Biomedical subjects

H Lemmi

Publications and source records attributed to H Lemmi.

At least 19 recordsLinked to original sources

PubMed1994

Gender differences dominate sleep disorder patients' body problem complaints.

We studied it age, gender, diagnostic status, and psychiatric features affected 291 consecutive sleep disorder patient's body complaints on a brief checklist. Gender had a strong impact on all four (tested) dependent measures, with women reporting more distress than men. Age produced significant regressions on two measures, with younger patients complaining more than older. Presence of psychiatric features was associated with more complaints on one dependent measure--previously found to reflect internal medicine patients' emotional distress. The results of regression analyses were largely supported by follow-up ANOVAs. However, contrasting insomniac versus hypersomniac versus all other sleep disorder diagnoses did not affect body complaints on any dependent measure. The results caution against combining males and females to compare self-reported distress between sleep disorders.

Adolescent↗

PubMed1991

Narcolepsy in childhood and adolescence.

The objective of this study was to evaluate clinical, polysomnographic and the multiple sleep latency test (MSLT) features in young narcoleptics. We evaluated 14 patients with mean age of 13.6 years old (ranging from 6 to 18 years); 11 were males and 3 females. Daytime sleepiness was the main complaint in all cases and started at the ages of 6 to 17 years. Cataplexy was described in 10 cases and it was considered mild to moderate in all but one case. Sleep paralysis was present in 6 cases and hypnagogic hallucinations in 7 cases. The main polysomnographic characteristics were the short sleep latency in 9 cases and the sudden onset of REM periods in 7 cases. The MSLT showed short or borderline sleep latencies in 13 cases, with a mean of 4.9 min; 2 or more REM periods were present in 13 cases. Clinical, polysomnographic and MSLT characteristics in the age bracket focused were remarkably similar to those of adult narcoleptics suggesting the stability of these physiopathological markers.

Adolescent↗

PubMed1991

Polysomnography in idiopathic muscle pain syndrome (fibrositis).

Muscle pain occurs in various neuromuscular disorders with characteristic physiological or biochemical abnormalities. There is, however, a group of patients in whom there is no clear physiological or structural basis for their pains. This syndrome has been called fibrositis or fibromyalgia. Sleep abnormalities have been reported in some of these patients, but have not been confirmed by others. We studied 8 patients with this disorder and found sleep abnormalities that were characterized by nocturnal myoclonus, alpha-delta sleep, and abnormalities compatible with depression. Polysomnography was, therefore, instrumental in helping direct the treatment of these patients. Therapeutic approaches aimed to correct the specific disorders were effective in improving the pain symptoms.

Alprazolam↗

PubMed1989

NCPAP for the treatment of obstructive sleep apnea.

Nasal continuous positive airway pressure (NCPAP) represents a real advance in the management of obstructive sleep apnea (OSA). Our data show that except for awakenings, all sleep and respiratory parameters were significantly improved (p less than 0.05) in favor of the group treated with NCPAP. A main problem with NCPAP is the acceptance by the patient; it also may disturb the sleep, at least, on short term basis and, in a small number of patients, it does not correct the apneas. In our patients series, males responded better to NCPAP than females.

Adult↗

PubMed1986

Obstructive sleep apnea treated with uvulopalatopharyngoplasty: a systematic follow-up study.

We evaluated ten consecutive cases of obstructive sleep apnea treated with uvulopalatopharyngoplasty (UPPP). The preoperative all-night polysomnograms were compared to those done one to three months after surgery. Excessive daytime sleepiness, the main complaint of every patient, partially improved in three and was completely abolished in seven. The lowest oxygen saturation levels were below 80% in nine cases before UPPP and in only three afterward. The number of apneic episodes per hour of sleep, or apnea index, decreased in every patient and reached normal levels in five. Improvement of other sleep indices was not statistically detectable and may require large numbers of patients and longer follow-up for documentation.

Adult↗

PubMed1986

[The role of gastroplasty in the treatment of obstructive sleep apnea].

Four male obese patients with obstructive sleep apnea were evaluated by polysomnography, both prior and 3-4 months following gastroplasty. The surgery was performed as an alternative weight loss treatment. These patients were selected for gastroplasty because they had severe obesity, obstructive sleep apnea with cardiopulmonary impairment and noncompliance on a weight loss diet. Tracheostomy was performed concomitantly in three cases. Preoperative recording demonstrated 21.2 to 100.3 apneas per hour of sleep; stage 3 was decreased in three and absent in one case; stage 4 was absent in every patient; stage REM was decreased in three cases; arterial oxygen saturation (SaO2) was below 80% in every case during apneas. Follow-up recordings with occluded tracheostomy were obtained 3-4 months after surgery. The weight reduction varied from 16.3 to 41.4% of the initial weight. The recording documented normal sleep apnea indices in three cases and partial recovery in the remainder; increase in stages 3, 4 and REM; normal SaO2 in three out of 4 cases. These findings suggest that gastroplasty may be used as an alternative treatment for weight reduction in selected OSA patients.

