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Magnetic fields mimic the behavioral effects of REM sleep deprivation in humans.

The discovery of rapid eye movement (REM) sleep by Aserinsky and Kleitman in 1953 initiated the impetus for sleep research and specifically the investigations of the effects of REM sleep deprivation (RSD) on animal and human behavior. The behavioral effects of RSD include the enhancement of motivational and "drive"-related behaviors. In laboratory animals, RSD has been reported to increase appetite, sexual behavior, aggressiveness, and locomotor activity. Moreover, RSD reportedly improves mood in patients with endogenous depression and heightens appetite and sexual interest in normal subjects. Since "drive"-related behaviors are thought to involve activation of limbic dopaminergic reward sites, RSD may enhance motivational behaviors through an action on limbic dopaminergic functions. In the present communication, we present two patients (one with multiple sclerosis and the other with Parkinson's disease) in whom treatment with magnetic fields produced behavioral effects which paralleled those observed in REM-sleep-deprived animals and humans. We propose, therefore, that the behavioral and mental effects of treatment with magnetic fields may be mediated via RSD and, by inference, involve activation of limbic dopaminergic reward sites.

Adult↗

Behavioral parasomnias.

Sleep is not a static state. During the sleep period, physiologic changes occur throughout the body and brain. This complex, dynamic process can, at times, result in episodes of unusual or undesirable behaviors. These phenomena are called parasomnias. The accurate diagnosis of this group of treatable disorders is important, because they can have a negative impact on sleep, health, and social function. In addition, some of the parasomnias may provide clues to the presence of other underlying pathologic conditions. The parasomnias may be categorized in more than one way, but any attempt to classify such a diverse collection of entities is likely to be somewhat arbitrary. This article discusses the parasomnias according to the classification of the International Classification of Sleep Disorders, with emphasis on those characterized by observable behavior. As the understanding of these disorders (and sleep, in general) continues to deepen, new entities and schemes of classification may emerge.

Brain↗

Sleep is undisturbed in elderly, depressed individuals who have not sought health care.

Sleep deficits are commonly found in geriatric depressed patients, particularly shortened rapid eye movements (REM) latency, disturbed sleep continuity, and decreased slow wave sleep (SWS). Here we report the sleep patterns of community volunteers responding to ads about memory loss and depression. The two groups, 24 geriatric-onset major depressive disorder (MDD) subjects with a minimal history of seeking treatment for depression and 24 gender- and age-matched control subjects, significantly differed from each other on only one measure of sleep--sleep latency; the MDD group showed a modest but significant shortening of latency to fall asleep. All other sleep/wake measures, including REM latency, temporal distribution of REM sleep across the night, SWS, and measures of nighttime wakefulness did not differ between groups. This lack of significant sleep disturbance suggests that the sleep deficits reported in many studies of major depression may be related to factors underlying treatment-seeking behaviors, physical health status, severity of the depression, or heterogeneity within the MDD population with some types seeking treatment and others not seeking it, rather than depressive state per se. The data indicate that community-dwelling healthy elderly individuals who have a diagnosed major depression but who have not actively sought health care do not necessarily manifest the sleep disturbances thought to be characteristic of major depressive illness.

Clinical Trials as Topic↗

Alterations in motor activity, sleep, and biochemistry in a cycling manic-depressive patient.

Biochemical and electrophysiological factors were studied longitudinally in a rapidly cycling manic-depressive patient. Slow changes in mood, motor activity, sleep, and urinary norepinephrine levels during the course of each depressed and manic episode are reported, as well as rapid alterations in many variables at the time of mood switch. Urinary concentrations of norepinephrine and its metabolite, 3-methoxy-4-hydroxyphenyl glycol (MHPG) were significantly lower in depression than in mania; norepinephrine but not MHPG excretion increased prior to the switch. We postulate that the slow behavioral and biological changes preceding switches in this patient are an important manifestation of the cyclic process in manic-depressive illness.

Adult↗

Depression in dialysis patients: a review of psychological factors.

A review of the literature reveals that the incidence and prevalence of depression among dialysis patients is unknown but that estimates may vary from 20 to 50 percent. Diagnostic and methodological problems related to the population are examined and the notion that depression in this population may represent a qualitatively different entity, is evaluated. Finally, several theoretical models of depression are described and their particular relevance to depression among dialysis patients is discussed.

Adaptation, Psychological↗

Computer-assisted analysis of fetal behavior in fetal abnormalities.

Fetal behavior was studied in 17 cases of fetal abnormalities including nonimmune hydrops fetalis and in 11 cases of intrauterine growth retardation (IUGR) in comparison to 30 healthy fetuses. Breathing movements, rapid eye movements and trunk movements were observed ultrasonically and analyzed using a computer-assisted system. The cases with central nervous system anomalies showed a markedly different behavioral pattern. In the fetal abnormalities without chromosomal anomalies, the cases without major behavioral disorders were cured by neonatal treatment. IUGR cases with decreased trunk, breathing and REM period were finally diagnosed as having fetal distress by fetal heart rate monitoring. The findings on fetal behavior hint at the possibility of diagnosing abnormalities in neural development as well as in well-being.

Abnormalities, Multiple↗

Parasomnias.

