Mortality related to actigraphic long and short sleep.

Background: The folk belief that we should sleep 8 h seems to be incorrect. Numerous studies have shown that self-reported sleep longer than 7.5 h or shorter than 6.

Self-reported sleep latency in postmenopausal women.

The aim of this study was to access how self-reported sleep latency (SRSL) was affected by sleep habits, mood, and circadian rhythm in postmenopausal women. Subjects (n=384, 67.9+/-7.

Ethnicity, sleep, mood, and illumination in postmenopausal women.

Background: This study examined how ethnic differences in sleep and depression were related to environmental illumination and circadian rhythms.

Methods: In an ancillary study to the Women's Health Initiative, 459 postmenopausal women were recorded for one week in their homes, using wrist monitors. Sleep and illumination experience were estimated.

Melatonin excretion with affect disorders over age 60.

Numerous studies have reported low melatonin secretion in depression, but other studies have suggested no deficit or an increase. Alterations of circadian phase or duration of melatonin secretion have also been described. Since melatonin secretion decreases as we age, it seemed interesting to examine melatonin and depression in an aging sample.

Depression and endogenous melatonin in postmenopausal women.

Background: Previous reports on melatonin secretion in depression are numerous but conflicting. There are very few studies relating the duration of the nocturnal melatonin peak to depression, and the results of those studies have been equivocal.

Methods: We studied mood disorders and urinary melatonin excretion in 382 postmenopausal women.

Effect of light treatment on sleep and circadian rhythms in demented nursing home patients.

Objectives: To determine whether fragmented sleep in nursing home patients would improve with increased exposure to bright light.

Design: Randomized controlled trial.

Setting: Two San Diego-area nursing homes.

Mortality associated with sleep duration and insomnia.

Background: Patients often complain about insufficient sleep or chronic insomnia in the belief that they need 8 hours of sleep. Treatment strategies may be guided by what sleep durations predict optimal survival and whether insomnia might signal mortality risks.

Methods: In 1982, the Cancer Prevention Study II of the American Cancer Society asked participants about their sleep duration and frequency of insomnia.

Circadian abnormalities in older adults.

This study examined the circadian phase adjustment of symptomatic elders ages 60-79 years in comparison with that of young, healthy adults ages 20-40 years. Seventy-two elders with complaints of insomnia or depression, and 30 young, healthy adults were assessed for 5-7 days at home. Sleep and illumination were recorded with Actillume wrist monitors and sleep diaries.

Short version of the CES-D (Burnam screen) for depression in reference to the structured psychiatric interview.

A new screen for depression was compared with clinician diagnoses based on the Structured Clinical Interview for DSM-IV (SCID) as the standard. Post-menopausal women (n=436) completed the Burnam screen, a short version of the Center for Epidemiologic Studies Depression Scale (CES-D). The Burnam screen had a sensitivity of 74% and a specificity of 87% for current major depression and dysthymia, but the positive predictive value was low (20%) and the overall error rate was 14%.

Sleep duration, illumination, and activity patterns in a population sample: effects of gender and ethnicity.

Background: Current knowledge of the population's sleep durations emanates primarily from questionnaires and laboratory studies. Using Actillumes, we investigated whether self-reported sleep durations were indicative of a population decline in sleep duration. We also explored illumination and activity patterns.

Circadian sleep, illumination, and activity patterns in women: influences of aging and time reference.

Patterns of sleep, illumination, and activity of women of different ages were continuously monitored in their natural environments with a wrist activity monitor. Partial correlation analyses were performed to determine relationships between age and sleep and several circadian rhythm measures including the amplitudes, mesors, and timings of sleep, of illumination, and of activity. We found no age-related decline in actigraphic sleep duration.

The correlation between the severity of peripheral arterial disease and carotid occlusive disease.

Peripheral arterial disease (PAD) and carotid occlusive disease (COD) are both known to be specific manifestations of atherosclerosis. Because they both have a common cause, it is reasonable to hypothesize that they should correlate with each other to a certain extent, and previous studies have shown that there is a correlation between the prevalence of PAD and COD. The purpose of this study was to determine whether a correlation exists between the severity of PAD and the severity of COD by retrospectively looking at a group of 203 patients who underwent non-invasive testing for suspicion of PAD at the San Diego VA Hospital or UCSD Medical Center, and who also had a non-invasive duplex carotid scan.

Quantitative and qualitative progression of peripheral arterial disease by non-invasive testing.

There is little information on the progression of peripheral arterial disease (PAD) over time. A series of 508 patients with a prior examination for PAD were contacted and brought in for follow-up to evaluate the natural history of PAD. A total of 85 patients were excluded because they had interventions in both limbs prior to their return visit.

Hourly profiles of sleep and wakefulness in severely versus mild-moderately demented nursing home patients.

The purpose of the current study was to examine differences in hour-by-hour sleep/wakefulness profiles between severely and mild-moderately demented patients, and to assess how many elderly patients remain almost fully asleep or nearly fully awake in each hour of a 24-hour period. Sleep/wakefulness patterns of 67 demented nursing home residents (mean age = 85.7 years) were recorded using Actillume recorders.