Adult↗

PubMed1986

[Concomitant narcolepsy and sleep apnea: report of a case].

A case of concomitant narcolepsy and obstructive sleep apnea evaluated in a sleep disorder center is reported. Tracheostomy decreased the frequency of the apneas but the clinical and polysomnographic features of narcolepsy remained on 3 and 6 months post-surgical follow-ups. These findings support the need for systematic use of all-night polysomnography and multiple sleep latency test in patients with excessive daytime sleepiness.

Adult↗

PubMed1986

[Density of rapid eye movements during active sleep in preterm newborn infants].

Rapid eye movement (REM) density has been helpful as a reliable index of phasic eye movements activity during REM (active) sleep in adults. We evaluated this index in 28 newborns, at 34 to 39 weeks of conceptional age (CA). The 5 hours polysomnographic recording during sleep included electroencephalogram, electrooculogram, electrocardiogram, pneumogram, nasal thermistor for detecting airflow, and continuous oxygen saturation (tcPO2) monitoring. REM density was measured by two distinct criteria: REM density as the duration of phasic eye movements in relation to REM periods (REMP). Such index varied from 10.6 to 14.1% and was higher in the 36-37 weeks CA group. REM density was calculated as a percentage of 10-second epochs of REM sleep in which phasic eye movements occurred. This criterion confirmed the narrow range of such index in this age bracket (39.9-44.6%), was higher in the first REMP and in the 36-37 weeks CA group. Our data suggest that REM density is a consistent phasic REM sleep feature in preterm newborns with levels close to the adult population, in spite of the gradual decrease of REM sleep duration with age. Higher indices were also found in the first REMP and in the 36-37 weeks CA group by both methods.

Female↗

PubMed1985

The nosologic status of borderline personality: clinical and polysomnographic study.

The REM latencies of 24 nonschizotypal borderline outpatients--who were not in the midst of a major depressive episode--were in the range of those of 30 patients with primary major depression but were significantly shorter than those of 16 patients with nonborderline personality disorders and 14 nonpsychiatric controls. Also, more of the borderline subjects had lifetime diagnoses of affective disorder, such as dysthymic, cyclothymic, and bipolar II disorder, and of a spectrum of anxiety and somatization disorders. The authors conclude that contemporary operational criteria for borderline disorder identify a wide net of temperamental disorders with strong affective coloring rather than a unitary nosologic entity.

Adult↗

PubMed1985

[Jactatio capitis nocturnus: report of a case in an adult].

A case of an adult female patient with jactatio capitis nocturnus evaluated in a sleep disorders center is reported. the unusual characteristics included symptoms initiating in early childhood and becoming more frequent with age, specifically observed during REM sleep. The occurrence in a 2-year-old son indicates the familial aspects of this syndrome.

Adult↗

PubMed1985

[Obstructive apnea during sleep: clinical and polygraphic evaluation of 150 cases].

Obstructive sleep apnea is one of the most common causes of excessive daytime sleepiness. In our sample, clinical evaluation generally suggested this diagnosis by daytime sleepiness (90.6%) and loud snoring (92.0%). Respiratory pauses and inspiratory gasps were frequently reported (12.6%). The age of presentation was after the fourth decade in 87.2%. Polysomnography was characterized by numerous obstructive or mixed apneas, with mean apnea index 37.1; frequent arousals following the apneas; reduction or abscence of stages 3 and 4; reduction of sleep efficiency; hypoxemia and EEG arrhythmias during the respiratory pauses. Tracheostomy was performed in 45 cases, uveopalatopharyngoplasty in 43 and both surgeries in 5, as treatment of choice.

Adolescent↗

PubMed1985

[Narcolepsy and sudden onset of REM periods after nocturnal awakenings].

The objective of this study was to evaluate polysomnographic data, and especially the sudden onset of REM periods that occur after spontaneous awakenings during the night as characteristics of narcolepsy. We evaluated 148 consecutive patients with excessive daytime somnolence, except for those with sleep apnea. After clinical evaluation, all-night polysomnographic recording and multiple sleep latency test, 55 were diagnosed as narcoleptics and 93 were grouped as non-narcoleptics. The mean age of narcoleptics was 42.9 +/- 14.4 years old and the non-narcoleptics were 40.3 +/- 13.5 years old. Polysomnographic variables were compared between both samples using unpaired t test. Non-significant differences were found for: sex; total time in bed; total sleep time; time in stages 3, 4 and REM; number of arousals (less than 30 sec); number of body movements; REM density. The following significant differences were found: number of sleep onset REM periods during the night was higher for narcoleptics (p less than 0.001); total sleep time was lower for narcoleptics (p = 0.02); sleep latency was shorter for narcoleptics (p less than 0.001); REM latency to stage 1 was shorter for narcoleptics (p less than 0.001); time in stage 1 was higher for narcoleptics (p less than 0.001); time in stage 2 was lower for narcoleptics (p less than 0.001); number of full awakenings (greater than 30 sec) was higher for narcoleptics (p less than 0.001); number of awakenings longer than 5 minutes was higher for narcoleptics (p = 0.002). In conclusion, there were marked differences in the sleep architecture between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1985

[Polysomnographic follow-up of sleep apneas after uvulopalatopharyngoplasty].

