Showing papers by "Peretz Lavie published in 1991"

Actigraphic home-monitoring sleep-disturbed and control infants and young children: a new method for pediatric assessment of sleep-wake patterns.

Abstract: Two studies were conducted to evaluate actigraphic home-monitoring for the assessment of infants' and children's sleep patterns. In the first study, 11 children (aged 12 to 48 months) were monitored in the laboratory by traditional polysomnography and by actigraphy for one night. Actigraphic automatic sleep-wake scorings were compared with those of the polysomnograph; total agreement rate was 85.3%. In the second study, sleep patterns of 63 sleep-disturbed and 34 control healthy children (aged 9 to 27 months) were compared. These children were home-monitored by actigraph for a mean of 4.45 nights (total 482 nights). Actigraphic data were analyzed by an automated scoring procedure. Sleep quality of the sleep-disturbed children, measured by actigraphically derived sleep percent and number of longer-than-5-minute wakings, was significantly lower than that of the control subjects (P less than .0001). Sleep measures showed significant night-to-night stability in both groups. The stability of specific measures and their age trends were different between the groups. Actigraphic sleep measures alone could discriminate between sleep-disturbed and control children with a highly correct assignment rate of 79.4% and 91.2%, respectively.

Sleep‐wake cycles in multi‐infarct dementia and dementia of the Alzheimer type

Abstract: We monitored by actigraphs minute-by-minute activity of 10 patients with multi-infarct dementia (MID), 15 patients with dementia of the Alzheimer type (DAT), and 11 control volunteers for eight consecutive 24-hour periods to assess sleep-wake cycles and sleep quality. MID patients had disrupted sleep-wake cycles associated with decreased sleep quality. In contrast, ambulatory DAT patients maintained a relatively normal sleep-wake cycle that did not differ significantly from controls. There was no correlation between the severity of intellectual deterioration and the degree of sleep-wake cycle disintegration in either group of dementia patients.

Sleep and dreaming in Holocaust survivors. Dramatic decrease in dream recall in well-adjusted survivors.

Abstract: Sleep data were obtained on 12 well-adjusted and 11 less-adjusted Holocaust survivors and on 10 control subjects. Each was also awakened from rapid eye movement sleep for dream recall. The less-adjusted survivors had more prolonged sleep latency than the well-adjusted and the control groups and lower sleep efficiency than the control subjects. The well-adjusted group had a significantly lower dream recall rate (33.7%) than the less-adjusted (50.5%) and control groups (80%). There were also significant between-groups differences in dream structure and dream content, in the direction of less complex and less salient dreams in the well-adjusted survivors. It is suggested that the decrease in dream recall is one of the forms of long-term adjustment to severe traumatic events.

Nonsteroidal antiinflammatory drug therapy in rheumatoid arthritis patients. Lack of association between clinical improvement and effects on sleep.

Abstract: Thirteen patients with rheumatoid arthritis (mean +/- SD age 55.8 +/- 10.5 years) received 20 mg of tenoxicam daily for 90 days following a 3-7 day "washout" period and 4 days of placebo treatment. Clinical evaluations were conducted at the end of the washout period and at monthly intervals thereafter. All-night polysomnography was performed in a sleep laboratory during the last 2 days of placebo treatment and on days 13, 14, 89, and 90 of tenoxicam treatment. Although there was improvement in the patients' clinical condition, there were no treatment-related changes in any of the sleep parameters. Eight of the 13 patients, however, were found to have primary sleep disorders. Four had periodic leg movements during sleep, 3 had sleep apneas, and 1 had a combination of both disorders. The implications of these findings in the treatment of sleep disorders in patients with rheumatoid arthritis are discussed.

Circadian rhythms in 6-sulphatoxymelatonin and nocturnal sleep in blind children.

Abstract: This article describes the relationship between melatonin secretion and sleep quality and subjective complaints about sleep in totally blind children. Eleven boarding-school children (mean age 15.2 years) participated. The major urinary melatonin metabolite 6-sulphatoxymelatonin (aMT6s) was measured five times a day for 48 h. Sleep-wake cycles were recorded by continuous actigraphic recordings during the same time period. Results showed that delayed secretory peaks in aMT6s were significantly associated with disturbed nocturnal sleep and with complaints about morning fatigue.

Sleeping under the threat of the Scud: war-related environmental insomnia.

Abstract: The influence of the Scud missile attacks during the Persian Gulf war on the sleep of the Israeli population is described. Our study group comprised a random sample of 200 people (mean age 41.13 +/- 15.32) who were contacted by telephone during the third week of the war and interviewed about their sleep. Overall, 28% of the entire sample complained about sleep: 10% complained about mid-sleep awakenings, 4.5% on difficulties falling asleep, and 13.5% about the combination of the two. People living in the Tel Aviv and Haifa areas complained significantly more than those in the rest of the country. Women complained significantly more than men, and people with lower education complained significantly more than people with higher education. Only 3% of the sample reported using sleeping pills. During the war actigraphic sleep recordings in 19 adults living in the Tel Aviv and Haifa areas did not reveal any measurable decrease in sleep quality in comparison with pre-war recordings. Possible explanations for the discrepancy between the subjective and objective assessments are discussed.

Discontinuation of lithium treatment in remitted bipolar patients: relationship between clinical outcome and changes in sleep-wake cycles.

Abstract: In this preliminary report, we describe four patients in whom long-term lithium therapy was discontinued, combined with actigraphic monitoring to assess changes in motor activity and the sleep-wake cycle. Two patients experienced rapid relapse of manic symptomatology, while two remained stable throughout a 1-year follow-up. Actigraphic monitoring revealed disintegration of the sleep-wake cycle and increased motor activity in the relapsed patients only. It is suggested that actigraphic recordings can be used to monitor lithium discontinuation

REM periodicity under ultrashort sleep/wake cycle in narcoleptic patients.

Abstract: Six narcoleptic patients were tested three times on the 13-min waking/7-min resisting sleep paradigm each time after a night of sleep in the laboratory. The three experiments were conducted after 10 days without any antinarcoleptic treatment or after 2 weeks of daily treatment with either methyl-phenidate or aniracetam. The results showed that patients had pronounced levels of diurnal sleepiness in all three experimental conditions with a midafternoon peak at around 1300-1500 hr and a nadir at around 1800 hr. Methyl-phenidate significantly reduced REM sleep and marginally reduced total sleep in comparison with the no-treatment and aniracetam conditions. REM sleep in the 7/13 paradigm appeared cyclically with a dominant periodicity of 80 min/cycle. The cycles tended to be synchronized across patients and were unrelated to the temporal structure of total sleep. The present results support the continuation of the REM oscillator during brief periods of waking, but suggest that the REM periodicity is unrelated to Kleitman's BRAC model of arousal.