Matrix

Matrix theme by Big Willie

Download: Matrix_Theme.p3t

http://img248.imageshack.us/img248/5885/61911previewon8.png
(4 backgrounds)

Matrix (pl.: matrices or matrixes) most commonly refers to:

Matrix may also refer to:

Science and mathematics[edit]

Technology[edit]

Arts and entertainment[edit]

Fictional entities[edit]

Film and television[edit]

Games[edit]

Literature[edit]

Music[edit]

Businesses and organisations[edit]

People[edit]

  • David Krejčí (born 1986), Czech ice hockey player nicknamed "The Matrix"
  • Shawn Marion (born 1978), American basketball player nicknamed "The Matrix"
  • Marco Materazzi (born 1973), Italian footballer nicknamed "Matrix"

Transportation[edit]

Other uses[edit]

See also[edit]

God of War #2

God of War theme by GoW

Download: GodOfWar.p3t

GOW Theme 2
(3 backgrounds)

A god of war is a deity associated with war.

God of War or Gods of War may also refer to:

Books[edit]

  • The Gods of War, a 1985 novel by historical author John Toland
  • The Gods of War, a 2005 novel by Conn Iggulden and the fourth in the Emperor series
  • The God of War, a 2008 novel by Marisa Silver
  • Gods of War, a 2009 science fiction novel by Ashok Banker
  • God of War (DC Comics), a 2010–2011 limited six-issue comic book series published by WildStorm and DC Comics, based around the Greek era of the video game series.
  • God of War, a 2010 novelization of the 2005 video game, God of War, written by Matthew Stover and Robert E. Vardeman
  • God of War II, a 2013 novelization of the 2007 video game, God of War II, written by Robert E. Vardeman.
  • God of War – The Official Novelization, a 2018 novelization of the 2018 video game, God of War, written by James Barlog.
  • God of War (Dark Horse Comics), a 2018–2021 limited two-volume eight-issue comic book series published by Dark Horse Comics, based around the Norse era of the video game series.

Film and television[edit]

Video games[edit]

Music[edit]

Albums[edit]

Songs[edit]

See also[edit]

Bubble Aquarium V1.2

Bubble Aquarium version 1.2 theme by Apocallos

Download: BubbleAquariumV1.2.p3t

Bubble Aquarium V1.2 Theme
(1 background)

P3T Unpacker v0.12
Copyright (c) 2007. Anoop Menon

This program unpacks Playstation 3 Theme files (.p3t) so that you can touch-up an existing theme to your likings or use a certain wallpaper from it (as many themes have multiple). But remember, if you use content from another theme and release it, be sure to give credit!

Download for Windows: p3textractor.zip

Instructions:

Download p3textractor.zip from above. Extract the files to a folder with a program such as WinZip or WinRAR. Now there are multiple ways to extract the theme.

The first way is to simply open the p3t file with p3textractor.exe. If you don’t know how to do this, right click the p3t file and select Open With. Alternatively, open the p3t file and it will ask you to select a program to open with. Click Browse and find p3textractor.exe from where you previously extracted it to. It will open CMD and extract the theme to extracted.[filename]. After that, all you need to do for any future p3t files is open them and it will extract.

The second way is very simple. Just drag the p3t file to p3textractor.exe. It will open CMD and extract the theme to extracted.[filename].

For the third way, first put the p3t file you want to extract into the same folder as p3textractor.exe. Open CMD and browse to the folder with p3extractor.exe. Enter the following:
p3textractor filename.p3t [destination path]Replace filename with the name of the p3t file, and replace [destination path] with the name of the folder you want the files to be extracted to. A destination path is not required. By default it will extract to extracted.filename.

NFL

NFL theme by 1_BAD_SOLDIER

Download: NFL.p3t

NFL Theme
(1 background)


Reservoir Dogs

Reservoir Dogs theme by hitman1986

Download: ReservoirDogs.p3t

http://img444.imageshack.us/img444/1272/61423previewtc9.png
(1 background)

Reservoir Dogs
Theatrical release poster
Directed byQuentin Tarantino
Written byQuentin Tarantino
Produced byLawrence Bender
Starring
CinematographyAndrzej Sekuła
Edited bySally Menke
Production
companies
Distributed byMiramax Films
Release dates
  • January 21, 1992 (1992-01-21) (Sundance)
  • October 9, 1992 (1992-10-09) (United States)
Running time
99 minutes[1]
CountryUnited States
LanguageEnglish
Budget$1.2–3 million[1][2][3]
Box office$2.9 million[1]

Reservoir Dogs is a 1992 American crime film written and directed by Quentin Tarantino in his feature-length debut. It stars Harvey Keitel, Tim Roth, Chris Penn, Steve Buscemi, Lawrence Tierney, Michael Madsen, Tarantino, and Edward Bunker as diamond thieves whose heist of a jewelry store goes terribly wrong. Kirk Baltz, Randy Brooks, and Steven Wright also play supporting roles. The film incorporates many motifs that have become Tarantino's hallmarks: violent crime, pop culture references, profanity, and nonlinear storytelling.

