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Biomedical subjects

J F Sassin

Publications and source records attributed to J F Sassin.

At least 19 recordsLinked to original sources
PubMed1988

Sleep apnea and sleep-related periodic leg movements in community resident seniors.

The elderly have a high incidence of sleep complaints. A high incidence of sleep apnea (SA) and sleep-related periodic leg movements (PLMs) is also suspected. The relationship between the incidence and severity of SA and PLMs and sleep complaints has not, however, been determined in terms of symptomatology and physiologic abnormality. In a group of 46 community resident seniors (60 to 95 years old), the incidence of SA and PLMs was correlated with subjective sleep-wake complaints. Sixty-one percent of subjects had SA and/or PLMs. Apneas/hypopneas were associated with an average oxygen desaturation of less than 5% and an average change in heart rate of less than 10 beats per minute. While subjects with SA or PLMs had clear evidence of objective sleep disturbance, only one quarter of them admitted to any subjective sleep complaints or daytime sleepiness. Furthermore, severity of SA or PLMs failed to predict sleep-wake complaints, and vice versa. This study confirms that typically mild SA and PLMs are widespread in the elderly but tend not to be manifested in sleep-wake complaints and probably go untreated as a result. Further research is needed to determine any long-term medical significance.

Aged↗
PubMed1987

A historical perspective on sleep disorders medicine.

The recent development of sleep disorders medicine traces its origins to the increased understanding of basic human sleep physiology gained over the past 30 years. The primary tool for diagnosis and management is the long-term polygraphic recording of multiple physiologic variables (polysomnography). A "style" of practice is emerging that is multidisciplinary and often institutionally-based in sleep disorders centers. High patient and physician satisfaction in this field indicate that rapid growth will continue.

History of Medicine↗
PubMed1984

Nocturnal REM latency and sleep disturbance in narcolepsy.

A retrospective study of 92 narcoleptics was undertaken to investigate the significance of prolonged nocturnal REM latencies observed in approximately one in every five narcoleptics undergoing single all-night clinical polysomnograms in our laboratory. Clinical and laboratory findings were examined as a function of REM latency. Our findings emphasize a high incidence of other sleep disorders, particularly sleep-related periodic leg movements, in narcoleptics. Furthermore, sleep disturbance secondary to other sleep disorders, especially during the period of NREM sleep preceding the first REM episode, accounts in large part for prolonged REM latencies observed in some narcoleptics. This study also provides one of the most extensive compilations of clinical and laboratory findings in a large population of narcoleptics.

Adolescent↗
PubMed1984

Middle latency auditory evoked potentials in sleep apneics during waking and as a function of arterial oxygen saturation during apneas.

In adults with obstructive sleep apnea middle latency auditory evoked responses were recorded as a function of apnea-related arterial oxygen desaturation both before sleep onset and during nocturnal sleep. In waking, wave Pa latency was normal in five of six subjects, and Pa amplitude was normal in all. During sleep apneas, wave Pa remained stable even during intervals of severe oxygen desaturation (e.g., 45-90% and 50-84% saturation in two subjects). Furthermore, wave Pa recorded immediately on awakening in the morning was unaltered compared with the response recorded just prior to sleep onset, despite a high frequency of nocturnal apneas in all subjects. These data indicate that repetitive nocturnal oxygen desaturation associated with severe obstructive sleep apnea syndrome has neither immediate nor cumulative measureable effects on the functioning of neurons that subserve the middle latency evoked response. These findings are discussed in relation to a possible cortical contribution to the middle latency response.

Adult↗
PubMed1984

Disorders of sleep and wakefulness.

This article provides information on the background and development of "sleep disorders medicine" and sleep disorders centers and a discussion of obstructive sleep apnea, narcolepsy, sleep-related periodic leg movements, and the use and misuse of hypnotic medication.

Humans↗
PubMed1983

Surgical treatment of sleep apnea.

Contemporary surgical techniques and the preoperative and postoperative treatment of patients with this condition were analyzed, based on surgical treatment of 51 cases of obstructive sleep apnea syndrome (OSAS) and review of the relevant literature. The results indicate the permanent tracheostomy remains the established and highly successful method of treatment of carefully chosen patients with OSAS. Palatopharyngoplasty may also prove useful in treating certain select cases of OSAS, although careful analysis of a large number of successful cases followed up over an extended period of time will be needed. The development of new, effective surgical procedures in the treatment of OSAS depends on a complete understanding of the mechanisms involved in each individual airway obstruction.

Adult↗
PubMed1983

The 24-hour rhythm of core temperature in narcolepsy.

