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Biomedical subjects

F Zorick

Publications and source records attributed to F Zorick.

At least 73 records · Page 4Linked to original sources

Effects of acute administration of brotizolam in subjects with disturbed sleep.

Effects of ingestion of brotizolam (0.25 and 0.50 mg) over 1-3 days on polysomnographic measures of sleep were assessed in patients complaining of insomnia. Brotizolam reduced latency to sleep, number of awakenings and wake during sleep, and increased total sleep time. It also increased stage 2 sleep and decreased slow wave and rapid eye movement sleep. Increasing the dose from 0.25 to 0.50 mg increased hypnotic efficacy, and there was a more consistent and reliable effect. Discontinuation of brotizolam had minimal effects on sleep compared with placebo over the 3 nights after acute administration. No side-effects or disruption of daytime function was found using questionnaires and objective tests of performance.

Adult↗

Age-related sleep-wake disorders at a sleep disorder center.

The specific sleep disorders of 97 patients 61-81 years old were compared with those of 264 middle-aged (41-60 years old) and 202 young (20-40 years old) patients. Sleep disorder diagnoses were made according to the Diagnostic Classification of the Association of Sleep Disorders Centers based on evaluations consisting of mental and physical examinations and all-night sleep recordings. Most young and middle-aged patients complained of excessive daytime sleepiness; the elderly complained of insomnia as often as excessive daytime sleepiness. The evaluations revealed objective findings in 93 per cent of the elderly, but only 77 per cent of younger patients. Nocturnal myoclonus or restless leg syndrome was the diagnosed cause of 23 per cent of elderly patients' sleep-wake problems, but only 11 per cent of middle-aged and 4 per cent of young patients had this problem. Respiratory disorders of sleep were found in 27 per cent of elderly, 35 per cent of middle-aged, and 20 per cent of young patients. Elderly patients (6 per cent) had psychiatric disorders diagnosed as the causes for their problems less frequently than did younger patients (22 per cent).

Adult↗

Narcolepsy and disturbed nocturnal sleep.

Disturbed nocturnal sleep is considered a symptom of narcolepsy. Polysomnographic recordings of 57 consecutive narcoleptic patients were reviewed for evidence of disturbed sleep. When disrupted sleep was present, it was attributable to recognized sleep disorders: nocturnal myoclonus and sleep apnea. Comparison of standard polysomnographically derived parameters of patients who had narcolepsy without sleep apnea or nocturnal myoclonus with those of a normal control group, showed no evidence of disturbed sleep in the patient population. The narcoleptics that also had nocturnal myoclonus or upper airway sleep apnea did have disturbed sleep in comparison with the normals. Our data suggest disturbed sleep tends to develop in narcolpetic patients with age, but is not an inherent element of the narcolepsy syndrome.

Adult↗

Dose-related effects of estazolam on sleep of patients with insomnia.

The dose range of estazolam for hypnotic effects was studied in seven men and eight women (mean age 30.3 +/- 8.6 years) who complained of insomnia and had polysomnographic evidence of disturbed sleep. Patients slept in the laboratory and were monitored using standard polysomnographic techniques. Four consecutive nights in the laboratory with placebo, which served as baseline and screening nights, were followed by five 2-night drug administration periods separated by 5-day drug washout periods spent at home. Each of the patients received a sequence of four doses (0.25, 0.5, 1.0, and 2.0 mg) of estazolam and placebo administered according to a Latin square design and in a double-blind manner. Estazolam significantly increased total sleep time and reduced time awake during sleep in a dose-dependent manner. Sleep latency parameters were reduced systematically with increasing doses of estazolam, but these effects on sleep latency were not statistically significant. Increasing doses of estazolam had systematic and statistically significant effects on sleep stages. Subjective estimations of sleep were consistent with the polysomnographic findings bur were not statistically significant.

Adult↗

[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↗

Flurazepam for short-term treatment of complaints of insomnia.

The short-term hypnotic efficacy of 15 mg flurazepam was evaluated in nine patients (mean age 37.2 +/- 15.9 years) who complained of insomnia and had polysomnographic evidence of disturbed sleep. Patients slept in the laboratory 14 consecutive nights, and their sleep was monitored using standard polysomnographic procedures. Prior to bedtime, they received a placebo the first four nights, 15 mg flurazepam on nights 5 through 11, and a placebo again on nights 12 through 14. Flurazepam significantly increased total sleep time while reducing the latency to stage 1 sleep, the number of awakenings in the night, and the amount of wakefulness after sleep onset. Sleep stage patterns also were altered significantly with flurazepam: percentage stage 2 sleep increased, and percentages of 3-4 sleep and REM sleep (on drug night 1 and nights 1-3) decreased. With the exception of REM sleep, most of these drug effects were first detected on the second night of administration, did not diminish over the next six nights, and persisted during the three-day withdrawal period. Subjective evaluations of sleep generally corresponded with the polysomnographic data. It was concluded that 15 mg flurazepam has significant hypnotic properties with minimal adverse side effects.

Adult↗

Biological markers for depression in chronic pain.

