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Biomedical subjects

E D Weitzman

Publications and source records attributed to E D Weitzman.

At least 19 recordsLinked to original sources

Are periodic movements in sleep a basal ganglia dysfunction?

Muscle activity during sleep is a new area of interest in sleep research. No precise brain structures are known to be involved in sleep movement. The etiology of periodic movements during sleep is unknown. The present study was dedicated to evaluate involvement of basal ganglia in periodic movements of the legs during sleep (PMS) in Parkinson's diseased patients. Sleep was monitored in 3 patients suffering from Parkinson's disease and PMS (PMS/PD) and in 3 patients suffering from restless legs syndrome and PMS (PMS/non PD). Following treatment, the six patients were monitored again during sleep. It was found that only the PMS/PD group of patients had improved significantly with appropriate treatment. Improved motor function in PD patients is associated with decreased PMS, regardless of wether the patients are treated with dopaminergic or anticholinergic agents. This is consistent with our previous data. It may be suggested that the striopallidal system is involved in periodic sleep movements of Parkinson's diseased patients.

Aged↗

Signs of REM prior to the first REM period in prepubertal children.

In a previous publication, prepubertal depressives were found not to exhibit a shortened REM period latency during active illness when compared with pathological and normal control groups. It was hypothesized that this might be due to a nonselective inhibition of REM sleep by slow-wave sleep (SWS), which is quite intense among prepubertal children, especially during the first 2 h of the sleep period. A number of polysomnographic signs normally associated with REM sleep were observed to occur periodically, prior to the beginning of the first REM period. It was thought that these signs might be indicative of "minor escapes" of REM sleep activity from the inhibitory influence of SWS. It was further hypothesized that differences among the experimental groups in the occurrence (timing and amount per minute) of these signs support the idea of an inhibitory effect of SWS on REM; and thus offer an explanation for the apparent dissociation between the depressive disorder among prepubertal children and a shortened REM period latency. The hypotheses were not supported by the results presented here indicating that the above dissociation is probably not due to inhibitory mechanisms of SWS on REM sleep.

Child↗

Growth hormone secretion in prepubertal children with major depression. II. Sleep-related plasma concentrations during a depressive episode.

Plasma growth hormone (GH) concentrations were determined every 20 minutes during sleep in 71 prepubertal children: 22 had endogenous major depressive disorder, 20 had nonendogenous major depressive disorder, 21 had nondepressed neurotic disorders, and eight were normal. Both depressive groups secreted significantly more GH during sleep than did controls. Measures included maximal GH plasma peak and area under the curve (AUC) during the total sleep period, during the first three hours after sleep onset, and during the first five hours after sleep onset. An AUC cutoff of 2,000 ng X min/mL identified positively half the prepubertal children with major depression; with a specificity of 78% (v neurotics) and 100% (v normal children). Increased GH secretion during sleep may be a marker of illness, a past episode, or trait for prepubertal major depression regardless of endogenicity.

Affective Symptoms↗

Growth hormone secretion in prepubertal children with major depression. IV. Sleep-related plasma concentrations in a drug-free, fully recovered clinical state.

Prepubertal children with major depressive disorder have shown increased growth hormone (GH) secretion during sleep while in a depressive episode. When restudied in a fully recovered state (for at least three months) and drug free (for at least one month), their increased GH secretory pattern during sleep had not changed. Illness-recovery correlations using area under the curve for GH secretion during sleep were highly significant, whereas paired comparisons showed no significant differences. In addition, children who had recovered from major depressive episodes secreted significantly more GH during sleep than did nondepressed neurotic and normal children. No significant differences in delta-sleep were found in the depressed group between ill and recovered states nor among those who had recovered from major depressive episodes or controls. It is concluded that increased GH secretion during sleep is independent of depressive episodes, remains unaltered after full recovery, and may be a true marker of trait for major depressive disorder in prepuberty.

