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Biomedical subjects

E Stepanski

Publications and source records attributed to E Stepanski.

9 recordsLinked to original sources
PubMed1995

Sleep disorders in patients on continuous ambulatory peritoneal dialysis.

Sleep complaints, habits, and medical history were surveyed in 81 patients chronically receiving continuous ambulatory peritoneal dialysis. Seventy-three percent of the sample reported insomnia, and 52% reported unintentional napping during the day. Behavioral factors (such as caffeine or alcohol use) or the severity of concurrent medical disease did not account for the sleep problems. Eighteen of these patients subsequently underwent polysomnography and objective measurement of daytime sleepiness. Clinically significant sleep apnea syndrome was present in 11. The presence of sleep apnea was associated with increased levels of psychological distress and daytime sleepiness. Periodic leg movements during sleep were also frequently observed but had minimal effect on sleep quality. Implications of these findings for clinical practice are discussed.

Adult↗
PubMed1989

Characteristics of individuals who do or do not seek treatment for chronic insomnia.

Survey data have shown that a minority of people who complain of insomnia receive medical treatment for this problem. Patients who seek treatment for insomnia at medical clinics and sleep disorders centers are a self-selected group who may not be representative of all individuals with insomnia. Fifty patients presenting to a sleep disorders center with an insomnia complaint were compared to 50 subjects with insomnia recruited through the newspaper for psychopharmacological studies. No differences in sleep parameters were found, but significant differences on psychometric measures and in daytime alertness were present. The implications of these differences are discussed.

Adult↗
PubMed1988

Sleep and memory.

Generally sleep is considered a time of amnesia. It is not uncommon for an individual to experience 8 h of sleep and have no memory for events during that time. Similarly, a substantial proportion of the population has no memory for dreams that occurred during the night, despite the fact that the literature on awakening during rapid eye movement (REM) sleep clearly shows that individuals normally have four to six "dream experiences" a night. Research on this issue seems to indicate that the lack of memory cannot be explained by the organisms' inability to perceive stimuli. The data indicate that although perceptual thresholds are elevated, organisms can clearly perceive stimuli, and, in fact, can discriminate between them during sleep. The amnesia also cannot be explained by a defect in long-term memory, as studies have indicated that stimuli put into the memory during wakefulness are more efficiently retrieved after a sleep period than after a comparable period of wakefulness. The most likely explanation for the amnestic property of sleep seems to be the inability of organisms to transfer information from short-term memory to long-term memory during sleep. There are several sources of evidence to support this hypothesis. First, the probability of remembering a stimulus given during wakefulness is related to the proximity of sleep onset to the stimulus. Generally, information put into the system within 5 min of sleep onset is lost from memory. Secondly, disorders of excessive daytime somnolence which cause individuals to have frequent microsleeps are often associated with complains of memory problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1988

Daytime alertness in patients with chronic insomnia compared with asymptomatic control subjects.

Despite the subjective reports of patients with difficulty initiating and maintaining sleep (DIMS) that they are impaired during the day, consistent differences in daytime functions have not been found between normal sleepers and patients with insomnia. The present study compares polysomnography and Multiple Sleep Latency Test (MSLT) data from 70 clinic patients seeking evaluation for chronic insomnia with data from a group of 45 asymptomatic sleepers. The DIMS group was found to sleep significantly less than the control group; yet they were also significantly more alert than the control group the following day, as measured by MSLT. Within the insomnia diagnostic subgroups, a correlation of -0.67 (p less than 0.05) was found between nocturnal total sleep time and mean MSLT. The results are interpreted as supporting the existence of a tendency towards physiological hyperarousal in patients with chronic insomnia. This tendency may be exacerbated by other factors (e.g., personality disorder, periodic leg movements) also associated with insomnia.

Adult↗
PubMed1987

Experimental sleep fragmentation in normal subjects.

Recent research has suggested that sleep fragmentation in the absence of sleep loss is an important cause of excessive daytime sleepiness in certain clinical populations (e.g., sleep apnea syndrome or periodic leg movements). This study experimentally varied the number and rate of arousals in sleep to define more clearly the relation of sleep fragmentation and daytime sleepiness. Five male subjects participated in the study. Data from each were recorded for three consecutive nights (one baseline followed by two experimental nights) under three experimental conditions. All nocturnal polysomnograms were followed by a Multiple Sleep Latency Test (MSLT) the next day. The experimental conditions consisted of three different schedules of arousal produced by series of tones presented to subjects over headphones. The MSLT showed statistically significant changes after two nights of fragmented sleep, but the three fragmentation schedules did not differ from each other. Arousal threshold also changed significantly with sleep fragmentation from night one to night two.

Adolescent↗
PubMed1987

Fragmenting sleep diminishes its recuperative value.

The recuperative effects of naps fragmented by different rates of electroencephalographic (EEG) arousal were evaluated. Forty healthy subjects with normal hearing and daytime sleep tendency (measured by the Multiple Sleep Latency Test at 10:00 a.m., 12:00 p.m., 2:00 p.m., and 4:00 p.m.) were randomly assigned to one of five conditions. Each was deprived of sleep for one night and then at 8:30 a.m. was given 100 min of natural sleep, sleep with arousals 1/5 min, 1/3 min, 1/1 min, or no sleep. After the recovery nap at 12:00 p.m., 2:00 p.m., 4:00 p.m., and 6:00 p.m., sleep latencies were again evaluated. Mean sleep latencies increased linearly as the rate of arousal during the recuperative nap decreased. Latency in the high-arousal condition was similar to no sleep and lower than natural sleep. The sleep latency of the low-arousal condition was similar to natural sleep and higher than no sleep, whereas latency in the medium arousal condition was intermediate to and differed from both natural sleep and no sleep. Although the natural sleep provided recuperation relative to no sleep or fragmented sleep, it did not restore daytime sleepiness to the screening level.

Adult↗
PubMed1984

Sleep fragmentation and daytime sleepiness.

It has been noted that clinical populations complaining of excessive daytime sleepiness (EDS) frequently have disrupted or fragmented nocturnal sleep. The relation between sleep fragmentation and daytime sleepiness has not been systematically studied. This study was designed to use correlational techniques evaluating the relation between these variables in patients complaining of EDS, patients complaining of insomnia, and asymptomatic controls. The four groups studied included patients complaining of EDS with sleep apnea (n = 15) or with periodic leg movements (n = 15), patients complaining of insomnia (n = 15), and healthy volunteers with no sleep complaint (n = 10). One night of polysomnography followed by a Multiple Sleep Latency Test was obtained for each subject. Each recording was evaluated using standard criteria and also by a four-level arousal scoring system. Across all subjects, the total number of arousals correlated significantly with sleepiness index (r = 0.48, p less than 0.001). Closer analysis of the data shows that, depending upon the sleep complaint, different types of arousals are predictive of degree of daytime sleepiness. It is concluded that the number and type of nocturnal arousals play an important role in subsequent daytime sleepiness.

Adult↗
PubMed1982

[Effects of the chronic administration of triazolam 0.50 mg on the sleep of insomniacs].

Several studies have been conducted in view to evaluate the short and medium-term efficacy of triazolam. The present investigation was aimed at assessing its long-term effectiveness. Four female and six male (average age: 29.9 years +/- 9.6) insomniacs took part in this study. After selection of the subjects, they are kept under observation in the sleep laboratory during two consecutive nights per week for ten weeks, during which they were given a placebo on weeks 1, 8, 9 and 10 and triazolam 0.50 mg on weeks 2 to 7. Triazolam proved to be an effective hypnotic during the six weeks of treatment, with no withdrawal effects upon discontinuation.

Adult↗