1/5. Therapeutic progress of two sibling cases exhibiting sleep-wake rhythm disorder.In this study, two females, siblings who exhibited a non-24 h sleep-wake rhythm (non-24 h) at home were observed. However, they showed a delayed sleep phase syndrome (DSPS) immediately after admission to Kurume University Hospital. melatonin (3 mg) was commenced following chronotherapy and this improved their sleep-wake rhythm. polysomnography (PSG) showed decreased sleep latency and increased sleep stage. In these cases, the involvement of environmental factors was strongly suggested for the sleep-wake rhythm abnormalities as well as familial factors.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/5. Environmental and behavioral influences on affective illness.A behavioral factor, sleep, and a physical environmental factor, light, can trigger or terminate episodes of affective illness. The authors review the experimental evidence for these effects and discuss recent research on their biological mechanisms. In light of these findings the authors speculate that affective illness could partly be a disorder of systems that mediate the organism's adaptations to changes in the physical environment.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |
3/5. Sleep reduction as a final common pathway in the genesis of mania.Diverse psychological, interpersonal, environmental, and pharmacological factors that appear to trigger the onset of mania could act via their capacity to cause sleep deprivation, a mechanism that has been shown in experiments with bipolar patients to induce transient or sustained switches into mania. Since mania in turn causes insomnia, the development of mania is potentially self-reinforcing and could become autonomous after being initiated by precipitating factors. The sleep reduction model is based on experimental evidence and is a parsimonious explanation for the precipitation of manic episodes by a wide variety of factors. Furthermore, this model has clear implications for the prevention and treatment of mania and provides a conceptual focus and an experimental paradigm for psychological investigations of the causes of mania.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/5. The social environment and neurological disease.This chapter has reviewed some of the methodological and theoretical issues in research linking the social environment to medical illnesses. The second part of the chapter has focused on three specific neurological entities to examine evidence for a possible association between neurological illness and life stress. There is some suggestion that certain vulnerable epileptic patients can experience convulsions in response to acute emotional upheaval or certain types of cognitive challenges. More commonly, it is probable that social stress and emotional tension can produce lowering of seizure threshold by increasing levels of fatigue and disrupting sleep. The latter factor, in particular, is known to lower seizure threshold. In the case of stroke, several dramatic cases of intracranial hemorrhage have been related to disastrous life circumstances. A general association between life stress and stroke has yet to be established. The case for a link between life events and onset of exacerbation of multiple sclerosis seems stronger. Events which produce emotional upset seem capable of worsening symptoms in patients with existing disease, and several studies have reported unusual life stresses in the period preceding onset of symptoms in this disorder.- - - - - - - - - - ranking = 5keywords = environment (Clic here for more details about this article) |
5/5. Restoration of detectable melatonin after entrainment to a 24-hour schedule in a 'free-running' man.We evaluated a 37-year-old male with a non-24-h sleep-wake disorder. His environment gave him little exposure to bright light. Circadian profiles of temperature, melatonin, thyrotropin, cortisol and testosterone were obtained along with endocrine challenges of the thyroid, adrenal, growth hormone and gonadal axes. Multiple endocrine abnormalities were detected. testosterone was low and nocturnal thyrotropin levels were erratic. serum melatonin was undetectable throughout the day and night on multiple occasions, and responses to infusions of TRH, GnRH and GRF-44 were abnormal. Responses to CRH infusion were normal. The patient was successfully entrained to a 24-h schedule by daily exposure to 2500 lux light from 0700h to 0900h, avoidance of light (by wearing dark goggles) from 1800h to 2300h, and strict enforcement of a dark environment from 2300h to 0700h. After entrainment, a normal pattern of nocturnal melatonin secretion was found. GH response to GRF-44 also normalized, although abnormal responses to TRH and GnRH persisted. This case raises the possibility that a complex interaction of light exposure with the circadian system can reversibly suspend pineal gland secretion of melatonin indefinitely. It also suggests that circadian rhythm disorders be considered in the differential diagnosis of abnormal endocrine function.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |