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Biomedical subjects

J Sicklesteel

Publications and source records attributed to J Sicklesteel.

14 recordsLinked to original sources
PubMed1987

Sedative effects of antihistamines.

The central effects of a newly developed, long-acting H1 antihistamine, loratadine (10 and 40 mg), were compared with those of a standard H1 antihistamine, diphenhydramine (50 mg three times a day) with measures of performance and daytime sleepiness (multiple sleep latency test). Sixteen healthy adults (six women and 10 men), 19 to 35 years of age, received each of the drugs and placebo for 2 days, separated by 5 days at home. Each day, the drug or placebo was administered at 8 A.M. and 12 and 4 P.M. Diphenhydramine was administered in three equal doses (50 mg), and loratadine was administered in a single dose followed by two placebo doses. Mean latency to sleep on tests done at 9 and 11 A.M. and 1, 3, and 5 P.M. was reduced significantly with diphenhydramine compared to placebo, whereas neither loratadine dose reduced sleep latency. Performance measured at 9:30 P.M. and 1:30 P.M. with a battery of tests, including reaction time, vigilance, digit symbol substitution, and symbol copying tasks demonstrated a significant reduction in symbols copied and digits substituted after diphenhydramine compared to both loratadine doses. These results demonstrate that loratadine (10 and 40 mg doses) did not have clinically significant central nervous system activity, whereas diphenhydramine increases sleepiness and disrupts performance efficiency.

Adult↗
PubMed1986

Sleep-wake abnormalities in narcolepsy.

To evaluate the degree to which sleep (REM vs. NREM) intrudes into wake and wake intrudes into sleep in narcolepsy, 103 patients with narcolepsy were compared to 105 patients with other diagnoses of disorders of excessive sleep (DOES). Narcoleptic patients had more frequent REM onsets on the multiple sleep latency test (MSLT) and nocturnal polysomnograms. But the MSLT latencies to REM versus NREM in narcoleptic patients did not differ. Nocturnal measures of REM pressure, percentage of REM, and REM latency excluding the REM onsets, did not differ among patient groups. With respect to the intrusion of wake into sleep, narcoleptic patients had more and longer awakenings compared with other DOES patients, but the distribution of wake into REM and NREM sleep did not differ among groups. These data suggest that narcolepsy is not exclusively a REM-related disorder, but involves an inability to sustain a specific neural state for periods comparable to those in normal subjects or other DOES patients.

Adult↗
PubMed1986

Alerting effects of naps in patients with narcolepsy.

As part of their standard diagnostic evaluation, 45 patients with narcolepsy and 45 patients with other disorders of excessive sleepiness (DOES), primarily obstructive sleep apnea, each underwent one of three nap conditions that involved manipulating time in bed on the 1600 h latency test of the standard multiple sleep latency test (MSLT) and varying the time between the 1600-h latency test and a subsequent fifth latency test. Compared with the mean of tests 1-4, a 15-min nap at 1600 h (condition 1) increased latency to stage 1 sleep on a latency test 15 min later in both groups. However, the increase was greater for patients with narcolepsy than with other DOES. A 30-min nap at 1600 h (condition 2) produced increased latency 15 min later, but the increase was greater for patients with other DOES. While narcoleptic patients showed no change in latency as a function of increased nap duration, the other DOES patients had increased latencies. When tested 30 min after a 15-min nap (condition 3), narcoleptic patients had latencies that did not differ from those of tests 1-4, while the other DOES patients sustained their increased latencies.

Adult↗
PubMed1985

Sleep-wake complaints in patients with sleep-related respiratory disturbances.

The relation of sleep complaint to sleep continuity and respiratory disturbance was studied by comparing 2 series of patients with sleep apnea, one group complaining of insomnia and the other of excessive daytime sleepiness. On polysomnographic evaluation, patients with insomnia complaints had fewer and shorter, primarily central, apneas that had little hypoxemic effects. Patients with excessive sleepiness complaints had more and longer, primarily obstructive, apneas that produced significant hypoxemia. Sleep of the excessively sleepy patients was lighter and longer, whereas that of the patients with insomnia was characterized by more wake time before and after sleep onset. The excessively sleepy patients were objectively sleepy on a test of daytime sleepiness, whereas patients with insomnia were alert.

Adult↗
PubMed1985

Uvulopalatopharyngoplasty. One-year followup.

Uvulopalatopharyngoplasty (UPPP), originally evaluated in 66 patients with objectively documented sleep apnea syndrome, was successful in 33 of the patients as indicated by clinical and polysomnographic improvements. One-year followup polysomnographic evaluations were obtained in 20 of these patients; the remaining 13 were lost to followup. After one year, the patients maintained the improvements seen at the six-week evaluation. Frequency and duration of apnea was significantly reduced from presurgery levels and similar to the six-week results. Oxygenation measures also did not differ from the six-week results, remaining better than presurgery values. Thus, respiration did not disrupt sleep to the degree it had before surgery. Sleep measures were improved compared to presurgery and similar to the six-week data. Body weight remained stable over the entire period.

Female↗
PubMed1984

Periodic movements during sleep, sleep fragmentation, and sleep-wake complaints.