The film is regarded as a classic of independent film and a cult film[4] and was named "Greatest Independent Film of All Time" by Empire. Although controversial at first for its depictions of violence and heavy use of profanity, Reservoir Dogs was generally well-received, and the cast was praised by many critics. Despite not being heavily promoted during its theatrical run, the film became a modest success in the United States after grossing $2.8 million against its scant budget. It achieved higher popularity after the success of Tarantino's next film, Pulp Fiction (1994). A soundtrack was released featuring songs used in the film, which are mostly from the 1970s.

Plot[edit]

Eight men eat breakfast at a diner. All but the boss, Joe Cabot, and his son, "Nice Guy" Eddie Cabot, use aliases: Mr. Brown, Mr. White, Mr. Blonde, Mr. Blue, Mr. Orange and Mr. Pink.

The men carry out a diamond heist. White flees with Orange, who was shot during the escape and is bleeding profusely in the back seat of White's car. At their hideout, White and Orange rendezvous with Pink, who believes that the job was a setup and that the police were waiting for them. White informs him that Brown is dead, Blue and Blonde are missing, and Blonde murdered several civilians during the heist. White is furious that Joe, his old friend, would employ Blonde, whom he describes as a psychopath. Pink has hidden the diamonds nearby and argues with White over whether to get medical attention for Orange, and the pair draw guns on each other. They stand down when Blonde arrives with a kidnapped policeman, Marvin Nash.

Some time earlier, Blonde meets with the Cabots, having completed a four-year prison sentence. To reward him for not having given Joe's name to the authorities, they offer him a job. Blonde is grateful but insists that he wants to get back to "real work", and they recruit him for the heist.

In the present, White and Pink beat Nash for information. Eddie arrives and orders them to go with him to ditch the getaway vehicles, leaving Blonde in charge of Nash and Orange. Nash denies knowledge, but Blonde ignores him and resumes the torture, cutting off Nash's ear with a straight razor. He prepares to set him on fire, but Orange shoots Blonde dead. Orange reveals to Nash that he is an undercover police officer, and that the police will arrive when Joe comes to the warehouse.

When Eddie, Pink, and White return, Orange tries to convince them that Blonde planned to kill them all and steal the diamonds for himself. Eddie shoots and kills Nash and accuses Orange of lying, since Blonde was loyal to his father. Joe arrives with news that the police have killed Blue. He is about to execute Orange, who he suspects is the traitor behind the setup, but White intervenes and holds Joe at gunpoint, insisting that Orange is not a police officer. Eddie aims his gun at White, creating a Mexican standoff. All three fire. Both Cabots are killed, and White and Orange are hit.

Pink takes the diamonds and flees. As White cradles the dying Orange in his arms, Orange confesses that he is a police officer. White presses his gun to Orange's head. The police storm the warehouse and order White to drop his gun. Gunshots sound and White collapses.

Cast[edit]

The film's opening credits sequence, a slow-motion scene featuring the eight criminals, accompanied by "Little Green Bag" by the George Baker Selection

Rich Turner played Sheriff #1. Nina Siemaszko played police officer Jody McClusky; her scenes were deleted from the theatrical release.[5] There is an unseen accomplice of Joe and Eddie who speaks to Eddie on the phone. His name is Dov Schwarz, named after the sound editor on My Best Friend's Birthday.[6]

Production[edit]

Quentin Tarantino had been working at Video Archives, a video store in Manhattan Beach, California, and originally planned to shoot the film with his friends on a budget of $30,000 in a 16 mm black-and-white format, with producer Lawrence Bender playing a police officer chasing Mr. Pink.[7] Bender gave the script to his acting teacher, whose wife gave the script to Harvey Keitel.[8] Keitel liked it enough to sign as a co-producer so Tarantino and Bender would have an easier job finding funding; with his assistance, they raised $1.5 million.[2] Keitel also paid for Tarantino and Bender to host casting sessions in New York, where the duo found Steve Buscemi, Michael Madsen, and Tim Roth.[9] Jon Cryer was asked to audition for the role of Mr. Pink, but he backed out at the last minute.[10] Viggo Mortensen and George Clooney also read for roles,[11][12] while Tim Roth's agents originally wanted him to be Mr. Pink or Mr. Blonde, but he preferred Mr. Orange because he would "be an English actor pretending to be American playing a cop pretending to be a robber".[13]

The film contains multiple homages to other films.[14] Tarantino himself has said that Reservoir Dogs was influenced by Stanley Kubrick's 1956 film noir The Killing: "I didn't go out of my way to do a rip-off of The Killing, but I did think of it as my 'Killing', my take on that kind of heist movie."[2] The film's plot was also inspired by the 1952 film Kansas City Confidential.[15] Additionally, Joseph H. Lewis's 1955 film The Big Combo and Sergio Corbucci's 1966 Spaghetti Western Django inspired the scene where a police officer is tortured in a chair.[15][16] Having the main characters named after colors (Mr. Pink, White, Brown, etc.) was first seen in the 1974 film The Taking of Pelham One Two Three.[17] The film also contains key elements similar to those found in Ringo Lam's 1987 film City on Fire.[18] Tarantino praised the film City on Fire and mentioned it as a major influence.[19]