A multicenter trial on the efficacy of using tirilazad mesylate in cases of head injury.

Object: The authors prospectively studied the efficacy of tirilazad mesylate, a novel aminosteroid, in humans with head injuries.

Methods: A cohort of 1120 head-injured patients received at least one dose of study medication (tirilazad or placebo). Eighty-five percent (957) of the patients had suffered a severe head injury (Glasgow Coma Scale [GCS] score 4-8) and 15% (163) had sustained a moderate head injury (GCS score 9-12).

Periodic leg movements during sleep and sleep disturbances in elders.

Background: Periodic limb movements in sleep (PLMS) are an increasingly pervasive disturbance for aging adults. The aims of this experiment were: (a) to describe the index of periodic limb movements in sleep (myoclonus index [MI] in elderly subjects with complaints of poor sleep or depression (N = 22; 68 +/- 5.5 SD years); and (b) to correlate MI with sleep history, depression scores, and objective and subjective indices of sleep.

Neurogenic hypotension in patients with severe head injuries.

Objective: To examine the occurrence of hypotensive episodes in patients with severe traumatic brain injuries that are not of hypovolemic origin and to investigate possible neurogenic or iatrogenic causes of such episodes.

Methods: We reviewed Traumatic Coma Data Bank (TCDB) records of the 248 patients with early hypotension. We attempted to eliminate episodes related to hemorrhagic hypovolemia by excluding patients with (1) extracranial injuries of Abbreviated Injury Scale scores > 3 (n = 99, 40%); (2) postresuscitation hematocrit levels < 35% (n = 76, 30.

Mortality hazard associated with prescription hypnotics.

Background: The American Cancer Society's Cancer Prevention Study II was a large survey designed primarily to examine cancer risks such as cigarette smoking. From the same survey and methods, data on usage of "prescription sleeping pills" in 1982 were examined.

Methods: Standardized mortality ratios were computed.

Blunted phase-shift responses to morning bright light in premenstrual dysphoric disorder.

Patients with premenstrual dysphoric disorder (PMDD) respond therapeutically to sleep deprivation and light therapy. They have blunted circadian rhythms of melatonin. The authors sought to test the hypothesis that these disturbances are a reflection of a disturbance in the underlying circadian pacemaker or, alternatively, that they reflect a disturbance in the input pathways to the clock.

Effects of apolipoprotein E on dementia and aging in the Shanghai Survey of Dementia.

We investigated the status of the apolipoprotein E allele in 538 participants in the incidence phase of the ongoing Shanghai Survey of Dementia, including 103 demented subjects, 72 with mild cognitive impairment and 363 cognitively normal. The apo E epsilon 4 allele was present in 10.2% of control subjects and the allelic frequency did not change between ages 60 to 96 years.

A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study.

Background: There is evidence that medications or vitamins that increase the levels of brain catecholamines and protect against oxidative damage may reduce the neuronal damage and slow the progression of Alzheimer's disease.

Methods: We conducted a double-blind, placebo-controlled, randomized, multicenter trial in patients with Alzheimer's disease of moderate severity. A total of 341 patients received the selective monoamine oxidase inhibitor selegiline (10 mg a day), alpha-tocopherol (vitamin E, 2000 IU a day), both selegiline and alpha-tocopherol, or placebo for two years.

Plasma melatonin circadian rhythms during the menstrual cycle and after light therapy in premenstrual dysphoric disorder and normal control subjects.

The aim of this study was to replicate and extend previous work in which the authors observed lower, shorter, and advanced nocturnal melatonin secretion patterns in premenstrually depressed patients compared to those in healthy control women. The authors also sought to test the hypothesis that the therapeutic effect of bright light in patients was associated with corrective effects on the phase, duration, and amplitude of melatonin rhythms. In 21 subjects with premenstrual dysphoric disorder (PMDD) and 11 normal control (NC) subjects, the authors measured the circadian profile of melatonin during follicular and luteal menstrual cycle phases and after 1 week of light therapy administered daily, in a randomized crossover design.

Nocturnal light effects on menstrual cycle length.

Objectives: In previous University of California, San Diego (UCSD) studies, nocturnal illumination shortened menstrual cycles that were longer than 33 days. The studies reported here extend the previous findings, confining the illumination to the sleep period.

Design: Two light levels (235 to 250 lux and less than 1 lux) and 2 modes of light delivery (lighted sleep mask and bedside lamp) were tested.

Prevalence of sleep-disordered breathing in ages 40-64 years: a population-based survey.

Previous research has offered widely varying prevalence estimates for sleep apnea in the population, leaving uncertain which breathing patterns are abnormal. To explore the distribution of sleep apnea in the population and its co-morbidities, random telephone dialing was used between 1990 and 1994 to recruit subjects for a prevalence survey of sleep-disordered breathing in San Diego adults. Events from which blood oxygen desaturations > or = 4% resulted were monitored with home recording instruments, usually for three consecutive nights.