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Biomedical subjects

C M Shapiro

Publications and source records attributed to C M Shapiro.

At least 37 records · Page 2Linked to original sources
PubMed1999

EEG spectral analysis of the sleep-onset period in narcoleptics and normal sleepers.

The sleep-onset period of 10 drug-free patients with narcolepsy-cataplexy and 10 normals matched for age and gender was investigated using the multiple sleep latency test to elicit episodes of intentional sleep onset. Spectral analyses were calculated for delta, theta, alpha, sigma, and beta frequencies using 5-second epochs beginning at lights-out and continuing until the first 2 minutes of stage 2 or REM sleep were reached, or until 20 minutes had elapsed. The sleep-onset period was divided into quartiles, and mean root mean square (RMS) amplitude within each quartile was calculated. Mean delta amplitude was significantly higher across the sleep-onset period of narcoleptic REM naps and narcoleptic stage 2 naps compared to the sleep-onset period of normal stage 2 naps or normal stage 1 naps. Mean theta amplitude was significantly higher for narcoleptic REM naps compared to normal stage 1 naps, and tended to be higher for narcoleptic stage 2 naps compared to normal stage 1 naps. Mean alpha amplitude was significantly lower for narcoleptic REM naps and narcoleptic stage 2 naps compared to normal naps containing just stage 1. Mean sigma amplitude was significantly lower for narcoleptic REM naps compared to normal stage 1 naps, and tended to be lower for narcoleptic REM naps compared to normal stage 2 naps. Mean beta amplitude did not differ between the narcoleptic and normal sleep-onset process. These findings support the existence of electrophysiologic differences within the microstructure of the process of sleep entry in narcoleptics and normals.

Adult↗
PubMed1999

Pseudo-narcolepsy: case report.

This report describes the case of a 44-year-old woman presenting to a Sleep and Alertness clinic with symptoms of narcolepsy. The patient had clinical and polysomnographic features of narcolepsy, which disappeared after disclosure of severe psychological stress. Following a discussion of the differential diagnosis of narcolepsy, alternative diagnoses are considered. The authors suggest that the patient had a hysterical conversion disorder, or "pseudo-narcolepsy." Careful inquiry into psychological factors in unusual cases of narcolepsy may be warranted.

Adult↗
PubMed1998

Motivations for sex and risky sexual behavior among adolescents and young adults: a functional perspective.

The implications of a functionalist perspective for understanding sexual risk taking are explored. Key motivational dimensions thought to underlie human behavior (viz., approach vs. avoidance, autonomy vs. relatedness) were used to identify 4 broad domains of sexual motivations and to develop a measure of specific motives within each of these domains. Data from both college student and community samples are used to demonstrate the psychometric adequacy of these scales and to show that having sex for different reasons predicts distinctive patterns of sexual risk taking both cross-sectionally and longitudinally: that selection into specific types of sexual relationships partially mediates these effects; and that these needs may be differentially expressed, or even suppressed, depending on relationship context. Results provide strong support for the functionalist perspective on behavior and indicate that an adequate understanding of sexual risk-taking behavior must take into account the various needs and goals that such behavior can serve.

Adolescent↗
PubMed1997

The alpha attenuation test: assessing excessive daytime sleepiness in narcolepsy-cataplexy.

Daytime sleep tendency was assessed in 10 drug-free patients with narcolepsy-cataplexy and 10 normals matched for age and gender. Following nocturnal polysomnography, the alpha attenuation test (AAT) and the multiple sleep latency test (MSLT) were administered during five sessions occurring at 2-hour intervals beginning at 0900 and 1000 hours, respectively. For the AAT, participants were polysomnographically recorded for 8 minutes while seated in an illuminated room with their eyes alternately opened and closed. Power spectral analyses of electroencephalograph (EEG) activity at 02-A1 (10 second epochs) were calculated using fast Fourier transformations (FFT) within the alpha frequency range (8-12 Hz) to obtain ratios of mean eyes-closed to mean eyes-open alpha power (i.e. the alpha attenuation coefficient, AAC). The narcoleptics were sleepier than the normals as indicated by a significantly smaller mean AAC and a significantly shorter mean latency to stage 1 on the MSLT. These findings suggest that the AAT may provide a quick and practical objective assessment of the excessive daytime sleepiness (EDS) associated with narcolepsy.

Adult↗
PubMed1997

Prevalence of panic disorder in cardiac outpatients.

