SLEEP

Stepanski,, E.;Lamphere,, J.;Badia,, P.;Zorick,, F.;Roth,, T.

doi: 10.1093/sleep/7.1.18pmid: 6718922

Summary: It has been noted that clinical populations complaining of excessive daytime sleepiness (EDS) frequently have disrupted or fragmented nocturnal sleep. The relation between sleep fragmentation and daytime sleepiness has not been systematically studied. This study was designed to use correlational techniques evaluating the relation between these variables in patients complaining of EDS, patients complaining of insomnia, and asymptomatic controls. The four groups studied included patients complaining of EDS with sleep apnea (n = 15) or with periodic leg movements (n = 15), patients complaining of insomnia (n = 15), and healthy volunteers with no sleep complaint (n = 10). One night of polysomnography followed by a Multiple Sleep Latency Test was obtained for each subject. Each recording was evaluated using standard criteria and also by a four-level arousal scoring system. Across all subjects, the total number of arousals correlated significantly with sleepiness index (r = 0.48, P < 0.001). Closer analysis of the data shows that, depending upon the sleep complaint, different types of arousals are predictive of degree of daytime sleepiness. It is concluded that the number and type of nocturnal arousals play an important role in subsequent daytime sleepiness. Daytime sleepiness, Sleep fragmentation, Sleep disorders This content is only available as a PDF. © 1984 Raven Press, New York

Wever, Rütger, A.

doi: 10.1093/sleep/7.1.27pmid: 6718923

Summary: Sleep-wake alternations are governed by circadian regularities. In order to evaluate these regularities without interference from social constraints or behavioral influences, we conducted experiments under constant conditions, excluding all external time references. The experiments were conducted for approximately 1 month to ensure that the rhythms were at a steady state. A homogeneous sample of 27 human subjects with free-running and internally synchronized rhythms was analyzed with regard to numerous sleep-wake parameters. There was no temporal trend during the entire period or in individual wake or sleep episodes. The onset of sleep was consistently and by far the most variable reference phase within the sleep-wake cycle. The results of negative serial correlations within the sleep-wake rhythm were relevant. Essentially, every distortion in the duration of a cycle is followed, with high probability, by a deviation in the duration of the following cycles in the opposite direction; i.e., any chance variation in the duration of a cycle is corrected with the next, and to a smaller amount with the next but one, cycle. Hence, an intrinsic stabilizing mechanism of the underlying pacemaker is in effect. Secondarily, there are negative serial correlations among adjacent wake and sleep episodes. Every deviation of an episode from the long-term mean results in an opposite deviation of the following episode. In other words, a wake episode determines the duration of the following sleep, and a sleep episode determines the duration of the following wake. All these negative serial correlations are highly significant interindividually. Another relevant result concerns the difference between females and males. The mean sleep-wake cycle is significantly shorter in females than in males, on the average by 28 min. Even more significant is the sex difference in the fraction of sleep. On the average, the wake episode is shorter by 1 h 49 min and the sleep episode is longer by I h 21 min in females than in males; i.e., the fraction of sleep is larger for 18% in females than males. There are indications that the established sex difference concerns, within the human multioscillator system, only that oscillator which is predominantly responsible for sleep-wake rhythm, but net the other oscillator, which is predominantly responsible, for instance, for deep body temperature. On the other hand, no parameter describing variabilities for the period or the separate episodes shows a sex difference, either in amount or in the temporal sequence of the variations as expressed in the serial correlations. Human circadian rhythms, Sleep-wake cycles, Constant conditions, Negative serial correlations, Intrinsic stabilization mechanism, Sex differences This content is only available as a PDF. © 1984 Raven Press, New York

Herman, John H.; Erman, Milton; Boys, Randy; Peiser, Liora; Taylor, Mary Ellen; Roffwarg, Howard P.

doi: 10.1093/sleep/7.1.52pmid: 6718925

Summary: We examined the relationship between eye movement direction in REM sleep recorded by electrooculograph (EOG) and gaze direction in dream imagery. In a double-blind protocol, carefully screened and trained subjects were awakened subsequent to direct coupled EOG activity that was either predominantly horizontal or vertical. Following a target eye movement that fulfilled predetermined amplitude and directional criteria, a brief period of ocular quiescence was allowed to transpire before the subject was awakened. The dream narratives and EOG activity occurring prior to the REM awakenings were each reduced to a series of quantitatively scaled ratings. Analyses of variance demonstrated that when the confidence level of the experimenters' prediction is taken into account, statistically significant relationships exist between the number and direction of shifts of gaze in the dream report and scaled measurements of the corresponding EOG. When given dream narratives and the corresponding EOG recordings in sets of four, judges were unable to match them correctly better than by chance. However, in the above matching, judges significantly paired the dream narratives with EOG recordings that were in the same axis of gaze. Eye movements, Dream imagery, REM sleep, Saccades, Oculomotor system This content is only available as a PDF. © 1984 Raven Press, New York © 1984 Raven Press, New York

