Managing pregnancy-related nocturnal nasal congestion. The external nasal dilator.

Objective: To assess the efficacy of an over-the-counter mechanical nasal dilator during sleep in pregnant women with nasal congestion.

Study Design: Pregnant women with symptoms of nocturnal nasal congestion not attributed to allergies or "cold" symptoms were randomized in a double-blind manner to receive either a spring-loaded device or placebo device without a spring. Each patient assessed breathing and sleep quality for a three-day baseline and three-day treatment period.

A laboratory validation study of a portable system for remote recording of sleep-related respiratory disorders.

This study represents the validation of an out-of-laboratory recording system for screening sleep disorders by comparing it to an in-laboratory system which accomplishes complete polysomnography. Forty patient cases were collected. Each patient slept in the sleep laboratory with the simultaneous monitoring of eight channels from the Sleep I/T (CNS, Inc), as well as complete polysomnographic monitoring comparable to that which accomplishes routine patient evaluations utilizing the Sleeplab (CNS, Inc) system.

Genetic markers in familial narcolepsy.

We studied three patients in a single family (father and two sons), all with long histories of overwhelming daytime sleepiness, hypnagogic hallucinations and sleep paralysis. Two of the three had a clear history of cataplexy. Multiple sleep latency tests revealed extremely short sleep onset latencies and at least two sleep onset rapid eye movement periods in each patient.

Polysomnography methods and interpretations.

As the field of sleep disorders medicine continues to mature, appropriate diagnostic techniques are becoming properly defined and standardized. This article focuses principally upon diagnostic testing for sleep apnea, although other sleep disorders are discussed briefly. When interpreting a polysomnogram, one must consider a number of complex variables.

Persistent hypoxemia and excessive daytime sleepiness in chronic obstructive pulmonary disease (COPD).

Fourteen patients with chronic obstructive pulmonary disease (COPD) and chronic hypoxemia were studied to evaluate the relationship between hypoxemia and objective and subjective daytime sleepiness. Patients were selected with a waking PaO2 of less than 70 mm Hg and less than 50 percent predicted FEV1. Clinically, none of these patients had complaints of significant daytime sleepiness.

Dose effects of methaqualone on stimulus encoding in a memory scanning task.

Three task variables, stimulus quality, memory set size and response type, were used in a Sternberg binary classification task to define stimulus encoding, short-term memory scanning, and response selection stages within a serial stage reaction process. Mean reaction times, and the slopes and intercepts of the function relating reaction time to memory set size, were used to test the hypothesis that performance deficits seen at two doses of methaqualone (2.9 mg/kg and 5.

Commentary on the utility of experimental social and learning models of alcoholism.

This chapter reviews the status of models in scientific research generally and in alcohol research in particular. The reader's attention is drawn to both advantages and disadvantages of models. The authors concur with others that models should be judged primarily by a criterion of usefulness rather than that of truthfulness .

Effect of alcohol on recall and recognition as functions of processing levels.

Other investigators have suggested that the memory impairments found in alcohol intoxication represent the failure to process information to sufficient depth, i.e., an encoding deficit.

Secobarbital effects on recall and recognition in a levels-of-processing paradigm.

Dose effects of secobarbital on free recall and recognition of words were examined in levels-of-processing paradigms. Secobarbital significantly impaired recall, even when initial item processing was guided with appropriate orienting tasks. However, when processing was guided both at input (with orienting tasks) and at retrieval (with recognition testing), secobarbital-related retention deficits reported in conventional 'learn these words' experiments were not found.

Altered sleep physiology in chronic alcoholics: reversal with abstinence.

Somnograms obtained from recently abstinent chronic alcoholics reveal gross disruption succinctly described as "fractured" sleep. Sleep onset is delayed and the rhythmic properties of the sleep pattern are markedly disturbed with numerous brief arousals and changes of sleep stage. Excessive stage 1 and stage rapid eye movement sleep are present while the high voltage slow wave sleep is markedly reduced or absent.

Feasibility of an alcoholism health insurance benefit.

The present study examined the impact of alcoholism treatment upon the subsequent utilization of health care services. Information gathered on a sample of 2,362 alcoholic clients at time of admission and six months later, was utilized to compare the savings in medical care expenses with the costs of alcoholism treatment. For the first year following treatment, costs exceeded savings by an average of $263 per client (benefit-cost ratio = 0.

Dose effects of secobarbital in a Sternberg memory scanning task.

Mean reaction times obtained in a Sternberg memory-scanning task were examined for the effects of secobarbital at two doses (1.47 mg/kg and 2.94 mg/kg) spanning the dose range commonly used in clinical practice.

A model for service delivery research and evaluation: management implications for alcohol, drug abuse and mental health organizations.

Public alcohol, drug and mental health organizations have failed to adequately demonstrate their impact. Historically, the justification for these programs have relied more on good intentions and good faith to support their efforts than on their documented efficacy. This lack of documentation has contributed, in part, to recent federal and state mandates for better management, control, and evaluation of publicly financed mental health, alcohol and drug abuse care.

Psychiatric morbidity in prisons.

Faced with the recommendation by an outside consultant to construct a large hospital for the criminally insane, the Oklahoma legislature approved a proposal by the state mental health department to study the mental health treatment needs of the prison population. Through a variety of assessment techniques, the authors found the inmates had a spectrum of disorders needing different treatment approaches. Approximately 78 per cent of the inmates are diagnosable.

Benefit--cost methodology in the evaluation of therapeutic services for alcoholism.

Benefit--cost analysis as a form of "social profitability analysis" can be a powerful tool in the overall evaluation of alcoholism treatment efforts. Alcoholism treatment potentially leads to a multiplicity of benefits in addition to sobriety. Benefit--cost analysis provides a methodology for converting many of these diverse benefits into a common metric (dollars), thereby allowing the comparison of aggregate benefits and treatment costs.

Treatment outcome for alcoholics as a function of therapeutic effort.

The association between therapeutic effort measured in terms of reimbursements for services and several treatment outcome variables was examined. A sample of clients regarded as definitely alcoholic was grouped into five categories according to the amount of money reimbursed for treatment in a fee-for-service arrangement. A systematic positive relationship was found between the amount of treatment measured in dollars and therapeutic outcome measured by remission rate and income.

Drinking behavior, remission, and relapse: the Rand Report revisited.

Utilizing the Armor, Polich, and Stambul 1976 criteria, the clinical course of patients from 26 treatment programs was studied, with relapse analyses differing from the data reported by Armor et al. The overall rate of remission at 6 mo follow-up was considerably lower (54%) in this study. The data suggest that those alcoholics who chose to reduce their drinking, as an option, experienced a substantial risk of relapse.

Secobarbital and information processing.

The Sternberg fixed-set memory-search paradigm was used to assess the relative vulnerability of hypothetical stages of information processing to an oral dose of secobarbital (2.9 mg/kg). D-amphetamine (15 mg, oral dose) was intended to serve as an active placebo.