1/15. 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 = rhythm (Clic here for more details about this article) |
2/15. myocardial infarction during sleep deprivation in a patient with dextrocardia--a case report.A patient with dextrocardia who suffered his first myocardial infarction after approximately 26 hours of a diagnostic sleep deprivation protocol is described. The infarction started about 3 hours after a significant improvement in mood, which persisted during and after infarction. Total sleep deprivation may be an acute risk factor for myocardial infarction.- - - - - - - - - - ranking = 0.00072010013149062keywords = hour (Clic here for more details about this article) |
3/15. Relationship between amount of sleep and daytime sleepiness in three cases.The effect of sleep amount on daytime sleepiness was investigated, and the appropriate amount of sleep for each subject was evaluated. Three children were longitudinally evaluated for three conditions: control, sleep extension, and sleep reduction. A sleep latency test was conducted five times for each condition at 2-h intervals from 10.00 hours. The results showed that the effects of sleep loss increased sleepiness at 10.00 hours and 18.00 hours, and there were positive correlations between sleep amount and sleep latency for each subject (r = 0.590-0.903). Whether or not the amount of sleep for each subject was sufficient was evaluated from the relationship between the two measures.- - - - - - - - - - ranking = 0.0010801501972359keywords = hour (Clic here for more details about this article) |
4/15. Transient total sleep loss in cerebral Whipple's disease: a longitudinal study.A case with transient, almost complete sleep loss caused by cerebral manifestation of Whipple's disease (WD) is presented. Cerebral WD is rare and in most cases occurs after gastrointestinal infection. In our case, a progressive and finally almost complete sleep loss was the initial and predominant symptom. Polysomnographic studies in several consecutive nights and over 24 h showed a total abolition of the sleep-wake cycle with nocturnal sleep duration of less than 15 min. Endocrine tests revealed hypothalamic dysfunction with flattening of circadian rhythmicity of cortisol, TSH, growth hormone and melatonin. cerebrospinal fluid (CSF) hypocretin was reduced. [18F]deoxyglucose positron emission tomography (FDG-PET) revealed hypermetabolic areas in cortical and subcortical areas including the brainstem, which might explain sleep pathology and vertical gaze palsy. In the course of treatment with antibiotics and additional carbamazepine for 1 year, insomnia slowly and gradually improved. Endocrine investigations at 1-year follow-up showed persistent flattening of circadian rhythmicity. The FDG-PET indicated normalized metabolism in distinct regions of the brain stem which paralleled restoration of sleep length. The extent of sleep disruption in this case of organic insomnia was similar to cases of familial fatal insomnia, but was at least partially reversible with treatment.- - - - - - - - - - ranking = 0.28571428571429keywords = rhythm (Clic here for more details about this article) |
5/15. Changing the law, changing the culture: rethinking the "sleepy resident" problem.Ms. Whetsell examines the Bell Regulations, which limit new york's hospital residents' work hours and require increased supervision from senior doctors, in light of the currently pending federal bill that seeks to do the same. The article argues that the federal government should draw lessons from the new york experience before proceeding with similar guidelines. The article notes that many roadblocks have prevented successful implementation of the new york policy, including a long-standing tradition of "hazing" first-year residents with long, unsupervised hours; medical community resistance to the notion of residents' sleep deprivation and dislike of government interference; and a general fear within the medical community of increased medical malpractice liability and other indicia of "blame culture." The Article concludes that the most effective approach to patient safety related to residency sleep deprivation should work within hospital culture, not against it. The proposed alternative approach would encourage patient safety strategies that value teamwork and cross-discipline collaboration, and consequently result in greater satisfaction for residents, hospitals, and patients.- - - - - - - - - - ranking = 0.00072010013149062keywords = hour (Clic here for more details about this article) |