Tarantino said that everybody hated Lawrence Tierney by the end of the first week of production.[20]

The warehouse scenes were filmed in an unused mortuary filled with coffins, funeral equipment, embalming fluid, and a hearse. Mr. Orange's apartment was a room on the second floor of the mortuary, set to look like living quarters. The building has since been demolished.[21]

Tarantino's decision not to film the diamond robbery was twofold: for budgetary reasons, and to keep the details of the heist ambiguous. By not showing the robbery and having the characters describe it, Tarantino explained, the film is allowed to be "about other things", similar to the way in which the burglary in Glengarry Glen Ross and its film adaptation is discussed, described, and debated, but never shown.[2] Tarantino compared the technique to the work of a novelist, and said he wanted the film to be about something not seen and to "play with a real-time clock as opposed to a movie clock ticking".[22]

Reception[edit]

Box office[edit]

Reservoir Dogs premiered at the Sundance Film Festival in January 1992. It became the festival's most talked-about film, and it was subsequently picked up for distribution by Miramax Films.[23] After being shown at several other film festivals, including in Cannes, Sitges, and Toronto,[23] Reservoir Dogs opened in the United States in 19 theaters on October 9, 1992, with a first week total of $147,839.[1] It was expanded to 61 theaters on October 23, 1992, and totaled $2,832,029 at the domestic box office.[1] The film grossed more than double that in the United Kingdom,[24] where it did not receive a home video release until 1995.[25] During the period of unavailability on home video, the film was re-released in UK cinemas in June 1994.[26]

Critical reception[edit]

Reservoir Dogs is regarded as an important and influential milestone of independent filmmaking.[27][28] Review aggregation website Rotten Tomatoes gives the film an approval rating of 90% based on 81 reviews, and an average rating of 8.9/10. The site's critical consensus reads, "Thrumming with intelligence and energy, Reservoir Dogs opens Quentin Tarantino's filmmaking career with hard-hitting style."[29] On Metacritic the film has an average score of 81 out of 100, based on 24 critics, indicating "universal acclaim".[30] Empire magazine named it the "Greatest Independent Film" ever made.[31]

At the film's release at the Sundance Film Festival, film critic Jami Bernard of the New York Daily News compared the effect of Reservoir Dogs to that of the 1895 film L'Arrivée d'un Train en Gare de la Ciotat, when audiences supposedly saw a moving train approaching the camera and ducked. Bernard said that Reservoir Dogs had a similar effect and people were not ready for it.[28] Vincent Canby of The New York Times enjoyed the cast and the usage of non-linear storytelling. He similarly complimented Tarantino's directing and liked the fact that he did not often use close-ups in the film.[32] Kenneth Turan of the Los Angeles Times also enjoyed the film and the acting, particularly that of Buscemi, Tierney and Madsen, and said "Tarantino's palpable enthusiasm, his unapologetic passion for what he's created, reinvigorates this venerable plot and, mayhem aside, makes it involving for longer than you might suspect."[33] Critic James Berardinelli was of a similar opinion; he complimented both the cast and Tarantino's dialogue writing abilities.[34] Hal Hinson of The Washington Post was also enthusiastic about the cast, complimenting the film on its "deadpan sense of humor".[35]

Roger Ebert was less enthusiastic, as he felt that the script could have been better and said that the film "feels like it's going to be terrific", but Tarantino's script does not have much curiosity about the characters. He also said that Tarantino "has an idea, and trusts the idea to drive the plot." Ebert gave the film two and a half stars out of four and said that while he enjoyed it and that it was a very good film from a talented director, "I liked what I saw, but I wanted more."[36]

The film has received substantial criticism for its strong violence and language. One scene that viewers found particularly unnerving was the ear-cutting scene. Madsen himself reportedly had great difficulty finishing it, especially after Kirk Baltz ad-libbed the desperate plea "I've got a little kid at home."[37] Many people walked out during the film. During a screening at Sitges Film Festival, 15 people walked out, including horror film director Wes Craven and special makeup effects artist Rick Baker.[38] Baker later told Tarantino to take the walkout as a "compliment" and explained that he found the violence unnerving because of its heightened sense of realism.[38] Tarantino commented about it at the time: "It happens at every single screening. For some people the violence, or the rudeness of the language, is a mountain they can't climb. That's OK. It's not their cup of tea. But I am affecting them. I wanted that scene to be disturbing."[2]

Analysis[edit]

Reservoir Dogs has often been seen as a prominent film in terms of on-screen violence.[27][39][40] J. P. Telotte compared Reservoir Dogs to classic caper noir films and points out the irony in its ending scenes.[41] Mark Irwin also made the connection between Reservoir Dogs and classic American noir.[42] Caroline Jewers called Reservoir Dogs a "feudal epic" and paralleled the color pseudonyms to color names of medieval knights.[43]

