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

Described is a 67-year-old man whose initial symptoms evoked an obesity-hypoventilation syndrome. Polysomnography showed hypopneas associated with O2 desaturation episodes, and no apnea; maximal changes were noted during REM sleep. A few months later, in spite of marked weight loss, acute alveolar hypoventilation occurred and necessitated mechanical ventilatory support. Tracheostomy was performed. The patient appeared to be dependent on nocturnal ventilatory assistance. Diaphragmatic paralysis was noted in addition to clinical and electrodiagnostic evidence of amyotrophic lateral sclerosis. While the patient was not ventilated, a nocturnal recording of SaO2 again revealed desaturation episodes partly corrected by O2 2 L/min administered through the tracheostomy tube. With volume-controlled ventilation, desaturations completely disappeared, although no oxygen enrichment of the air was provided. We speculate that sleep disorders with hypopneas and O2 desaturation episodes were the initial symptoms of amyotrophic lateral sclerosis. This leads us to suggest that nonspecific respiratory muscle fatigue frequently seen in COPD might be included in the hypothetic causes of nocturnal hypoxemia.
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PMID:Amyotrophic lateral sclerosis presenting with sleep hypopnea syndrome. 337 Nov 13

This study examines the influence of daytime noise load on the spontaneous EEG activity during wakefulness and sleep. Twelve healthy male subjects participated in two experimental series, each consisting of three consecutive nights and the two days in between. EEG, EOG, EMG, ECG and respiration were continuously recorded. During one series from 9:00 to 21:00 h the subjects were exposed to 85 dB(A) industrial noise. Direct effects of the noise exposure were a slight blockade of the alpha and theta activity; towards the evening, when self-estimated tiredness was high, increased alpha and beta power were found (p less than .01). Aftereffects on subsequent undisturbed night sleep were a reduction in REM sleep (p less than .001), shortened sleep cycles (p less than .01) and an increase in slow wave sleep during the 2nd sleep cycle (p less than .05). These results are interpreted as signs of strained wakefulness and intensified fatigue, as disturbance of sleep processes and as an intensified need for recovery.
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PMID:Effects of daytime noise load on the sleep-wake cycle and endocrine patterns in man: I. 24 hours neurophysiological data. 341 Jun 39

The treatment of sleep disorders in depressives depends basically on the nature of the underlying affective disorder (endogenous, organic, psychogenic or constitutional depression). Therapeutic approaches may be categorized in: psychological, somatic and pharmacological ones. The former include psychotherapies and behavioral treatments which are useful in psychogenic and constitutional depressions with sleep-onset insomnia but may also be supportive in endogenous depressions. The basic therapeutic factor common to all is anxiety reduction. Somatic therapies, such as ECT, total, partial and REM-sleep deprivation, sleep schedule shifts and bright light (EL) are utilized mostly in endogenous depressions. Sleep laboratory findings and different hypotheses concerning the mode of action of these alternative treatment methods are reviewed. Somnopolygraphic, psychometric, and neuroendocrinological data of our comparative trial with BL and partial sleep deprivation in normals and patients are discussed. The similarity of changes after BL, antidepressants and lithium points to a chronobiological factor in the pathogenesis and treatment of affective disorders. Electrosleep is still controversial, hydro-, ergo- and physical therapy are supportive therapies and as such indicated in all depressions. Exercise, fatigue and nutritional factors may influence sleep. Psychopharmacological treatment has to be regarded as the most important therapeutic approach for sleep disorders in depressives. Antidepressants are the drugs of choice for most patients. Based on their effects on sleep-induction, -maintenance, and -architecture and REM measures, one may differentiate at least two subtypes: sedative antidepressants of the amitriptyline type and nonsedative antidepressants of the desipramine type. Bedtime infusions of antidepressants may have sleep promoting properties, which was objectivated by an EEG spectral analysis during infusion and subsequently by all night sleep studies. Measures indicative of therapeutic outcome are still controversial. Tranquilizers, hypnotics, neuroleptics and serotonin precursors are utilized if the antidepressants alone do not ameliorate insomnia. However, as evidence of a shared diathesis of origin of depressive and anxiety disorders is building up, benzodiazepines are increasingly prescribed as monotherapy too. Finally, sleep laboratory data concerning the hypnotic properties of a pharmacological 80 mg doses of melatonin are demonstrated.
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PMID:Therapy for sleep disorders in depressives. 355 6

