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1/16. 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.
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keywords = rhythm disorder, rhythm
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2/16. 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.
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ranking = 0.0080524168899071
keywords = rhythm
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3/16. 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.
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ranking = 0.013420694816512
keywords = rhythm
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4/16. 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.
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ranking = 1.0442925557901
keywords = circadian rhythm, rhythm
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5/16. 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.
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ranking = 0.016104833779814
keywords = rhythm
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6/16. 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.
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ranking = 0.01073655585321
keywords = rhythm
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7/16. Arrhythmicity in a child with septo-optic dysplasia and establishment of sleep-wake cyclicity with melatonin.

    We identified a 3-year-old child with septo-optic dysplasia with arrhythmic activity patterns. To assess whether melatonin could improve rest-activity patterns, 0.1 mg was administered orally at 19:00 hours. After therapy onset, normal rest-activity patterns appeared. These observations show that melatonin can restore normal rhythmicity in the absence of a normally functioning circadian clock.
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ranking = 0.016104833779814
keywords = rhythm
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8/16. Low, but not high, doses of melatonin entrained a free-running blind person with a long circadian period.

    In a previous report, we were unable to entrain one out of seven totally blind people with free-running endogenous melatonin rhythms to 10 mg of exogenous melatonin. This person had the longest circadian period (24.9 h) of the group. We now find that this person can be entrained to 0.5 mg of melatonin, but not to 20 mg. These results are consistent with the idea that too much melatonin may spill over onto the wrong zone of the melatonin phase-response curve.
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ranking = 0.0026841389633024
keywords = rhythm
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9/16. Case study of circadian rhythm sleep disorder following haloperidol treatment: reversal by risperidone and melatonin.

    A patient with Gilles de la tourette syndrome treated with haloperidol, ingested once daily after awakening from sleep, exhibited an irregular sleep-wake pattern with a free-running component of approximately 48 h. Transfer to risperidone, ingested once daily after awakening from sleep, was beneficial resulting in a sleep-wake cycle more synchronized at the appropriate phase to the external zeitgebers, and fewer nocturnal disturbances. The circadian sleep-wake schedule was fully synchronized when the patient had been subsequently treated with melatonin at 21:00h, before intended nocturnal sleep, in addition to risperidone in the morning. Restoration of the sleep-wake circadian pattern was accompanied by the patient's subjective report of significant improvement in his quality of life, social interactions, and occupational status. This observation suggests that circadian rhythm sleep disorders can be related to the typical neuroleptic haloperidol and restored by the atypical neuroleptic risperidone. Similar findings reported in patients suffering from other disorders support the hypothesis that the described disruption of the sleep-wake schedule is medication rather than illness-related. Therefore, it is very important to realize that circadian rhythm sleep disorders may be a side effect of neuroleptics.
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ranking = 6.249650500961
keywords = circadian rhythm, rhythm
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10/16. 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.
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ranking = 2.0832168336537
keywords = circadian rhythm, rhythm
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