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Biomedical subjects

Q R Regestein

Publications and source records attributed to Q R Regestein.

At least 19 recordsLinked to original sources
PubMed1991

Is the poor sleep of shift workers a disorder?

OBJECTIVE: The purpose of this article is to describe the impact of shift work on sleep, as recently acknowledged in official nosologies of sleep disorders, and to discuss whether sleep altered by shift work actually constitutes a disorder. METHOD: The authors review subjective responses to recent survey questions about sleep and polygraphic measurements of sleep in shift workers and describe sleep clinic experiences with complaints related to shift work. FINDINGS: Shift work entails wide variation in work schedules, sleep quality, and worker tolerance and a high prevalence of night-shift sleepiness. It probably affects rates of drug use, health status, and family organization. Clinical presentations were rare, highly varied, and empirically treated. The United States, unlike other countries, has no legal restrictions on shift work. CONCLUSIONS: As a clinical phenomenon, sleep altered by shift work is common and varied, probably expresses nonphysiological sleep-wake scheduling, and is little treated. Further study of its health effects and consideration of whether it is a "disorder" or a "problem" seem warranted.

Adult↗
PubMed1988

Relief of sleep apnea by revision of the adult upper airway. A review of clinical experience.

Surgical revision of the upper airway for obstructive sleep apnea has repeatedly improved subjective more than objective laboratory outcome measures. To examine this disparity, we obtained subjective sleepiness questionnaire scores, Continuous Performance test, and polysomnography (PSG) in 40 patients with mild to moderate obstructive sleep apnea (mean apnea index, 33.9; mean minimum oxygen saturation during sleep, 75.4%). Continuous Performance test confirmed abnormal daytime sleepiness and correlated with minimum oxygen saturation and number of transitions between stages. Postoperatively, questionnaire scores fell a mean of 62%, indicating a marked improvement in subjective sleepiness. Changes in questionnaire score correlated with changes in minimum oxygen saturation. Mean PSG indexes showed no change. Individual patients without PSG improvement reported long-term improvement in daytime functioning, as confirmed by family members. These results suggest that measures in addition to PSG, including patient subjective response, would more fully characterize the outcome of revision of the upper airway for sleep apnea.

Adult↗
PubMed1987

Specific effects of sedative/hypnotic drugs in the treatment of incapacitating chronic insomnia.

Sedative/hypnotic drugs for the treatment of chronic insomnia are generally considered ineffective by most experts but helpful by many patients. Occasionally, insomnia-induced debilitations may be remedied by long-term use of sedative/hypnotic drugs; some examples are given. The present discrepancy between expert and patient opinion may be derived from current research practices. The improbability that series of sedative/hypnotic drug trials will be carried out for patients with insomnia further biases against observation of rarer but clinically significant distinctions among these drugs.

Adult↗
PubMed1987

Daily sleep patterns observed among institutionalized elderly residents.

The sleep/wake patterns of 16 institutionalized demented women were visually monitored hourly for 14 consecutive days. Individual mean total sleep time varied markedly from 5.0 to 12.1 hours per 24 hours. Unexpectedly, amounts of day sleep and night sleep correlated positively, suggesting a general sleep tendency manifested throughout the 24-hour day. Consistent individual sleep patterns and high inter-day correlations were found. A high degree of individuality in the sleep/wake patterns was also found, contrary to expectations that elderly obtain less sleep than others. Night sleep in the institutionalized elderly was not lessened by daytime sleep. Visual monitoring of sleep/wake patterns generated reliable data.

Aged↗
PubMed1986

Effects of various hippocampal lesions on monkey plasma cortisol levels in two experimental conditions.

The plasma cortisol levels of Rhesus monkeys with anterior, posterior, or near-total hippocampal lesions were compared to controls during two separate stressful conditions. In the first condition, each monkey was placed for the first time in a primate restraint chair for 72 h. In the second condition each monkey performed a complex behavioral task (titrating shock avoidance) to control the intensity of frequent footshock for a 24-h period. Control subjects had either no surgical operation or else surgical exposure of the hippocampus with no hippocampal lesion. They manifested lower plasma cortisol levels during shock avoidance compared with during the chair condition. Subjects with posterior hippocampal lesions manifested the same pattern but near-totally hippocampectomized subjects showed an opposite pattern with cortisol levels higher in the shock avoidance condition compared with the chair condition. Subjects with anterior hippocampal lesions had similar cortisol levels in both conditions. Thus hippocampal modulation of corticosteroid levels may depend on the specific condition under which such levels are measured, and may be relatively more subserved by anterior compared with posterior hippocampus in the monkey.

Animals↗
PubMed1985

Agitation observed during treatment with newer hypnotic drugs.

Side effects involving agitation, e.g., sleepwalking, anger, and panic, were observed in 10 insomniac patients treated with temazepam or triazolam but not other benzodiazepines. Each patient described these side effects as uncharacteristic. Milder agitation was observed in 2 cases. In 4 cases, these effects were doubted by the prescribing physician. This type of side effect has been only slowly recognized for other benzodiazepines and has not been much reported for these newer agents. Agitation observed during treatment with these agents may be related to their short elimination half-lives.

Adult↗
PubMed1978

Pedophilia occurring after onset of cognitive impairment.

Four married patients are reported who first manifested pedophilia and other signs of disinhibition after sustaining illnesses that led to cognitive impairments. Although pedophilia may often be related to a long-standing inadequacy of sexual functioning, the onset of pedophilia in an individual without a previous histroy of sexual perversion may indicate the presence of recently sustained cognitive impairments.

Adult↗
PubMed1977

Sudden catatonic stupor with disastrous outcome.

Catatonic stupor occurred in two psychiatric inpatients, predisposing them to staphylococcal pneumonia, venous thrombosis, and pulmonary embolism. Disastrous outcomes ensued. Catatonic stupor can lead to fatal complications, and aggressive medical and psychiatric therapy is indicated.

Acute Disease↗