Prevalence of use of medically prescribed hypnotics among adult Japanese women in urban residential areas

Abstract Based on a population survey on insomnia among 3600 adult Japanese women living in urban areas, the prevalence of use of medically prescribed hypnotics is determined. The prevalence of use of medically prescribed hypnotics increases with an increase in age (<1.0% for those aged 49 or younger, while 14.3% for those aged 70 or older), in agreement with the results reported in many Western nations. The current sleep disturbance is mild in nearly half of these hypnotics users. More than one-third of the hypnotic users are receiving health care not for sleep problems but for depression, anxiety, or other reasons. More than one-third of the hypnotic users are found to be receiving hypnotics from non-psychiatrists. The percentage of this group is particularly high among those aged 60 or over, probably reflecting the fact that they are often consulting physicians for physical reasons. On the other hand, more than 80% of insomniacs are suggested to be untreated. Future public health research should focus on the quality of life and health care behaviors of untreated insomniacs and hypnotic users, especially among the elderly people, in order to assess the need for primary health care to prevent accidents, mortality, and psychiatric disorders related to sleep problems.     

The prevalence and pattern of insomnia in Japanese industrial workers: Relationship between psychosocial stress and type of insomnia

We examined the prevalence of insomnia among Japanese male industrial workers and analyzed the effect of psychosocial stress on the prevalence of three types of insomnia: `difficulty in falling asleep', `frequent sleep interruption' and `early morning arousal'. The study population consisted of male day workers (n = 319) in a manufacturing heavy industry company located in Nagasaki City, Japan. The subjects answered a questionnaire consisting of six sleep-related items and 24 questions related to occupational and private life conditions. A total of 271 men (average age 40.9 years) completed the questionnaire; a response rate of 85%. Insomnia within the month preceding the survey was present in 27.7% of the workers (75/271). Multiple logistic regression analysis demonstrated that different psychosocial stressors were associated with different types of insomnia. Visual display terminal (VDT) work overload was significantly associated with all types of insomnia, while `over-involvement in the job' was associated with difficulty in falling asleep and early morning arousal. Our results demonstrated that the prevalence of insomnia in Japanese workers is similar to that reported among European and American general adult population. Our results also indicate that the use of VDT in the workfield is associated with insomnia.     

Hyaluronan Facilitates Corneal Epithelial Wound Healing in Diabetic Rats

We investigated the effect of hyaluronan on corneal epithelial wound healing in rats affected by diabetes. Furthermore, because hyaluronan is thought to affect corneal epithelial wound healing through the mechanism of binding of hyaluronan to provisional fibronectin in the wounded area, we compared the localization of fibronectin immunohistochemically during corneal epithelial wound healing in diabetic and non-diabetic rats. Streptozotocin was used to induce diabetes in half the rats. Two weeks after treatment, the whole corneal epithelium of diabetic and untreated rats was debrided. The rats were divided into groups (seven or eight rats per group), and hyaluronan eye drops at concentrations of 0.03, 0.1, or 0.3%, chondroitin sulfate (3%), or phosphate buffered saline (PBS) was given in eye drops 6 times a day for 4 days, starting immediately after debridement. The area of the corneal epithelial wound was measured immediately after debridement and at 12, 18, 24, 30, 48, 72, and 96 hours afterwards. Although the healing process was similar in non-diabetic and diabetic rats, the healing rate in diabetic rats was slower than that in normal controls. In both diabetic and non-diabetic rats, hyaluronan increased the healing rate in a dose-dependent manner; the difference was significant compared with the PBS-treated group, at hyaluronan doses of 0.1% and 0.3%. However, chondroitin sulfate did not affect corneal epithelial wound closure, regardless of whether the rats were diabetic or not; the healing rates were identical to those of PBS-treated diabetic and non-diabetic controls. In both diabetic and non-diabetic corneas, fibronectin was localized in the corneal subepithelial region, and in streaks between collagen fibers of the stroma. One day after debridement, a layer of fibronectin immunofluorescence was clearly visible on the surface of the denuded stroma. As healing progressed staining of fibronectin diminished at the interface between the new epithelium and the stroma. These changes in localization of fibronectin during corneal epithelial wound healing were similar in both diabetic and non-diabetic rats. Our results demonstrate that hyaluronan facilitates corneal epithelial wound healing in diabetic rats, and suggest that one possible mechanism of its stimulatory effect lies in its binding to a provisional fibronectin matrix, in both diabetic and non-diabetic rats.