Affective Symptoms↗

Patterns of daytime sleepiness in narcoleptics and normals: a pupillometric study.

Pupil diameter was measured in light and dark conditions every half hour for 6.5-10 h in 3 normal controls and 3 narcoleptics. Mean pupillary diameter was significantly smaller in the narcoleptic group than in the normal group. Pupil activity was correlated with pupil diameter only in the dark condition in narcoleptics. Pupil diameter varied with a circa 90 min periodicity in the narcoleptics but not in the normal controls. These results indicate firstly, that one-time assessment of pupil size is insufficient; and secondly, that the appearance of these rhythms may be the result of a defect in arousal mechanisms of narcoleptics which usually play an inhibitory role.

Adult↗

Sleep architecture and REM sleep measures in prepubertal major depressives. Studies during recovery from the depressive episode in a drug-free state.

The sleep of 28 fully recovered, drug-free, prepubertal patients with major depressive disorder was recorded for three consecutive nights in the laboratory. Recovered depressives had significantly shorter first rapid eye movement period (REMP) latencies and a higher number of REMPs compared with themselves when depressed and with nondepressed neurotic and normal children. In addition, most sleep continuity measures improved considerably on recovery. We suggest that a short first REMP latency may be a marker of past episode or of trait in prepubertal major depressives.

Age Factors↗

Plasma growth hormone during sleep in young and aged men.

Plasma growth hormone measured at 20-min intervals across the night via indwelling venous cannula revealed a significant reduction in 16 healthy aged men as compared with 14 healthy young men. The decrease in growth hormone was entirely confined to the first 3 hours of the night (M +/- SEM for the integrated level was 5.0 +/- 1.2 and 21 +/- 4.2 ng . hr/ml). Growth hormone across the latter part of the night did not differ. Day and evening growth hormone levels measured hourly in five of the aged and nine of the young men failed to reveal an age effect. Growth hormone release is known to be associated with sleep onset, and particularly with slow wave sleep, stage 3 and 4, which was reduced in amount in these aged men (9.9 +/- 1.9 and 22.8 +/- 2.3% of time in bed for aged and young groups, respectively). Sleep stage 3 and 4 correlated significantly with growth hormone level (R = .463, p less than .01) for young and aged men combined, but not for either age group alone, indicating that growth hormone does not have a direct, simple relationship with slow wave sleep.

Adult↗

Spindle characteristics in prepubertal major depressives during an episode and after sustained recovery: a controlled study.

In a previous publication, this group reported a dissociation between multiple sleep complaints and polysomnographic abnormalities in prepubertal major depressive children. Spindle activity has been thought by some to be a correlate of restorative sleep. On this basis, it was hypothesized that prepubertal depressives might exhibit differences in sleep spindle characteristics when compared with normal and psychiatric control groups, and with their former state during sustained recovery in a drug-free state. Further, it was thought that clinical complaints of disrupted sleep might be related to differences in spindle characteristics. Spindle frequency (Hz) was the only significant finding among the groups, but it was not specific to depressive disorder, since all psychiatric groups presented higher frequencies than did normal children. As expected, significant differences across halves of the sleep period time (SPT) were also found for the number of spindles, frequency (Hz), duration (ms), spindle density (rate), and the amount of stage 2 sleep (min). The presence or absence of sleep complaints had no bearing on spindle characteristics, thus indicating a lack of apparent relationship between the two. Upon recovery the depressives exhibited no changes across clinical state, and a cross-sectional comparison of the recovered data with the original control data gave results essentially identical to the first (active illness) comparisons. It is suggested that high spindle frequency may be a nonspecific correlate of emotional disorders in prepuberty, which, at least in depressives, does not change with clinical state.

Adolescent↗

Cortisol secretion is inhibited during sleep in normal man.