OBJECTIVE: To evaluate outpatients from Toronto-area cardiology clinics for panic disorder (PD) and investigate differences between patients with and without PD. METHOD: Participants were diagnosed using both standard DSM-IV criteria and an altered formulation that identified a more fearful panic group. RESULTS: There was a prevalence of panic disorder (12.5%) in cardiac outpatients in keeping with previous studies. Patients with PD did not differ significantly from other patients with regard to the presence of significant heart disease. The higher prevalence of palpitations found in patients who met criteria for PD compared with those who did not reflects previous findings. PD cases did not differ significantly in family history from respondents without the disorder, but the more fearful group did (P < 0.05). CONCLUSION: PD often presents with cardiac symptoms, especially palpitations, and is often comorbid with heart disease.

Adult↗
PubMed1997

Drug-induced sleep disturbances. Focus on nonpsychotropic medications.

Different medications can have significant effects on sleep quality and/or quantity. When prescribing medications it is important to be aware of these possible adverse effects of drugs. Disturbances of the sleep/wake cycle caused by medications can vary and include insomnia, daytime sleepiness, nightmares and changes in the sleep architecture. Psychotropic drugs are well known to have an effect on the sleep/wake cycle, but there is only limited information about the sleep effects of nonpsychotropic medications. Cardiovascular drugs, especially beta-blockers, which are widely used drugs, often change the sleep architecture and cause nightmares and insomnia. Both of these effects can be a potential source of noncompliance. Because of the complicated relationship between sleep, nocturnal asthma and antiasthmatic agents, the appropriate dosage and timing of medications should always be considered. Patients with Parkinson's disease often experience disrupted sleep due to their disorder and the adverse effects of anti-parkinsonian medications.

Antiparkinson Agents↗
PubMed1996

Circadian rhythms and psychiatric disorders in the elderly.

This article reviews changes in circadian rhythms that have been reported to occur in the elderly psychiatric population. Data relating to circadian changes in normal aging are included where relevant. Information was obtained from: (1) a computerized MEDLINE search from 1975 to May 1996; (2) a review of bibliographies of papers obtained through the computerized search; and (3) texts on chronobiology. We could not locate any information relating to circadian rhythms and mania, anxiety, or paranoid disorders in old age. Disruption to the sleep/wake cycle, temperature, melatonin, and motor activity rhythms have been reported in dementia and depression, and disruption to some neuroendocrine and cardiovascular rhythms are reported in dementia. Disruption to circadian rhythmicity has implications for the management of dementia patients: for example, the sleep/wake and behavioral disturbances, and for the long-term management of mood disorders. A number of circadian markers have not been studied and several patient groups have received no research attention to date.

Aged↗
PubMed1996

The socioeconomic impact of insomnia. An overview.

Insomnia is an extremely common symptom both de novo and in the context of other medical and psychiatric disorders. The impact of insomnia is often ignored both by the individual and by society in terms of its clinical and socioeconomic ramifications. Insomnia is therefore under-appreciated and almost certainly under-treated, thus making it a serious health concern. It is estimated that more than 60 million Americans suffer from insomnia annually, and this figure is expected to grow to 100 million by the middle of the 21st century. Whether it be difficulty initiating or maintaining sleep, the disruption of nocturnal sleep will invariably impact on daytime activities and often results in daytime fatigue, performance deficits (including memory and other cognitive deficits), an increase in the number of sick days taken by an individual and accidents (some catastrophic). This review examines the costs directly related to insomnia in various sectors of healthcare, the indirect costs associated with accidents, sick days and decreased work productivity, and related costs resulting from insomnia but which meet neither the criteria of direct nor indirect cost categories. The total direct, indirect and related costs of insomnia are conservatively estimated at $US30 to 35 billion annually in the US (1994 dollars). Economic gains can be made by treating patients on an outpatient basis in sleep centres.

Absenteeism↗
PubMed1995

Obstructive sleep apnea in a consecutive series of obese women.

The prevalence of obstructive sleep apnea (OSA) in women who were being seen for obesity assessment, rather than for assessment of sleep disturbance, was assessed. A consecutive series of referrals to an eating disorders clinic (n = 40) were studied in the sleep laboratory. Their body mass index (BMI) ranged from 29.4 to 66.9 kg/m2. Overnight polysomnograms were carried out, with respiration and oxygen saturation being monitored. Four women (10%), 1 postmenopausal and 3 premenopausal, had significant OSA. They tended to have a higher percentage of body fat and higher BMIs than the nonapnea group. These findings indicate that the prevalence of OSA is higher in the general population of obese women than is generally thought. They highlight the need for professionals who work with obese women to consider the possibility that some of the complaints of fatigue and tiredness may be a result of OSA.

Adult↗