PubMed Health⌕ Search

Biomedical subjects

R A Kowatch

Publications and source records attributed to R A Kowatch.

7 recordsLinked to original sources
PubMed1992

Patients' acceptance of psychological and pharmacological therapies for insomnia.

This study evaluated the acceptance of psychological and pharmacological therapies among chronic insomniacs and noncomplaining good sleepers. After reading a brief written description of two treatment methods commonly used for persistent insomnia (i.e. cognitive-behavior therapy and pharmacotherapy), the subjects rated in a counter-balanced order several dimensions of these two treatment modalities. The results showed that the psychological intervention was rated as more acceptable and more suitable than the pharmacological one among both insomniacs and their noncomplaining significant others. Behavior therapy was also expected to be more effective on a long-term basis and to produce fewer side effects as well as more benefits on daytime functioning. The clinical implications and relevance of treatment acceptance in the management of insomnia are discussed.

Aged↗
PubMed1992

Electroencephalographic sleep and mood during cocaine withdrawal.

We report on nine patients between the ages of 21 and 39 years who were admitted to an inpatient substance abuse treatment unit for cocaine treatment. The patients' sleep was studied in the laboratory for 4 nights during the first week, and 2 nights during the second and third weeks of their hospitalization. Daily mood ratings, cocaine craving scores and sleep logs were also recorded on each patient. During the first week of withdrawal, these patients had a markedly shortened REM latency, an increased REM sleep percentage, a very high REM density and a long total sleep period time. During the third week, REM latencies were very short and total percentage of REM sleep was increased. By week three of withdrawal the sleep continuity pattern was similar to that found in chronic insomnia, with a long sleep latency, an abnormally increased total time awake after sleep onset and a poor sleep efficiency. The subjects' ratings of cocaine craving, total POMS scores and depression fell precipitously after the first week of withdrawal and were at sub-clinical levels by week three of withdrawal.

Adult↗
PubMed1990

Sleep restriction for the inpatient treatment of insomnia.

This study evaluates the efficacy of sleep restriction therapy for treating insomnia on an inpatient psychiatric unit. A depressed patient with concomitant chronic pain and severe insomnia was treated with a sleep restriction procedure. This procedure consisted of curtailing the amount of time spent in bed and then gradually increasing it contingent upon improved sleep efficiency. The treatment was found to be effective for increasing total sleep time from an initial baseline of 2.5 h of sleep per night to 6 h of sleep per night at discharge time. Clinical gains were well maintained immediately after discharge and at a 4-month follow-up.

Affect↗
PubMed1989

Behavioral management of sleep disturbances secondary to chronic pain.

The clinical efficacy of a behavioral management program for treating insomnia secondary to chronic pain was evaluated within a multiple-baseline design across subjects. Treatment consisted of a combination of stimulus control and sleep restriction procedures. Daily sleep diaries and all-night polysomnographic (PSG) measures were used to document changes in sleep/wake patterns. The results showed that treatment was effective in improving sleep patterns in all three patients. A substantial decrease of time awake at night was obtained and this was reflected by reductions of sleep onset latency, wake time after sleep onset, and early morning awakenings. Sleep improvements were well maintained at follow-ups and were also paralleled by improved mood states. The findings indicate that behavioral procedures are effective for treating sleep disturbances associated with chronic pain conditions.

Back Pain↗
PubMedDate not supplied

Ten cases of head-injured, suicide-surviving adolescents: challenges for rehabilitation.

This paper describes ten adolescents who made unequivocal suicide attempts which resulted in near-death and brain damage. As predicted from studies of successful suicide, this group was mostly male, in late adolescence, and with histories of psychiatric difficulties. The fact that each had tried to commit suicide was avoided by the medical care facilities and by the families. The term 'accident' was customary. This paper makes suggestions for mental health clinicians who consult to head-injury rehabilitation teams treating such adolescents. Two cases are presented to highlight the findings and recommendations of this study.

Adolescent↗