Sleep disorders

Most breast cancer patients with non-metastatic disease receive adjuvant local or loco-regional radiotherapy. To be scheduled for irradiation may cause distress and fears that can lead to sleep disorders. Few reports focused on sleep problems in patients assigned to radiotherapy.

6p vielonmusk 21-01-2022 17 0   Download

The research works were published at international paper mainly focused on diagnosing epilepsy sleep disorders, coma and brain death, stress, depresssion pathological… in automation field as spelling, eye blink, head movement, mental arithmetic… this were performed by offline, no mainly focus on resolving in realtime and in control automation field.

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Behavioral arousal requires integration of multiple neurotransmitter and neuromodulatory systems. Identifying these systems is the key to not only a better understanding of the neurobiology of sleep⁄wakefulness but may also lead to the discovery of potential therapeutic targets for various sleep disorders.

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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Fibromyalgia and sleep-disordered breathing: the missing link author’s response...

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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Fibromyalgia and sleep-disordered breathing: the missing link...

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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Residual sleep disturbance and risk of relapse during the continuation/maintenance phase treatment of major depressive disorder with the selective serotonin reuptake inhibitor fluoxetine...

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Drugs that act upon the central nervous system (CNS) influence the lives of everyone, every day. These agents are invaluable therapeutically because they can produce specific physiological and psychological effects. Without general anesthetics, modern surgery would be impossible. Drugs that affect the CNS can selectively relieve pain, reduce fever, suppress disordered movement, induce sleep or arousal, reduce the desire to eat, or allay the tendency to vomit. Selectively acting drugs can be used to treat anxiety, mania, depression, or schizophrenia and do so without altering consciousness....

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Medical Implications of Circadian Rhythmicity Prominent circadian variations have been reported in the incidence of acute myocardial infarction, sudden cardiac death, and stroke, the leading causes of death in the United States. Platelet aggregability is increased after arising in the early morning hours, coincident with the peak incidence of these cardiovascular events. A better understanding of the possible role of circadian rhythmicity in the acute destabilization of a chronic condition such as atherosclerotic disease could improve the understanding of the pathophysiology.

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Shift-Work Disorder: Treatment Caffeine is frequently used to promote wakefulness. However, it cannot forestall sleep indefinitely, and it does not shield users from sleep-related performance lapses. Postural changes, exercise, and strategic placement of nap opportunities can sometimes temporarily reduce the risk of fatigue-related performance lapses. Properly timed exposure to bright light can facilitate rapid adaptation to night-shift work. While many techniques (e.g.

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Circadian Rhythm Sleep Disorders A subset of patients presenting with either insomnia or hypersomnia may have a disorder of sleep timing rather than sleep generation. Disorders of sleep timing can be either organic (i.e., due to an intrinsic defect in the circadian pacemaker or its input from entraining stimuli) or environmental (i.e., due to a disruption of exposure to entraining stimuli from the environment). Regardless of etiology, the symptoms reflect the influence of the underlying circadian pacemaker on sleep-wake function.

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Source: Modified from TA Roth, L Merlotti in SA Burton et al (eds), Narcolepsy 3rd International Symposium: Selected Symposium Proceedings, Chicago, Matrix Communications, 1989. Narcolepsy affects about 1 in 4000 people in the United States and appears to have a genetic basis.

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Parasomnias The term parasomnia refers to abnormal behaviors or experiences that arise from or occur during sleep. A continuum of parasomnias arise from NREM sleep, from brief confusional arousals to sleepwalking and night terrors. The presenting complaint is usually related to the behavior itself, but the parasomnias can disturb sleep continuity or lead to mild impairments in daytime alertness. Two main parasomnias occur in REM sleep: REM sleep behavior disorder (RBD), which will be described below, and nightmare disorder.

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Specific questioning about the occurrence of sleep episodes during normal waking hours, both intentional and unintentional, is necessary to determine the extent of the adverse effects of sleepiness on a patient's daytime function. Specific areas to be addressed include the occurrence of inadvertent sleep episodes while driving or in other safety-related settings, sleepiness while at work or school (and the relationship of sleepiness to work and school performance), and the effect of sleepiness on social and family life.

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Restless Legs Syndrome (RLS) Patients with this sensory-motor disorder report an irresistible urge to move the legs, or sometimes the upper extremities, that is often associated with a creepycrawling or aching dysesthesias deep within the affected limbs. For most patients with RLS, the dysesthesias and restlessness are much worse in the evening or night compared to the daytime and frequently interfere with the ability to fall asleep. The symptoms appear with inactivity and are temporarily relieved by movement.

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Insomnia Associated with Neurologic Disorders A variety of neurologic diseases result in sleep disruption through both indirect, nonspecific mechanisms (e.g., pain in cervical spondylosis or low back pain) or by impairment of central neural structures involved in the generation and control of sleep itself. For example, dementia from any cause has long been associated with disturbances in the timing of the sleep-wake cycle, often characterized by nocturnal wandering and an exacerbation of symptomatology at night (so-called sundowning).

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Evaluation of Insomnia Insomnia is the complaint of inadequate sleep; it can be classified according to the nature of sleep disruption and the duration of the complaint. Insomnia is subdivided into difficulty falling asleep (sleep onset insomnia), frequent or sustained awakenings (sleep maintenance insomnia), early morning awakenings (sleep offset insomnia), or persistent sleepiness/fatigue despite sleep of adequate duration (nonrestorative sleep). Similarly, the duration of the symptom influences diagnostic and therapeutic considerations.

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Psychophysiologic Insomnia Persistent psychophysiologic insomnia is a behavioral disorder in which patients are preoccupied with a perceived inability to sleep adequately at night. This sleep disorder begins like any other acute insomnia; however, the poor sleep habits and sleep-related anxiety ("insomnia phobia") persist long after the initial incident. Such patients become hyperaroused by their own efforts to sleep or by the sleep environment, and the insomnia becomes a conditioned or learned response.

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Disorders of Sleep and Wakefulness Approach to the Patient: Sleep Disorders Patients may seek help from a physician because of one of several symptoms: (1) an acute or chronic inability to initiate or maintain sleep adequately at night (insomnia); (2) chronic fatigue, sleepiness, or tiredness during the day; or (3) a behavioral manifestation associated with sleep itself. Complaints of insomnia or excessive daytime sleepiness should be approached as symptoms (much like fever or pain) of underlying disorders.

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Behavioral Correlates of Sleep States and Stages Polysomnographic staging of sleep correlates with behavioral changes during specific states and stages. During the transitional state between wakefulness and sleep (stage 1 sleep), subjects may respond to faint auditory or visual signals without "awakening." Memory incorporation is inhibited at the onset of NREM stage 1 sleep, which may explain why individuals aroused from that transitional sleep stage frequently deny having been asleep.

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Physiology of Circadian Rhythmicity The sleep-wake cycle is the most evident of the many 24-h rhythms in humans. Prominent daily variations also occur in endocrine, thermoregulatory, cardiac, pulmonary, renal, gastrointestinal, and neurobehavioral functions. At the molecular level, endogenous circadian rhythmicity is driven by self-sustaining transcriptional/translational feedback loops (Fig. 28-2). In evaluating a daily variation in humans, it is important to distinguish between those rhythmic components passively evoked by periodic environmental or behavioral changes (e.g.

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