The pupil dark response in narcolepsy.

The pupil dark response and maintenance of pupil area in darkness were compared in seven narcoleptic patients and 14 age-matched normal volunteers. Onset and degree of miosis after maximal pupil dilation in darkness were similar in the two groups, although three narcoleptic patients and no normal volunteers fell asleep during the experiment. The results of this study contradict earlier suggestions that pupillography can be used to distinguish normal individuals in family studies of narcoleptic patients.

Topographic cortical mapping of EEG sleep stages during daytime naps in normal subjects.

Computer-generated cortical maps of power spectral estimates derived from 16 leads were drawn based on daytime sleep recordings in four normal volunteers. These data were compiled from nine 10-s artifact-free, EEG epochs from awake, stages 1-4 and REM sleep in each volunteer. EEG leads were placed on the left hemisphere and midline according to the 10-20 system with four additional interpolated posterior locations.

REM sleep suppression induced by selective monoamine oxidase inhibitors.

The effects of 4 weeks of treatment with the selective monoamine oxidase (MAO) inhibiting antidepressant clorgyline and pargyline on the sleep of affectively disordered patients were studied. Both inhibitors resulted in near total suppression of REM sleep, a decrease in total sleep time, and an increase in the percent of stage 2 sleep. Clorgyline also increased awake time and decreased total recording period and sleep latency.

A clinical study of flurazepam.

Eleven patients suffering from chronic insomnia were given 30 mg flurazepam for 28 nights. While EEG measures of total sleep time and sleep efficiency were improved, changes in sleep latency and intermittent waking time were small and nonsignificant. Subjective benefits in sleep were confined to the first 2 nights.

Childhood obsessive-compulsive disorder.

The authors collected clinical diagnostic, neurophysiological, electrophysiological, and biochemical data on 9 adolescents who had primary obsessive-compulsive disorder. The results indicate considerable descriptive validity of the syndrome in childhood and its independence from obsessional traits; however, all of the children had a history of major depressive disorder, and their sleep EEG measures resembled those of young adults with primary depressive disorder. The patients' families did not have a more consistent pattern of anxiety disorder or any other psychiatric disorder than do families of adult obsessive patients.

EEG sleep patterns in schizophrenic patients undergoing hemodialysis.

All-night electroencephalographic (EEG) sleep studies were obtained before and during a double-blind clinical trial of hemodialysis in six schizophrenic patients with normal renal functioning. No significant changes were observed in either clinical status or sleep, except for a significant reduction in rapid eye movement (REM) density, a measure of the number of eye movements per minute of REM sleep.

REM sleep, naps, and depression.

Continued interest in rapid eye movement (REM) sleep abnormalities in depression stimulated comparative studies on daytime naps versus nighttime sleep. In a group of 15 depressed patients, REM latencies in morning and afternoon naps were similar to the shortened REM onset at night. Although REM latency did not vary across the three times, the propensity for REM sleep appeared to be greater in the morning nap than in the afternoon nap and the early portion of nocturnal sleep.

Wheat gluten challenge in schizophrenic patients.

Eight chronic schizophrenic patients were maintained on a diet free of gluten, cereal grains, and milk (CM-F diet) and challenged in a double-blind manner with dietary wheat gluten and placebo. While on the CM-F diet, each patient received a daily challenge of 30 g of gluten for 5 weeks and a placebo challenge for 8 weeks. No deterioration in clinical status as measured by the BPRS was noted on gluten challenge.

Flurazepam-induced sleep apnea syndrome in a patient with insomnia and mild sleep-related respiratory changes.

Sleep EEG and respiratory measures were examined in a 38-year-old man with a long-standing history of insomnia and daytime sleepiness. He was found to have seven to 18 primarily obstructive apneas per night on four baseline recordings, a finding not generally considered to be indicative of pathology. On the first two nights on which he received 30 mg of the benzodiazepine hypnotic flurazepam, there were 22 and 100 apneas, and during the daytime he became extremely sleepy.

Piperidine enhances sleep-related and insulin-induced growth hormone secretion: further evidence for a cholinergic secretory mechanism.

Piperidine, a nicotinic cholinergic receptor stimulator, was used in paired design studies of sleep-related and insulin-induced GH and PRL secretion. For the sleep studies, 100 mg piperidine or an equal volume of saline were infused for 30 min starting at sleep onset in eight normal volunteers. The same dose of piperidine was infused for 30 min (beginning 15 min before insulin injection) in an additional eight volunteers undergoing insulin tolerance tests.

Physostigmine induction of depressive symptomatology in normal human subjects.

Nine normal volunteers, screened for the absence of a personal or family history of affective disorders and free of concurrent marijuana usage, received intravenous infusions of high dose physostigmine or saline in a randomized, double-blind, counterbalanced paradigm. Self-rating and observer ratings both demonstrated a statistically significant, physostigmine associated increase in depressive-type symptoms in the group as a whole, particularly pronounced in certain individuals. These results are the first report of physostigmine associated depressive symptomatology in normal subjects.

Age-related changes in sleep in depressed and normal subjects.

All-night electroencephalographic (EEG) sleep data were examined a function of age in normal control subjects and hospitalized, unmedicated depressed patients with primary affective illness. By analysis of variance, Total Sleep time, Delta Sleep, Sleep Efficiency, Rapid Eye Movement (REM) Sleep, and REM Latency decreased as a function of age, whereas Early Morning Awake time and Intermittent Awake time increased. Compared with normal controls, after the effects of age were covaried out, depressed patients had a greater Sleep Latency, Early Morning Awake time, Intermittent Awake time, Duration and REM Density of the first REM period, and average REM Density for the night, as well as less Sleep Efficiency, less Delta Sleep, and shorter REM Latency, Early Morning Awake time increased with age in depressives but not in normals.

Development and use of pharmacological probes of the CNS in man: evidence of cholinergic abnormality in primary affective illness.

The role of cholinergic mechanisms in the regulation of CNS functions was studied in normal humans. The purpose was to develop in vivo pharmacological techniques to assess central neurotransmitter activity in normals and apply them in primary affective illness and other neuropsychiatric conditions. Central cholinergic stimulation by cholinomimetics induced rapid eye movement (REM) sleep, dreaming, cortical arousal, and accelerated the REM cycle.

Relationship between EEG sleep patterns and clinical improvement in depressed patients treated with sleep deprivation.

The effects of a single night of total sleep deprivation were observed in 16 primary depressed patients. Responders to treatment were rated as significantly more depressed and revealed a more "depressed" EEG sleep pattern prior to sleep deprivation than did nonresponders. Following sleep deprivation, patients who improved experienced a rebound in REM sleep during the second night of recovery sleep.

Effects of melatonin and propranolol on sleep of the rat.

Melatonin and L-propranolol, which inhibits melatonin synthesis, were administered to rats at 07.45 h and 19.45 h.

Childhood enuresis. I. Sleep patterns and psychopathology.

Forty severely enuretic boys (mean age, 10.8 years) were selected; 20 had associated psychiatric disturbance and 20 had enuresis as an isolated symptom. Psychiatrically disturbed enuretics had both slightly higher scores on a neurological examination for "soft signs" and more "stressful" background events.