Search PubMed⌕ Search

Biomedical subjects

C Guilleminault

Publications and source records attributed to C Guilleminault.

At least 415 records · Page 23Linked to original sources
PubMed1976

Narcolepsy. Diagnosis and treatment.

Narcolepsy may affect as many as 200,000 Americans. The illness involves a neurologic defect in the regulation of sleep and wakefulness. The chief symptoms are sleepiness, inappropriate sleep episodes, and cataplexy. A characteristic history of cataplexy establishes the diagnosis. Narcoleptic patients also frequently complain of hypnagogic hallucinations, sleep paralysis, blackouts (or automatic behavior), and disturbed nocturnal sleep. Narcolepsy usually develops in adolescence and is a life-long illness. Symptoms may also appear in young children who may be misdiagnosed as hyperactive or psychotic. No completely satisfactory treatment is available at the present time. The current treatments of choice are methylphenidate (for sleepiness and sleep episodes) and imipramine (for cataplexy). Medication dosages must be adjusted for individual patients. A careful history of the illness can rule out hypothyroidism, hypoglycemia, and epilepsy. Sleep apnea is a serious complication of narcolepsy and may be life threatening.

Adolescent↗
PubMed1976

The pathophysiology of sleep disorders in pediatrics. Part I. Sleep in infancy.

In this part of the chapter we have described the characteristics of two alternating sleep states - REM and NREM sleep in preterm and full-term infants. We have indicated how individual physiologic measures, recorded during sleep, mature and become synchromized into patterns that define the sleep states. We have described abnormalities in this process and have related them to clinical populations of deviant infants. Throughout, we have emphasized the complexity of the process and the methodologic sophistication required to investigate adequately the multiple dimensions of sleep. Despite somewhat discrepant and confusing reports in the literature, we continue to believe that sleep studies will provide rewarding insights into the central nervous system functioning of the developing young infant.

Apnea↗
PubMed1976

The pathophysiology of sleep disorders in pediatrics. Part II. Sleep disorders in children.

In this part of the chapter we have used new terminology and developed a new system for classification of sleep disorders in children. We suggest that excessive daytime sleepiness should be investigated by clinicians before troubles at school necessitate referral. The narcolepsy-hypersomnia syndrome generally has not been recognized in the pediatric age group. Symptoms of excessive fear of falling asleep need to be viewed in this context. Sleep apnea-hypersomnia has received insufficient attention in the American literature. It is a syndrome that affects both adults and children with potentially disastrous cardiovascular and pulmonary complications. The relationship of the sleep apnea-hypersomnia syndrome to the sudded infant death syndrome remains speculative, although preliminary results from our longitudinal study have indicated a possible link. Both the narcolepsy-hypersomnia and the sleep apnea-hypersomnia syndromes are reviewed in detail. In contrast, we review briefly the NREM dyssomnias, including night terrors, sleepwalking, sleep talking and enuresis. All are well known to clinicians dealing with children, and we have related them to findings emanating from the sleep laboratory. We suggest that they are physiologically rather than psychogenically based and frequently represent immaturities of the central nervous system. Finally, the insomnias of childhood are presented. We emphasize that they are rare, and after ruling out organic conditions and drug-dependency syndromes, cultural styles or family stresses generally account for the majority of complaints.

Apnea↗
PubMed1976

Sleep apnea in eight children.

Eight children, 5 to 14 years of age, were diagnosed by means of nocturnal polygraphic monitoring with a sleep apnea syndrome similar to that seen in adults. Excessive daytime sleepiness, decrease in school performance, abnormal daytime behavior, recent enuresis, morning headache, abnormal weight, and progressive development of hypertension should suggest the possibility of a sleep apnea syndrome when any of these symptoms is associated with loud snoring interrupted by pauses during sleep. Surgery may eliminate the clinical symptomatology.

Adenoidectomy↗
PubMed1975

Apneas during sleep in infants: possible relationship with sudden infant death syndrome.

Several types of apnea are described in premature infants and in infants who have survived breathing-stoppage episodes which may be related to the sudden infant death syndrome. Upper airway apnea appears to induce the greatest changes: oxygen desaturation is more pronounced than in a central apnea of similar duration, and secondary cardiac changes are observed earlier and are more severe.

