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Biomedical subjects

R Wittig

Publications and source records attributed to R Wittig.

At least 37 records · Page 2Linked to original sources
PubMed1986

Dose effects of temazepam tablets on sleep.

The dose effects of temazepam tablets (15 and 30 mg) were studied at two sleep centres in 48 volunteers who had objective polysomnographic evidence of sleep onset insomnia. Volunteers slept in the laboratory, retiring at their usual bedtime after taking placebo or temazepam 30 min earlier, and were monitored for 8 h using standard polysomnographic techniques. Acute (nights 5-7) and short term (nights 11-13) temazepam, both 15 and 30 mg, improved the sleep of these volunteers by reducing sleep latency and increasing sleep time compared to the placebo baseline (nights 2-4). Dose differences were found primarily on the measurement of sleep staging, with 30 mg having a greater or more consistent effect than 15 mg. No residual effects were observed on the basis of questionnaires and objective tests of performance and no consistent evidence of disturbed sleep after discontinuing treatment was seen.

Adult↗
PubMed1985

Efficacy of a reduced triazolam dose in elderly insomniacs.

Elderly persons with insomnia are unique because the cause of their insomnia differs from that of younger people and their metabolism of benzodiazepine hypnotics differs as well. This study used nocturnal polysomnography and daytime sleep/wake tendency measures (Multiple Sleep Latency Test, MSLT) to assess the efficacy and safety of a reduced triazolam dosage (0.125 mg) in elderly subjects with insomnia. After 2 nights and an intervening day of screening each subject received triazolam and placebo for 2 consecutive nights presented in a counter-balanced design. Compared to placebo the reduced triazolam dose induced and maintained sleep thereby increasing total sleep time. Sleep stage distribution and the frequency of apneas and periodic leg movements was not altered. The improved sleep was associated with a restoration of the normal pattern of daytime alertness. The correspondence of this clinical data to known pharmacokinetic data is discussed.

Aged↗
PubMed1985

Eligibility requirements in hypnotic trials.

Forty-eight patients complaining of insomnia were studied at two sleep laboratories using an identical protocol to evaluate hypnotic efficacy. All met the screening requirement of a mean sleep latency of 30 min or greater on 3 laboratory nights following an adaptation night. Of these patients 34 still complaining of insomnia were screened a second time 2 to 6 months later. Sixteen of the 34 failed the second screen. Sleep parameters for the 34 on screen 1 compared with screen 2 were the same except for sleep latency (the eligibility criteria), which was significantly shorter. There was no evidence of a systematic difference between laboratories, a change in procedure from screen 1 to 2, or a systematic loss of patients from screen 1 to 2. The data show that the statistical phenomenon of regression toward the mean must be considered in designing hypnotic efficacy studies.

Adult↗
PubMed1985

Sleep-wake complaints in patients with sleep-related respiratory disturbances.

The relation of sleep complaint to sleep continuity and respiratory disturbance was studied by comparing 2 series of patients with sleep apnea, one group complaining of insomnia and the other of excessive daytime sleepiness. On polysomnographic evaluation, patients with insomnia complaints had fewer and shorter, primarily central, apneas that had little hypoxemic effects. Patients with excessive sleepiness complaints had more and longer, primarily obstructive, apneas that produced significant hypoxemia. Sleep of the excessively sleepy patients was lighter and longer, whereas that of the patients with insomnia was characterized by more wake time before and after sleep onset. The excessively sleepy patients were objectively sleepy on a test of daytime sleepiness, whereas patients with insomnia were alert.

Adult↗
PubMed1985

Uvulopalatopharyngoplasty. One-year followup.

Uvulopalatopharyngoplasty (UPPP), originally evaluated in 66 patients with objectively documented sleep apnea syndrome, was successful in 33 of the patients as indicated by clinical and polysomnographic improvements. One-year followup polysomnographic evaluations were obtained in 20 of these patients; the remaining 13 were lost to followup. After one year, the patients maintained the improvements seen at the six-week evaluation. Frequency and duration of apnea was significantly reduced from presurgery levels and similar to the six-week results. Oxygenation measures also did not differ from the six-week results, remaining better than presurgery values. Thus, respiration did not disrupt sleep to the degree it had before surgery. Sleep measures were improved compared to presurgery and similar to the six-week data. Body weight remained stable over the entire period.

Female↗
PubMed1984

Periodic movements during sleep, sleep fragmentation, and sleep-wake complaints.

To better understand the relation of sleep complaint to sleep continuity and periodic movements during sleep (PMS), two groups of patients were studied retrospectively. One group of 51 patients, 26 men and 25 women, with a mean age of 56.4 years, complained of insomnia. The other group of 29 patients, 20 men and nine women, with a mean age of 55.8 years, complained of excessive daytime sleepiness. Sleepy patients differed significantly from insomnia patients in that they fell asleep faster and slept longer. They showed more frequent arousals (shifts to stage 1 sleep and number of awakenings) than insomnia patients who had longer arousals (mean duration of awakenings). Insomnia patients had more series of PMS, but sleepy patients had more PMS bursts per series.

Arousal↗
PubMed1984

Temazepam's efficacy in patients with sleep onset insomnia.

The hypnotic efficacy of temazepam capsules (30 mg) was studied in twelve patients who had objective polysomnographic evidence of sleep onset insomnia. Patients slept in the laboratory, retiring at their usual bedtime after taking placebo or temazepam 30 min earlier, and were monitored for 8 h using standard polysomnographic techniques. Acute (nights 5-7) and chronic (nights 11-13) temazepam improved the sleep of these patients by reducing sleep latency and increasing sleep time compared to the placebo baseline (nights 2-4). No detrimental effects on daytime function the following morning were observed using questionnaires and objective tests of performance. No consistent evidence of disturbed sleep after discontinuation of treatment was obtained over three recovery nights.

