PubMed Health⌕ Search

Biomedical subjects

E D Weitzman

Publications and source records attributed to E D Weitzman.

At least 19 recordsLinked to original sources
PubMed1987

Are periodic movements in sleep a basal ganglia dysfunction?

Muscle activity during sleep is a new area of interest in sleep research. No precise brain structures are known to be involved in sleep movement. The etiology of periodic movements during sleep is unknown. The present study was dedicated to evaluate involvement of basal ganglia in periodic movements of the legs during sleep (PMS) in Parkinson's diseased patients. Sleep was monitored in 3 patients suffering from Parkinson's disease and PMS (PMS/PD) and in 3 patients suffering from restless legs syndrome and PMS (PMS/non PD). Following treatment, the six patients were monitored again during sleep. It was found that only the PMS/PD group of patients had improved significantly with appropriate treatment. Improved motor function in PD patients is associated with decreased PMS, regardless of wether the patients are treated with dopaminergic or anticholinergic agents. This is consistent with our previous data. It may be suggested that the striopallidal system is involved in periodic sleep movements of Parkinson's diseased patients.

Aged↗
PubMed1985

Signs of REM prior to the first REM period in prepubertal children.

In a previous publication, prepubertal depressives were found not to exhibit a shortened REM period latency during active illness when compared with pathological and normal control groups. It was hypothesized that this might be due to a nonselective inhibition of REM sleep by slow-wave sleep (SWS), which is quite intense among prepubertal children, especially during the first 2 h of the sleep period. A number of polysomnographic signs normally associated with REM sleep were observed to occur periodically, prior to the beginning of the first REM period. It was thought that these signs might be indicative of "minor escapes" of REM sleep activity from the inhibitory influence of SWS. It was further hypothesized that differences among the experimental groups in the occurrence (timing and amount per minute) of these signs support the idea of an inhibitory effect of SWS on REM; and thus offer an explanation for the apparent dissociation between the depressive disorder among prepubertal children and a shortened REM period latency. The hypotheses were not supported by the results presented here indicating that the above dissociation is probably not due to inhibitory mechanisms of SWS on REM sleep.

Child↗
PubMed1984

Patterns of daytime sleepiness in narcoleptics and normals: a pupillometric study.

Pupil diameter was measured in light and dark conditions every half hour for 6.5-10 h in 3 normal controls and 3 narcoleptics. Mean pupillary diameter was significantly smaller in the narcoleptic group than in the normal group. Pupil activity was correlated with pupil diameter only in the dark condition in narcoleptics. Pupil diameter varied with a circa 90 min periodicity in the narcoleptics but not in the normal controls. These results indicate firstly, that one-time assessment of pupil size is insufficient; and secondly, that the appearance of these rhythms may be the result of a defect in arousal mechanisms of narcoleptics which usually play an inhibitory role.

Adult↗
PubMed1979

Circulating melatonin in man: episodic secretion throughout the light-dark cycle.

A sensitive and specific RIA for melatonin has been validated for human plasma. Five young adult men had plasma samples obtained every 20 min during two 24-h periods. One was a normal active period and the other a basal period with complete bed rest. Melatonin was found to be secreted episodically throughout the 24 h in each condition, with secretory episodes clearly present during the waking day in the presence of bright light.

Adult↗
PubMed1978

Hypersomnia-sleep apnea due to micrognathia. Reversal by tracheoplasty.

A 67-year-old woman with acquired micrognathia developed severe daytime hypersomnia, loud snoring, nocturnal enuresis, encopresis, and hypertension. A polysomnogram demonstrated 564 sleep apneas, primarily obstructive, recurrent hypoxia, a bradytachycardia, and absent stages III, IV, and REM sleep. Endoscopy during sleep revealed recurrent active closure of the upper pharynx associated with loud snoring. A tracheoplasty was done because of severity of symptoms and failure of conservative therapy. Dramatic improvement in sleepiness and hypertension occurred within 48 hours. On postoperative night 15 a repeated polysomnogram showed only 23 apneas, no hypoxia or bradytachycardia, and long periods of stage II, IV, and REM sleep. Patients with the hypersomnia-sleep apnea syndrome should be provided with a tracheal opening during sleep when severe daytime somnolence, cardiac arrhythmias, and hypertension are present.