Elderly women had better recovery sleep than elderly men following 36-h sleep deprivation, as evidenced by higher sleep maintenance/efficiency and more slow wave sleep (particularly in the amount of stage 4 sleep). During recovery sleep, both groups showed REM latency reduction (two men and three women had seven sleep-onset REM periods out of a total of 40 recovery nights), decrease in percentage of early REM sleep and increase in whole-night REM sleep time. Total Mood Disturbance scores on the Profile of Mood States increased in both men and women following sleep deprivation (reflecting a decrease in vigor and increase in fatigue and tension). While the increase tended to be greater in women, in both groups self-ratings of mood returned to baseline after 1 night of recovery sleep. These observations underscore the importance of gender in determining late-life sleep structure and suggest that the ability of older women to achieve slow wave sleep and to have long uninterrupted sleep in greater than that of men.
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PMID:Sleep deprivation in healthy elderly men and women: effects on mood and on sleep during recovery. 380 63

The effect of the nootropic drug, piridoxilate on normal and on exogenously (by traffic noise) disturbed sleep and awakening quality was investigated in a double-blind placebo-controlled study. 10 elderly subjects with a mean age of 62 years spent 13 nights in the sleep laboratory: 2 adaptation nights, 1 baseline night, 3 drug nights (placebo, 300 and 600 mg piridoxilate), as well as 2 drug nights with nocturnal traffic noise (placebo and 600 mg piridoxilate) and the subsequent wash-out nights. Polysomnographic recordings (including EEG, EMG and EOG) were carried out between 10:30 p.m. and 6.00 a.m. Traffic noise was pre-recorded at a busy Viennese street and presented continuously by a loudspeaker with a sound pressure level at the ear of between 68 and 83 dB (A) [mean 75.6 dB (A)]. In the morning the subjects completed a sleep questionnaire for the subjective evaluation of their quality of sleep and awakening. Thereafter objective awakening quality was measured by a psychometric test battery. Piridoxilate did not induce any significant changes in objective and subjective sleep variables. Nocturnal traffic noise produced a decrease in total sleep time and sleep efficiency, an increase in wakefulness and drowsiness (stage 1), as well as a decrease in REM and deep sleep stages, the last-mentioned being of statistical significance. Subjectively, the elderly subjects reported a deterioration in sleep quality due to traffic noise, an increase in middle and late insomnia, as well as a deterioration in awakening quality (dizziness, tiredness, headaches). Piridoxilate did not ameliorate these sleep disturbances.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effect of nootropic drugs on normal and disturbed sleep of the elderly: controlled studies with pyridoxilate and street noise]. 639 69

PFS is a characteristic and clinically recognizable rheumatologic syndrome. It is a very common condition, but only recently has investigational interest grown in this interesting syndrome. PFS should be diagnosed by its own characteristic features and not merely by excluding other conditions. Pathophysiology of PFS is not well understood at this time and needs further study. Sleep EEG studies in PFS have revealed disturbed non-REM sleep, and normal volunteers deprived of non-REM sleep develop many features of non-REM sleep develop many features of PFS, including musculoskeletal aching, tenderness, and fatigue. Psychologic studies have shown that only a subset of PFS patients have shown that only a subset of PFS patients are significantly disturbed as determined by MMPI scores, and PFS patients as a group are more stressed than RA patients and normal controls as measured by Holmes-Rahe Life Events Inventory. It appears that chronic anxiety-stress causes muscle spasm that can be appreciated clinically in some patients and indirectly, possibly by electron microscopic findings of muscle biopsy. Likely role of other factors, e.g., constitutional, trauma, posture, and weather are also discussed. Biochemical transmitters of pain remain to be studied in PFS. Lack of a specific physical or laboratory finding should not deter acceptance of PFS as an entity, since such specific findings are absent in other similar and well-accepted conditions, e.g., irritable bowel syndrome, with which PFS shares many other common features, including muscle tenderness and spasm. PFS is different from psychogenic pain, and any implication by a physician that it is "all in the head" is certain to perpetuate chronic pain and disability.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Primary fibromyalgia syndrome: current concepts. 659 Jan 71

