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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a 10-week longitudinal study, 29 parents and their children kept daily records of the children's sleep behaviors, excitement levels, and tiredness levels. Although the hypothesized increase in sleep behaviors such as sleepwalking and restlessness during the week of Christmas did not occur, children rated as more excitable by their parents and themselves exhibited a higher frequency of sleep behaviors. Positive associations were also found between averaged tiredness ratings and sleep scores. The results support previous findings of an association between arousal characteristics of children and their sleep behavior. Moderate validity coefficients were obtained for parents' and children's ratings of excitement, tiredness, and nocturnal waking.
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PMID:Parents' and children's ratings of sleep behavior, excitement, and tiredness: a 10-week longitudinal study. 793 Nov 95

Aging is a physiological process that shares many behavioral, biochemical and neuroendocrine phenomena with the pathophysiological situation of unresolved stress, as well as with a pharmacologically induced syndrome resulting from chronic benzodiazepine (BZ) consumption. Behavioral findings include symptoms such as drowsiness, ataxia, fatigue, confusion, weakness, dizziness, vertigo, syncope, reversible dementia, depression, impairment of intellectual, psychomotor and sexual function, agitation, auditory and visual hallucinations, paranoid ideation, panic, delirium, depersonalization, sleepwalking, aggressivity, orthostatic hypotension, and insomnia. Neuroendocrine findings include: central depletion of noradrenaline (NA), dopamine, adrenaline (AD), and serotonin (5-HT); reduction in the ratio of circulating NA/AD as well as platelet 5-HT and increase of AD, plasma free 5-HT and cortisol. These disturbances together with the increased platelet aggregability observed in the three groups are typical of unresolved-stress situations. Immunological findings include significant reduction of peripheral T lymphocytes (CD3, CD4, CD8) and the CD4/CD8 ratio, CD16 and gamma-delta cells. On the other hand, the three groups (elderly subjects, subjects faced with unresolved stress, and BZ consumers) show increase of the CD57 lymphocyte subset as well as natural killer cytotoxicity. Alterations of several biological markers have also been found, specifically in the oral glucose tolerance test, the intramuscular clonidine test, and the supine/orthostasis/exercise test. From a clinical point of view, the three groups appear to be more susceptible to the appearance and progression of many acute and chronic diseases (infectious and malignant diseases). As a result, chronic consumption of BZs should be avoided in both the elderly and subjects in unresolved-stress situations.
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PMID:Benzodiazepines: tolerability in elderly patients. 884 97

Parasomnias emerging from NREM sleep such as sleep walking, sleep terrors and confusional arousals are considered arousal disorders. Nocturnal video-polysomnography is the gold standard to diagnosing and differentiating parasomnias from other arousals with atypical motor behaviors such as nocturnal frontal lobe epilepsy (NFLE). This form of nocturnal seizures with prominent dystonic-dyskinetic components, in some cases genetic, has been recently identified by means of detailed video-analysis of movements during sleep. The clinical picture of parasomnias (with onset in early childhood, rare episodes of long duration, absence of stereotypy, general disappearance after puberty) is different from that of NFLE (which first occurs between the age of 10 and 20, manifests frequent complex and repetitive behaviors of short duration excluding rare prolonged seizures, nocturnal agitation, some daytime complaints such as fatigue or sleepiness, persistence into adulthood). Patients show no difference from classical sleep parameters whilst microstructure analysis shows sleep instability and arousal fluctuations in parasomnias and NFLE. In children as well, at least in our experience, the differential diagnosis between the two disorders is difficult and requires one or more complete nocturnal video-polygraphic recording. In any case the diagnosis of NFLE should be considered in children with nocturnal motor episodes or nocturnal motor agitation, when the attacks persist; this diagnosis is probably more frequent than expected.
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PMID:NREM parasomnias: arousal disorders and differentiation from nocturnal frontal lobe epilepsy. 1099 66

Sleep-related disturbed breathing and parasomnia in very young children are in the focus of epidemiological interest. The cardinal symptom, i.e. snoring, in connection with nocturnal perspiration, mouth breathing, susceptibility to infection of the upper respiratory tract and tiredness during the day or hypermotility, can be an indication of obstructive sleep apnea (OSA). The common treatment is adenotomy unless there is indication of allergic swelling of the nasal mucous membrane. Other anatomic predispositions for OSA must be considered (tonsillar hypertrophy, midfacial hypoplasia, micro- and retrognathia, e.g. in patients with Down's syndrome or patients with preoperated cleft lip face palate). Inhalative nasal corticoids are a possible alternative to adenotomy in light to medium grade cases of OSA. Tonsillotomy is indicated only in serious OSA cases, tonsillectomy is only justified in cases of chronic tonsillitis or more than 4-6 cases of angina in the last 12 months. Treatment with nasal CPAP is tolerated well also in childhood. Patients with central hypoventilation syndromes, insufficiency of the respiratory musculature or obesitas hypoventilation syndrome can usually be ventilated by non-invasive approach using a nasal mask. Patients suffering from parasomnia should always be asked if they snore at night because if OSA is diagnosed and treated, there are very good prospects of curing somnambulism as well. Like with narcolepsy and REM sleep, a close HLA association has also been identified for family somnambulism. In cases of parasomnia which becomes manifest only after very young age frontal lobe epilepsy should be suspected and searched by polysomnographic and simultaneous continuous nocturnal video surveillance. If reversive development or unclear motoric and utterance phenomena are observed, sleep-bound convulsive disorder should be looked for. Syncopal events can require comprehensive cardiological diagnosis, including exclusion of nightly disorders of the cardiac rhythm.
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PMID:[Sleep disorders in infancy--aspects of diagnosis and somatic background]. 1649 23

Habitual snoring is associated with daytime symptoms like tiredness and behavioral problems. Its association with sleep problems is unclear. We aimed to assess associations between habitual snoring and sleep problems in primary school children. The design was a population-based cross-sectional study with a nested cohort study. The setting was twenty-seven primary schools in the city of Hannover, Germany. Habitual snoring and sleep problems were assessed in primary school children using an extended version of Gozal's sleep-disordered breathing questionnaire (n = 1144). Approximately 1 year later, parents of children reported to snore habitually (n = 114) and an equal number of children who snored never or occasionally were given the Sleep Disturbance Scale for Children, a validated questionnaire for the assessment of pediatric sleep problems. Snoring status was re-assessed using the initial questionnaire and children were then classified as long-term habitual snorers or ex-habitual snorers. An increasing prevalence of sleep problems was found with increasing snoring frequency for sleep-onset delay, night awakenings, and nightmares. Long-term habitual snorers were at significantly increased risk for sleep-wake transition disorders (e.g. rhythmic movements, hypnic jerks, sleeptalking, bruxism; odds ratio, 95% confidence interval: 12.0, 3.8-37.3), sleep hyperhidrosis (3.6, 1.2-10.8), disorders of arousal/nightmares (e.g. sleepwalking, sleep terrors, nightmares; 4.6, 1.3-15.6), and excessive somnolence (i.e. difficulty waking up, morning tiredness, daytime somnolence; 6.3, 2.2-17.8). Ex-habitual snorers were at increased risk for sleep-wake transition disorders (4.4, 1.4-14.2). Habitual snoring was associated with several sleep problems in our study. Long-term habitual snorers were more likely to have sleep problems than children who had stopped snoring spontaneously.
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PMID:Sleep problems and daytime somnolence in a German population-based sample of snoring school-aged children. 1730 68