[Primary insomnia].

Primary insomnia is relatively common. According to The International Classification of Sleep Disorders, primary insomnia is a syndrome mainly composed of psychophysiological insomnia, paradoxical insomnia and idiopathic insomnia. Primary insomnia is difficulty initiating sleep (sleep onset insomnia), difficulty maintaining sleep (mid-sleep awakening, early morning awakening) or chronic non restorative sleep, which persist longer than three weeks despite having adequate opportunity for sleep and result in impaired daytime functioning.

Risk factors for obstructive sleep apnea syndrome screening in mood disorder patients.

Aims: Previous studies have reported that the incidence of obstructive sleep apnea syndrome (OSAS) in patients with depression is higher than in the general population. We examined the risk factors to predict OSAS in mood disorder patients with depressive symptoms.

Method: We conducted polysomnography for patients who satisfied the following criteria: (i) diagnosis of major depressive disorder or bipolar disorder according to the Mini-International Neuropsychiatric Interview (MINI); (ii) a score of > or =10 on the Hamilton Rating Scale for Depression (HAM-D); (iii) fulfillment of either (a) or (b) below: (a) at least one of the following: severe snoring, witnessed apnea during sleep, excessive daytime sleepiness; (b) at least one of the following plus an oxygen desaturation index of 4% > or =5 times/h by pulse oximeter: mild snoring, sleep disturbance, headache, high blood pressure.

Nasal resistance for determinant factor of nasal surgery in CPAP failure patients with obstructive sleep apnea syndrome.

Objectives: Given that criteria for nasal surgery in individuals with obstructive sleep apnea syndrome (OSAS) have not been proposed, we investigated the effectiveness of nasal surgery for CPAP failure in patients with both severe OSAS and nasal obstruction.

Patients And Methods: Conventional nasal surgery was performed in 12 patients who were refractory to treatment by CPAP. The subject group consisted of 12 males (mean age, 54.

[Excessive daytime sleepiness and low CSF orexin-A/hypocretin-I levels in a patient with probable progressive supranuclear palsy].

We report a 74-year-old woman with excessive daytime sleepiness (EDS) who were diagnosed as probable progressive supranuclear palsy (PSP). Her EDS mimicked narcolepsy without cataplexy, because multiple sleep latency tests showed short latencies, human leukocyte antigen testing was positive for DR2/DQB1, and orexin A (hypocretin-I) concentration in her cerebrospinal fluid was undetectable. In PSP, neurofibrillary tangles appears in the hypothalamus, neuronal loss and gliosis are seen in a number of pontine and mesencephalic tegmental nuclei, substantia nigra, locus caeruleus.

Rapid eye movement-localized apnea in a female patient with chronic insomnia.

A middle-aged female patient with chronic insomnia showed rapid eye movement (REM)- localized obstructive sleep apnea. She visited the Sleep Disorders Clinic and complained of insomnia with loud snoring. Once, in the past, her sleep complaints had disappeared after weight reduction but, 6 months later, she complained of excessive daytime sleepiness.

Evaluating mental fatigue in patients with obstructive sleep apnea syndrome by the Maastricht Questionnaire.

Mental fatigue in patients with obstructive sleep apnea syndrome (OSAS) was investigated and compared with subjects without OSAS. The study series comprised 189 habitual snoring patients and 75 controls. To measure subjective mental fatigue and somnolence, subjects were asked to complete the Maastricht Questionnaire (MQ) and the Epworth Sleepiness Scale (ESS), respectively, and patients also underwent diagnostic polysomnography.