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Biomedical subjects

M M Mitler

Publications and source records attributed to M M Mitler.

At least 73 records · Page 4Linked to original sources
PubMed1982

Maintenance of wakefulness test: a polysomnographic technique for evaluation treatment efficacy in patients with excessive somnolence.

Ten patients with narcolepsy were given five 20 min opportunities to remain awake throughout the day. Trials were offered at 2 h intervals beginning at 10:00. Polysomnographic variables were monitored during each trial. Sleep latency increased when patients were instructed to maintain wakefulness compared to when instructed to sleep; however, sleep latencies were still lower for narcoleptics than for control subjects. Unexpectedly, we were not always able to document patients' reports of increased ability to stay awake. The findings suggested that clinical data on symptom control in narcolepsy do not predict ability to stay awake. Objective measures of the ability are potentially more useful in evaluating treatment.

Adult↗
PubMed1981

Disorders of excessive daytime somnolence: polygraphic and clinical data for 100 patients.

A consecutive series of 100 sleep apnea free patients with the complaint of excessive daytime somnolence (EDS) were evaluated; data from medical histories, physical examination, personality inventories, and polysomnography [nocturnal polysomnography (NPSG) and daytime multiple sleep latency testing (MSLT)] were tabulated. Significant differences were found between narcoleptic and non-narcoleptic patients in a number of parameters, including EDS severity, mean sleep latency on MSLT, sleep latency on NPSG, latency to REM sleep at night, number of REM sleep at night, number of REM sleep segments throughout the night, the total number of nocturnal myoclonic jerks (as well as the number occurring per hour of NREM and REM sleep), and the number of arousals and wake periods preceded by a myoclonic jerk. Significant differences in sleep latency during MSLT and NPSG testing were found between different EDS diagnostic groups of non-narcoleptic patients. The majority of patients in the MSLT group with long sleep latencies were in the diagnostic groups of EDS associated with psychophysiological and/or psychiatric problems or with drug abuse; patients with a diagnosis of idiopathic central nervous system hypersomnia or EDS associated with disturbed nocturnal sleep formed the majority of the MSLT group with short sleep latencies. The non-narcoleptic patients in a MSLT group with short sleep latencies had significantly shorter sleep latencies at night, more sleep cycles, higher sleep efficiency, and earlier REM sleep than patients with long sleep latencies.

Adolescent↗
PubMed1980

Narcolepsy.

Explore the source record for details and available documents.

Animals↗
PubMed1979

REM sleep episodes during the Multple Sleep Latency Test in narcoleptic patients.

Forty narcoleptic patients were given the Multiple Sleep Latency Test, consisting of 20 min opportunities to sleep offered at 10.00, 12.00, 14.00, 16.00 and 18.00 o'clock. Eleven patients had 2 episodes of REM sleep, 5 had 3, 11 had 4, and 13 had 5 before they were awakened. Fourteen control subjects given similar opportunities to sleep (reported in a companion article (Richardson et al. 1978)) had no REM sleep episodes. For the 10.00-18.00 o'clock opportunities respectively, there were 32, 29, 30, 28 and 27 REM sleep episodes. We conclude that this procedure can provide physicians with data useful in the diagnosis of narcolepsy.

Adult↗
PubMed1979

Genetic factors in canine narcolepsy.

The mating of narcopleptic Doberman pinschers yielded 30 puppies in five litters, all of which developed the disease between 1 and 4 months of age. Pedigrees of the Doberman probands are indicative of an autosomal recessive mode of transmission. An analysis of the pedigree of five affected Labrador retriever littermates suggests a similar mode of transmission. Crosses of affected dogs in two other breeds (miniature poodles and beagles) have resulted in all-unaffected F1 generations, thus allowing rejection of the simplest genetic hypothesis of a fully penetrant autosomal or sex-linked dominant or recessive gene.

Age Factors↗
PubMed1979

Hypnotic efficacy of temazepam: a long-term sleep laboratory evaluation.

1 Temazepam was evaluated in a strictly defined insomniac patient population under sleep laboratory conditions. Two protocols were used: a short-term (26-night) and a long-term (54-night) protocol evaluated the efficacy of the drug administered at night at 15 mg (short-term study) and 30 mg (long-term study), respectively. 2 Temazepam seemed to be both safe and effective at doses of 15 and 30 mg with up to 5 weeks of ingestion. 3 Suppression of slow wave sleep was observed at the high dose, but no suppression of REM sleep, found in studies with other benzodiazepines, was noted. 4 No evidence was found for development of tolerance or rebound effects.

Adult↗
PubMed1978

Excessive daytime sleepiness in man: multiple sleep latency measurement in narcoleptic and control subjects.

