PubMed Health⌕ Search

Biomedical subjects

E D Weitzman

Publications and source records attributed to E D Weitzman.

At least 55 records · Page 3Linked to original sources
PubMed1980

Periodic movements in sleep (nocturnal myoclonus): relation to sleep disorders.

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.

Electroencephalography↗
PubMed1980

Impaired nocturnal erections and impotence following transurethral prostatectomy.

A case of impotence with significantly impaired nocturnal penile tumescence (NPT) following transurethral resection of the prostate (TURP) is described. The patient was studied with polysomnographic recording including measurements of NPT for three consecutive nights at nine months after surgery and showed a total absence of full erections. Possible causes of his impotence are discussed. It is concluded that the total clinical picture strongly suggests that the erectile dysfunction was a result of physiologic complications of the surgery. Methodologic problems in past work are discussed, and the need for detailed diagnostic studies is stressed. The sleep studies that should be a part of this comprehensive evaluation are described.

Erectile Dysfunction↗
PubMed1980

Obstructive sleep apnea and death associated with surgical correction of velopharyngeal incompetence.

We have observed three children who developed obstructive sleep apnea immediately following construction of pharyngeal flaps designed to improve the speech of these patients with velopharyngeal incompetence. Postoperatively the patients were noted to have repeated episodes during sleep of strong respiratory efforts without airflow. Sleep apnea can be debilitating and lethal, and should be looked for following surgery of the upper airway. Respiratory depressants should be avoided. Airway intubation, revision of the surgery, or tracheostomy may be necessary.

Child↗
PubMed1980

Theoretical and technical problems in the measurement of nocturnal penile tumescence for the differential diagnosis of impotence.

Theoretical and technical problems in using Nocturnal Penile Tumescence (NPT) measurements for the differential diagnosis of impotence are discussed and possible solutions are offered: 1) The basic assumption that NPT measurements can distinguish psychogenic from organic impotence has never been demonstrated in patients shown to be psychogenically and organically impotent independent of the NPT measurements themselves. Studies attempting to do this are necessary to determine definitively the limits of the clinical applicability of this important diagnostic tool. 2) Evidence is presented showing that though a direct observation of one of the patient's fullest erections is required for an adequate NPT evaluation, this is not always done. The danger of misdiagnosis if this step is omitted is illustrated with a case report. 3) Disagreements in the literature about NPT criteria for diagnosing psychogenic impotence are discussed and criteria are suggested that are based on demonstrating the intactness of the physiological mechanisms required for erection rather than on values recorded in normal subjects.

Anthropometry↗
PubMed1980

Melatonin does not suppress the pituitary luteinizing hormone response to luteinizing hormone-releasing hormone in men.

The effect of an iv melatonin infusion on the pituitary LH response to LHRH was studied in five young men. Melatonin (30 micrograms/min; total dose, 7.2 mg) was infused for a 4-h period, 2 h before and 2 h after a LRH stimulation (single iv 150-microgram dose). Each subject's control response to LRH was obtained previously. During the melatonin infusion, supraphysiological concentrations of melatonin (20 times) were documented using a specific RIA. All five subjects had a LH rise after LRH stimulation, and this response was not affected by the melatonin infusion. These results indicate that an acute constant infusion of a pharmacological amount of melatonin does not suppress LRH-induced LH release from the pituitary in men. In addition, no change in sleepiness and behavior was found.

Adult↗
PubMed1980

Effect of alcohol on sleep and nighttime plasma growth hormone and cortisol concentrations.

The acute and chronic effects of alcohol and alcohol withdrawal on sleep patterns and plasma GH and cortisol fluctuations occurring during sleep were studied. Five healthy men, aged 21-26 yr, consumed a placebo drink for 3 baseline nights, alcohol (0.8 g/kg) for 9 nights, and a placebo drink on final withdrawal night. All-night polygraphic sleep recordings and blood samples (every 20 min with a venous catheter) were collected for 1 placebo, 1 acute alcohol, 1 chronic alcohol (night 9), and 1 alcohol withdrawal night. Acute and chronic alcohol consumption reduced rapid eye movement sleep nonsignificantly during the first half of the night, whereas slow wave sleep (stages 3 and 4) was increased significantly after acute alcohol, returning to baseline values on the chronic alcohol night. On the withdrawal night, rapid eye movement sleep and slow wave sleep were not significantly different from placebo sleep. Alcohol significantly suppressed plasma GH values (70-75%) on acute and chronic nights. All measures of GH, including total integral for bedtime hours, mean hourly rate, and peak level, were similarly affected by alcohol. GH returned to placebo values on the withdrawal night. Measures of nighttime plasma cortisol were not significantly altered by alcohol or alcohol withdrawal at this dose level.

Adult↗
PubMed1980

Timing of REM sleep is coupled to the circadian rhythm of body temperature in man.

Ten male subjects were studied for a total of 306 days on self-selected schedules. Four of them developed bedrest-activity cycle period lengths very different from 24 hr (mean = 36.8 hr) despite the persistence of near-24-hr oscillations in other physiologic functions, including that of body temperature (mean = 24.6 hr). The percentage of sleep time spent in REM sleep varied significantly with the phase of that near-24-hr body temperature cycle. The peak in REM sleep propensity (RSP) occurred on the rising slope of the average body temperature curve, coincident with the phase of peak sleep tendency. This was associated with a significantly increased REM episode duration and shortened REM latency (including sleep-onset REM episodes), but without a significant change in the REM-NREM cycle length. We conclude that there is an endogenous circadian rhythm of REM sleep propensity which is closely coupled to the body temperature rhythm and is capable of free-running with a period different from both 24 hr and the average period of the sleep-wake cycle.

Adult↗
PubMed1980

Timing of REM and stages 3 + 4 sleep during temporal isolation in man.

During nonentrained sleep--wake conditions in man, healthy adult subjects spontaneously develop "long" biological days (greater than 35 hr) in addition to the normal, approximately 25 hr day. The ratio of sleep to total time remains constant (approximately 0.30), with long sleep episodes occurring approximately 180 degrees out of phase with the short sleep episodes. The timing and amount of REM sleep advance to an earlier time within the sleep episode during free-running, whereas stage 3 + 4 sleep is related to the initiation and course of the sleep process itself. The REM--NREM cycle length does not change, comparing entrained and nonentrained conditions. The study of the chronophysiology of humans under nonentrained conditions may serve as a model of the chronopathology of sleep--wake changes which occur in sleep disorders associated with depression, narcolepsy--cataplexy, sleep--wake dyssomnias, delayed sleep phase insomnia, and aging.

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↗