Endocrine response of prolactin, cortisol, and growth hormone to low dose intravenous L-tryptophan in healthy subjects during day and night.
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Adult↗
Biomedical subjects
G Hajak
Publications and source records attributed to G Hajak.
The influence of intravenous L-tryptophan on plasma melatonin and sleep in men.
The sleep-inducing mechanisms of L-Tryptophan (L-Trp) are generally thought to be mediated by a central serotonergic activation. Evidence is presented that some effects of L-Trp on sleep may be mediated by melatonin, a Trp-metabolite with sedative properties. Trp effects on vigilance, sleep, and plasma-melatonin concentrations were measured after double-blind application of 0, 1, 3, and 5 g L-Trp in nine and five healthy probands during daytime and nighttime, respectively. A significant sleep-inducing effect was observed after L-Trp administration during daytime and nighttime. The infusions of L-Trp caused a massive elevation of plasma melatonin levels. This effect was significant both during the night and the day, indicating that the increment of circulating melatonin may be of extrapineal origin.
Adult↗
[ST segmental changes and arrhythmias in obstructive sleep apnea].
Patients with obstructive sleep apnea show a fall in arterial oxygen saturation during apneas. Whether this is causing myocardial ischemia and consecutively ST segment depressions in the electrocardiogram is not known. Therefore 15 consecutive patients (53 +/- 8 years, apnea index 45 +/- 28, minimal oxygen saturation 71 +/- 14%) with OSA were studied by Holter electrocardiogram and polysomnography. History and exercise testing gave no evidence of coronary heart disease. Three patients had ventricular arrhythmias Lown IVA and 10 had Lown I or III. Three patients showed unspecific negative T waves or ST segment elevations. In no patient significant ST segment depression was found. It is concluded that OSA does not lead to ischemic ST segment depression in the absence of coronary heart disease. The cause of ventricular arrhythmias in OSA seems not be related to myocardial ischemia.
Adult↗
Onset of nocturnal attacks of chronic cluster headache in relation to sleep stages.
Nocturnal attacks are symptomatic of numerous primary headache syndromes. It has proven possible to verify, with polygraphic sleep recordings, a strict correlation between the onset of headache attacks and the rapid eye movements (REM) stage for migraineurs, patients with chronic paroxysmal hemicrania and cluster headache (CH). The purpose of this study was to investigate the correlation between attack onset of chronic CH and sleep stages, the REM stage in particular. Nine patients from our headache outpatient service with a diagnosis of CH were examined in this study. All medication was discontinued at least one week prior to sleep polygraphias, which were conducted in a sleep laboratory on two consecutive nights. Any attacks were treated with oxygen inhalation during the drug-free period. EEG, EMG, and EOG were continuously monitored during the sleep polygraphias. Eight patients had 25 CH attacks during 12 of the 17 nights recorded. Only three of these patients had arousals with attacks in the REM stage and these amounted to five of the 25 recorded attacks. Eleven attacks were in stage 2, four in stage 1 and two in stage 3. These results correlate with recent findings according to which headache attacks were often related to REM in episodic CH, but rarely in the chronic type. Whether or not different pathogenic mechanisms are involved in the episodic and the chronic type of CH is a matter for further discussion.
Adult↗
Consensus for the pharmacological management of insomnia in the new millennium.
Insomnia, a common symptom throughout the world, is characterised by difficulty initiating or maintaining sleep or non-restorative sleep and is associated with significant morbidity. A comprehensive medical and sleep history and physical examination are necessary before treating patients with insomnia; the presence of co-morbidities, including medical and psychiatric disorders, or the possible use of substances that may contribute to sleeplessness should be thoroughly investigated. Non-pharmacological approaches include correction of sleep hygiene as well as behavioural treatments. Pharmacotherapy includes benzodiazepine-receptor agonists, which are the drugs of choice for this disorder. They can be subdivided into classic benzodiazepines and non-benzodiazepines. Although many agents in these classes have been prescribed, potential shortcomings include residual sedation, rebound insomnia, and psychomotor and memory impairment. Novel pharmacological strategies that address limitations of the traditional treatment approach, combined with proven modes of behavioural therapy, offer the most successful results in the management of insomnia. These advances provide the opportunity to establish these current recommendations for the optimal management of insomnia. This report from the XXII Collegium Internationale Neuro-Psychopharmacologicum Consensus Workshop outlines recommendations to serve as the foundation for developing a therapeutic plan for each patient.
Antidepressive Agents↗