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PubMedDate not supplied

[Peptide therapy of sleep disorders in neurotic rats].

As a result of chronic stress, anxiety appeared in the rats behaviour, motor activity increased, heart rate quickened, blood pressure raised, conditioned instrumental alimentary reflexes missed, the duration of deep phases of sleep lowered, time of falling asleep became longer, the number of awakening increased. The change in quantitative characteristics of sleep was accompanied by its worsening, especially of rapid sleep. Administration of substance P (SP) eledoisin hexopeptide (EH) (250 mcg/kg), 100-200 mcg/kg of delta sleep peptide and 10 mcg/kg of ethylcrotyl barbiturate improved the rats behaviour and sleep parameters. Calipnon accelerated falling asleep. Delta sleep peptide increased sleep duration. SP and EH restored not only the quantitative characteristics of deep phases of sleep but greatly improved their quality: lowered the blood pressure disrupted tachycardia, normalized the conditioned activity.

Animals↗
PubMed1995

[Parameters for determining the effective treatment pressure in nCPAP therapy of sleep apnea].

We evaluated the accuracy of single parameters from the polysomnography in establishing the effective nCPAP treatment pressure in order to possibly economize pressure adjustment. In four patients (pts) a standard polysomnography was performed. 67 segments of 30-60s in duration, showing different typical types of breathing disturbances or normal breathing were selected. The segments were divided into 5 horizontal parts consisting of only one of the following signals: SaO2, snoring, mask pressure, esophageal pressure (Poes) and respiratory movements (RC + Abd). A second investigator then classified these 335 one lead recordings without knowing the complete segment. The classification based on the complete segment compared to that based on only one parameter gave an identical result in 44.8% (SaO2), 61.2% (Poes), 64.2% (RC + Abd), 80.6% (sonoring) and 82.1% (mask pressure) respectively. 97% of the complete segments were classified identically by both investigators. Each of the studied parameters alone was not adequate in establishing the correct pressure level. SaO2 corresponds least, mask pressure and snoring best to the classification based on all parameters.

Air Pressure↗
PubMed1993

[Long-term theophylline therapy in sleep apnea--follow-up over a period of 12 months].

Among all the sleep-related respiratory disorders, sleep apnoea is clinically the most important one because of its high incidence and potential cardiovascular sequelae. Treatment depends upon the risk profile of the individual patient; in severe cases or in risk patients nasal continuous superpressure ventilation is employed, whereas in milder cases theophylline has been successfully used alongside general measures. 103 patients were followed up during treatment on an outpatient basis for 2 to maximum 12 months. Initially a significant reduction of the apnoea index by a 50% average was achieved. This therapeutical effect remained largely constant with a slight average deterioration at the end of the observation period, whereas the subjective feeling tone also improved in most patients. The treatment course was prematurely discontinued in 34 patients. Good to very good success was achieved in a total of 43 patients, whereas 26 patients were non-responders either initially or as the treatment proceeded. Even though theophylline treatment is now well-tried in mild forms of sleep apnoea, predictors for its use in certain groups of patients must be determined before treatment is initiated.

Adult↗
PubMed1998

[Change in attitude to the management, diagnosis and therapy of sleep apnea syndrome. Hungarian Health Service].

Sleep apnea syndrome occurs in 4% of the general population. Due to its incidence, clinical symptoms and its causal or precipitating roles in other diseases, sleep apnea represents a real public health problem. Its early identification and its adequate treatment require a continuously functioning system of screening and care based on the family doctors and the therapeutic centres. The efficacy of such a system consist of following factors: integrated action in screening, care, treatment, postgraduate and health education, suitable regional distribution of basic screening and specialized care and a new type of cooperation among specialists working together in specialized care. The aim of this paper is to present an effective system for its management relying on both the international know-how and the experience obtained in Hungary, which has been adjusted to the structure of the Hungarian Health Service.

Cerebrovascular Disorders↗
PubMed1995

[Experiences with therapy of pediatric sleep apnea syndrome and obstructive nasopharyngeal respiratory pattern with nasal BIPAP and CPAP therapy].

Sleep-apnea in childhood shows a frequency similar to adults but it is caused by many other reasons. Therapeutic effects of nasal CPAP and BIPAP can replace surgical ENT-Therapy in large extent mainly in ages at 2-5 years. But also in older children is it possible to treat obstructive sleep apnea and hypoventilation neuromuscular diseases by BIPAP. Examples for treatment of children by BIPAP who are two years old were given. Other demonstrated cases cover children with stridor congenitus, obstructive sleep apnea, hypoventilation, adenoidal breathing disturbances with primary surgical treated tonsillar hyperplasia and one case of thoracal postobstructive malformation with therapeutic BIPAP options.