Critics have observed parallels between Reservoir Dogs and other films. For its nonlinear storyline, Reservoir Dogs has often been compared to Akira Kurosawa's Rashomon.[14] Critic John Hartl compared the ear-cutting scene to the shower murder scene in Alfred Hitchcock's Psycho and Tarantino to David Lynch. He furthermore explored parallels between Reservoir Dogs and Glengarry Glen Ross.[2] Todd McCarthy, who called the film "undeniably impressive", was of the opinion that it was influenced by Mean Streets, Goodfellas and Stanley Kubrick's The Killing.[44] After this film, Tarantino himself was also compared to Martin Scorsese, Sam Peckinpah, John Singleton, Gus Van Sant, and Abel Ferrara.[14]

A frequently cited comparison has been to Tarantino's second and more successful film Pulp Fiction,[22][42] especially since the majority of audiences saw Reservoir Dogs after the success of Pulp Fiction. Comparisons have been made regarding the black humor in both the films, the theme of accidents,[22] and more concretely, the style of dialogue and narrative that Tarantino incorporates into both films.[45] Specifically the relationship between white people and black people plays a big part in the films—though underplayed in Reservoir Dogs. Stanley Crouch of The New York Times compared the way the white criminals speak of black people in Reservoir Dogs to the way they are spoken of in Scorsese's Mean Streets and Goodfellas. Crouch observed the way black people are looked down upon in Reservoir Dogs, but also the way that the criminals accuse each other of "verbally imitating" black men and the characters' apparent sexual attraction to black actress Pam Grier.[45]

In February 2012, as part of an ongoing series of live dramatic readings of film scripts being staged with the Los Angeles County Museum of Art (LACMA), director Jason Reitman cast black actors in the originally white cast: Laurence Fishburne as Mr. White; Terrence Howard as Mr. Blonde; Anthony Mackie as Mr. Pink; Cuba Gooding Jr. as Mr. Orange; Chi McBride as Joe Cabot; Anthony Anderson as Nice Guy Eddie (Joe Cabot's son); Common as both Mr. Brown and Officer Nash (the torture victim of Mr. Blonde), and Patton Oswalt as Holdaway (the mentor cop who was originally played by Randy Brooks, the only black actor in the film). Critic Elvis Mitchell suggested that Reitman's version of the script was taking the source material back to its roots since the characters "all sound like black dudes."[46]

Accolades[edit]

The film was screened out of competition at the 1992 Cannes Film Festival.[47] It won the Critic's Award at the 4th Yubari International Fantastic Film Festival in February 1993, which Tarantino attended.[48] The film was also nominated for the Grand Prix of the Belgian Syndicate of Cinema Critics.[49] Steve Buscemi won the 1992 Independent Spirit Award for Best Supporting Male.[50] Reservoir Dogs ranks at No. 97 in Empire magazine's list of the 500 Greatest Films of All Time.[51] In 2024, Reservoir Dogs was ranked second on the list of the Sundance Film Festival's Top 10 films of All Time based on a survey conducted with 500 filmmakers and critics in honor of the festival's 40th anniversary.[52][53]

Home media[edit]

In the United Kingdom, release of the VHS rental video was delayed until 1995 due to the British Board of Film Classification initially refusing the film a home video certificate (UK releases are required to be certified separately for theatrical release and for viewing at home).[25] The latter is a requirement by law due to the Video Recordings Act 1984.[25] Following the UK VHS release approval, PolyGram released a "Mr Blonde Deluxe Edition",[54] which included an interview with Tarantino and several memorabilia associated with the character Mr. Blonde, such as sunglasses and a chrome toothpick holder.

Region 1 DVDs of Reservoir Dogs have been released multiple times. The first release was a single two-sided disc from LIVE Entertainment, released in June 1997 and featuring two versions of the film: the original letterbox 2.39:1 widescreen version and an open matte 1.33:1 full screen version.[55] Five years later, on August 27, 2002, Artisan Entertainment (who changed their name from LIVE Entertainment in the interim) released a two-disc 10th anniversary edition on DVD and VHS featuring multiple covers color-coded to match the nicknames of five of the characters (Pink, White, Orange, Blonde, and Brown) and a disc of bonus features such as interviews with the cast and crew.[56] However, the full screen version on the second disc was a pan and scan transfer from the 2.39:1 widescreen version, as opposed to open matte like the 1997 DVD.

