Showing papers on "Sleep disorder published in 1979"
287 citations
Journal Article•
TL;DR: The authors' therapeutic experience includes mainly healthy living associated with treatment of systemic disorders and use of medroxyprogesterone and protriptyline, supplemented, if needed, by palatopharyngoplasty with or without temporary tracheostomy.
133 citations
TL;DR: The Multiple Sleep Latency Test can provide physicians with data useful in the diagnosis of narcolepsy, and it is concluded that this procedure can receive physicians' approval.
122 citations
TL;DR: Clinical and laboratory findings are presented, the causative factors of in somnia are defined, assessment guidelines are delineated, and appropriate treatment methods are reviewed.
Abstract: The general physician is the most appropriate person to evaluate and treat patients presenting with the complaint of insomnia. However, there has recently been an overemphasis on the need for patients to be evaluated in sleep disorders clinics, particularly in their sleep laboratories. These sleep laboratory evaluations are expensive and time consuming, and often con tribute only minimally to the overall management of the insomniac patient. In fact, they may even detract from the comprehensive psychiatric, neuro logical, pharmacological, and general medical approac:h that is necessary for the effective management of insomnia. The primary goal of sleep disor ders clinics and their staff should be to supplement and enhance the general physician's ability to evaluate and treat patients with sleep disorders, partic ularly insomnia, the most common sleep disorder (1). This review is de signed to strengthen the physician's ability to more rationally and effectively evaluate and treat the condition of insomnia in his office practice. Thus, clinical and laboratory findings are presented, the causative factors of in somnia are defined, assessment guidelines are delineated, and appropriate treatment methods are reviewed.
108 citations
TL;DR: The sleep changes induced in normal volunteers following the administration of scopolamine on 3 consecutive mornings resemble many of the abnormalities observed in the sleep of patients with primary depression, suggesting that muscarinic supersensitivity in normals may function as a pharmacological model for the sleep disturbances of depression.
Abstract: The sleep changes induced in normal volunteers following the administration of scopolamine on 3 consecutive mornings resemble many of the abnormalities observed in the sleep of patients with primary depression: increased sleep latency and reduced rapid eye movement (REM) latency, total sleep time, and sleep efficiency. Furthermore, in a multivariate discriminant analysis—previously shown to distinguish the sleep records of depressed patients from those of normal controls and insomniac patients—the records from baseline nights were selected as normal and those after scopolamine as predominately depressed. Those observations suggest to us that muscarinic supersensitivity in normals may function as a pharmacological model for the sleep disturbances of depression.
85 citations
41 citations
TL;DR: The notion that narcolepsy is a sleep disorder characterized by a disruption of the normal sleep-wake cycle is supported, and strong evidence that this disease entity is similar in man and dog is provided.
36 citations
Journal Article•
TL;DR: Since some of these patients were suspected of having non-restorative sleep syndrome, it is suggested that increased sleep motility and autonomic activity might be related to this sleep disorder.
25 citations
TL;DR: Results indicate that alterations in normal sleep patterns occur routinely within coronary care environments, even in the absence of disturbing environmental stimuli, and suggest that a closer analysis be made of sleep in these settings in light of the known relationships between sleep and cardiac function.
Abstract: Of 42 coronary care patients studied during 10 hr. of poly-graphically recorded sleep, 28 were in an open-ward coronary care unit and 14 were in a semi-private telemetry unit. The observed sleep disturbances were not a function of type of unit, length of hospitalization, sex, or medications. Sleep was significantly less fragmented in those patients judged less severe in pathology. These results indicate that alterations in normal sleep patterns occur routinely within coronary care environments, even in the absence of disturbing environmental stimuli and suggest that a closer analysis be made of sleep in these settings in light of the known relationships between sleep and cardiac function.
24 citations
TL;DR: Stimulus control, a behavioral technique designed to reduce sleep difficulties, has been demonstrated to be effective when compared with control procedures, and a comparison with the credible placebo procedure indicated that the stimulus control techniques reduced subjects' sleep onset latency to a mean latency below 30 min per week.