Patients with chronic psychogenic pain appear to suffer from a specific depressive type of disease, with somatized pain as the prime expression of a concealed mental agony (pain-prone disorder). This view is supported by clinical, premorbid, and psychodynamic findings, as well as by the presence of biological markers including a family history of affective disorders and response to antidepressants. Additional biological markers of depression include shortened rapid eye movement (REM) latency in sleep and nonsuppression in the dexamethasone suppression test (DST). The study of both markers in 20 consecutive pain-prone patients with insomnia showed clearly abnormal REM latency and/or DST nonsuppression in one half of the otherwise homogeneous group. There was high correlation between DST cortisol level and REM latency. both biological markers tend to predict response to antidepressants. The findings confirm that the pain-prone disorder can be viewed as a variant of depressive disease.

Depressive Disorder↗

Relationship of psychopathology to insomnia in the elderly.

Three groups of 18 volunteers each (nine men and nine women) were selected on the basis of age and the response to a sleep status questionnaire. Younger subjects (mean age, 43.8 years) who complained of difficulty in falling asleep or in staying asleep or of awakening too early were compared for evidence of psychopathologic signs with older subjects (mean age, 68.5 years) who had sleep-related complaints and with older subjects (mean age, 71.3 years) who did not have sleep-related complaints. Older subjects with insomnia complained more frequently of having trouble staying asleep and of awakening too early (P less than 0.05), whereas the younger subjects with insomnia complained primarily about difficulty in falling asleep (P less than 0.005). On a short form of the Minnesota Multiphasic Personality Inventory (MMPI-168), the number of elevated scores indicating pathologic disturbances (T score less than 70) was higher (p less than 0.05) for the younger subjects with insomnia (2.5 high scores) than for older subjects with insomnia (0.7 high scores) or for older normal sleepers (0.4 high scores). These results imply that although in younger persons psychopathologic disorders are associated with insomnia, psychopathic disorders usually are not the cause of insomnia in the elderly.

Age Factors↗

Protriptyline in the treatment of sleep apnoea.

Nine patients with obstructive sleep apnoea were treated with 5 to 20 mg of protriptyline each night for two to 18 months. In four patients, there was dramatic, sustained improvement in symptoms and measured sleep quality and apnoea frequency and duration. There was no improvement in two patients and three developed intolerable side-effects preventing adequate treatment. Apnoea frequency was the only apparent predictor of responsiveness. Those with fewer than 30 episodes of apnoea per hour consistently improved. Only two of four patients with more than 60 episodes per hour improved. These results provide additional evidence that a carefully monitored trial of protriptyline may benefit selected patients with mild to moderate obstructive sleep apnoea.

Adult↗

The effects of doxepin HCl on sleep and depression.

The effects of doxepin hydrochloride (Adapin) on sleep and depression were evaluated in nine depressed patients with documented sleep difficulties. All subjects were screened for depression on the Hamilton Psychiatric Rating Scale. Sleep disturbance was measured by all-night polysomnography. Doxepin in doses of 75 and 150 mg/day significantly improved sleep efficiency, as evidenced by decreased sleep latency and increased total sleep time. After 2 weeks of treatment, REM latency and percent REM time were dramatically changed. Maximal improvement in depression occurred after 2 weeks of doxepin therapy and at the 150 mg dose.

Adult↗

Personality differences between insomniac and non-insomniac psychiatry outpatients.

The relationship between self-reported measures of sleep disturbance and psychopathology was investigated. Previous studies on this topic have failed to use appropriate control groups. The current study examined the relationship between sleep disturbance and personality using insomniac and non-insomniac outpatient counseling clients. The results confirm the significant and positive relation between emotional disturbance and insomnia. The insomniac group showed the expected pattern of MMPI abnormalities (elevated D, Hy, Pt and Sc). However, only the Pt scale of the MMPI and the Cornell Medical Index significantly differentiated the two groups. This suggests that characteristics such as obsessional worry which lead to elevated Pt scores play a more important and unique role in insomnia than previously hypothesized.

Adult↗

The efficacy of triazolam and chloral hydrate in geriatric insomniacs.

A double-blind crossover study was performed to evaluate the efficacy of hypnotics in geriatric insomniacs. Twenty-seven patients with a mean age of 70 years (range 60-94 years) received each of five treatments on 5 consecutive nights. The treatment conditions, consisting of chloral hydrate 250 and 500 mg, triazolam 0.25 and 0.50 mg, and placebo, were administered using a Latin Square design. Subjective estimates of sleep were collected in the morning following each treatment night. The patients' global evaluation of effectiveness indicated that triazolam 0.25 mg and 0.50 mg improved sleep more than placebo, while chloral hydrate 250 and 500 mg were not better than placebo. Triazolam 0.50 mg was felt to be significantly better than either dose of chloral hydrate. In addition, triazolam 0.50 mg was found to significantly decrease the patients' estimates of their sleep latency. Patients estimated their total sleep time to be longer following the use of triazolam 0.25 mg as compared to choral hydrate 500 mg, and their estimates of the number of awakenings was significantly lower on triazolam 0.50 mg than it was on chloral hydrate 500 mg or placebo.

Aged↗

Exacerbation of upper-airway sleep apnea by lymphocytic lymphoma.

A 55-year-old obese man was evaluated for excessive daytime sleepiness and found to have upper-airway sleep apnea. Evaluation discovered a lymphocytic lymphoma with head and neck involvement. Treatment of the lymphoma resulted in improvement in the sleep apnea and the sleepiness.

Head and Neck Neoplasms↗