1/52. Response covariation of escape-maintained aberrant behavior correlated with sleep deprivation.We examined the relation between sleep deprivation and changes in level and allocation of aberrant behavior (aggression and self-injury) for a child with moderate mental retardation. First, a series of functional analyses identified that self-injury (SIB) and aggression were maintained by escape from demands (i.e., were members of the same response class). Escape from demand conditions were then held constant over time while natural levels of sleep deprivation occurred. This final analysis demonstrated a correlation between sleep deprivation and increases in escape-maintained aberrant behavior. sleep deprivation seemed to be related to increases in levels of self-injury but did not seem to influence levels of aggression.- - - - - - - - - - ranking = 1keywords = sleep (Clic here for more details about this article) |
2/52. Can critically timed sleep deprivation be useful in pregnancy and postpartum depressions?BACKGROUND: The aim of this study was to test the efficacy of critically timed sleep deprivation in major mood disorders (MMD) occurring during pregnancy and postpartum. methods: Nine women who met DSM-IV criteria for a MMD with onset during pregnancy or within 1 year postpartum underwent a trial of either early-night sleep deprivation (ESD), in which they were sleep deprived in the early part of one night and slept from 03:00-07:00 h, or late-night sleep deprivation (LSD), in which they were deprived of sleep in the latter part of one night and slept from 21:00-01:00 h. Mood was assessed before the night of sleep deprivation, after the night of sleep deprivation, and after a night of recovery sleep (sleep 22:30-06:30 h) by trained clinicians, blind to treatment condition, using standardized scales. RESULTS: More patients responded to LSD (nine of 11 trials: 82%) compared with ESD (two of six trials: 33%) and they responded more after a night of recovery sleep (nine of 11 nights: 82%) than after a night of sleep deprivation (six of 11 nights: 55%). pregnant women were the only responders to ESD and the only nonresponders to LSD. LIMITATIONS: The small and heterogeneous sample size prevents us from making more definitive conclusions based on statistical analyses. CONCLUSIONS: Although the findings are preliminary, the results suggest that with further study, critically timed sleep deprivation interventions may benefit women with pregnancy or postpartum major mood disorders and potentially provide a viable alternative treatment modality for those women who are not candidates for pharmacologic or psychotherapeutic interventions. Such interventions are needed to help prevent the devastating effects of depression during pregnancy and the postpartum period on the mother, infant, her family and society.- - - - - - - - - - ranking = 2.2857142857143keywords = sleep (Clic here for more details about this article) |
3/52. 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 = 1.4285714285714keywords = sleep (Clic here for more details about this article) |
4/52. 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 = 0.85714285714286keywords = sleep (Clic here for more details about this article) |
5/52. sleep disorders caused by brainstem tumor: case report.Few studies concerning sleep disorders in brainstem lesions or tumors have been published. We report the case of a girl who was operated on for a brainstem tumor at the age of 4 years. In postsurgery, she had hemiparesis of the left side, swallowing difficulties, and severe apneas requiring a tracheotomy with nocturnal ventilation. The child's health improved progressively. Two sleep recordings were performed at 7 and 9 years without nocturnal ventilation. These recordings showed sleep disorders with a decrease in total sleep time and rapid eye movement (REM) sleep. Several central apneas were observed. The apneas were more frequent during REM sleep in the first recording and were associated with desaturation and microarousals.- - - - - - - - - - ranking = 0.85714285714286keywords = sleep (Clic here for more details about this article) |
6/52. 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 = 2.7142857142857keywords = sleep (Clic here for more details about this article) |
7/52. 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 = 1.5714285714286keywords = sleep (Clic here for more details about this article) |
8/52. Elevated salivary cortisol levels as a result of sleep deprivation in a shift worker.BACKGROUND: This paper reports a case from a group of 63 shift-workers for whom adaptation to shift-work was evaluated through measurement of salivary cortisol levels. methods: Workers' saliva was sampled and cortisol levels measured at intervals of 2 h during morning, evening and night shifts. RESULTS: For one subject among the 63, very high values of cortisol (an approximately 6-fold increase) were observed for the morning (M) shift, but with normal values found for evening (E) and night (N) shifts. Individual mean and peak cortisol values were 48.4 and 67.8 nmol/l against group mean and peak cortisol values of 8.9 and 11.0 nmol/l. Retrospective questioning showed that this subject was healthy and there were no indicators of long-term stress. CONCLUSION: This cortisol rise was deduced to be caused by sleep deprivation as a result of rapidly rotating shift patterns.- - - - - - - - - - ranking = 0.71428571428571keywords = sleep (Clic here for more details about this article) |
9/52. Obstructive sleep apnoea syndrome presenting in a neurology outpatient clinic.The various neurological guises in which obstructive sleep apnoea syndrome (OSAS) may present are illustrated by reporting four previously undiagnosed patients seen by one consultant neurologist in general neurological outpatient clinics. Presenting features were episodes of loss of consciousness (2), stroke, and excessive daytime somnolence; morning headache and cognitive decline were also observed. Two patients had been involved in road traffic accidents. Diagnoses suggested by the referring doctors included epilepsy, stroke and narcolepsy. Since OSAS is associated with increased morbidity and mortality, yet is frequently amenable to treatment, neurologists should be familiar with the heterogeneous presentations of this condition.- - - - - - - - - - ranking = 0.71428571428571keywords = sleep (Clic here for more details about this article) |
10/52. 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 = 0.85714285714286keywords = sleep (Clic here for more details about this article) |
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