1/31. Night eating syndrome. Preliminary results. Clinical aspects of the "night eating syndrome" (NES) are described. Recent studies, also referred to in the present report, have revealed certain triggering factors of this syndrome, but do not reveal the nature of the relationship between awakening and compulsory need for food. According to the psychodynamic interpretation, these subjects eat at night to replace dreaming, to which they offer strong resistance, whilst according to the psychobiological interpretation, motivational stimuli develop the irresistible and repeated desire for food. Within a post-rational cognitive theoretical model, the compulsion to food would be the mode through which subjects obtain a modified conscious state necessary to appease the suffering due to an experience of emptiness and incapacity. Psychological support associated with pharmacological treatment (benzodiazepine, gamma-hydroxybutyric acid) has been shown, in a personal series, to be effective both upon the sleep disorder and craving. ( info) |
2/31. 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. ( info) |
3/31. Case of a non-24 h sleep-wake syndrome patient improved by phototherapy. polysomnography (PSG) and body temperature were examined in a patient with non-24 h sleep-wake syndrome who responded to phototherapy. The patient was a 17-year-old male who had been suffering from a free-running sleep-wake rhythm for 2 months. phototherapy was administered to the patient while he was admitted to our hospital. This treatment immediately changed the free-running sleep-wake and body temperature rhythm of the patient to the environmental 24-h rhythm. On a polysomnography, total sleep time and stages 1 and 2 and REM sleep were decreased, and percentage stage 3 4 was increased by phototherapy. The time of minimum body temperature (mBT) was located at the latter half of the sleep phase through the clinical course of the patient. ( info) |
4/31. Effects of phototherapy on the phase relationship between sleep and body temperature rhythm in a delayed sleep phase syndrome case. We examined polysomnography (PSG) and body temperature of a patient with delayed sleep phase syndrome (DSPS) who was successfully treated with only phototherapy. This case showed a possible improvement of the phase relationship between sleep and body temperature rhythm given that the time of minimum body temperature (mBT) shifted to the latter portion of the sleep phase after constant phototherapy. ( info) |
5/31. Bright light treatment for night-time insomnia and daytime sleepiness in elderly people: comparison with a short-acting hypnotic. Night-time bright light (BL) treatment and triazolam (0.125 mg/day) were given to three healthy elderly people in a cross-over design. They kept a daytime sleepiness test and a sleep log, and their wrist-activity was monitored simultaneously. Subjectively, BL increased daytime sleepiness and naps, and decreased night-time sleep. triazolam decreased daytime sleepiness and naps, and increased night-time sleep. Actigraphic night-time sleep and naps on the first day were similar to these results. However, on the fourth day night-time insomnia induced by BL had recovered, and naps were shorter than the baseline. triazolam increased actigraphic naps as the days passed. ( info) |
6/31. Case of a mentally retarded child with non-24 hour sleep-wake syndrome caused by deficiency of melatonin secretion. A case of a 5-year-old boy with non-24 hour sleep-wake syndrome and mental retardation is reported. His free-running sleep-wake rhythm was remarkably improved by the oral administration of melatonin. The circadian variation in melatonin secretion was extremely low, and circadian rhythm of cortisol secretion was noted. It was speculated that his non-24 hour sleep-wake syndrome was due to a congenital deficiency of melatonin secretion, and supplemental melatonin therapy proved effective for treating his condition. ( info) |
7/31. Effect of melatonin on sleep-wake rhythm: the sleep diary of an autistic male. This study reports on melatonin treatment in autism. A 14-year-old autistic male with severe mental retardation was given melatonin at a dose of 6 mg at 9:00 pm (C1) or 11:00 pm (C2). His parents kept a sleep diary. In C1, he often experienced early morning waking and fragmented night sleep but in C2, night sleep was prolonged and sleep-wake rhythm was improved. Suitable medication time, therefore, improved the sleep-wake rhythm. ( info) |
8/31. Peculiar respiratory response observed during sleep-onset REM sleep of an infant with Ondine's curse. We treated an infant with congenital central hypoventilation syndrome ("Ondine's curse"). She was cyanotic and given ventilatory support at the first hour after birth. An investigation of sleep state and respiration performed at the age of 3 months led to this diagnosis. hypoventilation persisted in all sleep stages, with the most severely reduced tidal volumes occurring during delta-wave sleep (stages 3 and 4). In addition, severe secondary reduction in tidal volumes occurred in sleep-onset REM sleep. This phenomenon was absent in non sleep-onset REM sleep. At 4 months of age, her respiratory treatment was successfully converted to positive-pressure ventilation via a nasal mask, thus avoiding tracheotomy. This transition to noninvasive ventilatory support dramatically improved her quality of life during wakefulness. This report may be a clue to discuss the function of sleep-onset REM sleep seen in the early stage of life and suggests that nasal mask ventilation is a viable option in selected cases with congenital central hypoventilation syndrome (CCHS). ( info) |
9/31. Detection of insomnia in primary care. Insomnia is a widespread condition with diverse presentations. Detection and diagnosis of insomnia present a particular challenge to the primary care physician. patients seldom identify their sleep habits as the source of the complaints for which they are seeking treatment. Insomnia may be the result of many different medical or psychiatric illnesses or the side effects of medications or legal or illegal recreational drugs. Insomnia has a serious impact on daily activities and can cause serious or fatal injuries. With ever-increasing competition with sleep from 24-hour television broadcasts from hundreds of channels and the internet, as well as more traditional distractions of late-night movies, clubs, and bars, we have become a society that sleeps 25% less than our ancestors did a century ago. We have no evidence, however, that we require less sleep than they did. This article presents strategies for detecting and diagnosing insomnia. ( info) |
10/31. Sleep-wake rhythm during stay in an intensive care unit: a week's long-term recording of skin potentials. To monitor the sleep-wake cycle of patients during their stay in the intensive care unit (ICU), we tried continuous and long-term recording of skin potential (SP) levels in patients after surgery. A graph of the week-long SP showed the sleep-wake pattern to be evident until the fourth day. It disappeared beginning on the fifth day, resulting finally in delirium with a relatively high mean SP level. In another record, the administration of sedative agents to calm the excitement lowered the mean SP level and suppressed SP responses evoked by frequent day and night treatment or nursing care. Continuous monitoring of arousal level by SP will be of help in prevention of ICU syndrome. ( info) |