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7. Effects of Japanese policies and novel hypnotics on long-term prescriptions of hypnotics

Author

Takeshima, Masahiro, Yoshizawa, Kazuhisa, Enomoto, Minori, Ogasawara, Masaya, Kudo, Mizuki, Itoh, Yu, Ayabe, Naoko, Takaesu, Yoshikazu, and Mishima, Kazuo

Subjects
orexin, insomnia, hypnotic, melatonin, benzodiazepine
Abstract

Aim: The current study aimed to examine the effect of Japanese policies for appropriate hypnotics use and novel hypnotics (e.g. melatonin receptor agonist and orexin receptor antagonist [ORA]) on long-term prescriptions of hypnotics. Methods: This retrospective study was conducted using a large-scale health insurance claims database. Among subscribers prescribed hypnotics at least once between April 2005 and March 2021, those prescribed hypnotics for the first time after being included in the database in three periods (period 1: April 2012–March 2013; period 2: April 2016–March 2017; and period 3: April 2018–March 2019) were eligible. These were set considering the timing of the 2014 and 2018 medical fee revisions (2014 for polypharmacy of three or more hypnotics, 2018 for long-term prescription of benzodiazepine receptor agonists for >12 months). The duration of consecutive prescriptions of hypnotics over 12 months was evaluated. Factors associated with short-term prescriptions of hypnotics were also investigated. Results: In total, 186 535 participants were newly prescribed hypnotics. The mean duration of prescriptions was 2.9 months, and 9.3% of participants were prescribed hypnotics for 12 months. Prescription periods were not associated with short-term prescriptions of hypnotics. ORA use was associated with short-term prescriptions of hypnotics (adjusted hazard ratio, 1.077 [95% confidence interval, 1.035–1.120]; P < 0.001), but melatonin receptor agonist use was not. Conclusion: Japanese policies had no statistically significant effect on long-term prescriptions of hypnotics. Although this study suggests initiating ORA for insomniacs as a candidate strategy to prevent long-term prescriptions of hypnotics, further research is necessary to draw conclusions.

Published
2022

8. Prevalence of childhood obstructive sleep apnea syndrome and its role in daytime sleepiness

Author

Tsukada, Eriko, Kitamura, Shingo, Enomoto, Minori, Moriwaki, Aiko, Kamio, Yoko, Asada, Takashi, Arai, Tetsuaki, Mishima, Kazuo, Tsukada, Eriko, Kitamura, Shingo, Enomoto, Minori, Moriwaki, Aiko, Kamio, Yoko, Asada, Takashi, Arai, Tetsuaki, and Mishima, Kazuo

Abstract

Objectives To investigate childhood obstructive sleep apnea syndrome (OSAS) and its role in daytime sleepiness among school-age children. Methods A questionnaire survey was conducted with 25,211 children aged 6-15 (mean, 10.39) years attending 148 elementary and 71 middle schools in 10 prefectures across Japan and their parents. Questions concerned 4 sleep habit items (bedtime, sleep onset latency, wake time after sleep onset, wake-up time) and 4 sleep disorder items (loud snoring, snorts/gasps, breathing pauses, seems very sleepy in the daytime). Total sleep time (TST) was calculated with sleep habits. Severe possible OSAS (p-OSAS) was defined as having loud snoring, snorts and gasps, or breathing pauses frequently (>= 5 times per week), and mild p-OSAS was rated as having any of these sometimes (2-4 times per week). Severe daytime sleepiness was defined as seeming very sleepy frequently and mild daytime sleepiness as seeming very sleepy sometimes. Results Mean prevalence of mild to severe p-OSAS and severe p-OSAS in children across all grade levels was 9.5% and 1.6%, respectively. p-OSAS was particularly prevalent in children at lower elementary levels, decreasing with advancing grade levels. Prevalence of mild and severe daytime sleepiness was 6.1% and 0.9%, respectively, among all children (7.0%). Prevalence of daytime sleepiness increased with advancing grade levels, particularly in middle-school level. Average TST was 8.4 +/- 2.2 h in both elementary and middle-school levels, and decreased as grades advanced, particularly in middle-school levels. Multivariate logistic regression analysis showed that middle-school level, TST < 8 h, and p-OSAS were independent factors for daytime sleepiness. Strong correlations were found between severe daytime sleepiness and severe p-OSAS or TST < 6 h, and between daytime sleepiness and loud snoring or breathing pauses. Conclusion p-OSAS may be an independent factor influencing daytime sleepiness in school-age children. Loud sn

Published
2023

13. Current state of hypnotic use disorders: Results of a survey using the Japanese version of Benzodiazepine Dependence Self-Report Questionnaire

