Sleep

Geriatrics accounts for 7% of the total world population. As age advances apartfrom health, sleep quality also becomes compromised in geriatrics. In addition, an increased incidenceof insomnia has been noted in the elderly. As a result geriatric population constitutes the largestconsumers of hypnotics. The aim of the study was to assess the effectiveness of hypnotics prescribedfor insomnia in the geriatric population. A prospective study for a period of ten months wascarried out in the geriatric population who consumed at least one hypnotic during their hospital stay. A total of 93 patients were included in the study. Data was collected from the patient's case report forms.The sleep quality was assessed using Pittsburgh Sleep Quality Index and the patients were categorizedbased on their PSQI score. A total of 93 patients who met the inclusion criteria were includedin the study. Among them 49(53%) were female and 44(47%) were male. 59(63%) patients of thestudy population were experiencing trouble in falling asleep, 47(51%) were complaining of lessduration of sleep and 43(46.2%) were complaining early morning awakening as their major sleepcomplaint. The analysis of sleep quality by PSQI revealed that a total of 29% (27) patients had scoredless than 5 points (PSQI score) and had good quality sleep and the rest 71% (66) patients were foundto have poor quality of sleep. Zolpidem was found to be most effective for providing fast onset of sleep,diazepam for duration of sleep and clonazepam to reduce the early morning awakening. A statisticallysignificant improvement of sleep quality was observed in alprazolam 0.5mg and 0.25mg with a p-valueof 0.001 and 0.002 respectively.

Men spend about one-third of their lives asleep and sleep is responsible for memory, emotion, perception, thought, judgement and even consciousness. Sleep is not only responsible for maintenance of healthy life but also for establishment of homeostasis in biological system. Sleep deprivation is a stressor affecting the brain as well as many body systems and researchers are continuously working to understand the sleep architecture and various substances which affect sleep. Wakefulness and sleep-wake-regulation are complex states, a lot of different components and regulatory mechanisms contribute to these functions. One of the factors involved in sleep wake regulation is the immune system particularly cytokines. Interleukin-1 is a pleotrophic cytokine, serving both physiological and pathological functions including modulation of memory, mood, inflammation, appetite, brain development and sleep. This article reviews and try to elaborate various downstream pathways and mediators involved in influence of cytokines on sleep architecture.