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At least 109 records · Page 6Linked to original sources

Sleep characteristics in milk-intolerant infants.

We have shown that there is a relation between allergy to cow's milk and chronic sleeplessness in infants. In the present report we describe the sleep characteristics of children with allergy-related sleep disruption. We compared the polygraphic characteristics of nine infants studied before and after the exclusion of milk from the diet. The infants had a mean age of 18.3 +/- 13.3 and 25.4 +/- 12.7 weeks at the first and the second recording, respectively. Diagnosis of allergy was based on clinical observation. Sleep normalized after milk was withdrawn, deteriorated after a challenge with milk, and normalized again on a second trial of milk elimination. Before the change in diet, the infants' polygraphic recording showed frequent arousals (8-22), short sleep cycles, and a large amount of NREM1 sleep. Gastroesophageal reflux and sleep apnea were not responsible for the sleep fragmentation. After milk was excluded from the diet for 7 weeks, the infants showed striking changes in sleep quality. There was a significant decrease in number of arousals (-41.7%) and an increase in total sleep time (+22.7%) and in NREM2 and 3 sleep (+387.9%). NREM1 sleep decreased significantly (-42.1%). During the second recordings, these sleep values could not be distinguished from those of 40 age-matched controls studied in the same laboratory environments. We do not know if the observed modifications in sleep could reflect immunologic changes within the central nervous system.

Arousal↗

Motor dysfunction during sleep in posttraumatic stress disorder.

A subjective disturbance of sleep, including the occurrence of repetitive, stereotypical anxiety dreams, is characteristic of posttraumatic stress disorder (PTSD). The phenomenology of the PTSD anxiety dream has seemed most consistent with an underlying rapid eye movement (REM) sleep dysfunction. However, motor behavior reportedly can accompany PTSD dreams, and normal REM sleep typically involves a nearly total paralysis of the body musculature. As a means of understanding this discrepancy, anterior tibialis muscle activity during sleep was studied in a group of Vietnam combat veterans with current PTSD and in an age-matched normal control group. The PTSD subjects had a higher percentage of REM sleep epochs with at least one prolonged twitch burst; they also were more likely to have periodic limb movements in sleep, during nonrapid eye movement sleep. Both these forms of muscle activation also have been observed in REM behavior disorder (RBD), a parasomnia characterized by the actual enactment of dream sequences during REM sleep. The identification of RBD-like signs in PTSD adds to the evidence for a fundamental disturbance of REM sleep phasic mechanisms in PTSD.

Electrooculography↗

Modafinil decreases hypersomnolence in the English bulldog, a natural animal model of sleep-disordered breathing.

The English bulldog is a natural model of sleep-disordered breathing (SDB). This condition is marked by 1) hypersomnolence and 2) disordered breathing episodes that are most frequent and severe during rapid eye movement (REM) sleep. Modafinil has been found to increase arousal levels in animals and decrease excessive daytime sleepiness in humans. Therefore, in this study we focused mainly on the effects of the drug on total sleep time and sleep latency and secondarily assessed its effect on REM SDB. Five English bulldogs were implanted with subcutaneous electroencephalographic/electrooculographic (EEG/EOG) electrodes and instrumented with respiratory oscillation belts to measure abdominal and rib cage movements and an ear oximeter to measure saturation. The dogs were studied for approximately 8 hours each subsequent day on two consecutive days. On the first day, they received the vehicle dimethyl sulfoxide (DMSO) i.v. as a control. On the following day they received 10 mg/kg body weight of modafinil i.v. dissolved in the DMSO vehicle. Our findings indicate that modafinil significantly alleviates hypersomnolence (p < 0.05) in the bulldog, as evidenced by dramatically decreased mean total sleep time (from a control value of 50.5% to 8.3% with the drug) and increased mean sleep latency (from a control value of 71.0 minutes to a value of 346.6 minutes with the drug). We obtained limited data on the effect of modafinil on SDB because the drug either greatly diminished or entirely eradicated REM sleep in all five dogs.

Animals↗

Insomnia.

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Humans↗

Insomnia.

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Health Services↗

Sleep, scratching and dreams in eczema. A new approach to alexithymia.

6 patients with itching due to skin disorder and 6 student controls were studied in the sleep laboratory. It was found that some of the patients had personality characteristics consistent with Sifneos' concept of alexithymia and that these were associated with a trend towards less REM sleep and with a significant lack of involvement in dreams collected under standardised sleep laboratory conditions. It is suggested that dreams collection in a sleep laboratory may be a valuable new method in the study of the link between emotional life and psychosomatic disorders.