For the film's 15th anniversary, Lionsgate (which had purchased Artisan in the interim) produced a two-disc anniversary edition with a remastered 16:9 transfer and a new supplement, but not all of the extra features from the 10th Anniversary edition.[57] In particular, the interviews with the cast and crew were removed, and a new 48-minute-long feature called "Tributes and Dedications" was included.[57]

Lionsgate Home Entertainment celebrated the 30th anniversary of Reservoir Dogs with a 4K Blu-ray release, which was released in the U.S. on November 15, 2022.[58]

Soundtrack[edit]

The Reservoir Dogs: Original Motion Picture Soundtrack was the first soundtrack for a Tarantino film and set the structure his later soundtracks would follow.[59] This includes the extensive use of snippets of dialogue from the film. The soundtrack has selections of songs from the 1960s to '80s. Only the group Bedlam recorded original songs for the film. Reasoning that the film takes place over a weekend, Tarantino decided to set it to a fictional radio station 'K-Billy' (presumably KBLY)'s show "K-Billy's Super Sounds of the Seventies Weekend", a themed weekend show of broadcasts of songs from the seventies. The radio station played a prominent role in the film.[60] The DJ for the radio was chosen to be Steven Wright, a comedian known for his deadpan delivery of jokes.[61]

An unusual feature of the soundtrack was the choice of songs; Tarantino has said that he feels the music to be a counterpoint to the on-screen violence and action.[62] He also stated that he wished for the film to have a 1950s feel while using '70s music.[62] A prominent instance of this is the torture scene to the tune of "Stuck in the Middle with You".[63]

Video games[edit]

A video game based on the film was released in 2006 for PC, Xbox, and PlayStation 2. However, the game does not feature the likeness of any of the actors with the exception of Michael Madsen. The game was received unfavorably, with GameSpot calling it "an out and out failure".[64] It caused controversy for its amount of violence and it was banned in Australia,[65] Germany and New Zealand.[66]

Another video game, Reservoir Dogs: Bloody Days, was released in 2017.[67]

On December 14, 2017,[68] Overkill Software added a heist to Payday 2 inspired by Reservoir Dogs in which the player is contracted to rob a jewelry store in Los Angeles with the Cabot family. It is unique in that the heist is played in reverse order, with day two occurring prior to day one, similar to how the film's plot is out of chronological order.

Remakes[edit]

Kaante, a Bollywood film released in 2002, is a remake of Reservoir Dogs, combined with elements of City on Fire.[69] The film also borrows plot points from Heat and The Killing. Tarantino has been quoted as saying that Kaante is his favorite among the many films inspired by his work.[70] Tarantino later screened Kaante at his New Beverly Cinema alongside Reservoir Dogs and City on Fire.[71]

Tarantino revealed in June 2021 that he had at one point considered remaking Reservoir Dogs as his tenth and final directed film, though he quickly iterated that he "won't do it".[72]

See also[edit]

References[edit]

  1. ^ a b c d e "Reservoir Dogs". Box Office Mojo. Archived from the original on December 6, 2019. Retrieved March 7, 2011.
  2. ^ a b c d<

Buuf 1.0

Buuf 1.0 theme by OrganicShadow

Download: Buuf.p3t

http://img441.imageshack.us/img441/3711/previewon4.jpg
(2 backgrounds)

P3T Unpacker v0.12
Copyright (c) 2007. Anoop Menon

This program unpacks Playstation 3 Theme files (.p3t) so that you can touch-up an existing theme to your likings or use a certain wallpaper from it (as many themes have multiple). But remember, if you use content from another theme and release it, be sure to give credit!

Download for Windows: p3textractor.zip

Instructions:

Download p3textractor.zip from above. Extract the files to a folder with a program such as WinZip or WinRAR. Now there are multiple ways to extract the theme.

The first way is to simply open the p3t file with p3textractor.exe. If you don’t know how to do this, right click the p3t file and select Open With. Alternatively, open the p3t file and it will ask you to select a program to open with. Click Browse and find p3textractor.exe from where you previously extracted it to. It will open CMD and extract the theme to extracted.[filename]. After that, all you need to do for any future p3t files is open them and it will extract.

The second way is very simple. Just drag the p3t file to p3textractor.exe. It will open CMD and extract the theme to extracted.[filename].

For the third way, first put the p3t file you want to extract into the same folder as p3textractor.exe. Open CMD and browse to the folder with p3extractor.exe. Enter the following:
p3textractor filename.p3t [destination path]Replace filename with the name of the p3t file, and replace [destination path] with the name of the folder you want the files to be extracted to. A destination path is not required. By default it will extract to extracted.filename.

Unreal Tournament 3 v1.0

Unreal Tournament 3 theme 1.0 by Palaez

Download: UnrealTournament3.p3t

Unreal Tournament 3 v1.0 Theme
(3 backgrounds)

P3T Unpacker v0.12
Copyright (c) 2007. Anoop Menon

This program unpacks Playstation 3 Theme files (.p3t) so that you can touch-up an existing theme to your likings or use a certain wallpaper from it (as many themes have multiple). But remember, if you use content from another theme and release it, be sure to give credit!

Download for Windows: p3textractor.zip

Instructions:

Download p3textractor.zip from above. Extract the files to a folder with a program such as WinZip or WinRAR. Now there are multiple ways to extract the theme.

The first way is to simply open the p3t file with p3textractor.exe. If you don’t know how to do this, right click the p3t file and select Open With. Alternatively, open the p3t file and it will ask you to select a program to open with. Click Browse and find p3textractor.exe from where you previously extracted it to. It will open CMD and extract the theme to extracted.[filename]. After that, all you need to do for any future p3t files is open them and it will extract.