Uvulopalatopharyngoplasty (UPPP) was performed in 12 patients with obstructive sleep apnea. Pre-surgical clinical and polysomnographic data were compared with those one to three months after surgery. Excessive daytime sleepiness was partially improved in 4 cases and completely abolished in 8. Total sleep time, sleep efficiency, number of arousals and sleep latency were similar in both evaluations. REM latency to stage 2 markedly increased on the follow-up. Stage distributions were similar in both nights except for stage 4 which was more frequently absent on the first recording. SaO2 levels below 80% were seen in 10 cases before UPPP and in 4 after it. Apnea index decreased in all cases but it reached normal levels only in 4.

Adult↗

PubMed1985

[Excessive daytime sleepiness, central type sleep apnea and myotonic dystrophy].

Two cases of myotonic dystrophy with excessive daytime somnolence are described. All-night polysomnographic studies were performed revealing high number of central sleep apnea which triggered micro-arousals and awakenings leading to decrease of sleep efficiency as well as of stage 3, 4 and REM. Obstructive and mixed apneas were found in the normal range. Hypoxia was not present in both recordings. Central sleep apneas and its secondary excessive daytime sleepiness may indicate early signs of the central nervous system impairment related to myotonic dystrophy, as a multi-organ disease.

Disorders of Excessive Somnolence↗

PubMed1984

Chronic depressions. Part 2. Sleep EEG differentiation of primary dysthymic disorders from anxious depressions.

In this clinical, psychometric and polysomnographic study, primary dysthymics (N = 20) were compared with anxious depressives (N = 22), and non-psychiatric controls (N = 11). Beck and MMPI depression scores were similar in the two affective groups. Prominent insomnia occurred in 82% of the anxious group; hypersomnia was more characteristic of the dysthymic group. On night 1, the anxious group had the poorest sleep efficiency (P less than 0.001), while dysthymics had the highest REM% (P less than 0.05) and shortest REM latency (P less than 0.01). On night 2, differences tended to be minimized, although the number of awakenings was still high (P less than 0.05) in the anxious group, and REM% was highest (P less than 0.01) and REM latency shortest (P less than 0.01) in the dysthymics. These findings suggest that patients with primary anxiety disorders experience greater sleep continuity difficulties on the adaptation night. Despite significant clinical overlap in depressive symptomatology between the two groups, REM% and REM latency appear as sturdy psychophysiological markers in differentiating primary dysthymics and anxious depressives on both nights. These data suggest that distinct anxious depressive and subaffective dysthymic subtypes can be distinguished within the universe of the atypical depressions.

Adult↗

PubMed1984

Spinocerebellar degeneration and slow saccades in three generations of a kinship: clinical and electrophysiologic findings.

Four members of a family with spinocerebellar degeneration and slow saccadic eye movements are described. Detailed electrophysiological studies revealed abnormalities of neurological pathways not apparent clinically. The patients had slow saccades as measured electrophysiologically, as well as absence of rapid eye movements (REM) despite REM stages of sleep. These studies suggest that although saccadic eye movement and REM are mediated through the pontine paramedian reticular formation, other characteristics of REM sleep are not necessarily mediated through the same neurons.

Adult↗

PubMed1984

[Polygraphic aspects of periodic movements in sleep].

One hundred patients were analyzed sequentially regarding to the presence of periodic movements in sleep (PMS) or nocturnal myoclonus. The criteria for considering PMS was the presence of 5 or more myoclonic movements per hour of sleep. The 18 patients included in the PMS category were compared with the remaining 82. Those with PMS had tendency to be older than the others. The movements were observed in stage 2 and less commonly in stages 3, 1, 4 and REM. Patients with PMS had generally higher number of arousals and K complexes. There was no difference between both groups regarding sex, history complaints, sleep efficiency, total sleep time, time in each stage and final diagnosis.

Adult↗

PubMed1983

Clinical, neuroendocrine, and sleep EEG diagnosis of "unusual" affective presentations: a practical review.

Numerous biologic measures are in the process of being developed for clinical use in psychiatry. It was the aim of this review to focus primarily on the practical usefulness of the DST and REM latency tests, the two most extensively researched of these new techniques. We believe that the emerging laboratory technology, if interpreted in the context of clinical findings, may assist in differential diagnostic decisions on difficult boundary issues surrounding affective disorders. As with other tests in medicine, to expect pathognomonic performance from the emerging laboratory technology in psychiatry would be unrealistic. No doubt, increasing knowledge will somewhat dampen the initial enthusiasm with which the DST and REM latency tests were accepted by many researchers and clinicians. On the other hand it is useful to remind skeptics that these tests have already made an impact on psychiatric ideology, research, and clinical practice, and appear to be with use to stay.

Adult↗