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Biomedical subjects

M Partinen

Publications and source records attributed to M Partinen.

At least 37 records · Page 2Linked to original sources
PubMed1994

The effect of four-day round trip flights over 10 time zones on the circadian variation of salivary melatonin and cortisol in airline flight attendants.

The effects of four-day round flights (Helsinki-Los Angeles-Seattle-Helsinki) were studied on the circadian rhythms of salivary melatonin (MT) and cortisol (COR) in 35 flight attendants. The mean age of the subjects was 33 +/- 7 years (median 34, range 21-50). Five 24 h profiles of unstimulated saliva were collected at 2 h intervals (except at 04:00) before, during, and after the four day flight. Salivary MT and COR were determined by radioimmunoassay. Both MT and COR exhibited a clear circadian rhythm with acrophases before the flight at 03:03 (MT) and 09:08 (COR). Two days after the westward flight from Helsinki to Los Angeles, the MT rhythm (circadian acrophase) had delayed 4 h 51 min and the COR rhythm 3 h 55 min compared to the control day before the flight. Two days later, during the last day in the USA, the MT rhythm had delayed 5 h 59 min and the COR rhythm 5 h 29 min as compared to the situation before the flight. After four days of the eastward flight from Seattle to Helsinki, the circadian acrophase of MT was still 1 h 35 min delayed compared to the control day before the westward flight. The results indicate that the restitution time of five days at the home base is on the average proper for recovery, if a four day round flight over 10 time zones takes four days or less. The resynchronization rate of salivary hormones after westward, outgoing flights is faster than the resynchronization rate after the eastward return flights.

Adult↗
PubMed1994

Controversies in the diagnosis of narcolepsy.

The diagnosis of narcolepsy can be problematic. Most sleep laboratories use polygraphic testing to establish the diagnosis. One polygraphic recording followed by a single multiple sleep latency test (MSLT) is used to differentiate the causes of syndromes with complaints of daytime somnolence. Prospective investigations have demonstrated that patients with periodic leg movements or upper airway resistance syndrome may present abnormal sleep latencies and more than one sleep onset rapid eye movement period (SOREMP) during MSLT. On the other hand, investigations of patients with daytime sleepiness and cataplexy have shown that the MSLT may not show more than one SOREMP. The combination of history of cataplexy and more than one SOREMP during MSLT is the best clinical determinant of narcolepsy. History of daytime sleepiness and presence of more than one SOREMP during MSLT, however, is a poorer discriminant of narcolepsy than history of cataplexy, particularly in an aging population.

Adolescent↗
PubMed1994

Twin studies in narcolepsy.

The genetic basis of narcolepsy is reflected by the strong association to human leukocyte antigen DR2 (most specifically to DQB1-0602) and the occasional familial occurrence, with several modes of transmission. At present, 12 monozygotic pairs with at least one affected twin have been reported. Of the three pairs considered concordant, the only well-documented pair is DR2 negative. Of the nine discordant pairs five are well documented, and all of these are DR2 positive. We performed a questionnaire study using a validated measure of narcoleptic symptoms (the Ullanlinna narcolepsy scale or UNS). The questionnaire was sent to 2,191 monozygotic twin pairs included in the Finnish Twin Cohort. In 225 pairs neither of the twins responded. In 1,550 pairs both twins responded, but in the answers of 228 pairs there were some missing data concerning the UNS items. Not a single case suggestive of narcolepsy was found. Narcolepsy in monozygotic twins is very rare. These facts support the hypothesis of a multifactorial etiology with a strong influence of nongenetic environmental factors.

Adult↗
PubMed1994

Epidemiology of narcolepsy.

The prevalence of narcolepsy is usually presented at about 50/100,000. There are, however, marked differences of about 2,500-fold between the lowest and the highest reported prevalence. This discrepancy is at least partly explained by differences in the study populations and methods. There are, however, no earlier population-based epidemiological studies with polygraphically confirmed diagnoses. We studied the occurrence of symptoms resembling the two main manifestations of narcolepsy, i.e. abnormal sleep tendency and emotion-associated muscular weakness, in an adult twin cohort (n = 16,179) with a questionnaire. A total of 3.2% met the minimal diagnostic criteria of the International Classification of Sleep Disorders for narcolepsy. Eleven questionnaire items assessing the main manifestations of narcolepsy formed a measure called the Ullanlinna Narcolepsy Scale (UNS), which has been validated. The UNS score was calculated for 11,354 subjects. Those (n = 75) having a UNS score equal or higher than the lowest value in a narcolepsy patient group were studied. Thirty-one of them (fulfilling also the minimal diagnostic criteria) were interviewed, and those suspected of having narcolepsy (n = 5) were evaluated in the sleep laboratory. In three subjects the narcolepsy diagnosis was verified (all dizygotic, nonfamilial and human leukocyte antigen DR2/DQB-0602 positive), giving a prevalence of 0.026% in the adult Finnish (Caucasian) population.

