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[Psychiatric problems and sleep disorders in surgical intensive care. A polygraphic study: 8 cases].

The patients hospitalized in intensive care units present sleep disorders, mainly a sleep deprivation, particularly in paradoxical sleep. Both on the experimental and clinical plan sleep deprivation has been considered to be responsible for psychotic disorders. Over the past fifteen years these results have been controversial. Polygraphic study of sleep in eight patients hospitalized in a post-operative intensive care unit confirmed this nightly sleep deprivation; the deep slow wave sleep decreases and there is often a lack of paradoxical sleep. Analysis of these eight cases corroborates the latest experimental résults on sleep deprivation and current methodological considerations. Sleep deprivation in itself does not seem to lead to major psychiatric disorders but it is one of the factors, contributing to genesis of psychiatric troubles in an intensive care unit. The other ones that have been suggested (environment, somatic pathology, psychological ill effects due to the hospitalization) are also quite important.

Adult↗
PubMed1984

[Respiratory problems during sleep].

Continuous recording of numerous physiological variables during the night has led to the discovery of various respiratory disorders occurring during sleep. The most important are: 1. central apneas, defined by excessive frequency of respiratory arrests of excessive duration, 2. obstructive apneas, characterized by marked obstruction at the level of the oropharynx with persistence of respiratory movements, 3. episodes of marked nocturnal hypoxemia, without apnea, in certain patients with chronic obstructive lung disease. The pathophysiology, clinical picture and possible therapeutic resources are analyzed for each of the respiratory disorders occurring during sleep.

Diagnosis, Differential↗
PubMed1984

Sleep after forty.

Patients should be aware of alterations in sleep with age, and they should not have unrealistic expectations. Drinking or taking sleeping pills is not likely to be a long-term solution to a sleep problem. Chronic difficulty in sleeping raises the possibility of sleep apnea, nocturnal myoclonus or depression, all of which commonly appear after 40. In the absence of these and other, less common disorders, sleep can often be improved by exercise, regular habits and removal of any disturbing elements from the bedroom.

Adult↗
PubMed1999

Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I.

The National Sleep Foundation in conjunction with the Gallup Organization conducted telephone interviews with a sample of Americans (N = 1000) to examine the prevalence and nature of difficulty with sleep. Consistent with other national studies, about one-third of Americans reported some type of sleep problem. Approximately one in four reported occasional insomnia while 9% reported that their sleep difficulty occurred on a regular nightly basis. The problem most frequently reported by insomniacs was waking up in the morning feeling drowsy or tired, followed by waking up in the middle of the night, difficulty going back to sleep after waking up and difficulty falling asleep initially. Importantly, insomniacs rarely visited a physician to discuss their sleep problem and four out of ten insomniacs self-medicated with either over-the-counter medications or with alcohol. Two-thirds of the insomniacs reported that they did not have an understanding of available treatments for insomnia.

Adolescent↗
PubMed1995

The sleep/wake rhythm in children with autism.

The sleep patterns of two groups of children with autism, one with moderate to severe intellectual handicap, and one with mild handicap to normal IQ level, were compared with those of children without autism. Parents completed 14 day sleep diaries and questionnaires. Results suggested that at some stage during childhood, particularly under 8 years of age, the majority of children with autism will experience sleep problems. These problems are likely to be severe in many cases and will generally include one or more of: extreme sleep latencies; lengthy periods of night waking, shortened night sleep; and early morning waking. Such problems may have some specificity for autism as they appear to be rare in non-handicapped children and in children with mild degrees of intellectual handicap. It is likely that sleep problems in early childhood are related to the severe social difficulties present in autism and the consequent inability of these children to use social cues to synchronize their sleep/wake cycle. Continued sleep difficulties at older ages and with higher IQ may also be related to arousal and anxiety factors.

Adolescent↗
PubMed2005

Insights from studying human sleep disorders.

Problems with sleep are one of the commonest reasons for seeking medical attention. Knowledge gained from basic research into sleep in animals has led to marked advances in the understanding of human sleep, with important diagnostic and therapeutic implications. At the same time, research guided by human sleep disorders is leading to important basic sleep concepts. For example, sleep may not be a global, but rather a local, brain phenomenon. Furthermore, contrary to common assumptions, wakefulness, rapid eye movement (REM) and non-REM sleep are not mutually exclusive states. This striking realization explains a fascinating range of clinical phenomena.

Circadian Rhythm↗
PubMed2003

Co-use of donepezil and hypnotics among Alzheimer's disease patients living in the community.

BACKGROUND: In clinical trials, sleep problems have been identified as side effects of donepezil, an acetylcholinesterase (AChE)-inhibiting medication for the treatment of Alzheimer's disease (AD). Poor sleep quality can exacerbate behavior problems among patients and add to the burden experienced by their caregivers. We examined the relationship between co-use of donepezil and hypnotics in a large sample of persons with AD living in the community. METHOD: This secondary data analysis used cross-sectional subjects from a multiwave, consumer-based survey of AD caregivers conducted in 1997 and 1998. Rates of hypnotic use among users and non-users of donepezil were compared using chi-square analysis for independent samples, and multivariate logistic regression was used to identify significant independent correlates of hypnotic use. RESULTS: A total of 2638 caregivers completed at least 1 study wave. Use of hypnotics was higher in the donepezil subgroup (9.78%) compared with subjects not taking this medication (3.93%). Multivariate analysis demonstrated that donepezil use was independently linked to increased hypnotic use after controlling for the potential confounding effects of disruptive behavior and depressive symptoms (adjusted odds ratio = 3.34, p <.001). CONCLUSION: In this large community sample, donepezil use was statistically linked to increased hypnotic use. Because sleep quality may be a critical issue for persons with AD and their caregivers, more rigorous evaluation of sleep problems linked to AChE-inhibitor treatment is indicated.

Aged↗
PubMed1985

A double-blind drug trial of treatment in young children with waking problems.

A double-blind trial using trimeprazine tartrate was carried out in 22 children with severe waking problems. On parental verbal reports sleep was significantly improved on the drug compared with the original baseline and the placebo, but diaries kept by the parents showed that this improvement was clinically only moderate, with many wakeful nights still occurring. Taking the drug produced no permanent effect on sleep patterns and a follow-up of 14 children 6 months later showed persisting sleep problems in the majority.

Child, Preschool↗