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T Faivre

Publications and source records attributed to T Faivre.

2 recordsLinked to original sources

[Sleep and aging].

A COMMON DISORDER: Sleep is one of the most often altered functions in elderly people. Obviously, insomnia is one of the main complain, inducing benzodiazepine (BSD) abuse, but we must keep in mind that sleep apnoea syndrome (SAS) and restless legs syndrome (RLS) are also frequent in this group of age. After exclusion of the various age-related conditions that could induce sleep disorders, we must focalise on primary and secondary sleep disorders. As an introduction, methods of sleep analysis are described and qualitative and quantitative sleep variables are given. PHYSIOLOGICAL SLEEP: Comparing the sleep of elderly people to the one of young adult give us the opportunity to define the limits of the physiological sleep aging. It seems that the main age-induced sleep disturbances are problems to maintain sleep and chronobiological disorganisation of the sleep-wake rhythm, both responsible for insomnia complains. It is important to note that SAS and RLS prevalence are correlated with age. Also crucial is the complex association between sleep, depression and dementia. These interactions are addressed from a diagnostic and a therapeutic point of view. THERAPEUTIC APPROACH: Lastly, concerning insomnia we emphasise the importance of therapeutic alternative to BZD, responsible for addictions and cognitive impairment, mainly behavioural and chronotherapeutic methods (phototherapy, melatonin). For clinicians, it is recommended to respect the individual rhythms of each elderly patient and to prefer nonpharmacological methods.

Age Factors↗

Valpromide increases amplitude of heart rate circadian rhythm in remitted bipolar and unipolar disorders. A placebo-controlled study.

The aim of this study was to investigate for the effects of valpromide on heart rate circadian rhythm in remitted recurrent unipolar and bipolar disorders (DSM-III-R). It consisted of a comparative, randomized, double-blind, repeated cross-over study of valpromide versus placebo over four four-week periods. The primary evaluation criteria was heart rate (HR). Secondary criteria comprised motor activity (MA) and the Bech and Rafaelsen mania assessment scale, Horne and Ostberg questionnaire, Montgomery and Asberg depression rating scale, Spiegel questionnaire, a sleep diary, and Clinical Global Impression. Fifteen patients were included, giving 60 one-month periods (30 valpromide periods and 30 placebo periods). Cosinor analysis of HR and MA data revealed a difference in amplitude (P = 0.037, analysis of variance, one-tailed test). The clinical sleep study shows that the duration of sleep was greater with valpromide than with placebo (P = 0.007, one-tailed test). Similarly, evaluation of the quality of sleep by patients themselves showed valpromide to be superior to placebo (P = 0.045, one-tailed test). The results of analysis of the Spiegel questionnaire also confirm the superiority of valpromide over placebo. Safety and compliance were comparable for the active drug and the placebo. In conclusion, the relatively small sample size requires cautious interpretation of this study. Nevertheless, these initial results show a definite effect of valpromide on a biological rhythm that leads one to suppose that it may be effective through a 'synchronizing' effect.

Adult↗