In order to test the hypothesis that cortisol secretion is inhibited during sleep, six healthy young men (ages 18-24) were studied in a 4-day protocol. A baseline nocturnal sleep period was followed by one night's total sleep deprivation, then sleep at 180 degrees phase shift, and then return to a normal nocturnal sleep episode (SP-3). Plasma cortisol concentrations were measured every 20 min (obtained by an indwelling venous catheter), rectal temperature was measured every minute, and sleep was polygraphically defined. During the first 4 h of sustained sleep, cortisol secretion was decreased even when sleep occurred during a time when the subject was usually awake; conversely, it was elevated if awake at the usual daily time of sleeping. This was not the case for the last 4 h of sleep. Body temperature was also decreased but during each entire 7- to 8-h sleep period. Meals produced only a small brief rise of cortisol and produced no change in body temperature. Stage 4 sleep was increased during the 180 degrees inverted sleep episode and decreased during SP-3, REM sleep however was increased during SP-3. A reciprocal relationship was found between REM and stages 3 and 4 for the second, third, and fourth, and sixth h of sleep for SP-3. These results demonstrate the inhibitory effect of the behavioral complex of sleeping on cortisol secretion superimposed on its endogenous circadian and ultradian rhythm. These neurophysiological events may be used to entrain and time the period and phase of biological rhythms in relation to shift work, sleep deprivation, and transmeridian jet travel.

Adolescent↗

Obstructive sleep apnea and its therapy: clinical and polysomnographic manifestations.

Obstructive sleep apnea syndrome was studied in 32 children, aged 2 to 14 years, in the sleep-wake disorders center at Montefiore Hospital and Medical Center during the years 1977 to 1980. All children underwent all-night polysomnograms; 17 of these children had surgery to relieve airway obstruction and seven had a repeat polysomnographic study 4 to 6 weeks following the surgery. There was a significant improvement in the number of obstructive apneas and in other apnea indices following surgery. There was no significant effect on the durations and the proportions of the various sleep stages, on sleep efficiency, or on the number of awakenings.

Adenoidectomy↗

Sleep architecture and REM sleep measures in prepubertal children with major depression: a controlled study.

We performed a three-night polysomnographic study of 54 rigorously assessed, drug free, prepubertal children who fit unmodified Research Diagnostic Criteria for major depressive disorder, and two groups of nondepressed controls (25 with emotional disorders and 11 who were normal). The groups did not differ polysomnographically, even though a high proportion of depressives and neurotics reported sleep disturbance in structured interviews. Sleep stage data do not appear to differentiate children with prepubertal major depressive disorders from nondepressed neurotic or normal children. Other psychobiologic findings in prepubertal depressives together with marked age effects on polysomnographic correlates of adult major depressive disorders suggest the hypothesis that polysomnographic abnormalities in adult major depressives are secondary to an interaction between depression and age.

Adult↗

Chronobiology of aging: temperature, sleep-wake rhythms and entrainment.

Studies were carried out on a group of six young (ages 23-30) and six older (ages 53-70) normal men who lived under conditions of temporal, but not social isolation, from three to eight weeks. During entrained and non-entrained (free-running) conditions, comparative measurements were made of sleep-wake cycles, sleep stages and rectal temperature rhythms for these two age groups. Results demonstrated a reduction in the period and amplitude of the body temperature rhythms during free-running in the older group. Sleep efficiency, total sleep time, REM sleep latency, REM episode length, percent REM in the last 2 hours of sleep, the length and frequency of arousals during sleep, and the terminal wake latency were all age related and dependent on entrainment. The period of the sleep-wake cycle, terminal awakenings from REM and percent REM in the first 3 hours of sleep were not age related but were dependent on entrainment. Sleep stages as percents of total sleep time were found to be age related but independent of entrainment, while sleep latency, mid-REM to mid-REM cycle length and the ratio of sleep to total time were neither age related nor dependent on entrainment. In addition, individual chronobiological differences were prominent in the older group. Changes of period and of the phase relationship of sleep-wake and temperature rhythms occurred in several subjects during the non-entrained condition.

Adult↗