Aged↗
PubMed1978

Long-term ambulatory temperature monitoring in a subject with a hypernychthemeral sleep--wake cycle disturbance.

A portable temperature data logger was used for prolonged rectal temperature monitoring in an ambulatory subject with a longer than 24 hr (hypernychthemeral) sleep-wake cycle. The mean period of the sleep-wake and circadian temperature cycles was 24.8 hr. However, the period of the sleep-wake cycle fluctuated considerably, being less than 24.8 hr when he slept during the socially desirable sleep hours and more than 24.8 hr when he slept during the day. In the first instance, the daily temperature fall occurred later than, and in the second earlier than, sleep onset. During the times of desynchronization of the two cycles, he complained of insomnia, fatigue, and reduced performance. We postulate that his hypernychthemeral cycles were the result of either a primary defect in the mechanism of entrainment or "weakened" social zeitgebers due to a personality disorder. These concepts are supported by a sleep-wake pattern resembling that of relative coordination. We therefore raise the possibility that 24 hr was beyond the range of entrainment of the subject's circadian temperature cycle during the study.

Adult↗
PubMed1978

Twenty-four-hour plasma prolactin patterns in prepubertal and adolescent boys.

The concentration of PRL was measured every 20 min for 24 h in six prepubertal and three adolescent boys. In both groups, PRL secretory episodes occurred throughout the 24-h period. In all subjects, the mean concentration of PRL was significantly higher during sleep than during wakefulness; the mean concentration during the entire 24-h period, during sleep or during wakefulness, was not different between the prepubertal subjects and the adolescents. These data suggest the absence of an ontogenetic change for PRL secretion in boys. During acute sleep-wake reversal, two of three pubertal boys showed significantly higher PRL during daytime sleep than during nocturnal wakefulness. This suggest that PRL release in adolescent boys is linked with sleep, rather than with clock time.

Adolescent↗
PubMed1978

Fibro-optic study of pharyngeal airway during sleep in patients with hypersomnia obstructive sleep-apnea syndrome.

Pharyngeal airway during sleep was observed with help of Fibro-optic flexible bronchoscope and cineradiography in 10 adult patients with Hypersomnia Sleep-Apnea (HSA) syndrome. The results of the study suggest that the structures involved in production of airway obstruction in the patients with HSA syndrome are the muscles of velopharyngeal sphincter and tongue. The laryngeal airway was not obstructed during the episodes of apnea.

Adult↗
PubMed1978

Studies of the 24 hour rhythm of melatonin in man.

In a series of four separate studies of the 24-hour pattern of melatonin secretory function in man, the following results were obtained. Sequential measurement of the concentration of melatonin in plasma and urine demonstrated a 24-hour rhythm in which more melatonin is secreted during the sleep-lights off as compared to the waking-lights on period. However, during "free-running" and after an acute phase shift of the sleep-wake cycle, a melatonin rhythm can be dissociated from the sleep-lights out rhythm. A radioimmunoassayable plasma melatonin substance was found in significant amounts throughout the entire 24-hour day using a frequent sampling technique (every 20 min). Melatonin appears to be secreted into the blood in discrete brief episodes superimposed on a maintained "baseline" concentration. The half-life appears to be less than 30 min.

Adult↗
PubMed1978

Ambulatory and in-hospital continuous recording of sleep state and cardiorespiratory parameters in 'near miss' for the sudden infant death syndrome and control infants.