To better understand the relation of sleep complaint to sleep continuity and periodic movements during sleep (PMS), two groups of patients were studied retrospectively. One group of 51 patients, 26 men and 25 women, with a mean age of 56.4 years, complained of insomnia. The other group of 29 patients, 20 men and nine women, with a mean age of 55.8 years, complained of excessive daytime sleepiness. Sleepy patients differed significantly from insomnia patients in that they fell asleep faster and slept longer. They showed more frequent arousals (shifts to stage 1 sleep and number of awakenings) than insomnia patients who had longer arousals (mean duration of awakenings). Insomnia patients had more series of PMS, but sleepy patients had more PMS bursts per series.

Arousal↗
PubMed1983

Excessive daytime sleepiness associated with insufficient sleep.

Chronic insufficient sleep as an identifiable cause of excessive daytime sleepiness was investigated post hoc by comparing a series of patients with this diagnosis with patients with narcolepsy. Among the prominent features differentiating patients with insufficient sleep from patients with narcolepsy was the report, obtained on the sleep history, of a disparity between the reported amount of sleep obtained on weekdays versus weekends. On evaluation in the laboratory, patients with insufficient sleep showed atypically high sleep efficiency at night and a prolonged sleep time (longer than they report sleeping on a weekday night at home). Compared with patients with narcolepsy, they show a somewhat elevated percentage of stage 3-4 and REM sleep, although this is probably not higher than that of age-matched controls. On the Multiple Sleep Latency Test they displayed moderate sleepiness and no sleep onset REM periods. A mental status examination and Minnesota Multiphasic Personality Inventory did not suggest a primary psychiatric disorder.

Adult↗
PubMed1983

Age-related sleep-wake disorders at a sleep disorder center.

The specific sleep disorders of 97 patients 61-81 years old were compared with those of 264 middle-aged (41-60 years old) and 202 young (20-40 years old) patients. Sleep disorder diagnoses were made according to the Diagnostic Classification of the Association of Sleep Disorders Centers based on evaluations consisting of mental and physical examinations and all-night sleep recordings. Most young and middle-aged patients complained of excessive daytime sleepiness; the elderly complained of insomnia as often as excessive daytime sleepiness. The evaluations revealed objective findings in 93 per cent of the elderly, but only 77 per cent of younger patients. Nocturnal myoclonus or restless leg syndrome was the diagnosed cause of 23 per cent of elderly patients' sleep-wake problems, but only 11 per cent of middle-aged and 4 per cent of young patients had this problem. Respiratory disorders of sleep were found in 27 per cent of elderly, 35 per cent of middle-aged, and 20 per cent of young patients. Elderly patients (6 per cent) had psychiatric disorders diagnosed as the causes for their problems less frequently than did younger patients (22 per cent).

Adult↗
PubMed1983

Narcolepsy and disturbed nocturnal sleep.

Disturbed nocturnal sleep is considered a symptom of narcolepsy. Polysomnographic recordings of 57 consecutive narcoleptic patients were reviewed for evidence of disturbed sleep. When disrupted sleep was present, it was attributable to recognized sleep disorders: nocturnal myoclonus and sleep apnea. Comparison of standard polysomnographically derived parameters of patients who had narcolepsy without sleep apnea or nocturnal myoclonus with those of a normal control group, showed no evidence of disturbed sleep in the patient population. The narcoleptics that also had nocturnal myoclonus or upper airway sleep apnea did have disturbed sleep in comparison with the normals. Our data suggest disturbed sleep tends to develop in narcolpetic patients with age, but is not an inherent element of the narcolepsy syndrome.

Adult↗
PubMed1982

[Effects of the chronic administration of triazolam 0.50 mg on the sleep of insomniacs].

Several studies have been conducted in view to evaluate the short and medium-term efficacy of triazolam. The present investigation was aimed at assessing its long-term effectiveness. Four female and six male (average age: 29.9 years +/- 9.6) insomniacs took part in this study. After selection of the subjects, they are kept under observation in the sleep laboratory during two consecutive nights per week for ten weeks, during which they were given a placebo on weeks 1, 8, 9 and 10 and triazolam 0.50 mg on weeks 2 to 7. Triazolam proved to be an effective hypnotic during the six weeks of treatment, with no withdrawal effects upon discontinuation.

Adult↗
PubMed1982

Flurazepam for short-term treatment of complaints of insomnia.

The short-term hypnotic efficacy of 15 mg flurazepam was evaluated in nine patients (mean age 37.2 +/- 15.9 years) who complained of insomnia and had polysomnographic evidence of disturbed sleep. Patients slept in the laboratory 14 consecutive nights, and their sleep was monitored using standard polysomnographic procedures. Prior to bedtime, they received a placebo the first four nights, 15 mg flurazepam on nights 5 through 11, and a placebo again on nights 12 through 14. Flurazepam significantly increased total sleep time while reducing the latency to stage 1 sleep, the number of awakenings in the night, and the amount of wakefulness after sleep onset. Sleep stage patterns also were altered significantly with flurazepam: percentage stage 2 sleep increased, and percentages of 3-4 sleep and REM sleep (on drug night 1 and nights 1-3) decreased. With the exception of REM sleep, most of these drug effects were first detected on the second night of administration, did not diminish over the next six nights, and persisted during the three-day withdrawal period. Subjective evaluations of sleep generally corresponded with the polysomnographic data. It was concluded that 15 mg flurazepam has significant hypnotic properties with minimal adverse side effects.

Adult↗