Author

Yamamoto, Mai, Inada, Ken, Enomoto, Minori, Habukawa, Mitsunari, Hirose, Takahisa, Inoue, Yuichi, Ishigooka, Jun, Kamei, Yuichi, Kitajima, Tsuyoshi, Miyamoto, Masayuki, Shinno, Hideto, Nishimura, Katsuji, Ozone, Motohiro, Takeshima, Masahiro, Suzuki, Mayumi, Yamashita, Hidehisa, Mishima, Kazuo, Yamamoto, Mai, Inada, Ken, Enomoto, Minori, Habukawa, Mitsunari, Hirose, Takahisa, Inoue, Yuichi, Ishigooka, Jun, Kamei, Yuichi, Kitajima, Tsuyoshi, Miyamoto, Masayuki, Shinno, Hideto, Nishimura, Katsuji, Ozone, Motohiro, Takeshima, Masahiro, Suzuki, Mayumi, Yamashita, Hidehisa, and Mishima, Kazuo

Abstract

Aims Benzodiazepine receptor agonists (BZ-RAs) are frequently prescribed to treat insomnia; however, their long-term use is not recommended. To introduce an appropriate pharmaco-therapy, the current state and background factors of BZ-RAs' dependence must be elucidated. In this study, we developed a Japanese version of the Benzodiazepine Dependence Self-Report Questionnaire (Bendep-SRQ-J) and conducted a study of BZ-RAs' use disorder. Methods The Bendep-SRQ-J was created with permission from the original developer. Subjects were inpatients and outpatients receiving BZ-RAs between 2012 and 2013. Clinical data collected were Bendep-SRQ-J scores, sleep disorders for which BZ-RAs were prescribed, physical comorbidities, psychotropic drugs, and lifestyle factors. Logistic analysis was performed to extract factors associated with severe symptoms. Results Of the 707 patients prescribed BZ-RAs, 324 had voluntarily tapered or discontinued their drugs. Logistic analysis showed that the total number of drugs administered in the last 6 months correlated with both worsening of symptoms or conditions. This was more notable among younger patients, and the proportion of patients with severe symptoms or conditions increased with the increasing number of drugs. Conclusion Using the Bendep-SRQ-J, we elucidated the current state of BZ-RA dependence. Nearly half of the patients were non-compliant. The proportion of patients with severe symptoms or disease conditions increased with the increase in the number of drugs administered. These findings highlight the need for clinicians to be aware of the likelihood of benzodiazepine dependence, especially in young patients and patients prescribed multiple hypnotics.

Published
2021

17. Current state of hypnotic use disorders: Results of a survey using the Japanese version of Benzodiazepine Dependence Self‐Report Questionnaire

Author

Yamamoto, Mai, primary, Inada, Ken, additional, Enomoto, Minori, additional, Habukawa, Mitsunari, additional, Hirose, Takahisa, additional, Inoue, Yuichi, additional, Ishigooka, Jun, additional, Kamei, Yuichi, additional, Kitajima, Tsuyoshi, additional, Miyamoto, Masayuki, additional, Shinno, Hideto, additional, Nishimura, Katsuji, additional, Ozone, Motohiro, additional, Takeshima, Masahiro, additional, Suzuki, Mayumi, additional, Yamashita, Hidehisa, additional, and Mishima, Kazuo, additional

Published
2020
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26. Increased cerebral blood flow in the right frontal lobe area during sleep precedes self-awakening in humans

Author

Aritake Sayaka, Higuchi Shigekazu, Suzuki Hiroyuki, Kuriyama Kenichi, Enomoto Minori, Soshi Takahiro, Kitamura Shingo, Hida Akiko, and Mishima Kazuo

Subjects
Time estimation ability, Self-awakening, Sleep, Cognitive science, Prefrontal cortex, Insomnia, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurophysiology and neuropsychology, QP351-495
Abstract

Abstract Background Some people can subconsciously wake up naturally (self-awakening) at a desired/planned time without external time stimuli. However, the underlying mechanism regulating this ability remains to be elucidated. This study sought to examine the relationship between hemodynamic changes in oxyhemoglobin (oxy-Hb) level in the prefrontal cortex and sleep structures during sleep in subjects instructed to self-awaken. Results Fifteen healthy right-handed male volunteers with regular sleep habits participated in a consecutive two-night crossover study. The subjects were instructed to wake up at a specified time (“request” condition) or instructed to sleep until the morning but forced to wake up at 03:00 without prior notice (“surprise” condition). Those who awoke within ± 30 min of the planned waking time were defined as those who succeeded in self-awakening (“success” group). Seven subjects succeeded in self-awakening and eight failed. No significant differences were observed in the amounts of sleep in each stage between conditions or between groups. On the “request” night, an increase in oxy-Hb level in the right prefrontal cortex and a decrease in δ power were observed in the “success” group around 30 min before self-awakening, whereas no such changes were observed in the “failure” group. On the “surprise” night, no significant changes were observed in oxy-Hb level or δ power in either group. Conclusions These findings demonstrate a correlation between self-awakening and a pre-awakening increase in hemodynamic activation in the right prefrontal cortex, suggesting the structure’s contribution to time estimation ability.