The second way is very simple. Just drag the p3t file to p3textractor.exe. It will open CMD and extract the theme to extracted.[filename].

For the third way, first put the p3t file you want to extract into the same folder as p3textractor.exe. Open CMD and browse to the folder with p3extractor.exe. Enter the following:
p3textractor filename.p3t [destination path]Replace filename with the name of the p3t file, and replace [destination path] with the name of the folder you want the files to be extracted to. A destination path is not required. By default it will extract to extracted.filename.

Insomnia

Insomnia theme by Stevie Klym

Download: Insomnia.p3t

http://img258.imageshack.us/img258/4959/62059previewyn0.png
(4 backgrounds)

Insomnia
Other namesSleeplessness, trouble sleeping
Depiction of insomnia from the 14th century medical manuscript Tacuinum Sanitatis
Pronunciation
SpecialtyPsychiatry, sleep medicine
SymptomsTrouble sleeping, daytime sleepiness, low energy, irritability, depressed mood[1]
ComplicationsMotor vehicle collisions[1]
CausesUnknown, psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, others[2]
Diagnostic methodBased on symptoms, sleep study[3]
Differential diagnosisDelayed sleep phase disorder, restless leg syndrome, sleep apnea, psychiatric disorder[4]
TreatmentSleep hygiene, cognitive behavioral therapy, sleeping pills[5][6][7]
Frequency~20%[8][9][10]

Insomnia, also known as sleeplessness, is a sleep disorder where people have trouble sleeping.[1] They may have difficulty falling asleep, or staying asleep for as long as desired.[1][9][11] Insomnia is typically followed by daytime sleepiness, low energy, irritability, and a depressed mood.[1] It may result in an increased risk of accidents of all kinds as well as problems focusing and learning.[9] Insomnia can be short term, lasting for days or weeks, or long term, lasting more than a month.[1] The concept of the word insomnia has two possibilities: insomnia disorder (ID) and insomnia symptoms, and many abstracts of randomized controlled trials and systematic reviews often underreport on which of these two possibilities the word insomnia refers to.[12]

Insomnia can occur independently or as a result of another problem.[2] Conditions that can result in insomnia include ADHD, psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, menopause, certain medications, and drugs such as caffeine, nicotine, and alcohol.[2][8] Other risk factors include working night shifts and sleep apnea.[9] Diagnosis is based on sleep habits and an examination to look for underlying causes.[3] A sleep study may be done to look for underlying sleep disorders.[3] Screening may be done with two questions: "do you experience difficulty sleeping?" and "do you have difficulty falling or staying asleep?"[9]

Although their efficacy as first line treatments is not unequivocally established,[13] sleep hygiene and lifestyle changes are typically the first treatment for insomnia.[5][7] Sleep hygiene includes a consistent bedtime, a quiet and dark room, exposure to sunlight during the day and regular exercise.[7] Cognitive behavioral therapy may be added to this.[6][14] While sleeping pills may help, they are sometimes associated with injuries, dementia, and addiction.[5][6] These medications are not recommended for more than four or five weeks.[6] The effectiveness and safety of alternative medicine is unclear.[5][6]

Between 10% and 30% of adults have insomnia at any given point in time and up to half of people have insomnia in a given year.[8][9][10] About 6% of people have insomnia that is not due to another problem and lasts for more than a month.[9] People over the age of 65 are affected more often than younger people.[7] Women are more often affected than men.[8] Descriptions of insomnia occur at least as far back as ancient Greece.[15]

Signs and symptoms[edit]

Potential complications of insomnia[16]

Symptoms of insomnia:[17]

  • Difficulty falling asleep, including difficulty finding a comfortable sleeping position
  • Waking during the night, being unable to return to sleep and waking up early
  • Not able to focus on daily tasks, difficulty in remembering
  • Daytime sleepiness, irritability, depression or anxiety
  • Feeling tired or having low energy during the day[18]
  • Trouble concentrating
  • Being irritable, acting aggressive or impulsive

Sleep onset insomnia is difficulty falling asleep at the beginning of the night, often a symptom of anxiety disorders. Delayed sleep phase disorder can be misdiagnosed as insomnia, as sleep onset is delayed to much later than normal while awakening spills over into daylight hours.[19]

It is common for patients who have difficulty falling asleep to also have nocturnal awakenings with difficulty returning to sleep. Two-thirds of these patients wake up in the middle of the night, with more than half having trouble falling back to sleep after a middle-of-the-night awakening.[20]

Early morning awakening is an awakening occurring earlier (more than 30 minutes) than desired with an inability to go back to sleep, and before total sleep time reaches 6.5 hours. Early morning awakening is often a characteristic of depression.[21] Anxiety symptoms may well lead to insomnia. Some of these symptoms include tension, compulsive worrying about the future, feeling overstimulated, and overanalyzing past events.[22]

Poor sleep quality[edit]

Poor sleep quality can occur as a result of, for example, restless legs, sleep apnea or major depression. Poor sleep quality is defined as the individual not reaching stage 3 or delta sleep which has restorative properties.[23]

Major depression leads to alterations in the function of the hypothalamic–pituitary–adrenal axis, causing excessive release of cortisol which can lead to poor sleep quality.

