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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

80 strictly selected patients with chronic renal insufficiency with plasma creatinine values of 1.4--14.5 mg% were examined according to a fixed scheme to determine the presence of symptoms and signs of renal encephalopathy. The general cerebral symptoms complained of were headache in 33.4% of the patient material, dizziness in 30.3%, easy fatigability in 62.5%, giddiness in 18.8% and insomnia in 37.5%. The most prominent neurological findings were hyperactive deep reflexes in 30% and action tremor in 23.8%. The symptoms of organic brain syndrome were impairment of memory in 32.5%, weakness of concentration in 28.8% and lability of affect in 63.7%. Diffuse EEG abnormalities were found in 26.2%. While the clinical neuropsychiatric symptoms did not show any statistically significant correlation with the various internal medical data, a trend was observed in the greater number of pathological EEGs with an increase in the impairment of renal function. Furthermore, there was a statistically significant correlation, (alpha less than or equal to0.015) between the occurrence of pathological EEGs and the plasma creatinine and BUN values. It is remarkable that the patients with abnormal EEGs had a relatively low mean creatinine level of 5.89 mg%. The strict dietetic management of the patients is regarded as one of the deciding factors for the relatively low frequency of neuropsychiatric symptoms in the material studied.
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PMID:Neuropsychiatric symptomatology with chronic renal insufficiency in the stage of compensated and decompensated retention. I. CNS disturbances. 5 91

St Christophers' Hospice near London is now internationally known as a special centre for the care of terminally ill patients. In these cases, the relief of symptoms is paramount, and prominent among those symptoms is pain. Such pain can almost always be relieved without euphoria or lessening of consciousness. More than 60% of patients admitted to St Christopher's complain of pain, and the scheme of management outlined below results in substantial or complete relief of pain in all of them. Addiction does not occur when control of the patient's pain is part of the pattern of total care. The author considers management of pain of varying severity, together with associated symptoms such as vomiting, anorexia, dry mouth and hiccup, dyspnoea, cough, anxiety and depression, insomnia, constipation and diarrhoea.
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PMID:Drug control of common symptoms in the terminally ill patient. 6 49

Treatment was interrupted abruptly in 6 hypertensive patients receiving clonidine 0-45-5-4 mg daily. Blood-pressure rose to pretreatment levels within 24-48 h of withdrawal and was accompanied by insomnia, headache, flushing, sweating, and apprehension. These symptoms began 18-20 h after the last dose of clonidine. Plasma-noradrenaline levels and urinary catecholamine excretion increased 24-72 h after withdrawal of clonidine. The subjective symptoms were most prominent in patients on higher doses (greater than 1 mg/day) and in those who had previously been receiving treatment with other antihypertensive drugs. One patient on a very low daily dose (0-15 mg) of clonidine had no symptoms and no significant changes in blood-pressure or catecholamine production after drug withdrawal.
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PMID:Clonidine withdrawal in hypertension. Changes in blood-pressure and plasma and urinary noradrenaline. 6 74

20 out of 36 children (aged two to eight years) with atopic eczema completed a twelve-week, double-blind, controlled, crossover trial of an egg and cows' milk exclusion diet. During the first and third four-week periods, patients on an egg and cows' milk exclusion diet received a soya-based milk substitute (trial period) or an egg and cows' milk preparation (control period). Response was assessed in terms of eczema activity, number of areas affected, pruritus, sleeplessness, and antihistamine usage while on the two diets. During the middle period patients resumed their normal diet to minimise any carry-over effect. 14 patients responded more favourably to the antigen-avoidance diet than to the control diet, whereas only 1 responded more favourably to the control diet than the trial diet. Patients experienced more benefit during the first diet period than the second, whatever the nature of the diet. There was no correlation between a positive prick test to egg and cows' milk antigen and response to the trial diet.
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PMID:A double-blind controlled crossover trial of an antigen-avoidance diet in atopic eczema. 7 38

To enhance physicians' knowledge of the prevalent problem of sleep disorders, a 50-minute videotape program designed as a learning and self-assessment experience in evaluating and treating these disorders was coproduced with the Network for Continuing Medical Education. The program has been presented nationally to about 25,000 medical professionals. The mean correct score was 50% for the pretest, 69% for the instructional section, and 79% for the posttest; the composite score on the posttest was 59% higher than that on the pretest. Physicians' responses indicated strengths and weaknesses in their knowledge of sleep disorders, thus delineating future directions for medical education in insomnia, narcolepsy/cataplexy, nightmares, night terrors, sleepwalking, and enuresis. All of these sleep disorders can be best evaluated and treated by the general physician.
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PMID:Resource for managing sleep disorders. 8 18