Adult↗
PubMed1994

Dopamine D2-receptors in human narcolepsy: a SPECT study with 123I-IBZM.

Increased dopamine D2 receptor binding in basal ganglia has been reported in human narcolepsy. These studies have been based on post-mortem material of 8 patients, most of them also medicated for narcolepsy. We studied six narcoleptics without stimulant or anticataplectic medication. The patients had an unambiguous history of cataplexy, and they were also studied polygraphically. Single photon emission computed tomography (SPECT) imaging was performed. The D2 receptor density was determined by using 123I-iodobenzamide (IBZM). The control subjects were 8 unmedicated Parkinson patients with one-sided (hemiparkinsonian) clinical symptoms. The D2 receptor density in them is known to be normal or somewhat increased compared to healthy normals. The striatum/frontal D2 activity ratio was 1.331 +/- 0.084 (with phantom study correction 2.101 +/- 0.300) in the narcoleptic patients, and in the parkinsonian controls 1.321 +/- 0.052 (2.067 +/- 0.185) for the asymptomatic side and 1.335 +/- 0.025 (2.117 +/- 0.090) for the symptomatic side (i.e. contralateral to the side with the clinical extrapyramidal signs). There was no statistical difference between the groups or between the symptomatic and asymptomatic side in the Parkinson patients. Thus, our results differ from the earlier post-mortem studies.

Adult↗
PubMed1994

Natural evolution of snoring: a 5-year follow-up study.

INTRODUCTION: The natural evolution of snoring was studied in a middle-aged population in Finland. MATERIAL AND METHODS: A questionnaire was mailed to a stratified random sample of 1600 people aged 36-50 years in 1985 with a response rate of 75.2%; 53% of them completed also the 5-year-follow-up questionnaire. Clinical examinations (N = 36) and whole-night polygraphic recordings (N = 22) were made to habitual (every or almost every night) snorers and daily sleepy persons. RESULTS: A total of 626 persons completed the 5-year-follow-up questionnaire. The prevalence of habitual snoring among men was 28.3-43.8% and among women 6.3-18.8%, increasing with age. Sleepiness was common: doze-off at the wheel was reported by 23% of snorers and traffic accidents because of sleepiness by 4.5%. Hypertension was clearly more common (p = 0.002) among habitual snorers, but the self-reported rates of strokes and coronary heart disease were not increased in this study. None of the snorers had been investigated because of their snoring or sleepiness during the five years. In polygraphic recordings 11/22 showed an oxygen desaturation index (ODI4) more than 5/h; active treatment was started for 8 of them. The observed prevalence of sleep apnea syndrome with ODI4 > 10 was 1.1% in this study. CONCLUSIONS: Snorers, even with clear sleepiness, are passive in seeking help for their symptoms. Physicians should actively diagnose this treatable condition impairing the quality of life and increasing the risk of traffic accidents and vascular diseases.

Accidents, Traffic↗
PubMed1994

Light treatment for seasonal affective disorder: theoretical considerations and clinical implications.

The concept of seasonal affective disorder (SAD) includes any depression whose onset is related to a certain season. Reduced environmental light is hypothesized to be the main precipitating factor of winter depression. Light treatment is used to prevent the onset of depressive episodes and to reduce depressive symptoms in patients with depression during winter months. The mechanisms of action which lead to the well-documented antidepressant response are still unknown. Several hypotheses of the pathogenesis of SAD are discussed, and the clinical practice of light treatment is reviewed.

Circadian Rhythm↗
PubMed1994

Selegiline in the treatment of narcolepsy.