22 citations
TL;DR: During this counterdemand period, the two relaxation groups showed significantly greater decreases in sleep onset latency than the control conditions, and it appeared that duration affected treated outcome.
TL;DR: A mildly dyslexic boy of 11 years, with no neurological deficit or history of epileptic seizures, had marked hypersomnia for 2 years, which was most pronounced in the morning hours.
Abstract: A mildly dyslexic boy of 11 years, with no neurological deficit or history of epileptic seizures, had marked hypersomnia for 2 years, which was most pronounced in the morning hours. Repeated EEG studies and power spectral analysis revealed simultaneous posterior alpha rhythm and sleep patterns (spindles, vertex waves, K complexes) over vertex and frontocentral regions, while the patient was behaviorally awake. Bilateral synchronous anterior spikes were frequently noted in association with sleep patterns. A polysomnogram over 24h confirmed excessive sleep, night and day (especially morning hours) and there was evidence of a large REM sleep percentage (on EMG and EOG basis) while the EEG had predominantly non-REM sleep patterns. Special neurotransmitter studies were performed in view of a presumed disturbance affecting the neurobiochemical sleep regulation. These studies were based on CSF metabolite levels and provided evidence for a high serotonin metabolite (5HIAA) level. It is tempting to hypothesize that the biochemical disturbance has led to encroachment of non-REM sleep patterns on both wakefulness and REM sleep. Further discussion deals with the bilateral-synchronous spike activity and its relationship to arousal patterns in sleep.
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TL;DR: The final author version and the galley proof are versions of the publication after peer review that features the final layout of the paper including the volume, issue and page numbers.
Abstract: • A submitted manuscript is the version of the article upon submission and before peer-review. There can be important differences between the submitted version and the official published version of record. People interested in the research are advised to contact the author for the final version of the publication, or visit the DOI to the publisher's website. • The final author version and the galley proof are versions of the publication after peer review. • The final published version features the final layout of the paper including the volume, issue and page numbers.
01 Sep 1979
TL;DR: Sleep of 6 depressed patients with hypersomnia was studied during their depressed phase and their remitted phase using 24-h polygraphic recording to derive total sleep time and latency to sleep onset.
Abstract: Sleep of 6 depressed patients with hypersomnia was studied during their depressed phase and their remitted phase using 24-h polygraphic recording Nine normal subjects were studied as the controls The latency to sleep onset of the depressed patients was significantly shorter than that of the remitted patients and that of the control subjects The total sleep time of the depressed patients was significantly longer than that of the remitted patients as well as that of the controls This increase in sleep time of the depressed patients was mainly due to the increased sleep in day time The intervals between sleep onset and start of each sleep stage, the relative percentage of individual sleep stages, REM latency and REM density of the depressed patients were not significantly different from those of the remitted patients
01 Jan 1979
TL;DR: The reason I underline this is that when testing hypnotic drugs it is necessary not only to study neurophysiological variables but also to use questionnaires, to rate the report of the subject and also to have trained observers’ opinion of the sleep rated.
Abstract: Sleep is a dynamic process and not a passive condition. From a behavioural standpoint it can be defined as a regularly recurrent state which is reversible and in which there is a greatly increased threshold for external stimulation. The neurophysiologists have specific EEG patterns when an individual is asleep, but this does not mean that the EEG pattern is the same as sleep. The reason I underline this is that when testing hypnotic drugs it is necessary not only to study neurophysiological variables but also to use questionnaires. It is of importance to rate the report of the subject and also to have trained observers’ opinion of the sleep rated. Another factor to control when studying the effect of a drug upon sleep is how the person functions the next day. This capacity for performing usual tasks does not necessarily correlate to the effect of the drug on EEG sleep or the subject’s own opinion.
TL;DR: It is considered that these hypnotics provide a basis for the management of sleep disturbance in persons involved in skilled activity because in limited doses each drug has hypnotic activity without residual effects on performance.