A circadian rhythm disturbance in narcolepsy has been postulated. To investigate this issue, the 24-h pattern of rectal temperature variation was monitored under entrained conditions in narcoleptics selected on the basis of documented sleep-onset REM episode(s). The 24-h temperature mesor of narcoleptics was elevated in comparison with control subjects. This is attributable to higher nocturnal temperatures, perhaps related to increased sleep disturbance. The actual recorded temperature minimum in narcoleptics appeared 1 h after sleep onset, independent of the occurrence of sleep-onset REM, compared with 4-5 h after sleep onset in control subjects. In contrast, the results of cosinor analyses indicated that the estimated temperature nadir is phase-advanced in those narcoleptics who exhibited sleep-onset REM during the 24-h temperature study compared with those without sleep-onset REM. An early nocturnal temperature minimum in narcolepsy is consistent with recent reports that the latency to the appearance of REM sleep in normals varies as a function of the phase of the circadian temperature rhythm when sleep onset occurs.

Adult↗
PubMed1983

Flow-volume curves reflect pharyngeal airway abnormalities in sleep apnea syndrome.

Twenty-nine patients with disorders of excessive somnolence were evaluated with standard nocturnal polysomnography, fiberoptic laryngoscopy, and flow-volume curves. Twenty-two had evidence of obstructive sleep apnea (OSA) by polysomnography and most had abnormal flow-volume curves, supporting earlier observations. Three of 7 patients without obstructive sleep apnea also had abnormal curves. Fiberoptic nasopharyngoscopy was performed in the OSA group while awake to evaluate the upper airway. Sixteen patients of the OSA group demonstrated pharyngeal obstruction; 14 of those with visualized airway obstruction had flow-volume abnormalities. In the 6 patients of the OSA group with no significant visual obstruction, 5 had normal curves. The flow-volume curve appears to correlate with direct visual assessment of upper airway patency during wakefulness in those patients demonstrating obstruction during sleep.

Adult↗
PubMed1982

Sleep-stage-dependent Cheyne-Stokes respiration after cerebral infarct: a case study.

Polysomnographic studies of nocturnal sleep were performed on a 63-year-old women. Sleep-onset and sleep-maintenance insomnia dated back to a cerebral infarction at age 53, which resulted in bilateral cerebral injury. Two patterns of respiration were observed, and both were sleep-stage-dependent. Classic Cheyne-Stokes respiration predominated during slow-wave sleep and stages 1 and 2. REM sleep, in contrast, was associated almost exclusively with normal respiration. Recurrent brief arousals, temporally linked to the Cheyne-Stokes pattern of respiration, markedly disturbed sleep stages 1 and 2 and appeared related to the patient's subjective sleep complaints. During waking, REM, and NREM sleep, respiration is known to have different sensitivity to CNS and peripheral controls. The selective association of Cheyne-Stokes respiration with NREM sleep in this patient supports the view that anatomically separate CNS mechanisms regulate respiration in REM and NREM sleep.

Cerebral Infarction↗
PubMed1981

Normal brain stem auditory evoked potentials recorded in sleep apneics during waking and as a function of arterial oxygen saturation during sleep.

Brain stem auditory evoked potentials (BAEPs) can be utilized as an index of neuronal dysfunction at the level of the brain stem. These waves are known to be independent of level of arousal. In the present study, BAEPs (waves I-V) to monaural click stimulation were recorded during daytime waking and as a function of arterial oxygen saturation during nocturnal sleep in 6 subjects with obstructive sleep apnea syndrome. Normal conduction times were recorded in all 6 subjects during daytime waking. In addition, BAEPs remained stable in every case during sleep-related apneas when averaged over intervals of arterial oxygen saturation as low as 45-70% in one subject. Our data indicate that (1) the repetitive oxygen desaturation experienced during sleep in apneics had neither acute nor chronic, measurable effects on neurons which subserve the BAEP, and (2) a brain stem abnormality involving the structures which subserve the BAEP does not underly obstructive sleep apnea.

Adolescent↗
PubMed1980

Impaired sexual maturation associated with sleep apnea syndrome during puberty: a case study.