6/15. Partial sleep deprivation to prevent 48-hour mood cycles.The course of a patient with the phenomenon of 48-h mood cycles, including her response to medication and to systematic partial sleep deprivation, is described. She had only a partial response to tranylcypromine alone. Partial sleep deprivation during the second half of alternate nights successfully prevented depressive mood cycles. Three to four weeks after discontinuing tranylcypromine she lost her ability to sustain this regimen. This case demonstrates an interaction between antidepressant medication and partial sleep deprivation in the prevention of depressive mood cycles.- - - - - - - - - - ranking = 0.0014402002629812keywords = hour (Clic here for more details about this article) |
7/15. Diagnostic applications of sleep deprivation.Four cases are described in which observation of the response to forty hour sleep deprivation was used in resolving the differential diagnosis between depression and dementia. In each case it was possible to conduct psychometric assessment of cognitive ability during the period of improvement of the clinical state. The utility of this approach and some of the difficulties associated with its use are discussed.- - - - - - - - - - ranking = 0.00036005006574531keywords = hour (Clic here for more details about this article) |
8/15. Abstinence from night sleep as a treatment for endogenous depressions. The earliest observations in a Danish mental hospital (1954) and an analysis of the causal mechanism.In the early 1950s before antidepressants were in use, I conceived the idea of treating patients with pure endogenous depressions by having them abstain from night sleep for two or more nights. The idea was based on several clinical observations: "It looks as if sleep as such has an unfortunate influence on the state of the depression and as if the organism itself resists the sleep rhythm during the period of depression." My first clinical experiment was conducted in June 1954 and was followed later by several others. At that time, I could not ascertain from the available literature whether this therapy had been tried elsewhere. The experiments completely confirmed that the hypothesis was correct--that the patients' condition had improved and that the treatment influenced the subcortical processes which determined the complaint. This led to studies on the transmitter function in the states of sleeping and waking, respectively, among healthy and sick people or, more precisely, the influence of darkness and light, respectively, on these functions. The studies appeared to confirm that therapy in which the patient is kept awake encourages the production of activating substances such as antidepressants. The most recent research on melatonin, which is formed in the corpus pineale, is briefly discussed. Provisional results seem to indicate that this substance has an inhibiting effect on vital brain functions in periods of darkness (periods of sleep) and thus contributes to the maintenance of the depression because melatonin is especially produced in the dark periods of the daily cycle. These investigations, though still at an experimental stage, suggest exciting possibilities, also for psychiatry.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 0.14285714285714keywords = rhythm (Clic here for more details about this article) |
9/15. Five variations of sleep deprivation in a depressed woman.Systematic variation in aspects of the sleep-wakefulness cycle of a depressed woman showed that recovery occurred reliably after 19 to 20 hours sustained wakefulness, unrelated to diurnal rhythm. depression returned during as little as 15 minutes sleep. The effect of sleep deprivation was a specific response, probably unrelated to REM sleep.- - - - - - - - - - ranking = 0.14321719292289keywords = rhythm, hour (Clic here for more details about this article) |
10/15. Sinus arrest during REM sleep in young adults.Four apparently healthy young adults with vague chest symptoms during the day, two of whom had infrequent syncope while ambulatory at night, had periods of asystole up to nine seconds in duration occurring repeatedly during rapid-eye-movement (REM) sleep. Extensive evaluations, including electrophysiologic studies in two patients, were normal. It is therefore suggested that the underlying pathophysiology involved autonomic dysfunction. REM sleep-related sinus arrests such as these, which may occur in apparently healthy subjects but are undetected, may explain some cases of sudden, unexpected death during sleep. Polygraphic monitoring during sleep may be helpful in delineating the pathophysiology of the sleep-related arrhythmia in persons with daytime cardiac arrhythmias thought to be secondary to abnormal vagal tone. The possibility of nocturnal asystole should be considered in patients such as those described here.- - - - - - - - - - ranking = 0.28571428571429keywords = rhythm (Clic here for more details about this article) |
| | Next -> |