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Biomedical subjects

R D Cartwright

Publications and source records attributed to R D Cartwright.

At least 19 recordsLinked to original sources
PubMed1992

Intrathecal baclofen. Effects on nocturnal leg muscle spasticity.

Electromyographic activity was recorded from tibialis anterior during nocturnal polysomnography in six patients with severe spasticity of spinal origin. The patients had a baclofen reservoir system implanted subcutaneously into their lumbar subarachnoid space and were studied for two nights in a double-blind, placebo controlled, crossover design. Tibialis anterior electromyographic activity per hour of sleep was reduced on the night of baclofen infusion. In particular, less electromyographic activity occurred after arousal from sleep.

Adult↗
PubMed1991

Adjustment disorders of sleep: the sleep effects of a major stressful event and its resolution.

Seventy volunteers had 3 nights of sleep recordings during a period of marital separation, and 61 returned for repeat studies 1 year later. At that time, the divorce was final for 42. Forty of the volunteers were depressed when first screened, and 30 were not. Initially all those undergoing marital separation had less delta sleep than an age-matched married comparison sample. Delta increased at followup for those whose divorce was completed. Rapid eye movement (REM) latency was reduced and REM percent was elevated only in the depressed. Among the not depressed, those whose divorces remained incomplete at the followup had lower delta, higher REM percent, and shorter REM latency than did those whose divorces were finalized. This suggests that prolonged emotional stress may put these subjects at some risk for a mood disorder.

Adaptation, Psychological↗
PubMed1991

The effects of sleep posture and sleep stage on apnea frequency.

The Apnea Plus Hypopnea Index (A + HI) of 60 male positional sleep apneics was analyzed by sleep stage to determine if positional differences are limited to NREM sleep. Differences in apnea severity by sleep position were found to persist in REM sleep and to be of equal extent to those differences found in NREM sleep, despite the fact that there is also a significant increase in the frequency of apneic events associated with REM sleep. The positional effect persists in REM sleep, making treatments to control sleep posture a viable option.

Adult↗
PubMed1991

REM latency and the recovery from depression: getting over divorce.

OBJECTIVE: The authors' goal was to address five questions: 1) What is the frequency of early REM sleep in subjects in the process of divorce who meet diagnostic criteria for major depressive disorder? 2) What is the frequency of this sign in subjects in the process of divorce who are not depressed? 3) How often does this sign persist following remission of depressive symptoms? 4) What is the predictive value of early REM sleep among depressed subjects for later adjustment to the process of divorce? and 5) What is the role of a family history of depression or alcoholism in the presence and persistence of early REM sleep? METHOD: Two hundred fourteen volunteers undergoing marital separation were recruited; 70 of these subjects were selected for a 3-night sleep study. Forty of the 70 subjects met criteria for depression and 30 did not; 61 (87%) returned for repeat studies 1 year later. RESULTS: Fifteen (38%) of the 40 depressed subjects had short REM latency. Seven of these continued to have short REM latency 1 year later, but none of these met the criteria for depression at that time. A higher proportion of these subjects had made a good adjustment to their new life than did depressed subjects whose initial and follow-up REM latencies fell within the normal range. CONCLUSIONS: These data suggest that depressed individuals with normal REM latency may need more aggressive treatment intervention.

Adult↗
PubMed1991

Nonpharmacologic treatment of periodic leg movements in sleep.

The effects of a 30-minute stimulation of the dorsiflexors of the feet and toes before bedtime were investigated in eight patients with periodic leg movements in sleep (PLMS). None were taking medications at the time of the investigation. All subjects were treated with the EMS-250 Neuromuscular Stimulator, which has a maximum output per channel of 1.5mA and a frequency of 47Hz. Stimuli were delivered via a pulse train (on for 1.5sec and off for 1.8sec). A single all-night polysomnogram after this stimulation showed that all patients responded to stimulation, with reduction of leg movements from an average pretreatment PLMS index of 44.6 per hour to a posttreatment PLMS index of 14 per hour (p less than .01). Nocturnal leg movements were primarily reduced during the non-REM sleep. Multiple indices of sleep continuity did not change significantly, although there was a trend toward better sleep consolidation.

Adult↗
PubMed1987

Silent partners: the wives of sleep apneic patients.

The wives of 10 male patients being treated for sleep apnea, obstructive type, were interviewed and given the Social Adjustment Scale (SAS) and Marital Satisfaction Inventory (MSI). The patients also completed an SAS and a Minnesota Multiphasic Personality Inventory (MMPI). These data were compared with those from a sample of divorced patients from the same pool. The married patients were significantly more depressed and socially isolated than were those divorced. Both marital partners showed poor adjustment in the Marital and Social/Leisure areas, and patients also showed poor adjustment in their Parental Role. Marriages do not necessarily represent social support but appear to be an added burden for sleep apneic patients.

Adult↗
PubMed1985

Predicting response to the tongue retaining device for sleep apnea syndrome.

Factors associated with increased severity of sleep apnea; obesity, the supine sleep posture, and age, were tested for their association with the effectiveness of the Tongue Retaining Device (TRD) for the control of the apneic events in a group of 16 male patients. Sixty-nine percent of the patients (11 of 16) were successful with this treatment. The strongest predictor of this success was the presence of an increased severity associated with the supine sleep posture. Patients with substantial worsening of apnea index while in the supine sleep position were more responsive to the TRD than those who were equally affected in both sleep positions. A discriminant function analysis that entered age, obesity, and the ratio of apneas per hour in side v back sleep posture correctly classified the success of patients' response to this treatment.

Adult↗
PubMed1985

Sleep position training as treatment for sleep apnea syndrome: a preliminary study.

Ten male patients selected as having sleep apnea predominantly of the obstructive type associated with the supine sleep position on their evaluation night were trained for 1 additional night to avoid the back sleep position by wearing a gravity-activated position monitor/alarm on the chest. This device emitted an auditory signal if the patient remained supine for more than 15 s. The number of apneic events was significantly reduced, as were the number of episodes of significant O2 desaturation. While wearing the alarm, the apnea index of seven patients remained within or near normal limits. On a follow-up night, with only instructions to maintain the lateral decubitus posture, five patients remained significantly improved. Sleep position training may be appropriate as a single or interim treatment for a significant number of sleep apnea patients who have position-related obstruction.

Adult↗
PubMed1985

Obstructive sleep apnea: variations in surgical management.

Forty patients with obstructive sleep apnea (OSA) were either treated by submucous resection, alone or by palatopharyngoplasty (PPP). Before surgery, each patient underwent a thorough sleep evaluation for the diagnosis of OSA. Of the 23 patients treated by submucous resection alone, eight had more than a 50% reduction in their apnea index and were considered successfully treated. Of the remaining 15, ten received a supplemental tongue retaining device (TRD). Five of the ten were markedly improved. The overall success rate in this group was 57%. Of the 17 patients treated by submucous resection and PPP, ten were treated successfully. Six of the remaining seven patients were subsequently treated with a TRD, which was successful in four. The overall success rate in this group was 82%.

Airway Obstruction↗
PubMed1984

Dream dimension differences during a life change.

Dreams reported from laboratory awakening of stably married women differed from those of women undergoing divorce: The former dreamed of the experiment; the latter had more threat themes. Those coping well during the divorce had more positive motives in the last dream than those who were depressed. Dreams of the nondepressed divorcées increased in anxiety from first to last dream report, whereas those of the depressed increased in masochism. Affiliation motives were common in dreams of the married subjects, while harm avoidance predominated in the divorcées' dreams. Nurturance and abasement were also common needs in the dreams of the depressed sample.

Adaptation, Psychological↗
PubMed1984

Broken dreams: a study of the effects of divorce and depression on dream content.

To investigate the dream characteristics associated with a major life change, 29 women (ages 30-55) undergoing divorce were studied six nights in a sleep laboratory. The group was stratified on a self-report depression scale (the Beck Depression Inventory) into a depressed (N = 19, mean = 23.2) and nondepressed (N = 10, mean = 8.2) group and compared to a nondepressed married group who had never considered divorce. The dreams of those divorcing without major mood upset were longer and dealt with a wider time frame than those of the other two groups. They also dealt with marital status issues which were absent in the dreams of the depressed group. On follow-up those who had been depressed showed positive dream changes in mood, dreamlike quality, and identification of dream self with the marital role. The study suggests that some dream characteristics respond adaptively during life changes but that this is delayed when subjects are depressed. This raises the possibility of a corrective intervention for such persons.

Adult↗
PubMed1984

Effect of sleep position on sleep apnea severity.

Thirty male patients evaluated sequentially for sleep apnea syndrome by all-night clinical polysomnography were compared for apnea plus hypopnea index (A + HI) during the time in the side versus time in the back sleep posture. For 24 subjects of this sample, who occupied both major body positions during the evaluation night, the apnea index was found to be twice as high during the time spent sleeping on their backs as it was when they slept in the side position. This difference is reliable and inversely related to obesity. Five patients meeting diagnostic criteria for sleep apnea on an all-night basis fell within normal limits while in the side sleep position. This suggests sleep position adjustment may be a viable treatment for some nonobese sleep apnea patients.

Body Weight↗
PubMed1984

Self-reported sleep disorder symptoms in epilepsy.

Three groups of adult epileptic subjects with simple partial, complex partial, and generalized seizures and normal control subjects completed a brief self-report sleep questionnaire. The simple partial and complex partial groups indicated significantly more sleep disorder symptoms, especially frequent night awakenings. The generalized group was most similar to the controls. Irrespective of seizure type, the epileptic patients with the most frequent seizures also had the most sleep disturbances. Sleep disorder symptoms did not increase with age in the seizure groups. It would thus seem that epileptic patients with partial seizures and those with more frequent seizures are at risk for developing sleep disorders.

Adolescent↗
PubMed1983

Rapid eye movement sleep characteristics during and after mood-disturbing events.

Twenty-nine women undergoing divorce were monitored for six nights to explore the relation of mood disturbance and rapid eye movement (REM) sleep. Follow-up evaluations were completed on 13 women one to two years later. The more traditional women were more depressed and had shortened REM latencies. Depression was also related to an irregular eye movement density sequence throughout the night. Although depression and REM latency were both significantly improved at follow-up, the REM latency of those initially most depressed remained at a lower than normal level and the eye movement density sequency remained irregular, suggesting some lag in the sleep response or a traitlike vulnerability to future depression.

Adaptation, Psychological↗