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Modafinil, sleep deprivation, and cognitive function in military and medical settings.

Military personnel of many professions, including health care workers, are routinely challenged with performing their duties during hours when the circadian rhythm is at its trough, namely, late night and early morning. Studies have shown that cognitive performance declines significantly during these hours. Although many pharmacologic agents have been studied in an attempt to find a safe medication to enhance alertness and cognitive function, no safe nonaddictive options have been identified. Modafinil is a novel wakefulness-promoting agent that has been shown to improve cognitive performance and promote wakefulness among shift workers. This article reviews the studies on modafinil administration and cognitive performance as they relate to military operations and the provision of health care by sleep-deprived individuals.

Benzhydryl Compounds↗

Understanding post operative psychosis and sleep deprivation: a case approach.

The care of a critically ill, intensive care unit patient dangerously out of touch with reality, is a challenge requiring exceptional problem solving skills. This article will discuss the nursing management of a distressing, unusual case of post-operative psychosis. Specifically, this case involved a patient who suddenly became psychotic on his first post-operative day after having an atrial septal defect repair. The patient's self-destructive actions and the innovative strategies used by nursing staff to effectively intervene are described. Discussion of the complex interrelationship of factors that contributed to this patient's erratic behaviour is highlighted. Questions about the effects of sleep deprivation are raised.

Cardiac Surgical Procedures↗

[24-hour sleep deprivation as a method of activating EEG signs in epilepsy].

In 195 patients with suspected epilepsy 24-hour waking was used as an activation method. Routine EEG tracings were normal in these cases (58%) or showed only non-characteristic changes (21%). In only 21% of cases typical seizure activity was visible. Typical epileptic changes were demonstrated after this activation in 43% of cases, that is twice as frequently. Seizure activity appeared usually at the time of somnolence and during light sleep, and 30-minute EEG recording was sufficient for its demonstration.

Adolescent↗