Disease relevance of Sleep Disorders

• The actions of melatonin on the sleep-wake cycle were investigated by means of a randomised, double-blind, placebo-controlled trial in 8 subjects with a delayed sleep phase syndrome attending a sleep disorders clinic [1].
• OBJECTIVE: To assess objective and subjective evidence of sleep disorders in patients with systemic lupus erythematosus (SLE) and to examine correlations between parameters of lupus activity, depression, and sleep disturbances [2].
• This same response is seen after initiating treatment of sleep apnea with nasal continuous positive airway pressure (CPAP), and can also occur in patients with other sleep disorders in response to particular medications, such as valproate or gabapentin [3].
• H(3) receptor antagonists may also have therapeutic value in the management of obesity, pain, sleep disorders, schizophrenia, and attention deficit hyperactivity disorder [4].
• Multivariate models showed that even after controlling for obesity and hypertension, the odds of having a DSM-IV breathing-related sleep disorders diagnosis was 5.26 for individuals with a major depressive disorder diagnosis [5].

Psychiatry related information on Sleep Disorders

• Whereas normal sleep architecture is conserved in RA, we confirmed former findings of severe sleep fragmentation and an enhanced presence of primary sleep disorders [6].
• DESIGN: Diagnosis of narcolepsy with cataplexy was based on International Classification of Sleep Disorders criteria with clinical, standard polysomnographic, and Multiple Sleep Latency Test features [7].
• Enhancement of dopaminergic activity may cause an initial worsening of levodopa-induced adverse effects, such as dyskinesia, nausea, vomiting, orthostatic hypotension, sleep disorders and hallucinations [8].
• Increased spontaneous motor activity was observed only during the rats' normal sleeping phase, suggesting a correlate to mefloquine-induced sleep disorders [9].
• Fluoxetine has overall therapeutic efficacy comparable with imipramine, amitriptyline and doxepin in patients with unipolar depression treated for 5 to 6 weeks, although it may be less effective than tricyclic antidepressants in relieving sleep disorders in depressed patients [10].

High impact information on Sleep Disorders

• The hypocretin/orexin ligand-receptor system: implications for sleep and sleep disorders [11].
• These results argue against the belief that sleep disorders in children can inhibit growth through a daily GH deficit [12].
• Among elderly people, even those who are healthy, the frequency of sleep disorders is high and there is an association with impairment of melatonin production [13].
• The histamine H3 receptor as a novel therapeutic target for cognitive and sleep disorders [14].
• The inhibitors may serve as useful tools to clarify the role of endogenous oleamide and anandamide and may prove to be useful therapeutic agents for the treatment of sleep disorders or pain [15].

Chemical compound and disease context of Sleep Disorders

• In the final section of this review, the GABA metabolite GHB is discussed in terms of its physiological significance and its role in epilepsy, sleep disorders, drug and alcohol addiction, and an inborn error of GABA metabolism, succinic semialdehyde dehydrogenase deficiency [16].
• Plasma endogenous benzodiazepine-like activity in sleep disorders with excessive daytime sleepiness [17].
• SETTING: American Academy of Sleep Medicine Accredited Sleep Disorders Center. INTERVENTIONS: None [18].
• It is often difficult to determine which disorder is "primary". The authors examine three cases of depression with atypical features associated with specific sleep disorders and report a favorable response to valproate [19].
• The dopamine agonists L-dopa/carbidopa, bromocriptine mesylate or both were initiated in 49 patients with RLS/PLMS who sought consultation at a sleep disorders center [20].

Biological context of Sleep Disorders

• This plasticity allows for an unusual form of mechanism-based inhibition with multiple turnovers, resulting in "molecular fratricide." N-bromoacetyltryptamine should serve as a useful tool for dissecting the role of melatonin in circadian rhythm as well as a potential lead compound for therapeutic use in mood and sleep disorders [21].
• Sleep disorders and ADHD: shared and common phenotypes [22].
• To determine predictors of subjective sleepiness in epilepsy patients, we gave self-administered, validated surveys of sleepiness [Epworth sleepiness scale (our major outcome measure)] and sleep apnea [sleep apnea scale of the sleep disorders questionnaire (SA/SDQ)] to 158 epilepsy patients and 68 neurology patients without epilepsy (controls) [23].
• Restriction fragment length polymorphism analysis was performed with several restriction enzymes and three cDNA probes for DQ alpha, DQ beta, and DR beta genes on genomic DNAs obtained from narcoleptics and patients with other sleep disorders, matched controls, and 3 homozygous typing cells representing the DR2 subtypes Dw2, Dw12, and DwAZH [24].
• Point mutations in the prion protein, period 2, and the prepro-hypocretin/orexin gene have been found as the cause of a few sleep disorders but the possibility that other gene defects may contribute to the pathophysiology of major sleep disorders is worth in-depth investigations [25].

Anatomical context of Sleep Disorders

• RECENT FINDINGS: Several studies on cerebrospinal fluid hypocretin-1 levels in narcolepsy and in various other sleep disorders have shown that hypocretin deficiency is both highly sensitive and specific for narcolepsy/cataplexy [26].
• The spectrum of post-streptococcal disease of the central nervous system (CNS) has been widened recently and includes movement disorders (chorea, tics, dystonia, and Parkinsonism), psychiatric disorders (particularly emotional disorders), and associated sleep disorders [27].
• Possible new indications for donepezil in psychiatric and neurologic diseases, other than AD, include dementia with Lewy bodies, brain injury, attention deficit hyperactivity, multiple sclerosis, Down's syndrome, delirium, mood disorders, Huntington's disease and sleep disorders [28].

Gene context of Sleep Disorders

• This raises the question of whether more direct interventions such as CRH receptor antagonists would open a new lead in the treatment of stress-related disorders such as depression, anxiety and sleep disorders [29].
• Mutation screening of the human Clock gene in circadian rhythm sleep disorders [30].
• Sleep disorders are common in NCL patients [31].
• Results highlight the prominence of parent-reported sleep disturbance in children with ADHD and the need for clinicians to routinely screen for the presence of sleep disorders and assess detailed sleep physiology where indicated [32].
• These results are consistent with the hypothesis that an age-related deterioration occurs in the Hcrt system that may contribute to age-related sleep disorders [33].

Analytical, diagnostic and therapeutic context of Sleep Disorders

• These clinical guidelines were developed by the Standards of Practice Committee and reviewed and approved by the Board of Directors of the American Academy of Sleep Medicine. The guidelines provide recommendations for the practice of sleep medicine in North America regarding the use of light therapy for treatment of various sleep disorders [34].
• Because cyclic alternating pattern can also be measured in CIPA, clinical exploitation of this phenomenon could include monitoring of epilepsy, studies of the effects of drug therapy, and assessment of other sleep disorders [35].
• Recognition of the variety of generalized and partial epileptic syndromes associated with sleep, familiarity with the differential diagnosis of nocturnal spells, and awareness of the role that antiepileptic drugs and sleep disorders may play in epilepsy are helpful in evaluating patients presenting with behavioral and motor disturbances of sleep [36].
• Finally, we predict the possible future promises for complementary and alternative medicine (CAM) that pave the way to the emergence of a "Holistic Sleep Medicine" approach to the treatment of sleep disorders in the ageing population [37].
• Efficacy and safety of exogenous melatonin for secondary sleep disorders and sleep disorders accompanying sleep restriction: meta-analysis [38].

References