Fibromyalgia, also called (primary) fibromyalgia syndrome or fibrositis (syndrome), is a chronic soft tissue pain syndrome characterized by the presence of widespread musculosceletal aching, tender points at characteristic sites, fatigue, and poor sleep. The etiology of this common and painful condition is incompletely understood, non-restorative sleep, which has been correlated with an electroencephalic abnormality called alpha-delta sleep (intrusion of alpha rhythms in the non-REM sleep EEG), may be important. Several observations suggest that serotonin is likely to mediate both pain and non-REM sleep, and serotonin deficiency in the brain has been suggested to be of pathogenetic significance in fibromyalgia syndrome. A lower than normal threshold for pain can often be observed. The newly proposed criteria for the classification of fibromyalgia syndrome (widespread pain in combination with tender points at 11 or more of 18 specific tender point sites) are important for the differential diagnosis and to compare results in international studies.
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PMID:[Fibromyalgia]. 748 45

General use of ambulatory noninvasive 24-h blood pressure monitoring in many patients has shown that new criteria for arterial hypertension are useful. A classification of circadian blood pressure in "dippers" and "nondippers" (no physiologic drop of blood pressure) needs to be specified. An altered circadian blood pressure profile, like that in nondippers, was used as a diagnostic criterion for secondary hypertension. Recent epidemiologic studies in patients with essential hypertension have shown that nondippers are at higher risk for cardiovascular complications such as myocardial infarction and cerebrovascular insult. The studies also revealed that sleep-related breathing disorders (SRBD) are characterized by increased cardiovascular risk. Increases in blood pressure caused by SRBD could be documented, with the highest amount occurring during REM sleep. A study performed in a general practice showed a high incidence (40/112) of nondippers in a group of snoring middle-aged men with obesity and daytime fatigue. This indicates diagnostic and therapeutic consequences for the control of 24-h blood pressure, including nocturnal breathing pattern and daytime symptoms due to SRBD. The goal of antihypertensive drug therapy is to reduce blood pressure significantly during the day and during the night in different stages of wakefulness and sleep. A new protocol was designed to investigate blood pressure over 24 h under a standardized load, including nocturnal hypertension. The angiotensin-converting enzyme (ACE) inhibitor cilazapril was used in this test procedure and showed a significant and clinically relevant mean blood pressure reduction of 10.0 mm Hg (versus placebo 4.3 mm Hg) over 24 h.
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PMID:Nocturnal hypertension and cardiovascular risk: consequences for diagnosis and treatment. 789 92

Adults rarely present with rhythmic movement disorders in the Sleep Laboratory. We report the case of a 34 year-old woman, in good health, with a complaint of chronic body rolling during sleep and fatigue. Polysomnographic and video recordings showed head and body rhythmic movements, mainly during REM sleep. The contribution of severe psychopathology or neurological disorder was ruled out with personality testing, structured psychiatric interview and neurological examination with EEG, cerebral CT, MRI, and PET scans.
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PMID:[Rhythm of paradoxical sleep in an adult]. 820 63

An experiment was conducted to assess sleep and circadian regulation in an orbiting spacecraft. In orbit the weakened influence of 24-h zeitgebers could result in delayed circadian phases with the possibility of a transition to free-running circadian rhythms. This and the specific stressors of a space mission may lead to changes in ultradian sleep regulation and in reduced sleep quantity and quality. During the mission sleep was recorded polygraphically on tape, as was body temperature. Daytime alertness was rated subjectively by a mood questionnaire. For comparison the same parameters were measured during a baseline period preceding the space mission. The circadian rhythms of body temperature and alertness were found to be delayed in space compared to baseline. This may mark a phase shift or the transition to a circadian state of free-run. Sleep was shorter and more disturbed. The structure of sleep was significantly altered. In space REM latency was shorter, there was less REM sleep in the second non-REM/REM cycle, and slow-wave sleep was redistributed from the first to the second cycle. The self-assessed mood resembled sleep disturbances and adaptation to the space environment. Reduced sleep quality and quantity are likely to result in fatigue and lower daytime performance. Countermeasures should be adopted to improve sleep of astronauts.
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PMID:Sleep and circadian rhythm during a short space mission. 824 22


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