Adolescent↗

Long-term effects of traumatic war-related events on sleep.

Eleven patients who had combat neuroses resulting from the 1973 Yom Kippur War and complained of sleep disturbances were studied in a sleep laboratory. Sleep-onset insomniacs, dream-interruption insomniacs, and pseudoinsomniacs were differentiated on the basis of electrophysiologic recordings. Compared with normal controls who actively participated in the Yom Kippur War, patients showed significantly longer sleep latencies, lower sleep efficiency indices, lower percentage of REM sleep, and longer REM latencies.

Adult↗

Recent developments in the diagnosis and treatment of sleep disorders.

The publication of a new nosology of sleep and arousal disorders in 1979 established the need for differential diagnosis of sleep disorders based on polysomnographic evaluations as well as medical history and physical examination. This review of recent developments in diagnosing and treating sleep disorders covers such topics as prevalence, findings related to sleeping pills and insomnia, effects of depression on sleep, and managing the elderly patient with disturbed sleep. The authors caution against misuse of hypnotic drug therapy for treatment of insomnia and encourage physicians to inquire about sleep patterns even when a patient is presenting a seemingly unrelated problem.

Aged↗

Treatment issues related to sleep and depression.

In the management of depression, the role of sleep and sleep disturbances is important for several reasons. The same neurotransmitter systems that regulate mood, interest, energy, and other functions that may be disturbed in depression also regulate sleep. Sleep disturbances may be responsive to treatment with some antidepressants and may be worsened during treatment with other antidepressants. Serotonergic neurons play a critical role in modulating the onset and maintenance of sleep, and it is thought that insomnia in depression is caused by dysfunction of serotonergic systems. For a significant minority, SSRIs can have negative effects on sleep patterns resulting in insomnia that requires concomitant sedatives or anxiolytics. By contrast, agents that block the serotonin type 2 (5-HT2) receptor have beneficial effects on depressive insomnia. For example, a recent 8-week study comparing the effects of nefazodone and fluoxetine on sleep disturbances in outpatients with nonpsychotic depression and insomnia found that fluoxetine was associated with approximately a 30% increase in the number of nocturnal awakenings whereas nefazodone was associated with about a 15% decrease, a net difference of 45%. Long-term studies must be conducted to determine whether sleep benefits provided by the newer antidepressants will continue past the acute treatment phase.

Antidepressive Agents↗

[Sleep-related headaches].

Headaches and sleep disorders are frequent and can be associated with each other. Some headache syndromes are related to certain sleep phases or circadian rhythms. These so-called sleep-related headache syndromes include specific types of migraine, cluster headache, chronic paroxysmal hemicrania, and the hypnic headache syndrome. Except for the latter, they were included in the International Classification of Sleep Disorders and are described in this article.

Cluster Headache↗

Sleep disorders in childhood: a review.

Several studies in the last ten years have been directed towards a better understanding of sleep disorders in childhood. Defining sleep disorders in this age is difficult in dependence of relevant differences in sleep patterns at subsequent developmental stages. In new-borns total sleep time is fairly equal during night and day. Normally, day-time sleep gradually decreases over the first three years of life, such that night-time sleep progressively increases till the age of four, and similar to adult sleep-time by adolescence. The most frequent sleep disorders observed in childhood are parasomnias, that, thought to be a CNS sign of immaturity, tend to be quite predictable, recurring in the same families and not even influenced by environmental stimuli. These disorders included: a) arousal disorders, that generally emerge from delta sleep or relate to arousals occurring during NREM sleep, very common in childhood and fairly common in adulthood either; b) somnambulism and somniloquy, that have many common characteristics: first of all, they have the potential to generate a great sense of discomfort and fear in parents watching a child who suddenly sits up in bed eyes-opened but 'unseeing'; c) nocturnal enuresis, that is substantially not a problem of depth of sleep, despite many parents believe. Although narcolepsy is more common in adolescence, many studies have demonstrated that narcoleptic symptoms may begin in childhood. Narcoleptic symptoms in children are similar in their appearance to those predominant in adults, but their expression may be different because of CNS maturational factors. Historical descriptions of the OSAS evidenced since the beginning the importance of neurobehavioral complications associated with the cessation of airflow at the nose and mouth accompanied by respiratory effort, deriving from upper airway obstruction which occurs during sleep.

Adolescent↗