A 20-year-old hypogonadal man was discovered to have had obstructive sleep apnea syndrome--secondary to hypertrophied tonsils, adenoids, and uvula--spanning the years of puberty. All-night polysomnographic recordings and 24 hr measurements of plasma luteinizing hormone (LH) concentrations (sampling at 20 min intervals) were performed before and after combined tonsillectomy, adenoidectomy, and uvulectomy. Two weeks preoperatively, nocturnal sleep was markedly disturbed by 407 apneic episodes, and the patient was found to be hypogonadotropic. Daytime LH concentrations were in the low-normal range for an adult male, and concentrations fell dramatically during nocturnal sleep. This contrasts with both the sleep-related elevation of LH normally seen in puberty and the adult pattern, where no difference is observed in mean concentrations during waking and sleep. Two week and 6 month postoperative evaluations revealed complete alleviation of the sleep apnea syndrome and normalization of the 24 hr pattern of plasma LH, although LH values remained in the low-normal range. Plasma testosterone concentrations were in the low to low-normal range both pre- and postoperatively. No evidence of continued sexual development, beyond that achieved preoperatively, was observed 20 months after surgery, despite continued relief from apnea. These data suggest that sleep apnea during puberty may impair sexual development by preventing the sleep-related elevation in LH secretion normally observed during a critical period spanning puberty.

Adenoidectomy↗
PubMed1975

Growth hormone effects on sleep and wakefulness in the rat.

The sleep-wakefulness pattern and brain protein levels were determined in rats for 3 h following these conditions: administration of an inhibitor of protein synthesis (anisomycin), administration of several doses of rat growth hormone (GH) or thyrotropin, and administration of a combination of anisomycin + GH or thyrotropin. Anisomycin inhibited sleep and increased wakefulness, GH increased REM sleep, and thyrotropin produced no change. The combined administration of GH and anisomycin returned sleep to control levels. Anisomycin produced a time-dependent decrease in brain protein levels, GH produced changes in brain protein levels as compared to controls in the second hour only, and thyrotropin had no effect upon brain protein levels. The results are discussed in terms of the possible relationship between sleep and proteins.

Animals↗
PubMed1975

Altered growth of hormone secretory pattern following prolonged sleep deprivation in the rhesus monkey.

Plasma concentrations of growth hormone (GH) were determined in samples obtained sequentially at 15-min intervals during the last 4 h in monkeys deprived of sleep for 76 h and the first 8 h of ensuing recovery sleep. Electroencephalographic (EEG), electro-oculographic (EOG), and electromyographic (EMG) activities were recorded. Stages 3-4 sleep occurred rapidly after sleep onset and were of long duration. Plasma GH secretion was markedly elevated during sleep recovery, without apparent relationship to stage of sleep.

Animals↗
PubMed1975

Seasonal patterns of sleep stages and secretion of cortisol and growth hormone during 24 hour periods in northern Norway.

A group of 7 healthy male subjects was studied in regard to sleep stages and 24 h plasma cortisol and growth hormone patterns during the 4 seasons of the year in an Arctic environment (Tromsø, Norway). No difference in total sleep or sleep stage per cents was found for any of the yearly seasons. A small but statistical significant increase in mean plasma cortisol concentration and amount secreted for 24 h was found for the autumn-winter seasons, as compared with the spring and summer. However, no difference in the circadian curve of cortisol hormonal pattern was found. All subjects secreted growth hormone shortly after sleep onset at night and no difference was found as a function of season of the year.

Adult↗
PubMed1975

Drug-induced dyskinesia in monkeys.

Easily definable dyskinetic syndromes have been produced by injection of L-DOPA, apomorphine, trivastal, carbachol, sodium azide, tetrahydrocannabinol, phenothiazines, and amphetamines into one or more sites. Three species of monkeys have been used: rhesus, green, and squirrel. The descriptive information available on each of these dyskinetic syndromes indicates a striking degree of similarity among the effects of these various drugs and combinations of drugs. The behavior patterns produced can be roughly divided into three areas: (1) increased movement (hyperkinesia) and vigilance, determined at least in part by the area in which the animal is confined; (2) a wide range of adventitious movements of extremities, as well as face and tongue; and (3) "stereotypic" behavior, sometimes destructive, such as grooming, biting, and drinking. None of the above studies or models has been employed in monkeys free-ranging in open areas with other animals. It might be expected that the effects of the drugs would be somewhat already by the social setting of the animal. It now seems adequately confirmed that the production of dyskinesia in monkeys is biochemically related to dopaminergic systems in the neostriatum. The evidence at present also points to a form of denervation hypersensitivity as the basis for the production of these syndromes in patients with dyskinesias on L-DOPA therapy (Chase, Holden, and Brody, 1972), although it is clear that in relatively high doses these drugs regularly produce dyskinesias in primates having no anatomical or biochemical pathology in the nervous system. These drug-induced dyskinesias in monkeys, especially those produced by L-DOPA in combination with other drugs or with anatomical and biochemical stereotaxically placed lesions, appear to be developed to a degree to be useful in the further evaluation of the mechanisms of dyskinesias in humans as well as providing methods of testing the effectiveness of various forms of therapy.

Amphetamine↗