Child↗
PubMed1998

Four-year-old girl with Goldenhar-sequence and severe obstructive sleep apnea, symptoms, diagnosis and therapy.

Recently sleep related breathing disorders in children have received considerable attention. Unfortunately, cardiorespiratory polygraphy is expensive and time-consuming, and up until now today only a few pediatric hospitals have complete facilities for all-night cardiorespiratory polygraphy. Nevertheless, the prevalence of sleep related breathing disorders in children is higher than has previously been thought. To show the importance of proper diagnosis of sleep related breathing disorders, we report a case of a 4-year-old girl with severe obstructive sleep apnea caused by Goldenhar-sequence (facio-auriculo-vertebral dysplasia). Despite some treatment efforts to correct the aplastic right mandible, the symptoms of obstructive sleep apnea were not immediately recognized and remained untreated. Untreated obstructive sleep apnea led to growth and mental retardation. After polygraphic confirmation of obstructive sleep apnea and appropriate interdisciplinary treatment, the 4-year-old girl made rapid advances in growth and mental development.

Child, Preschool↗
PubMedDate not supplied

Management of insomnia.

OBJECTIVE: To review current issues in the pharmacologic and nonpharmacologic management of insomnia. DATA SOURCES: Controlled trials and case studies identified via MEDLINE for 1990 through April 1999 under the search terms insomnia, hypnotics, flurazepam, quazepam, estazolam, temazepam, triazolam, zolpidem, zaleplon, L-846, CL-284,846, melatonin, and valerian. DATA SYNTHESIS: Insomnia is a common, undertreated disorder. Nonpharmacologic management strategies (e.g., stimulus control, relaxation therapy, sleep hygiene) are therapeutic options that, compared with medication use, provide more sustained effects. The benzodiazepines and zolpidem are the most commonly prescribed hypnotic agents, but their use is associated with tolerance and central nervous system adverse effects. A new nonbenzodiazepine hypnotic agent, zaleplon, was very recently approved in the United States. Because of its short half-life, zaleplon will be useful in patients experiencing difficulty in falling asleep and in those who wake up at night and have trouble falling back to sleep. Antidepressants, antihistamines, and alternative medications are other treatment options. To avoid complications of therapy, hypnotic agents should be used at their lowest possible doses and for limited treatment durations. CONCLUSION: Pharmacotherapy is currently the most common treatment modality for insomnia, but long-term use of hypnotic agents can become complicated by drug tolerance, dependence, or rebound insomnia. Nonpharmacologic options--including combinations of behavioral interventions, sleep-restriction therapy, and patient education--provide longer-lasting benefits.

Aged↗
PubMed1990

Drug therapy of sleep-related hypoxaemia.

In patients with chronic obstructive pulmonary disease (COPD) exhibiting daytime hypoxaemia, a worsening of the latter occurs during sleep, particularly during REM sleep. The most efficient therapy of this sleep-related hypoxaemia is the nocturnal administration of O2 at a flow rate of 1.5-3 l/min. An alternative therapy, when daytime hypoxaemia is not too severe (PaO2 greater than 55 mmHg), is the use of almitrine (100 mg/day), a drug which improves daytime hypoxaemia in most COPD patients. The improvement of sleep hypoxaemia with almitrine is related to the increased daytime PaO2 and cannot be considered as a specific effect of almitrine on sleep-related respiratory events. It must be emphasized that almitrine is ineffective in about 25% of COPD patients ("nonresponders") and that almitrine can be used with conventional O2 therapy in patients with severe hypoxemia (daytime PaO2 less than 55 mmHg).

Almitrine↗
PubMed1993

Back to bedlam? Chelmsford and the press.

The Australian press played a vital part in bringing the events at Chelmsford Private Hospital to the attention of the general public, and in pressuring the New South Wales government to institute a Royal Commission into Deep Sleep Therapy. This paper describes the ways in which the press brought Chelmsford events onto the public agenda. It pays particular attention to aspects of the press coverage of the findings of the Royal Commission. The paper identifies the discourses concerning psychiatric care, the doctor-patient relationship and the role of the government in regulating the medical profession which were dominant in press accounts of Chelmsford. It is argued that while pre-existing stereotypes about mad psychiatrists and asylums were used to describe Chelmsford, more confronting ideas concerning the need for medical regulation and patient consumerism received press attention and therefore a public airing. The implications for psychiatric care in Australia are examined.

Cause of Death↗