Mendelson, W., B.;Owen,, C.;Skolnick,, P.;Paul, S., M.;Martin, J., V.;Ko,, G.;Wagner,, R.

doi: 10.1093/sleep/7.1.64pmid: 6718926

Summary: Previous studies have implicated the benzodiazepine receptor in the sleep-inducing effects of these widely used hypnotics, but the effector mechanism ofthis process is poorly understood. There is also in vitro evidence that benzodiazepines enhance calcium entry into synaptosomal preparations, leaving open the possibility that altered calcium flux may be involved in their actions. In order to explore this hypothesis, we administered intraventricular nifedipine, a calcium blocking agent. It was found that pretreatment with a dose of nifedipine which by itself does not affect sleep will prevent sleep induction by flurazepam in rats. Effects on anticonvulsant properties of flurazepam or anxiolytic effects of diazepam were not apparent. This suggests that changes in calcium channel function may be involved in the hypnotic action of benzodiazepines. Nifedipine, Flurazepam, Sleep This content is only available as a PDF. © 1984 Raven Press, New York

Hinman, Donald, J.;Okamoto,, Michiko

doi: 10.1093/sleep/7.1.69pmid: 6538986

Summary: Sleep patterns were recorded during 5 weeks of chronic treatment with sodium barbital and after abrupt cessation of drug administration. Sodium barbital was administered intragastrically to adult cats twice daily in doses to produce a peak response of gross ataxia (“low-dose” barbiturate treatment). Sleep stages were scored from EEG, EOG, and neck EMG recordings from chronically implanted electrodes. Sleep was monitored continuously for 48 h once each week during barbital administration and continuously for 7 to 10 days during withdrawal. Rapid eye movement (REM) sleep during barbital treatment was reduced to approximately half compared with control. At the end of the treatment, equivalent doses of pentobarbital were substituted for barbital. Cessation of pentobarbital administration produced withdrawal. Withdrawal intensity was moderate and spontaneous convulsions occurred in half the animals. The duration of withdrawal insumnia was 2 to 3 days. Return of the non-REM and REM sleep was associated with changes in withdrawal behaviors, notably the appearance of overly affectionate behavior. Furthermore, during return of sleep both non-REM and REM sleep increased to values greater than control. Barbiturate, Physical dependence and withdrawal, Withdrawal, Withdrawal insomnia, REM rebound This content is only available as a PDF. © 1984 Raven Press, New York

Kaya,, Nusret

doi: 10.1093/sleep/7.1.77pmid: 6718927

Summary: After research studies, including systematic lateral x-rays, of normal controls and obstructive sleep apnea syndrome (OSAS) patients, we decided to perform a medial resection of the hyoid bone in OSAS patients. The procedure is similar to that performed for ductus thyreoglossus. To date, three patients have undergone the operation under anesthesia. The two cases have been followed for several months (the third underwent surgery only recently) and have improved, indicating that this procedure can be beneficial for OSAS. Obstructive sleep apnea, Hyoid bone, Surgery, Acromegaly This content is only available as a PDF. © 1984 Raven Press, New York

Riley,, R.;Guilleminault,, C.;Powell,, N.;Derman,, S.

doi: 10.1093/sleep/7.1.79pmid: 6718928

Summary: A 24-year-old man with obstructive sleep apnea syndrome and secondary daytime somnolence and nocturnal arrhythmias underwent palatopharyngoplasty. When he did not improve significantly, he underwent a new surgical procedure combining hyoid bone and mandibular horizontal sliding osteotomy. Obstructive sleep apnea, Hyoid bone, Geniotubercle, Osteotomy, Tongue This content is only available as a PDF. © 1984 Raven Press, New York

Samelson, Charles, F.

doi: 10.1093/sleep/7.1.83pmid: 6718929

Article PDF first page preview Close This content is only available as a PDF. © 1984 Raven Press, New York