Excessive daytime sleepiness is a complaint characterizing many disorders of the wakefulness--sleep cycle. This paper addresses the complaint of sleepiness objectively by an attempt to differentiate a group of control subjects from a group of patients with unambiguous narcolepsy. Fourteen control and 27 narcoleptic subjects were evaluated by one of three protocols involving nocturnal recordings, detailed interviews, and 5 or more 20-min opportunities to sleep offered at 2-h intervals beginning at 10.00 o'clock, +/- 30 min. Each 20-min opportunity to sleep was given to subjects lying in a darkened quiet room and asked to try to fall asleep. Polysomnographic variables were monitored and sleep was scored in 30-sec epochs by standard criteria. The interval from the start of each test to the first epoch of NREM (including stage 1 sleep) or REM sleep was called sleep latency. In two of the protocols, the subjects were awakened immediately after sleep onset. In the third protocol, the subjects were awakened after 10 min of sleep. Narcoleptics consistently fell asleep much more readily than did control subjects. We conclude that the Multiple Sleep latency test, in addition to providing opportunities to clinically document sleep onset REM sleep periods, can demonstrate pathological sleepiness. Based on these data, we suggest that an average sleep latency less than 5 min be set as the minimum cutoff point for pathological sleepiness.

Adult↗
PubMed1977

Sleep and activity rhythms in mice: a description of circadian patterns and unexpected disruptions in sleep.

Studies on daily and circadian rhythms in wheel running and electrographically defined wakefulness, NREM sleep, and REM sleep in M. musculus were done to gather data on the temporal distribution of activity and sleep. Generally, peaks in NREM and sleep tended to coincide and to alternate with the coincident peaks of wakefulness and wheel running. However, during the active phase of the circadian wheel running cycle some NREM and REM sleep did occur; conversely, during its rest phase, wakefulness was often present. The most striking finding was that in mice with clearly entrained or free-running activity onsets, the circadian peak-through patterns in wakefulness, NREM, and REM sleep were not always distinct--they could be damped and/or polyphasic. Several explanations of these phenomena are considered.

Animals↗
PubMed1977

Sleep studies on canine narcolepsy: pattern and cycle comparisons between affected and normal dogs.

Two narcoleptic and 2 normal poodle or mixed poodle dogs were polygraphically monitored for 48 h with one narcoleptic and one normal monitored concurrently. Data were categorized by 15-sec epochs into wakefulness, light sleep, slow wave sleep, REM sleep, cataplexy (immobility preceded by wakefulness with partial or complete electromyographic quiescence and pronounced theta activity from subcortical leads), and atonia with no theta (15-30 sec periods like cataplexy but without theta). In narcoleptics we could see no gross differences between the polygraphic records of cataplexy and those of REM sleep; scoring distinctions between the two states depended on the antecedent state. Results indicated that narcoleptic dogs do not differ from normals with respect to percent of time spent in wakefulness (39.8% vs. 42.6%), light sleep (16.2% vs. 18.4%), or slow wave sleep (27.2% vs. 28.0%). Narcoleptic dogs spent slightly less time than normals in REM sleep (6.9% vs. 11.1%) and spend 9.1% and 0.8% of the recording time in cataplexy and atonia with no theta respectively. Normal dogs presented neither of these pathological states.

Animals↗
PubMed1976

Narcolepsy in seven dogs.

Narcolepsy in 7 dogs was tentatively diagnosed on the onset of cataplexy, before or during young adulthood. Confirmatory polygraphic sleep recordings were done in 3 of the dogs. In 2 dogs, treatment with neostigmine did not cause the signs to disappear, thus ruling out myasthenia gravis; trials with imipramine reduced catapletic attacks. Data from case histories, polygraphic recordings, drug trials, and clinical tests were used to compare and contrast the disease in man and in the dog.

Animals↗
PubMed1976

Effects of imipramine, chlorimipramine, and fluoxetine on cataplexy in dogs.

Four narcoleptic dogs with cataplexy were given trials with the serotonin uptake blockers imipramine and chlorimipramine (known to be effective in treating cataplexy in humans). An even more selective serotonin uptake blocker, fluoxetine, was also tested. Injections of placebo, test compound, and placebo were given respectively on 3 successive days. Anticataplectic effects were measured approximately 30 min, 3 hr, and 6 hr postinjection by recording elapsed time and number of cataplectic episodes during the dogs' attempts to eat ten pieces of a desired food presented in a standard fashion. Imipramine (1 mg/kg) and fluoxetine (1.5 and 3.0 mg/kg)significantly improved performance, while chlorimipramine (0.5-5 mg/kg) had no clear effect. Data were not totally consistent with the notion that serotonin uptake blockers improve cataplexy in dogs, since chlorimipramine was not effective in these animals.

Animals↗
PubMed1976

Self-reports versus sleep laboratory findings in 122 drug-free subjects with complaints of chronic insomnia.

The authors compared the sleep laboratory recordings of 122 drug-free subjects who complained of chronic insomnia with the subjects' estimates of their habitual sleep characteristics and their estimated sleep time on the morning after sleeping in the laboratory. Most subjects consistently underestimated the amount of time they slept and overestimated the amount of time it took them to get to sleep in comparison with laboratory data. All subjects consistently underestimated the number of arousals they experienced. The authors discuss the implications of these findings for the treatment and definition of insomnia and for further research.

Adolescent↗