We treated 17 narcolepsy patients in a placebo-controlled, double-blind, crossover trial with 10-, 20-, 30-, and 40-mg daily doses of selegiline, a monoamine oxidase inhibitor widely used in Parkinson's disease. There was a dose-dependent as well as a statistically and clinically significant improvement in narcoleptic symptoms and polygraphic measures. At 40 mg, there was a 36% reduction in the number of daytime sleep episodes and a 34% reduction in their duration (compared with placebo, mean values). The number of excessive sleepiness episodes decreased by 43%, and the duration decreased by 47%. The number of cataplectic attacks was reduced by 89%. On the multiple sleep latency test, the REM sleep latency increased from 5.0 to 13.3 minutes, and the number of sleep-onset REM periods decreased from 3.1 to 0.6. Sleep (S1) latency was not changed. No intolerable adverse events occurred. The effective dose range was 20 to 40 mg, requiring a low-tyramine diet, which was easy to maintain. In conclusion, selegiline alleviates both main symptoms of narcolepsy--the abnormal sleep tendency and cataplexy. Thus, treatment with selegiline makes it possible to avoid polypharmacy and to use a potent stimulant without known addiction risk.

Adolescent↗
PubMed1994

Snoring and cardiovascular risk factors.

The association of snoring with some cardiovascular risk factors was studied cross-sectionally by a postal survey among 3750 males aged 40-59 years. In univariate analyses, snoring associated statistically significantly (P < 0.01) with hypertension, smoking, obesity, heavy alcohol use, physical inactivity, dyspnoea, hostility and morning tiredness. In a multiple logistic regression model adjusted by age, snoring associated significantly with smoking, obesity, physical inactivity, hostility and morning tiredness. When smoking was excluded from the multivariate model, alcohol use was also associated significantly with snoring. The association of snoring with smoking, and with obesity seemed to be almost independent from other studied correlates of snoring. Our results indicate that in further studies on predictive value of snoring with regard to coronary heart disease and stroke, the associations of snoring with hypertension, smoking, obesity, heavy alcohol use, physical inactivity and hostility have to be considered, as these risk characteristics may cause confounding effects.

Adult↗
PubMed1993

Effects of light treatment on sleep structure in seasonal affective disorder.

Twelve outpatients with seasonal affective disorder (depression, winter type) were treated by 1 h of bright light exposure for five mornings. The intervention produced a significant reduction in depression scores, but no change was seen in the sleep electroencephalographic variables recorded after light treatment. Significant changes were seen, however, in ratings of subjective sleepiness. The acrophase of the circadian sleepiness rhythm was phase advanced, the mean level of the sleepiness rhythm was diminished, and the mean values of sleepiness scores were reduced at 8 and 10 a.m. This minimal influence of bright light on sleep structure is unlikely to explain the well-documented antidepressant effect.

Adult↗
PubMed1993

Frequencies of seasonal major depressive symptoms at high latitudes.

A modified depression rating scale was distributed to a sample of the adult Finnish population (n = 1000) in November 1991. No dependence on latitude (60 degrees N-70 degrees N) was seen in the occurrence of depression. The depressed subjects (n = 54) were reevaluated the following May, and four cases with seasonal affective disorder were found. The results suggest that high latitudes with large variations in the daily lightperiod may not be responsible for high prevalence of major depression with a seasonal pattern.

Adult↗
PubMed1993

Effects of 10 h time zone changes on female flight attendants' circadian rhythms of body temperature, alertness, and visual search.

The aim of the study was to analyse the effects of rapid time zone changes on the circadian rhythms of flight attendants. The mean age of the 40 female subjects was 30.0 (SD = 6.9) years. Measurements of oral temperature, alertness, and visual search were performed at two hour intervals two days before the flight from Helsinki to Los Angeles, during the second and the fourth day in the USA and during the second and fourth day after the return flight to Finland. The body temperature desynchronized and the phases of the alertness and visual search rhythms shifted rapidly in the USA. After the return flight, the acrophases of the circadian rhythms delayed during the second and fourth day in Finland. During the fourth day the acrophase of alertness was 35 min and the acrophases of body temperature and visual search were 2 h 2 min and 3 h 8 min delayed, respectively. The mathematical model based on the C-, S- and W-process theory of alertness explained 25-96% of the variation of observed mean alertness of the subjects in different conditions. It is concluded that the duration of the de- and resynchronization process of the flight attendants' circadian rhythms is on the average longer than 9 days during and after round flights over ten time zones. The mean alertness of the subject can be predicted with considerable accuracy using the mathematical model.

Adaptation, Psychological↗
PubMed1993

Nocturnal oxygen saturation and sleep quality in long-term survivors of thoracoplasty.

