Showing papers on "Sleep disorder published in 1980"

Periodic movements in sleep (nocturnal myoclonus): Relation to sleep disorders

Abstract: Periodic movements in sleep (PMS) are stereotyped, repetitive, nonepileptiform movements of the lower extremities. A total of 409 sleep disorder patients were studied with all-night polysomnogram recording, and 53 (13%) had PMS. Such movements occurred in a wide variety of sleep-wake disorders in addition to insomnia. The prevalence and magnitude of PMS were not statistically greater in patients with insomniac disorders than in those with syndromes of excessive daytime sleepiness or other sleep-wake disorders. The results suggest that although PMS is responsible for disturbed sleep in relatively few patients, chronic sleep-wake disturbance is associated with PMS and may lead to the development of these movements.

Gilles de la tourette syndrome: Clinical and family study of 50 cases

Abstract: Fifty patients with Tourette syndrome were evaluated; data included family history, clinical characteristics, response to haloperidol, and side effects during haloperidol therapy. Sixteen patients had a family history of Tourette syndrome, and another 16 had a family history of tics. Twenty-four families had more than 2 members with Tourette syndrome or tics. There was no preponderance of families with a Jewish, Eastern European background in this sample. Thirty-four patients had obsessive-compulsive behavior. Among the 50 patients there was a high frequency of sleep disturbance, learning disability, self-destructive behavior, inappropriate sexual activity, and antisocial behavior. Family history was significantly related to the occurrence of sleep disturbance, obsessive-compulsive behavior, haloperidol response, and the frequency of side effects caused by haloperidol. The precise mode of genetic transmission in familial Tourette syndrome remains to be determined.

Sleep Disturbance and Father Hunger in 18- to 28-Month-Old Boys: The Erlkönig Syndrome

Abstract: (1980). Sleep Disturbance and Father Hunger in 18- to 28-Month-Old Boys. The Psychoanalytic Study of the Child: Vol. 35, No. 1, pp. 219-233.

Sleep Disturbances in a Series of Elderly Patients: Polysomnographic Findings

Abstract: A group of 27 elderly patients with complaints of either chronic insomnia or excessive daytime sleepiness were studied in the Sleep Evaluation Center of Western Psychiatric Institute and Clinic during the period January 1977-June 1979. On the basis of anamnestic data from patients and bedroom partners, together with polysomnographic findings, sleep disturbances were classified according to the nosology of the Association of Sleep Disorders Centers. Of the 27 patients, 19 had disorders of initiating or maintaining sleep (DIMS), 7 had disorders of excessive somnolence (DOES), and 1 had parasomnia (episodic nocturnal wandering). Of the 19 DIMS patients, two-thirds had either a primary affective disorder (depression) or a persistent psychophysiologic disturbance. Of the 7 DOES patients, 6 had a primary sleep disorder such as a sleep apnea syndrome or narcolepsy-cataplexy. Additional electroencephalographic sleep data are presented on elderly patients with primary nonpsychotic depression. The latency of rapid eye movements (REM) in the depressed patients was shorter (p less than 0.05) than in patients with a persistent psychophysiologic disturbance. The percentage of REM sleep was significantly elevated (p less than 0.05) in the depressed group, and intermittent wakefulness was decreased (p less than 0.01). The causes of sleep disturbance in the elderly are both heterogeneous and complex. The need for accurate differential diagnosis and a multiaxial approach is stressed.

The effect of deprenyl, a selective monoamine oxidase B inhibitor, on sleep and mood in man.

Abstract: The effect of (-)-deprenyl, a rapidly acting selective monoamine oxidase (MAO) B inhibitor, on the sleep and mood of six healthy young male adults was investigated. The drug was administered double-blind in a balanced cross-over design. The dose (5–10 mg/day for 3 days) was chosen to cause complete inhibition of MAO, a process which usually takes 1–2 weeks with conventional MAO inhibitors. The inhibition was monitored by measuring platelet MAO activity and phenylethylamine excretion. Urinary phenylethylamine concentration was raised in all subjects. Subjects were unaware of any sleep disturbance due to the drug although the electroencephalogram (EEG) showed increased wakefulness. The onset of rapid-eye-movement (REM) sleep was delayed and the total amount reduced; the amount of stage 2 sleep was increased. The only effect of the drug on mood was to decrease the level of alertness prior to sleep. There was a slight but significant increase in the pre-sleep systolic blood pressure. There were no effects due to drug withdrawal.

Sleep disorder over time: psychiatric correlates among males.