Adult↗
PubMed1984

Benzodiazepines and memory.

Benzodiazepines possess anterograde amnesic properties, disrupting both short-term and long-term memory function. The amount of amnesia is systematically related to dose effects and half-life differences among the benzodiazepines. Memory deficits are found for episodic, semantic, and iconic memory function. The deficits in long-term memory are probably the result of a disruption of consolidation of information in memory and not retrieval from memory. The disruption is produced by rapid sleep onset. Thus the long-term amnesia is really a retrograde effect of sleep and not the anterograde effect of the drug.

Amnesia↗
PubMed1983

Excessive daytime sleepiness associated with insufficient sleep.

Chronic insufficient sleep as an identifiable cause of excessive daytime sleepiness was investigated post hoc by comparing a series of patients with this diagnosis with patients with narcolepsy. Among the prominent features differentiating patients with insufficient sleep from patients with narcolepsy was the report, obtained on the sleep history, of a disparity between the reported amount of sleep obtained on weekdays versus weekends. On evaluation in the laboratory, patients with insufficient sleep showed atypically high sleep efficiency at night and a prolonged sleep time (longer than they report sleeping on a weekday night at home). Compared with patients with narcolepsy, they show a somewhat elevated percentage of stage 3-4 and REM sleep, although this is probably not higher than that of age-matched controls. On the Multiple Sleep Latency Test they displayed moderate sleepiness and no sleep onset REM periods. A mental status examination and Minnesota Multiphasic Personality Inventory did not suggest a primary psychiatric disorder.

Adult↗
PubMed1983

Effects of acute administration of brotizolam in subjects with disturbed sleep.

Effects of ingestion of brotizolam (0.25 and 0.50 mg) over 1-3 days on polysomnographic measures of sleep were assessed in patients complaining of insomnia. Brotizolam reduced latency to sleep, number of awakenings and wake during sleep, and increased total sleep time. It also increased stage 2 sleep and decreased slow wave and rapid eye movement sleep. Increasing the dose from 0.25 to 0.50 mg increased hypnotic efficacy, and there was a more consistent and reliable effect. Discontinuation of brotizolam had minimal effects on sleep compared with placebo over the 3 nights after acute administration. No side-effects or disruption of daytime function was found using questionnaires and objective tests of performance.

Adult↗
PubMed1983

Age-related sleep-wake disorders at a sleep disorder center.

The specific sleep disorders of 97 patients 61-81 years old were compared with those of 264 middle-aged (41-60 years old) and 202 young (20-40 years old) patients. Sleep disorder diagnoses were made according to the Diagnostic Classification of the Association of Sleep Disorders Centers based on evaluations consisting of mental and physical examinations and all-night sleep recordings. Most young and middle-aged patients complained of excessive daytime sleepiness; the elderly complained of insomnia as often as excessive daytime sleepiness. The evaluations revealed objective findings in 93 per cent of the elderly, but only 77 per cent of younger patients. Nocturnal myoclonus or restless leg syndrome was the diagnosed cause of 23 per cent of elderly patients' sleep-wake problems, but only 11 per cent of middle-aged and 4 per cent of young patients had this problem. Respiratory disorders of sleep were found in 27 per cent of elderly, 35 per cent of middle-aged, and 20 per cent of young patients. Elderly patients (6 per cent) had psychiatric disorders diagnosed as the causes for their problems less frequently than did younger patients (22 per cent).

Adult↗
PubMed1983

Narcolepsy and disturbed nocturnal sleep.

Disturbed nocturnal sleep is considered a symptom of narcolepsy. Polysomnographic recordings of 57 consecutive narcoleptic patients were reviewed for evidence of disturbed sleep. When disrupted sleep was present, it was attributable to recognized sleep disorders: nocturnal myoclonus and sleep apnea. Comparison of standard polysomnographically derived parameters of patients who had narcolepsy without sleep apnea or nocturnal myoclonus with those of a normal control group, showed no evidence of disturbed sleep in the patient population. The narcoleptics that also had nocturnal myoclonus or upper airway sleep apnea did have disturbed sleep in comparison with the normals. Our data suggest disturbed sleep tends to develop in narcolpetic patients with age, but is not an inherent element of the narcolepsy syndrome.

Adult↗
PubMed1982

The effects of doxepin HCl on sleep and depression.

The effects of doxepin hydrochloride (Adapin) on sleep and depression were evaluated in nine depressed patients with documented sleep difficulties. All subjects were screened for depression on the Hamilton Psychiatric Rating Scale. Sleep disturbance was measured by all-night polysomnography. Doxepin in doses of 75 and 150 mg/day significantly improved sleep efficiency, as evidenced by decreased sleep latency and increased total sleep time. After 2 weeks of treatment, REM latency and percent REM time were dramatically changed. Maximal improvement in depression occurred after 2 weeks of doxepin therapy and at the 150 mg dose.

Adult↗
PubMed1981

Personality differences between insomniac and non-insomniac psychiatry outpatients.

The relationship between self-reported measures of sleep disturbance and psychopathology was investigated. Previous studies on this topic have failed to use appropriate control groups. The current study examined the relationship between sleep disturbance and personality using insomniac and non-insomniac outpatient counseling clients. The results confirm the significant and positive relation between emotional disturbance and insomnia. The insomniac group showed the expected pattern of MMPI abnormalities (elevated D, Hy, Pt and Sc). However, only the Pt scale of the MMPI and the Cornell Medical Index significantly differentiated the two groups. This suggests that characteristics such as obsessional worry which lead to elevated Pt scores play a more important and unique role in insomnia than previously hypothesized.

Adult↗