Parasomnias are defined as unpleasant or undesirable behavioral or experiential phenomena that occur predominately or exclusively during the sleep period. Initially thought to represent a unitary phenomenon, often attributed to psychiatric disease, it is now clear that parasomnias are not a unitary phenomenon but rather are the manifestation of a wide variety of completely different conditions, most of which are diagnosable and treatable. The parasomnias may be conveniently categorized as "primary sleep parasomnias" (disorders of the sleep states per se) and "secondary sleep parasomnias" (disorders of other organ systems, which manifest themselves during sleep). The primary sleep parasomnias can be classified according to the sleep state of origin: rapid eye movement (REM) sleep, non-REM (NREM) sleep, or miscellaneous (i.e., those not respecting sleep state). The secondary sleep parasomnias can be further classified by the organ system involved. The underlying pathophysiology of many parasomnias is state dissociation-the brain is partially awake and partially asleep. The result of this mixed state of being is that the brain is awake enough to perform very complex and often protracted motor and/or verbal behaviors but asleep enough not to have conscious awareness of, or responsibility for, these behaviors.

Humans↗

alpha2 adrenoceptors are involved in the regulation of the gripping-induced immobility episodes in taiep rats.

In 1989 Holmgren et al. (Holmgren et al. 1989 Lab Anim Sci 39:226-228) described a new mutant rat that developed a progressive motor disturbance during its lifespan. The syndrome is characterized by a tremor in the hind limbs followed by ataxia, episodes of tonic immobility, epilepsy, and paralysis. The acronym of these symptoms (taiep) became the name of this autosomic, recessive mutant rat. The taiep rats are neurological mutant animals with a hypomyelination, followed by a progressive demyelination process. At 7-8 months of age, taiep rats develop immobility episodes (IEs) characterized by a cortical desynchronization, associated with the theta rhythm in the hippocampus and changes of the nucal electromyogram (EMG), whose pattern is like rapid-eye-movement (REM) sleep. These rats also show an altered sleep pattern with an equal REM sleep distribution. This study analyzed therole of alpha(2) adrenoceptors in the expression of gripping-induced IEs in 8-month-old male taiep rats. The alpha(2) adrenoceptor agonists clonidine and xylacine increased the frequency of gripping-induced IEs whereas the alpha(2) antagonists yohimbine and idazoxandecreased or prevented such episodes. These findings correlate with the pharmacological observations in narcoleptic dogs and humans in which alpha(2) adrenergic mechanisms are involved in the modulation of cataplexy. Unexpectedly, the repetitive administration of clonidine resulted in jumping behavior, indicative of phasic activation of extensor musculature. Taken together, our results show that alpha(2) adrenoceptors are involved in the modulation in gripping-induced IEs and after the administration of several doses of clonidine produced phasic motor activation.

Adrenergic alpha-2 Receptor Agonists↗

Treatment of insomnia associated with clinical depression.

Sleep disturbances are almost always present in patients with depression. Though sleep disturbances generally abate with the resolution of depression, some patients continue to report poor sleep. Since a number of studies have demonstrated that insomnia increases the risk of new-onset depression and recurrence of depression, optimal management of insomnia associated with depression becomes an important clinical goal. Antidepressant agents have variable effects on sleep and in fact, some antidepressants seem to worsen sleep in patients with depression. This article reviews various treatment options in the management of patients presenting with insomnia and depression, including single agents, combination strategies and behavioral interventions.

Antidepressive Agents, Tricyclic↗

[Clinical and sleep EEG monitoring characteristics and long-term follow-up study on narcolepsy].

OBJECTIVE: Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucination and sleep paralysis, with abnormal characteristics of shorter rapid eye movement (REM) sleep latency. The management of the patients is very important. The present study focused on the clinical characteristics, diagnostic methods and long-term prognosis of this particular syndrome. METHODS: The clinical data of 39 narcoleptic children were analyzed. Sleep EEG monitoring was performed in all patients. Among the 39 cases, 23 were followed up. RESULTS: All the patients manifested with excessive daytime sleepiness, with disrupted nocturnal sleep occurring in 35 cases. Cataplexy appeared in 36 cases, and sleep paralysis in 9, hypnagogic hallucination in 19, and automatic behavior in 6 cases, respectively. Sleep EEG monitoring demonstrated a short mean sleep latency (< 5 minutes) and two or more sleep onset REM periods (SOREMPs) in 38 cases. Twenty-three of the 39 cases were followed-up. Seventeen cases were followed-up for over one year. The longest follow-up duration was 14 years. Methylphenidate was administered in 10 cases. The excessive daytime sleepiness had been improved in 7 cases (70%). No obvious adverse effects were found. Psychosocial and academic problems appeared in most cases. CONCLUSION: Narcolepsy is a chronic neurological disorder. A definite diagnosis is established when the symptoms of cataplexy and excessive daytime sleepiness occur in association with the characteristic findings on sleep EEG monitoring. Appropriate drug therapy and psychosocial management are of help for such patients. Stimulant medication is an important component of the overall treatment program. A comprehensive approach is necessary to meet the needs of children with narcolepsy. Family education and emotional support are key elements in the management plan. The overall goal for managing childhood narcolepsy is to assist the child and family in achieving optimal quality of life.

Adolescent↗