The extent and the predictors of nocturnal hypoxemia were studied in 9 men and 11 women treated for pulmonary tuberculosis by thoracoplasty 30-54 years previously. The patients had a scoliotic (Cobb) angle of 4-53 degrees. Median values for pulmonary function were: forced expiratory volume in 1 s 1.2 liters (49% of the predicted value), vital capacity 1.9 liters (54%), total lung capacity 3.6 liters (62%), and supine waking partial pressure for arterial oxygen 9.7 kPa. Four patients were hypercapnic. The patients' mean nocturnal SaO2 ranged from 83 to 94% (median 91.8%), and the SaO2 level below which the patients spent 10% of the total nocturnal recording time ranged from 78 to 92% (median 89.4%). A multiple stepwise linear regression analysis identified supine waking SaO2 as a significant predictor of nocturnal O2 desaturation, accounting for about 80% of the variability in nocturnal SaO2 levels; lung function values and Cobb angle were not significant independent predictors. The sleep quality, assessed by EEG, was good. It is concluded that in thoracoplasty patients with mild hypoxemia during wakefulness, the degree of sleep-related oxygen desaturation was modest and closely related to the waking level of SaO2.

Aged↗
PubMed1993

The positive diagnosis of narcolepsy and narcolepsy's borderland.

We studied the validity of cataplexy and number of sleep-onset rapid-eye-movement periods (SOREMPs) during one Multiple Sleep Latency Test (MSLT) as determinants of narcolepsy in 306 subjects with excessive daytime sleepiness not related to obstructive sleep apnea or other known syndromes. The subgroup defined by a history of cataplexy was the most homogeneous in clinical and polygraphic variables. However, only 83% of these subjects had two or more SOREMPs in one MSLT. The subgroup defined by two or more SOREMPs included many patients without cataplexy. A disproportionate number of these subjects were older women whose chances of developing cataplexy are remote. This group of older women had a higher number of periodic leg movements during sleep than the other groups. Patients with both cataplexy and two or more SOREMPs have the greatest chance of being DR2 DQw1 positive. Thus, the combination of history of cataplexy and two or more SOREMPs is the best clinical determinant of narcolepsy. However, two or more SOREMPs is a poorer discriminant of narcolepsy than history of cataplexy.

Adolescent↗
PubMed1992

Epidemiology of obstructive sleep apnea syndrome.

Obstructive sleep apnea syndrome (OSAS) is the most common organic disorder of excessive daytime somnolence. In cross-sectional studies the minimum prevalence of OSAS among adult men is about one per cent. Prevalence is highest among men aged 40-65 years. The highest figures for this age group indicate that their prevalence of clinically significant OSAS may be 8.5% or higher. Habitual snoring is the most common symptom of OSAS (70-95%). The most significant risk factor for OSAS is obesity, especially upper body obesity. Other risk factors for snoring, and for OSAS, are male gender, age between 40 and 65 years, cigarette smoking, use of alcohol, and poor physical fitness. Upper airway obstruction with snoring or sleep apnea are commonly seen in children of all ages. Snoring is very common among infants and children with Pierre Robin syndrome and among infants with nasal obstruction. Snoring and obstructive sleep apnea are also very common in men with acromegaly. Many other syndromes or diseases exist in which the upper airway is narrowed. Prevalence of snoring and sleep apnea is increased in all such situations. It has been suggested that sleep apnea may be one mechanism contributing to sleep-related mortality. The prevalence of every night snoring seems to decrease after the age of 65. However, more than 25% of persons over 65 have more than five apneas per hour of sleep. It remains to be seen whether this finding has clinical significance. Partial upper airway obstruction, even without apneas, may influence pulmonary arterial pressure and may cause daytime sleepiness and some health consequences.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Daytime sleepiness: a risk factor in community life.

The prevalence of daytime sleepiness and background factors associated with it were investigated in a study carried out at the UKK Institute. The inquiry took the form of a questionnaire mailed to 1600 people of middle age. Daytime sleepiness was found to be associated with disturbed night sleep. Women were more tired than men, but men slept more frequently during the day. Those suffering from tiredness complained of poor health more than other respondents. Traffic accidents and other mishaps attributable to tiredness had occurred in 1.3% of cases, and almost 5% of male respondents had dozed off while driving at least five times in their lives. The findings indicate a need for increased attention to disturbance of sleep and daytime sleepiness in routine health screening.

Accidents, Traffic↗