Abstract: This 18 month prospective study assessed the time course of sleep disturbances in 85 male psychiatric out-patients and 103 male non-patients. Over one-third of the patients and 5 per cent of the non-patients reported frequent symptoms of insomnia during at least 14 of the 18 months. Frequency and chronicity of insomnia were strongly associated with intensity of psychiatric symptomatology, but not with diagnosis. Minor tranquillizers and hypnotics were used frequently by patients and occasionally by non-patients, but there was little indication that they altered the course of insomnia.

Episodic sleep disorder triggered by fever--a case presentation.

Abstract: An 18 year old boy suffering from episodic sleep disorders triggered by fever was studied in the sleep laboratory. An episode was recorded, starting in slow wave sleep. The diurnal sleep record showed the presence of benign epileptiform transients of sleep. The treatment with diazepam was successful. The relationships with disorders of arousal and epilepsy are discussed.

Reactive psychosis – A PROSPECTIVE STUDY

Abstract: A prospective study was carried out on 30 patients suffering from a psychotic episode following a stressful life event. They were found to have an Emotional, Timid, Sensitive, Tense and Insecure personality. Sleep disturbance, Affective symptoms, Histrionic behaviour and Excitement were the common clinical features. Sixty-six per cent were found to be clinically and socially remitted during a 6 months' follow-up. For 20% the diagnosis was revised to Affective Psychosis and for 10% to Schizophrenia.

Disorders of Sleep

Abstract: Sleep disorder is relatively uncommon as a neurological presenting symptom though very many patients complain of incidental insomnia

The Importance of Suspecting Sleep Apnoea as a Common Cause of Excessive Daytime Sleepiness: Further Experience from the Diagnosis and Management of 19 Patients

Abstract: Summary: Over an 18 month period, 19 patients were referred for assessment of excessive daytime sleepiness and/or loud snoring. Respiratory studies during sleep were performed in 14 of these patients with additional features such as disturbed sleep, observed apnoea during sleep, morning headache, mental and personality changes, hypertension and cardiac failure. Nocturnal respiratory studies undertaken for periods of 4–8 hours confirmed a diagnosis of the Sleep Apnoea Syndrome in eight patients. In these patients apnoeas, lasting from 30–144 seconds, occurred frequently during sleep (from 35–291 episodes per patient). In one severely affected patient, tracheostomy abolished all symptoms. The use of conservative therapy such as weight loss, protriptyline or a neck collar, highlighted the inadequacies of current medical treatment. Awareness of the symptom complex and potential complications of the Sleep Apnoea Syndrome is important because the diagnosis may easily be missed if the patient presents with one or two isolated complaints.

Age-specific doses of lormetazepam as a night sedative in cases of chronic sleep disturbance.

Abstract: Lormetazepam, a new benzodiazepine derivative, was tested under double blind conditions in order to find the optimal dosage for different age groups of out-patients. 120 patients suffering from chronic sleep disturbance were included in the study: a younger group (age 20 to 55) and an older group (age 56 to 85 years). Four different doses were given to each age group: 0.5, 1.0, 2.0, and 3.0 mg to the younger group and 0.5, 1.0, 1.5, and 2.0 mg to the older group. A pre-placebo week (i.e. when all patients received placebo) in which baseline data were recorded preceded the two verum weeks, and these were followed by a post-placebo or withdrawal week (again all patients receiving placebo). The level of significance accepted for statistical decisions was alpha = 0.05. No differences in effects between the different doses were observed with regard to sleep pattern variables (sleep latency, sleep duration, frequency of awakenings, sleep quality, occurrence of 'bad' dreams) with the exception of sleep quality which was better in the older group than in the younger group after 0.5 mg in week 2. Considerable differences with regard to hangover feelings the next morning and during the next day (morning feelings, tranquility, alertness, and concentration), comparison of the effects of discontinuing therapy upon the above-mentioned sleep pattern variables and small differences in side effects--which were few--led to the following conclusion: --0.5 mg stood out as the best dose for the older group. --None of the dosages given to the younger group emerged clearly as superior. However, it would seem that the 1 mg dose should be the dose recommended, since fewer unfavourable scores and side effects appeared after this dose.

Sleep EEG in depression.

Abstract: Depression is a common psychiatric disorder with sleep disturbance as a concomitant symptom This paper selectively reviews the earlier, more global research and more recent studies with improved methodologies Research has shown that EEG sleep changes (in particular, REM) can be used as an aid in differential diagnosis of depression and possibly as a way of treatment It is speculated that an ultradian cycle disruption involving REM sleep mechanisms is related to primary depression

Treatment of sleep disorders in the elderly

Abstract: The physiological and pathophysiological peculiarities of the aging organism require to be observed in the treatment of sleep disorders. After eliminating extracerebral causes one has to consider changes of cerebral blood flow as a reason for impaired sleep, for instance resulting from cardial insufficiency or pathological changes of blood pressure. In using sleeping drugs one should keep in mind type and severeness of the sleep disorders and prescribe with care, since the elimination potential in the aged is mostly reduced and the quote of side effects is increased.