Apnea↗
PubMed1975

[Can an anomaly of the central nervous system be responsible for hemodynamic disorders].

Twenty-seven subjects with insomnia or diurnal hypersomnolence presented a sleep apnea syndrome when their respiration was systematically checked during sleep. These sleep-induced respiratory abnormalities were completely occult and pulmonary function tests performed during wakefulness were normal. The patients, all non-obese, presented serious pulmonary artery pressure changes which were directly connected with the repetitive sleep apneas. Half of the patients also had systemic hypertension. Two children (aged 11 and 15) underwent tracheostomies which by-passed the sleep-induced obstruction. Systemic hypertension was reduced after surgery.

Adolescent↗
PubMed1975

A syndrome of hypersomnia with automatic behavior.

Five male patients, complaining of daytime sleep attacks, and hav ing a history of automatic behavior, were recorded continously by polygraph for 108 h under two different protocols: (1ents were given specific tests to perform during Phase 1. Six normal males were run as controls during Phase . At the end of the recordings, patients had measurements of homovanillic acid (HVA) and 5 Hydroxy-indol Acetic Acid (5HIAA) in CSF before and after Probenecid testing. Patients appeared to present an abnormal sleep structure, with lack of Stage 3 and 4 NREM sleep, but had no significant increase in total sleep time during 24 h compared to normals. They also had repetitive very short periods of "micro-sleep" which account for their automatic behavior and were responsible for their great decrement in performance compared to normal controls. No CSF HVA and 5HIAA abnormality could be detected. This syndrome, which greatly impairs the social life and working ability of the patients, may be more related to an impairment of the "wakefulness" structures than to a dysfunction of the "sleep" structures.

Adult↗
PubMed1975

Altered states of consciousness in disorders of daytime sleepiness.

Patients with daytime sleepiness present altered states of consciousness. The occurrence of these states impairs their professional, social and familial activities and may threaten life itself. The automatic behavior syndrome is characterized by continuation of mechanical activity and complete amnesia. Episodes lasting from a few seconds to several hours are correlated with repetitive micro-sleep periods. During cataplectic attacks, patients may have a meshing of reality with hallucinatory dream contents. Sleep-induced apnea may lead to abnormal movement and abnormal ambulation during sleep as well as hallucinations in the early morning. These altered states of consciousness must be considered as diagnostic indexes in differentiating epileptic syndromes from syndromes of daytime sleepiness.

Adult↗
PubMed1975

A menstruation-linked periodic hypersomnia. Kleine-Levin syndrome or new clinical entity?

A 13-year-old girl showed periodic episodes of somnolence without megaphagia recurring in association with each menstruation. During somnolent episodes total sleep time averaged 14 hours and 19 minutes per 24 hours. The level of performance evaluated by means of the Wilkinson Addition Test was significantly impaired. There was an abnormal increase of 5-hydroxyindolacetic acid in the cerebrospinal fluid after probenecid test, suggesting an increase of the turnover of 5-hydroxytryptamine during periodic hypersomnia. Investigation of the menstrual cycle failed to document any striking hormonal abnormality. Nevertheless, the close relationship between the episodes of hypersomnia and the end of the menstrual cycle led us to hypothesize a role of progesterone and to try a hormonal type of treatment that is thus far successful.

Adolescent↗
PubMed1975

Sleep apnea syndrome. Can it induce hemodynamic changes?

Of 250 patients referred to the Stanford Sleep Disorders Clinic, 35 were diagnosed for a sleep induced apnea syndrome. Thirty of them (27 adults and 3 children) were nonobese and complained of a sleep disorder. In 12 patients (9 adults and 3 children) extensive cardiorespiratory workups were done during sleep and wakefulness. Three types of sleep induced apnea syndrome were identified: diaphragmatic (or central), obstructive and mixed. The diaphragmatic type was predominant in sleep apnea insomnia; obstructive was predominant in sleep apnea hypersomnia. Hemodynamic changes were documented during sleep. Tracheostomy, done in two cases, improved the sleep induced symptomatology.

Adult↗