Sleep and memory were investigated in a well educated patient suffering from striato-nigral degeneration. Despite almost total insomnia (only 591 min of stages 1 and 2, without any stage 3, 4 or paradoxical sleep during a continuous 4 day recording) it was not possible to objectify significant short or long term memory impairment.
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PMID:[Insomnia and memory. Apropos of a case of striato-nigral degeneration]. 8 54

Psychiatric patients (N = 26) were treated chronically (from 1 week to 12 years) with nitrazepam, because of insomnia. The patients gave their subjective estimations of the effects and side effects of nitrazepam. The concentrations of nitrazepam in the plasma were measured by 63Ni-EC-gas-liquid chromatography. The pharmacokinetics of nitrazepam were compared between the psychiatric patients and healthy volunteers (N = 11). The steady-state concentrations and the half-life of nitrazepam in the psychiatric patients were comparable to those of the healthy volunteers. The subjective hypnotic effect of nitrazepam was mostly good or satisfactory and remained unchanged during long-term treatment. Only a few, mild side effects were reported. Nitrazepam does not seem to cause enzyme induction with lowered plasma levels and may therefore be of special value in the treatment of chronic insomnia.
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PMID:Long-term nitrazepam treatment in psychiatric out-patients with insomnia. 11 23

The effects of three oral doses of bedtime triazolam (0.25 mg, 0.5 mg, and 1.0 mg) a new benzodiazepine, on the laboratory sleep of insomniacs were studied in a double blind design which used the following 14 consecutive night schedule: 1-4 placebo; 5-11 drug; 12-14 placebo. Effects on sleep were measured objectively by conventional EEG/EOG/EMG sleep recordings and subjectively by questionnaires administered each morning. Side or toxic effects were assessed by screening physicals and questionnaires administered each morning and each evening and by a comparison of the prestudy vs. end-study physical exams and clinical lab tests. At the 0.5 mg dose triazolam significantly reduced several objective and subjective measures of insomnia. It had lesser effects at the 0.25 mg dose and equal or greater effects at 1.0 mg dose. There were no remarkable side or toxic effects at any dose.
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PMID:The effect of triazolam on the sleep of insomniacs. 16 80

The stability of sleep was examined in two kinds of induced insomnia, namely after caffeine administration and after hypnotic drug withdrawal. The duration of each episode of any one sleep stage or any episode of intervening wakefulness plus drowsiness was determined. After caffeine there was an increase in longer episodes of intervening wakefulness plus drowsiness, but no significant change in the episode duration of any of the sleep stages. In the case of drug withdrawal there was no change in the episode duration of intervening wakefulness plus drowsiness, but there was a significant shortening of episode duration in sleep stages 2 and 3+4, with a similar trend for REM sleep episodes. Caffeine 'insomnia' thus seems characterized by increased stability of wakefulness, and hypnotic withdrawal 'insomnia' by decreased stability fo sleep. The type of analysis undertaken in this study could increase understanding of other types of insomnia.
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PMID:Two types of insomnia: too much waking or not enough sleep. 16 68

(1) The bilateral destruction of the region of the dorsal norepinephrine bundle in the isthmus or in the mesencephalon induces a significant increase of both paradoxical sleep (PS) (up to 400%) and of slow-wave sleep (SWS). The increase of PS lasts for 4-5 days while the increase of SWS lasts at least 8-10 days. The same phenomenon is observed after total hypophysectomy. (2) control lesions effectuated in the isthmus outside the area of the dorsal norepinephrine bundle do not affect significantly the slee-walking cycle. (3) pretreatment with p-chlorophenylalanine suppresses the increase of sleep if the lesion is effectuated at the time of maximum insomnia, while a significant increase of PS is still observed if the lesion is made at the time of the recovery of sleep. (4) the mechanisms of this hypersomnia are discussed in light of the biochemical results showing an increase of the biosynthesis of serotonin in the rostral raphe system. It is postulated that some neurons of the dorsal norepinephrine bundle might tonically control the activity of the raphe system.
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PMID:[Hypersomnia by isthmic lesion in cat. II. Neurophysiological and pharmacological study]. 16 26


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