., Jungquist C.R., Perlis M.L. (2004) Defining Insomnia. In: Attarian H.P. (eds) Clinical Handbook of Insomnia. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-662-1_1