Published
2012
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27. Prevalence of childhood obstructive sleep apnea syndrome and its role in daytime sleepiness

Author

Tsukada, Eriko, Kitamura, Shingo, Enomoto, Minori, Moriwaki, Aiko, Kamio, Yoko, Asada, Takashi, Arai, Tetsuaki, Mishima, Kazuo, Tsukada, Eriko, Kitamura, Shingo, Enomoto, Minori, Moriwaki, Aiko, Kamio, Yoko, Asada, Takashi, Arai, Tetsuaki, and Mishima, Kazuo

Abstract

Objectives To investigate childhood obstructive sleep apnea syndrome (OSAS) and its role in daytime sleepiness among school-age children. Methods A questionnaire survey was conducted with 25,211 children aged 6-15 (mean, 10.39) years attending 148 elementary and 71 middle schools in 10 prefectures across Japan and their parents. Questions concerned 4 sleep habit items (bedtime, sleep onset latency, wake time after sleep onset, wake-up time) and 4 sleep disorder items (loud snoring, snorts/gasps, breathing pauses, seems very sleepy in the daytime). Total sleep time (TST) was calculated with sleep habits. Severe possible OSAS (p-OSAS) was defined as having loud snoring, snorts and gasps, or breathing pauses frequently (>= 5 times per week), and mild p-OSAS was rated as having any of these sometimes (2-4 times per week). Severe daytime sleepiness was defined as seeming very sleepy frequently and mild daytime sleepiness as seeming very sleepy sometimes. Results Mean prevalence of mild to severe p-OSAS and severe p-OSAS in children across all grade levels was 9.5% and 1.6%, respectively. p-OSAS was particularly prevalent in children at lower elementary levels, decreasing with advancing grade levels. Prevalence of mild and severe daytime sleepiness was 6.1% and 0.9%, respectively, among all children (7.0%). Prevalence of daytime sleepiness increased with advancing grade levels, particularly in middle-school level. Average TST was 8.4 +/- 2.2 h in both elementary and middle-school levels, and decreased as grades advanced, particularly in middle-school levels. Multivariate logistic regression analysis showed that middle-school level, TST < 8 h, and p-OSAS were independent factors for daytime sleepiness. Strong correlations were found between severe daytime sleepiness and severe p-OSAS or TST < 6 h, and between daytime sleepiness and loud snoring or breathing pauses. Conclusion p-OSAS may be an independent factor influencing daytime sleepiness in school-age children. Loud sn

Published
2018

28. Association Between the Use of Antidepressants and the Risk of Type 2 Diabetes: A Large, Population-Based Cohort Study in Japan.

Author

Hiroyuki Miidera, Minori Enomoto, Shingo Kitamura, Hisateru Tachimori, Kazuo Mishima, Miidera, Hiroyuki, Enomoto, Minori, Kitamura, Shingo, Tachimori, Hisateru, and Mishima, Kazuo

Subjects
TYPE 2 diabetes, PROPORTIONAL hazards models, GLYCOSYLATED hemoglobin, ANTIDEPRESSANTS, PROPENSITY score matching, RESEARCH, RESEARCH methodology, PROGNOSIS, RETROSPECTIVE studies, EVALUATION research, MEDICAL cooperation, COMPARATIVE studies, MENTAL depression, LONGITUDINAL method
Abstract