Nocturnal polyuria, excessive night-time urination, can also result in a poor quality of sleep.[24]

Subjectivity[edit]

Some cases of insomnia are not really insomnia in the traditional sense, because people experiencing sleep state misperception often sleep for a normal amount of time.[25] The problem is that, despite sleeping for multiple hours each night and typically not experiencing significant daytime sleepiness or other symptoms of sleep loss, they do not feel like they have slept very much, if at all.[25] Because their perception of their sleep is incomplete, they incorrectly believe it takes them an abnormally long time to fall asleep, and they underestimate how long they stay asleep.[25]

Problematic digital media use[edit]

In August 2018, Sleep Science and Practice published a systematic review and meta-analysis of 19 studies comprising 253,904 adolescent subjects that found that excessive technology use had a strong and consistent association with reduced sleep duration and prolonged sleep onset latency for adolescents 14 years of age or older.[26] Also in August 2018, Sleep Science published a systematic review of 12 studies investigating associations between exposure to video games, sleep outcomes, and post-sleep cognitive abilities that found the data present in the studies indicated associations between a reduction in sleep duration, increased sleep onset latency, modifications to rapid eye movement sleep and slow-wave sleep, increased sleepiness and self-perceived fatigue, and impaired post-sleep attention span and verbal memory.[27] In October 2019, Sleep Medicine Reviews published a systematic review and meta-analysis of 23 studies comprising 35,684 subjects that found a statistically significant odds ratio for sleep problems and reduced sleep duration for subjects with internet addiction.[28] In February 2020, Psychiatry Research published a systematic review and meta-analysis of 14 studies that found positive associations between problematic smartphone use and poor sleep quality and between higher levels of problematic smartphone use and elevated risk of poor sleep quality.[29]

Also in February 2020, Sleep Medicine Reviews published a systematic review of 31 studies examining associations between screen time and sleep outcomes in children younger than 5 years and found that screen time is associated with poorer sleep outcomes for children under the age of 5, with meta-analysis only confirming poor sleep outcomes among children under 2 years.[30] In March 2020, Developmental Review published a systematic review of 9 studies that found a weak-to-moderate association between sleep quantity and quality and problematic smartphone use among adolescents.[31] In October 2020, the International Journal of Environmental Research and Public Health published a systematic review and meta-analysis of 80 studies that found that greater screen time was associated with shorter sleep duration among toddlers and preschoolers,[32] while the Journal of Behavioral Addictions published a systematic review and meta-analysis of 40 studies with 33,650 post-secondary student subjects that found a weak-to-moderate positive association between mobile phone addiction and poor sleep quality.[33] In April 2021, Sleep Medicine Reviews published a systematic review of 36 cross-sectional studies and 6 longitudinal studies that found that 24 of the cross-sectional studies and 5 of the longitudinal studies established significant associations between more frequent social media use and poor sleep outcomes.[34]

In June 2021, Frontiers in Psychiatry published a systematic review and meta-analysis of 34 studies comprising 51,901 subjects that established significant associations between problematic gaming and sleep duration, poor sleep quality, daytime sleepiness, and other sleep problems.[35] In September 2021, BMC Public Health published a systematic review of 49 studies investigating associations between electronic media use and various sleep outcomes among children and adolescents 15 years of age or younger that found a strong association with sleep duration and stronger evidence for an association with sleep duration between the ages of 6 and 15 years than for 5 years of age or younger, while evidence for associations between electronic media use with other sleep outcomes was more inconclusive.[36] In December 2021, Frontiers in Neuroscience published a systematic review of 12 studies published from January 2000 to April 2020 that found that adult subjects with higher gaming addiction scores were more likely to have shorter sleep quantity, poorer sleep quality, delayed sleep timing, and greater daytime sleepiness and insomnia scores than subjects with lower gaming addiction scores and non-gamer subjects.[37] In January 2022, Early Childhood Research Quarterly published a systematic review and meta-analysis of 26 studies that found a weak but statistically significant association with increased smartphone and tablet computer use and poorer sleep in early childhood.[38]

In May 2022, the Journal of Affective Disorders published a meta-analysis of 29 studies comprising 20,041 subjects that found a weak-to-moderate association between mobile phone addiction and sleep disorder and that adolescents with mobile phone addiction were at higher risk of developing sleep disorder.[39] In August 2022, the International Journal of Environmental Research and Public Health published a systematic review and meta-analysis of 16 studies comprising 8,077 subjects that established a significant association between binge-watching and sleep problems and a stronger association between binge-watching and sleep problems was found during the COVID-19 pandemic than pre-pandemic.[40] In October 2022, Reports in Public Health published a systematic review of 23 studies that found that excessive use of digital screens by adolescents was associated with poor sleep quality, nighttime awakenings, long sleep latency, and daytime sleepiness.[41] In December 2022, Sleep Epidemiology published a systematic review of 18 studies investigating associations between sleep problems and screen time during COVID-19 lockdowns that found that the increased screen time during the lockdowns negatively impacted sleep duration, sleep quality, sleep onset latency, and wake time.[42] In March 2023, the Journal of Clinical Sleep Medicine published a systematic review and meta-analysis of 17 studies comprising 36,485 subjects that found that smartphone overuse was closely associated with self-reported poor sleep quality, sleep deprivation, and prolonged sleep latency.[43]

