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Biomedical subjects

P J Hauri

Publications and source records attributed to P J Hauri.

8 recordsLinked to original sources
PubMed1992

Wrist actigraphy in insomnia.

To assess the use of actigraphy in evaluating insomnia, 36 patients with a serious complaint of insomnia slept 3 nights each in the laboratory, where the usual polysomnograms (PSGs) were obtained as well as actigraphic assessments of their sleep. Patients also wore actigraphs for 7 days at home, were extensively interviewed and filled out psychometric tests. Based on all this information, the patients were then diagnosed according to the International Classification of Sleep Disorders. Averaged over the 3 nights for each insomniac, the mean discrepancy between actigram and PSG was 49 minutes per night. In three-fourths of the cases, actigram and PSG agreed to within 1 hour on the total amount of sleep per night. Discrepancies, however, were not random: In patients with psychophysiologic insomnia and in insomnia associated with psychiatric disease, the actigram typically overestimated sleep when compared with the PSG. In patients with sleep-state misperception, the actigram was either quite accurate or it underestimated sleep when compared with the PSG. Comparing laboratory with home sleep, one-third of all insomniacs slept better in the laboratory and two-thirds slept better at home. In addition, night-by-night variability was higher at home than in the laboratory. Based on our study, we now recommend actigraphy as an additional tool in the clinical evaluation of insomnia, but we believe that in complex cases it should be combined with 1 PSG night in the sleep disorders center.

Adult↗
PubMed1991

A controlled study of alprazolam and propranolol in panic-disordered and agoraphobic outpatients.

We studied the efficacy of propranolol (Inderal) compared to alprazolam (Xanax) in 29 patients with a diagnosis of agoraphobia with panic disorder or panic disorder with or without limited phobic avoidance in a 6-week double-blind controlled experiment. Alprazolam is effective in those syndromes, whereas to date only negative or ambiguous results had been reported for propranolol. Fourteen patients received a mean daily dose of 5.0 +/- 2.3 mg of alprazolam and 15 patients received 182.0 +/- 60.5 mg mean daily dose of propranolol. We found both drugs to be effective to suppress panic attacks and reduce avoidance behavior. The only significant between-drug difference was a more rapid onset of alprazolam's panicolytic effect. Propranolol merits further study. We suggest patients worthy of a clinical trial.

Adolescent↗
PubMed1990

Insomnia.

Because sleep needs vary from person to person, insomnia is defined as the chronic inability to obtain the amount of sleep needed for optimal functioning and well-being. Insomnia, which is a symptom rather than a disease, can be classified into three main etiologic groups: insomnias related to other mental disorders (for example, depression and anxiety), insomnias related to known organic factors (for example, sleep apnea and "nonrestorative" sleep), and primary insomnia (for example, learned psychophysiologic insomnias and insomnia complaints without objective findings). The treatment for insomnia often involves a combination of pharmacotherapy, behavioral and short-term psychotherapy, and sleep hygiene guidelines. Sleep disorders centers can provide specialized knowledge and techniques for patients with severe chronic insomnia.

Circadian Rhythm↗
PubMed1989

Reverse first night effect in insomnia.

This study evaluates the reverse first night effect (FNE) in insomniacs. All insomniacs evaluated at the Dartmouth Sleep Disorders Center between 1975 and 1980 were studied if they met specific criteria (n = 89). First night effects were assessed using the following four variables: sleep efficiency, sleep latency, percentage of rapid eye movement (REM) sleep, and REM latency. The 20 subjects who showed the strongest normal FNE were compared with the 20 showing the strongest reverse FNE. The two groups were similar in age, sex, and most aspects of reported home sleep. They differed in their sleep on night 1, but on nights 2 and 3 their sleep was quite similar. Both groups overestimated their sleep latencies on night 1 (by subjective reports) but unlike the normal FNE group, the reverse FNE patients very accurately assessed their sleep latency on nights 2 and 3. Reverse FNE patients had significantly higher scores than normal FNE patients on the Minnesota Multiphasic Personality Inventory (MMPI) K (defensiveness, guardedness) and Pa (paranoia) scales, and they were less depressed, marginally less anxious, and somewhat more sensation-seeking and more susceptible to boredom. This study concluded that evaluations using only 1 night in the laboratory may be missing the larger picture of a patient's insomnia. When data from only 1 laboratory night are available for an insomniac, care should be taken with the label of "subjective complaint without objective findings" in patients who are defensive, guarded, and sensation-seeking.

Arousal↗
PubMed1989

Sleep in patients with spontaneous panic attacks.

Twenty-four drug-free patients with a DSM-III diagnosis of panic disorders (and their age- and sex-matched normal controls) slept in the laboratory for 3 consecutive nights. Panic patients showed a slightly longer sleep latency and a lower sleep efficiency than their normal controls. They also had more overall movement time and more body movements during stage 2 sleep. Eight panic attacks were recorded arising out of sleep. Six of them occurred in the transition phase between stage 2 and stage 3 sleep. The nocturnal panic attacks of these patients are unique, different from stage 4 sleep terrors, and different from dream anxiety attacks.

Adolescent↗
PubMed1985

Insomnia in cancer patients.

This is a preliminary report of the sleep architecture in patients receiving radiation for unresectable lung cancer. One group of nine patients said they were good sleepers and a second group of five said they were poor sleepers. All fourteen patients slept for three consecutive nights in a sleep laboratory. No differences were found in the group means for sleep latency, REM latency or percentage of time spent in Stage I vs Stage II sleep. The cancer patient's perception of whether they slept well or poorly related solely and significantly to the amount of delta sleep. This stage of postulated anabolic and restorative sleep may be more critical for the cancer patient than for others. If substantiated, this can be an important issue in prescribing hypnotics. This quality of life issue for cancer patients deserves further study.

Child, Preschool↗
PubMed1985

Nocturnal enuresis in children with upper airway obstruction.

This article reviews 35 children between the ages of 3 1/2 and 11 years who have had symptoms of upper airway obstruction and enuresis. Twenty-eight patients had primary enuresis, and 7 had secondary enuresis. Removal of upper airway obstruction by surgical intervention led to a significant decrease or complete cure of nocturnal enuresis in 26 patients. Four children were studied with polysomnographic tracings in relationship to their enuresis.

Adenoidectomy↗