The behavioral treatment of insomnia. A review and methodological analysis of the evidence

Abstract: Insomnia is a broad concept embracing various forms of objective and/or purely phenomenological sleep disturbance. Clinically, the term insomnia usually refers to a chronic inability to initiate and maintain adequate sleep (Bootzin & Nicassio, 1978; Sleep Disorders Classification Committee, 1979; Williams, Karacan, & Hursch, 1974). That sleep disturbance is, without a doubt, a common clinical complaint is supported by a variety of research surveys. Weiss, Kasinoff, & Bailey (1962) reported that 15% of a sample of 110 Air Force personnel complained of some sort of sleep disturbance. Later, in an epidemiological survey (Williams, Karacan, & Hursch, 1974) of 1,645 people in the general population in one county in Florida, 45% of the sample reported experiencing difficulties in initiating and maintaining sleep. More recently, others (Kales, Bixler, Lee, Healy, & Slye, 1974; Montgomery, Perkins, & Wise, 1975; Webb, 1975) have observed that approximately 10% to 15% of the population complain of mild or occasional insomnia, and an additional 10% to 15% suffer severe and frequent insomnia. Finally, what appears to be an alarming amount of prescribed sleep medication (i.e., tranquilizers and hypnotics) in the United States alone provides further, albeit indirect, confirmation of the preva-

Sleep and depression: a case study of EEG sleep prior to relapse.

Abstract: By chance, we were able to record for five consecutive nights the sleep of a 61-year-old woman before each of two successive depressive episodes. In this patient, marked changes in EEG sleep (notably a decline in "sleep efficiency") preceded both episodes. These changes are considered to be of predictive, but not of etiological, significance.

Enuresis: a functional equivalent of a fetish

Abstract: The split in the ego between consciousness and unconsciousness which sometimes eventuates in fetishism can also be clinically manifested in sleep disturbances, depersonalization, deja vu and a variety of alterations in the sense of reality. It is suggested that this same split comprises the central dynamic mechanism in enuresis. The sleep disturbance which accompanies enuresis involves a confusion between waking and sleeping, sometimes taking the form of a dream that one is awake. Three patients(adult males) revealed in the course of their analyses that they suffered from childhood enuresis accompanied by a sleep disturbance. Milder forms of sleep disturbances persisted into adult life. In these analyses, certain perceptual distortions, difficulties in the sense of reality, and between fantasy and reality, confusions between waking and sleeping, could all be linked to the functional split between consciousness and unconsciousness and eventually to disavowal of the female genitals. The enuresis represented a functional equivalent of the fetish (and it may be that the urinary stream itself actually served as a fetish). Psychological test data from nine enuretic boys were examined as well. This material clearly demonstrated that these boys wished to deny the differences between males and females, that they suffered from sleep disturbances and that they confused reality and fantasy, sleeping and waking. The combined data suggest the existence of a functional split in the ego used in the service of defence, the product of a regressive fixation and a reinstatement of an archaic mode of thought.

Therapeutic Effects of Tracheostomy in Two Cases of Hypersomnia with Respiratory Disturbance during Sleep

Abstract: Recently the association of hypersomnia and respiratory insufficiency without lesion in the respiratory organ has attracted attention of many investigators. Obese patients with such a condition have been called the Pickwickian syndrome. In this report, two non-obese patients with a similar condition were presented, one with micrognathia and frequent apneic episodes during sleep, and the other with laryngeal stenosis due to paralysis of the bilateral laryngeal nerves and chronic laryngitis. Tracheostomy had a prompt and long-lasting therapeutic effect to make their sleep stable and also to relieve their excessive daytime sleepiness. These findings suggest that the obstruction or stenosis of the upper airway during sleep disturbed their nocturnal sleep, and that their excessive daytime sleepiness was a phenomenon compensating for their disturbed nocturnal sleep.

Cataplexy and Conjugate Gaze Paresis

Abstract: To The Editor— Cataplexy is thought to represent an abnormality of the rapid eye movement (REM) sleep mechanism whereby the motor and sleep components become dissociated This results in periodic episodes of profound loss of motor tone while consciousness is preserved Symptomatic cataplexy is rare, and the anatomical localization of the defect responsible for the syndrome is, to our knowledge, unknown 1 It is also unusual to encounter cataplexy in the absence of narcolepsy Report of a Case— A 58-year-old man gave a six-year history of recurrent falls occurring about twice a month and usually precipitated by anger or laughter He described the sudden onset of overwhelming weakness such that his legs gave way and he fell to the floor Consciousness was preserved and the attacks lasted only a few minutes There was no associated sleep disturbance He had never been able to look fully either to left or right