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Biomedical subjects

T Roth

Publications and source records attributed to T Roth.

At least 127 records · Page 7Linked to original sources
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↗
PubMed1982

Biological markers for depression in chronic pain.

Patients with chronic psychogenic pain appear to suffer from a specific depressive type of disease, with somatized pain as the prime expression of a concealed mental agony (pain-prone disorder). This view is supported by clinical, premorbid, and psychodynamic findings, as well as by the presence of biological markers including a family history of affective disorders and response to antidepressants. Additional biological markers of depression include shortened rapid eye movement (REM) latency in sleep and nonsuppression in the dexamethasone suppression test (DST). The study of both markers in 20 consecutive pain-prone patients with insomnia showed clearly abnormal REM latency and/or DST nonsuppression in one half of the otherwise homogeneous group. There was high correlation between DST cortisol level and REM latency. both biological markers tend to predict response to antidepressants. The findings confirm that the pain-prone disorder can be viewed as a variant of depressive disease.

Depressive Disorder↗
PubMed1982

Disturbed sleep in patients complaining of chronic pain.

Polygraphic recordings of the sleep of patients complaining of insomnia has led to recognition of specific patterns of disturbed sleep corresponding to different etiologies of insomnia. This study presents results of polygraphic recordings of the sleep of 26 patients with chronic pain for which no physical cause can be found. All 26 also complained of insomnia. Sleep parameters of this group were compared with those to two other groups also complaining of insomnia: 12 patients whose disturbed sleep was judged secondary to psychiatric disorder, and 16 patients with the subjective complaint of insomnia in whom no objective evidence of sleep disturbance could be demonstrated. The three groups differed significantly in terms of their sleep parameters. The pain patients slept less than the subjective insomnia patients. The sleep disturbance of the psychiatric patients was more severe than that of the chronic patients. Several chronic pain patients showed evidence of nocturnal myoclonus; several also showed alpha rhythm intrusions into their sleeping electroencephalograms. The study verifies that chronic pain patients do experience significant sleep disturbance and raises several questions concerning relationships among chronic pain, sleep disturbance, and psychiatric illness, particularly depression.

Adult↗
PubMed1982

Relationship of psychopathology to insomnia in the elderly.

Three groups of 18 volunteers each (nine men and nine women) were selected on the basis of age and the response to a sleep status questionnaire. Younger subjects (mean age, 43.8 years) who complained of difficulty in falling asleep or in staying asleep or of awakening too early were compared for evidence of psychopathologic signs with older subjects (mean age, 68.5 years) who had sleep-related complaints and with older subjects (mean age, 71.3 years) who did not have sleep-related complaints. Older subjects with insomnia complained more frequently of having trouble staying asleep and of awakening too early (P less than 0.05), whereas the younger subjects with insomnia complained primarily about difficulty in falling asleep (P less than 0.005). On a short form of the Minnesota Multiphasic Personality Inventory (MMPI-168), the number of elevated scores indicating pathologic disturbances (T score less than 70) was higher (p less than 0.05) for the younger subjects with insomnia (2.5 high scores) than for older subjects with insomnia (0.7 high scores) or for older normal sleepers (0.4 high scores). These results imply that although in younger persons psychopathologic disorders are associated with insomnia, psychopathic disorders usually are not the cause of insomnia in the elderly.

Age Factors↗
PubMed1982

Protriptyline in the treatment of sleep apnoea.

Nine patients with obstructive sleep apnoea were treated with 5 to 20 mg of protriptyline each night for two to 18 months. In four patients, there was dramatic, sustained improvement in symptoms and measured sleep quality and apnoea frequency and duration. There was no improvement in two patients and three developed intolerable side-effects preventing adequate treatment. Apnoea frequency was the only apparent predictor of responsiveness. Those with fewer than 30 episodes of apnoea per hour consistently improved. Only two of four patients with more than 60 episodes per hour improved. These results provide additional evidence that a carefully monitored trial of protriptyline may benefit selected patients with mild to moderate obstructive sleep apnoea.

Adult↗
PubMed1982

Sleep, arousals, and oxygen desaturation in chronic obstructive pulmonary disease. The effect of oxygen therapy.

In order to assess the role of hypoxemia in the sleep disruption of patients with COPD, we studied patients breathing air and oxygen during sleep. In 24 patients with COPD, we determined the 95% confidence bands for arterial O2 saturation (SaO2) in the various sleep stages. The lowest mean SaO2 was during REM sleep. Patients spent 22.4% of the night desaturated (SaO2 more than 5% below awake SaO2). Apneic episodes were uncommon and occurred in only 2 patients. When compared with established age-matched normal subjects from another center, poor sleep quality was indicated by reduced sleep time, increased sleep stage changes, and increased arousal frequency. Oxygen therapy had no apparent effect on sleep quality. Arousal frequency was independent of measurements of awake pulmonary function or chemical control of breathing. During room air breathing, arousals were strongly associated with periods of arterial oxygen desaturation. However, relief of the hypoxemia with supplemental oxygen had no effect on arousal frequency. This suggests that it is not hypoxemia per se, but an associated phenomenon such as hypercapnia that causes the arousals.

Aged↗
PubMed1982

The effects of doxepin HCl on sleep and depression.