Electrophysiologic and cardiorespiratory events were studied polygraphically and by ambulatory monitoring in 'near miss' for sudden infant death syndrome (SIDS) and normal control infants 1-4 months old. The data show that 'near miss' babies typically have many apneic periods in their sleep, particularly apneas lasting 10 sec or longer. These tend to decrease with age. They have longer lasting apneas than controls, although the latter have respiratory pauses lasting less than 10 sec, in particular during rapid eye movement (REM) sleep. An upper respiratory infection (URI) in 'near miss' infants clearly appears to be a risk factor which will be studied further both in-hospital and at home using a monitoring technique with our Medilog ambulatory system.

Ambulatory Care↗
PubMed1977

Absence of tonic electromyographic activity during sleep in normal and spastic nonmimetic skeletal muscles in man.

An electromyographic study of nonmimetic skeletal muscles was carried out in 8 normal adults and 4 patients with spastic hemiparesis during all stages of sleep for a total of 21 nights. All normal subjects showed absence of tonic electromyographic activity in all nonmimetic skeletal muscles in all stages of sleep. Also, during quiet, relaxed wakefulness, tonic muscle discharges disappeared in the normal subjects. Three patients with upper motor neuron spasticity demonstrated results during sleep similar to those obtained in the normal subjects. In the fourth patient, tonic muscle discharges persisted into stage 2 non-REM sleep, disappeared within 30 to 240 seconds following the onset of stage 2 sleep, and were absent during stages 3 and 4 sleep and REM sleep.

Adult↗
PubMed1977

Response to thyrotropin releasing hormone: an objective criterion for the adequacy of thyrotropin suppression therapy.

Most serum thyrotropin (TSH) assays do not adequately discriminate between normal values and absent TSH. We therefore evaluated the TSH response to thyrotropin releasing hormone (TRH) as a criterion for the adequacy of TSH suppression therapy. Twenty-six outpatients with various thyroid disorders (cancer, 10; nodules, 9; miscellaneous, 4; hypothyroidism after 131I therapy for Graves' disease, 3) were studied. Using the frequent sampling technique (samples every 20 min) in two normal volunteers and one untreated patient who was TRH-responsive, we first confirmed the observation that TSH secretion occurred episodically throughout the 24-h period. In contrast, serum TSH was undetectable (less than 0.6 micronU/ml) throughout the 24-h period in 5 patients on TSH suppression therapy who were TRH-unresponsive and one who had a minimal response to TRH. Thus, TRH-unresponsive patients did not secrete measurable amounts of TSH throughout the 24-h period. To suppress TSH secretion, all patients were treated with L-thyroxine (T4) at doses which resulted in undetectable TSH values in random plasma samples. TRH tests were carried out only when random TSH concentrations were less than 0.6 micronU/ml. Seven of the twenty-six patients (27%) including two with thyroid cancer were TRH-responsive indicating a potential for TSH secretion. In these seven, the T4 dose was adjusted until they were TRH-unresponsive. The mean change in T4 dose of these 7 patients was 20+/-10 (SD) microng/day and this resulted in a mean increase of 1.5+/-1.1 microng/dl for T4 and 20+/-20 ng/dl for T3. For all patients, the mean T4 dose required for TSH suppression was 172+/-53 microng/day or 2.6+/-0.8 microng per day per kg body weight. Twenty-three of 26 patients required between 100-200 microng/day and the remaining 3, 250-300 microng/day. The T4 dose required to suppress TSH resulted in normal serum concentrations of T4. 9.1+/-2.0 MICRONG/DL, AND T3, 136.7+/-33.6 NG/DL. These T4 doses did not produce a rapid heart rate, either awake or asleep, arrhythmias, or electrocardiographic abnormalties as assessed by 24-h Holter monitor tracings in 11 patients. Our results thus show that the T4 dose which results in an unresponsive TRH test ensures that serum TSH will remain undetectable (less than 0.6 micronU/ml) throughout the 24-h period. An unresponsive TRH test, therefore, appears to be a very useful and reliable index of TSH suppression.

Adult↗