Abstract: 1 The effects of diazepam 5, 10 and 15 mg and its hydroxylated metabolites, 3-hydroxydiazepam (temazepam) 10, 20 and 30 mg and 3-hydroxy, N-desmethyldiazepam (oxazepam) 15, 30 and 45 mg on sleep in healthy man were studied in young adulthood and in middle age. The effectiveness of the drugs for sleep during the day was also investigated.
2 In young adults diazepam and temazepam reduced sleep onset latencies and awake activity and increased total sleep time, and temazepam also reduced drowsy sleep. The activity of oxazepam was similar to that of temazepam except that it had no effect on sleep onset latencies. In middle age the effects of diazepam and temazepam were less pronounced than would be expected from studies in young adulthood. Essentially they reduced awake activity.
3 During the day diazepam increased total sleep time and reduced drowsy sleep in young adults, but temazepam and oxazepam had less activity than would be expected from their effect on night-time sleep. With temazepam there was no increase in total sleep time, although there was reduced awake activity and drowsy sleep, and with oxazepam total sleep time was increased without changes in awake activity and drowsy sleep.
4 It is considered that these hypnotics provide a basis for the management of sleep disturbance in persons involved in skilled activity. In limited doses each drug has hypnotic activity without residual effects on performance.
01 Jan 1979
TL;DR: 2 patients with hypoparathyroidism, one idiopathic and the other pseudoform, were studied by overnight polygraphic recording of the sleep EEG and related activities before and after start of treatment to investigate their sleep EEG patterns and states, showing findings suggestive of a possible disorder of the desynchronizing mechanism of the brain stem.
Abstract: 2 patients with hypoparathyroidism, one idiopathic and the other pseudoform, were studied by overnight polygraphic recording of the sleep EEG and related activities before and after start of treatment
Journal Article•
TL;DR: It is of the opinion that the appliance described in this article offers some promise as an alternative treatment for sleep apnea and should be considered for further research and experimentation.
Abstract: Sleep apnea syndrome encompasses several entities that are characterized by the inability of the victim to achieve restful sleep. The only known treatment for the syndrome is a tracheostomy. Further research and experimentation are required. We are of the opinion that the appliance described in this article offers some promise as an alternative treatment.
TL;DR: In a double-blind crossover study in general practice, flurazepam was shown to be significantly better than diazepam in treating sleep disturbance.
Abstract: In a double-blind crossover study in general practice, flurazepam was shown to be significantly better (p less than 0.001) than diazepam in treating sleep disturbance. Fewer patients reported side-effects on flurazepam.
TL;DR: The actual percentage of sleep clinic patients whose sleep is studied polygraphically varies widely among clinics and is affected by the proportion of patients referred specifically for laboratory study of their sleep disorder, evenness in the amount of insurance coverage for such procedures available to different clinic populations, and differences of opinion concerning the diagnosis of sleep disorders.
Abstract: To the Editor.— Kales et al (241:2413, 1979) imply inThe Journaland state elsewhere1that sleep clinics overemphasize polygraphic sleep studies when diagnosing sleep disorders. However, they do not mention the actual percentage of sleep clinic patients whose sleep is thus studied. This percentage varies widely among clinics and is affected by the proportion of patients referred specifically for laboratory study of their sleep disorder, evenness in the amount of insurance coverage for such procedures available to different clinic populations, and differences of opinion concerning the diagnosis of sleep disorders.2 Thus, we polygraphically study sleep in approximately 10% of cases in our clinic, whereas in some clinics, perhaps like that of Kales et al, a large majority of cases are studied polygraphically. Generalizations about the percentage of patients whose sleep is studied polygraphically, therefore, cannot be applied across sleep clinics.
TL;DR: The results suggest that chlormezanone produced prompt improvement within 2 nights of the start of treatment, and by the end of the study period only 2 patients still reported their sleep as being poor compared with 80% initially, and 19 rated their sleepAs good or excellent.
Abstract: Twenty-nine patients seen in general practice suffering from sleep disturbance due to mild neurotic anxiety were treated with 400 mg chlormezanone per night for 2 weeks. Patients' and doctors' asse...