The effects of doxepin hydrochloride (Adapin) on sleep and depression were evaluated in nine depressed patients with documented sleep difficulties. All subjects were screened for depression on the Hamilton Psychiatric Rating Scale. Sleep disturbance was measured by all-night polysomnography. Doxepin in doses of 75 and 150 mg/day significantly improved sleep efficiency, as evidenced by decreased sleep latency and increased total sleep time. After 2 weeks of treatment, REM latency and percent REM time were dramatically changed. Maximal improvement in depression occurred after 2 weeks of doxepin therapy and at the 150 mg dose.

Adult↗
PubMed1981

Waking and dreaming mentation: a test of their interrelationship.

The relationship of dream content to the immediate pre- and post-sleep mentation of the dreamer was studied using the electrophysiologically defined state of REM (rapid eye movement sleep) as dream collection time. The subjects were 20 male and 20 female volunteers, ages 18 to 25. Each slept for three non-consecutive nights in the laboratory and had REM awakenings and pre- and post-sleep verbal content collected. REM reports and waking verbal samples were scored on 18 Hall-Van de Castle content scales. The interscorer agreement of two judges was 0.90. Product moment correlations were performed on each of the 18 content categories between content of the REM reports and of the waking verbal samples. Across all 40 subjects, 9 out of 18 correlations were statistically significant and 14 of the 18 were positive. The zero-mu test indicated that the distribution of the 18 correlations was significantly different from zero. Thus it can be concluded that dream content is related to the psychological parameters of waking life, in a continuous rather than compensatory manner.

Adolescent↗
PubMed1981

Dose-related effects of flurazepam on human sleep-walking patterns.

Two consecutive nights of flurazepam at each of 15, 26, and 45 mg were compared to placebo in a Latin-square double-blind crossover design using 24 healthy young-adult males. Flurazepam had significant hypnotic effects on objective and subjective measures of efficacy: shorter sleep latency, longer sleep time, and fewer awakenings. It also induced morning sedation along with decrements in cognitive performance. Flurazepam had dose-related impacts on both human and computer-scored EEG-EOG parameters: less stages 3 + 4 and decreased EEG delta, less stage 1 REM and decreased REM density, more stage 2 and increased EEG spindling. Also, EEG alpha and movement artifact were decreased and EEG beta was increased. Only a few of the EEG-EOG variables and none of the subjective indices had cumulative changes on the two drug nights. Stage shifting was unaffected at the two lower doses on the first night but decreased at all three dose levels on the second night; percent stages 3 + 4 was unaffected on the first night but decreased at all dose levels on the second night. The rate of delta waveform activity was also diminished by a greater amount on the second night. This study conclusively established that flurazepam affects the EEG-EOG architecture of sleep on each of the first two nights of administration.

Adult↗
PubMed1981

A dose response study of the hypnotic effectiveness of alprazolam and diazepam in normal subjects.

One group of eight normal young males was administered three doses of alprazolam (0.25, 0.5 and 1.0 mg) and placebo, while a second group of eight normal young males was given three doses of diazepam (2, 5, and 10 mg) and placebo in the same design. All subjects slept in the sleep laboratory for 10 nights, 2 consecutive nights each week for 5 consecutive weeks. The first 2 nights served as adaptation. During the next 4 weeks subjects received a random dose of alprazolam (or placebo) or a random dose of diazepam (or placebo) each week. Similar dose-related benzodiazepine effects were found on sleep with both medications. Alprazolam reduced percent stage 4 and REM sleep and increased stage 2 sleep and latency to REM. Diazepam decreased percent stage 1 and increased percent stage 2 sleep. No drug by dose interactions were found. It was concluded that, while both drugs had similar effects on sleep, alprazolam showed significant effects on REM sleep parameters and might be evaluated for possible antidepressant effect.

Adolescent↗
PubMed1981

Dose-related effects of phenobarbitone on human sleep-waking patterns.

1 Twenty-four healthy male subjects had two consecutive drug nights at 2-week intervals using placebo and 80, 140 and 240 mg doses of phenobarbitone in a double-blind cross-over design. 2 Phenobarbitone produced significant dose-related decreases in sleep latency and number of awakenings, along with increased total sleep time. 3 Both subjective and objective measures of sleep indicated the presence of cumulative (first v second night) effects of phenobarbitone, especially decreases in the number of awakenings and in delta waveform activity. 4 Measures of REM sleep were highly sensitive to phenobarbitone. The high dose decreased REM density to 30% of baseline on the first night and to 18% on the second night. 5 EEG alpha activity was decreased, beta activity was increased and sigma spindle activity was unaffected by phenobarbitone during sleep. 6 Subjects experienced some impairment of cognitive performance along with residual sedation the following morning.

Adult↗
PubMed1981

Evaluation and diagnosis of persistent insomnia.

The authors placed 84 patients who complained of insomnia into 10 diagnostic categories on the basis of medical, psychiatric, and polysomnographic evaluations. Only half the patients had objectively defined difficulty inducing or maintaining sleep when compared with 20 normal control subjects. However, all but 16 patients showed polysomnographic evidence of some sleep disorder. Diagnostic categories within the insomnia groups could be distinguished from one another by polysomnography. Patients in only 3 of the 10 diagnostic categories showed evidence of psychological distress on the MMPI; patients in the other 7 categories displayed few psychological symptoms. These results have implications for the treatment of insomnia.

Conditioning, Psychological↗