Objective: This study aimed to reveal the associations between the risk of new-onset type 2 diabetes and the duration of antidepressant use and the antidepressant dose, and between antidepressant use after diabetes onset and clinical outcomes.Research Design and Methods: In this large-scale retrospective cohort study in Japan, new users of antidepressants (exposure group) and nonusers (nonexposure group), aged 20-79 years, were included between 1 April 2006 and 31 May 2015. Patients with a history of diabetes or receipt of antidiabetes treatment were excluded. Covariates were adjusted by using propensity score matching; the associations were analyzed between risk of new-onset type 2 diabetes and the duration of antidepressant use/dose of antidepressant in the exposure and nonexposure groups by using Cox proportional hazards models. Changes in glycated hemoglobin (HbA1c) level were examined in groups with continuous use, discontinuation, or a reduction in the dose of antidepressants.Results: Of 90,530 subjects, 45,265 were in both the exposure and the nonexposure group after propensity score matching; 5,225 patients (5.8%) developed diabetes. Antidepressant use was associated with the risk of diabetes onset in a time- and dose-dependent manner. The adjusted hazard ratio was 1.27 (95% CI 1.16-1.39) for short-term low-dose and 3.95 (95% CI 3.31-4.72) for long-term high-dose antidepressant use. HbA1c levels were lower in patients who discontinued or reduced the dose of antidepressants (F[2,49] = 8.17; P < 0.001).Conclusions: Long-term antidepressant use increased the risk of type 2 diabetes onset in a time- and dose-dependent manner. Glucose tolerance improved when antidepressants were discontinued or the dose was reduced after diabetes onset. [ABSTRACT FROM AUTHOR]

Published
2020
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30. Estimating individual optimal sleep duration and potential sleep debt

Author

Kitamura, Shingo, primary, Katayose, Yasuko, additional, Nakazaki, Kyoko, additional, Motomura, Yuki, additional, Oba, Kentaro, additional, Katsunuma, Ruri, additional, Terasawa, Yuri, additional, Enomoto, Minori, additional, Moriguchi, Yoshiya, additional, Hida, Akiko, additional, and Mishima, Kazuo, additional

Published
2016
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35. In vitro circadian period is associated with circadian/sleep preference

Author

Hida, Akiko, primary, Kitamura, Shingo, additional, Ohsawa, Yosuke, additional, Enomoto, Minori, additional, Katayose, Yasuko, additional, Motomura, Yuki, additional, Moriguchi, Yoshiya, additional, Nozaki, Kentaro, additional, Watanabe, Makiko, additional, Aritake, Sayaka, additional, Higuchi, Shigekazu, additional, Kato, Mie, additional, Kamei, Yuichi, additional, Yamazaki, Shin, additional, Goto, Yu-ichi, additional, Ikeda, Masaaki, additional, and Mishima, Kazuo, additional

Published
2013
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39. Rhythmic expression of circadian clock genes in human leukocytes and beard hair follicle cells

Author

Watanabe, Makiko, primary, Hida, Akiko, additional, Kitamura, Shingo, additional, Enomoto, Minori, additional, Ohsawa, Yosuke, additional, Katayose, Yasuko, additional, Nozaki, Kentaro, additional, Moriguchi, Yoshiya, additional, Aritake, Sayaka, additional, Higuchi, Shigekazu, additional, Tamura, Miyuki, additional, Kato, Mie, additional, and Mishima, Kazuo, additional

Published
2012
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44. Surrogate measurements for assessing individual's circadian clock properties

Author

Hida, Akiko, primary, Kitamura, Shingo, additional, Enomoto, Minori, additional, Nozaki, Kentaro, additional, Katayose, Yasuko, additional, Kato, Mie, additional, Watanabe, Makiko, additional, Aritake, Sayaka, additional, Higuchi, Shigekazu, additional, Moriguchi, Yoshiya, additional, Ikeda, Masaaki, additional, and Mishima, Kazuo, additional

Published
2011
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45. Diurnal fluctuations in subjective sleep time in humans

Author

Aritake-Okada, Sayaka, primary, Higuchi, Shigekazu, additional, Suzuki, Hiroyuki, additional, Kuriyama, Kenichi, additional, Enomoto, Minori, additional, Soshi, Takahiro, additional, Kitamura, Shingo, additional, Watanabe, Makiko, additional, Hida, Akiko, additional, Matsuura, Masato, additional, Uchiyama, Makoto, additional, and Mishima, Kazuo, additional

Published
2010
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47. Sleep-related problems and use of hypnotics in inpatients of acute hospital wards

Author

Enomoto, Minori, primary, Tsutsui, Takako, additional, Higashino, Sadanori, additional, Otaga, Masaaki, additional, Higuchi, Shigekazu, additional, Aritake, Sayaka, additional, Hida, Akiko, additional, Tamura, Miyuki, additional, Matsuura, Masato, additional, Kaneita, Yoshitaka, additional, Takahashi, Kiyohisa, additional, and Mishima, Kazuo, additional

Published
2010
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48. Effects of sleep deprivation on face emotion processing

Author

Tamura, Miyuki, primary, Higuchi, Shigekazu, additional, Hida, Akiko, additional, Aritake, Sayaka, additional, Enomoto, Minori, additional, Kitamura, Shingo, additional, Watanabe, Makiko, additional, Moriguchi, Yoshiya, additional, and Mishima, Kazuo, additional

Published
2010
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