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Biomedical subjects

M K Erman

Publications and source records attributed to M K Erman.

9 recordsLinked to original sources
PubMed1992

Maintenance of wakefulness test in obstructive sleep apnea syndrome.

The usefulness of a 40-min per trial version of the maintenance of wakefulness test was assessed in 322 patients with obstructive sleep apnea. This test is a variant of the multiple sleep latency test in which patients are asked to remain awake in a quiet darkened room, and then monitored for electroencephalographic sleep onset. The four trials of the test are each stopped after 40 min. The mean sleep latency for all patients was 26.0 +/- 11.8 (SD) min. In a group of 24 patients who underwent treatment with nasal continuous positive airway pressure, the mean sleep latency increased from 18.0 +/- 12.3 to 31.9 +/- 10.4. The strongest nocturnal correlates of the MWT sleep latency were respiratory arousal index (r = -.35), mean oxygen saturation (r = .30), and weight/height ratio (r = -.25). These correlations were comparable to other studies using the MSLT. There were strong intercorrelations among the variables. In the more severe groups, measures of hypoxemia were more strongly correlated with MWT sleep latency. A two-factor analysis of variance using respiratory arousal index and several measures of oxyhemoglobin saturation indicated that both arousals from sleep and degree of hypoxemia contribute interactively to daytime dysfunction in patients with sleep apnea. The MWT appears useful in evaluating disability from daytime sleepiness.

Analysis of Variance↗
PubMed1987

Insomnia.

Insomnia complaints are common in the general population and are seen with even greater frequency among psychiatric patients. In any patient, the development of insomnia complaints may reflect the combined influences of various psychological, psychophysiologic, pharmacologic, and other medical factors. The capacity to describe and define specific sleep disorders is an important component in the development of a workable plan for the treatment of these disturbances. Knowledge of specific behavioral and pharmacologic modalities is also necessary for the choice of safe and effective treatment approaches.

Humans↗
PubMed1987

Dream anxiety attacks (nightmares).

Nightmares--disturbances of dreaming sleep experienced at some point in time by most patients--are often seen in adults as a consequence of physical or emotional trauma. The presence of nightmares on a chronic basis in adult life may reflect specific personality characteristics and may define a population at risk for other psychiatric disturbances. Treatment, if indicated, may include psychotherapy and pharmacotherapy, with the regimen determined by the patient's specific history and symptoms.

Adult↗
PubMed1986

Polysomnographic findings in recently drug-free and clinically remitted depressed patients.

Thirteen patients were examined by sleep polysomnograph (PSG) and the dexamethasone suppression test when clinically depressed and later when clinically remitted for six months and no longer receiving antidepressant medication for two to five weeks. None of the PSG variables (rapid eye movement [REM] latency, total sleep time, stage 1 through 4 times, REM time, and REM densities in periods 1 through 3) was significantly changed between symptomatic depression and symptom remission. While symptomatic, 11 of 13 patients exhibited a reduced REM latency (65 minutes or less). After clinical remission, eight of the 11 continued to exhibit reduced REM latencies, whereas the dexamethasone suppression test tended to show nonsuppression only during clinical depression. These data represent either longer-term (ie, slow to normalize) biologic consequences of a depressive episode or biologic antecedents of clinical depression that may herald a return of the depression in individuals vulnerable to recurrence. Whether PSG abnormalities identify clinically remitted patients who are prone to develop another depressive episode requires longitudinal follow-up studies.

Adult↗
PubMed1985

Alprazolam vs amitriptyline in depressions with reduced REM latencies.

This study was designed to compare the antidepressant effects of alprazolam, a triazolobenzodiazepine, with amitriptyline hydrochloride in a group of patients with nonpsychotic, major depressions diagnosed by Research Diagnostic Criteria. A mean rapid eye movement latency of less than 65 minutes was required to enter this study. Dexamethasone suppression tests were conducted before treatment. By strictly applied Research Diagnostic Criteria, 83.6% of the subjects were endogenous, and 34.7% were inpatients. A significantly greater percentage of alprazolam-treated patients responded within the first seven days of treatment. By the end of this six-week trial, alprazolam was associated with significant reductions in Hamilton, Beck, Covi, Raskin, and Carroll Rating scores (pretreatment to posttreatment). However, by the end of treatment the effects of amitriptyline exceeded those of alprazolam on both the Hamilton and Beck scales. These data indicate that alprazolam is not as effective as amitriptyline in major depressions with a shortened rapid eye movement latency.

Adolescent↗
PubMed1979

A comparison of two unilateral ECT electrode placements: efficacy and electrical energy considerations.

The authors compared the treatment outcomes and ECT energy requirements of 10 patients treated with the Muller unilateral placement method (secondary electrode in the frontal position) with those of 10 matched patients treated with the unilateral placement described by d'Elia (secondary electrode lateral to the vertex). Both groups showed a similar dramatic clinical improvement after ECT; however, the mean watt seconds required for the Muller method was nearly four times that for the d'Elia procedure. The treating physicians reported that the patients treated by the d'Elia method had fewer anterograde and retrograde memory disturbances and that they were alert and oriented sooner after ECT.

Aged↗