In April 2023, Sleep Medicine Reviews published a systematic review of 42 studies that found digital media use to be associated with shorter sleep duration and poorer sleep quality and bedtime or nighttime use with poor sleep outcomes, but only found associations for general screen use, mobile phone use, computer and internet use, internet, and social media and not for television, game console, and tablet use.[44] In July 2023, Healthcare published a systematic review and meta-analysis of 16 studies that established a correlation coefficient of 0.56 between nomophobia and insomnia.[45] In September 2023, PLOS One published a systematic review and meta-analysis of 16 studies of smartphone addiction and sleep among medical students found that 57% of subjects had poor sleep and 39% of subjects had smartphone addiction with a correlation index of 0.3,[46] while Computers in Human Behavior published a meta-analysis of 23 longitudinal studies comprising 116,431 adolescent subjects that found that adolescent screen time with computers, smartphones, social media, and television are positively associated with negative impacts on sleep health later in life.[47]

Causes[edit]

While insomnia can be caused by a number of conditions, it can also occur without any identifiable cause. This is known as Primary Insomnia.[48] Primary Insomnia may also have an initial identifiable cause, but continues after the cause is no longer present. For example, a bout of insomnia may be triggered by a stressful work or life event. However the condition may continue after the stressful event has been resolved. In such cases, the insomnia is usually perpetuated by the anxiety or fear caused by the sleeplessness itself, rather than any external factors.[49]

Symptoms of insomnia can be caused by or be associated with:

Sleep studies using polysomnography have suggested that people who have sleep disruption have elevated night-time levels of circulating cortisol and adrenocorticotropic hormone.[66] They also have an elevated metabolic rate, which does not occur in people who do not have insomnia but whose sleep is intentionally disrupted during a sleep study. Studies of brain metabolism using positron emission tomography (PET) scans indicate that people with insomnia have higher metabolic rates by night and by day. The question remains whether these changes are the causes or consequences of long-term insomnia.[67]

Genetics[edit]

Heritability estimates of insomnia vary between 38% in males to 59% in females.[68] A genome-wide association study (GWAS) identified 3 genomic loci and 7 genes that influence the risk of insomnia, and showed that insomnia is highly polygenic.[69] In particular, a strong positive association was observed for the MEIS1 gene in both males and females. This study showed that the genetic architecture of insomnia strongly overlaps with psychiatric disorders and metabolic traits.

It has been hypothesized that epigenetics might also influence insomnia through a controlling process of both sleep regulation and brain-stress response having an impact as well on the brain plasticity.[70]

Substance-induced[edit]

Alcohol-induced[edit]

Alcohol is often used as a form of self-treatment of insomnia to induce sleep. However, alcohol use to induce sleep can be a cause of insomnia. Long-term use of alcohol is associated with a decrease in NREM stage 3 and 4 sleep as well as suppression of REM sleep and REM sleep fragmentation. Frequent moving between sleep stages occurs with; awakenings due to headaches, the need to urinate, dehydration, and excessive sweating. Glutamine rebound also plays a role as when someone is drinking; alcohol inhibits glutamine, one of the body's natural stimulants. When the person stops drinking, the body tries to make up for lost time by producing more glutamine than it needs. The increase in glutamine levels stimulates the brain while the drinker is trying to sleep, keeping them from reaching the deepest levels of sleep.[71] Stopping chronic alcohol use can also lead to severe insomnia with vivid dreams. During withdrawal, REM sleep is typically exaggerated as part of a rebound effect.[72]

Benzodiazepine-induced[edit]

Like alcohol, benzodiazepines, such as alprazolam, clonazepam, lorazepam, and diazepam, are commonly used to treat insomnia in the short-term (both prescribed and self-medicated), but worsen sleep in the long-term. While benzodiazepines can put people to sleep (i.e., inhibit NREM stage 1 and 2 sleep), while asleep, the drugs disrupt sleep architecture: decreasing sleep time, delaying time to REM sleep, and decreasing deep slow-wave sleep (the most restorative part of sleep for both energy and mood).[73][74][75]

Opioid-induced[edit]

Opioid medications such as hydrocodone, oxycodone, and morphine are used for insomnia that is associated with pain due to their analgesic properties and hypnotic effects. Opioids can fragment sleep and decrease REM and stage 2 sleep. By producing analgesia and sedation, opioids may be appropriate in carefully selected patients with pain-associated insomnia.[55] However, dependence on opioids can lead to long-term sleep disturbances.[76]

Risk factors[edit]

Insomnia affects people of all age groups but people in the following groups have a higher chance of acquiring insomnia:[77]