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Daytime Alertness (daytime + alertness)
Selected AbstractsImpact of the novel antidepressant agomelatine on disturbed sleep,wake cycles in depressed patients,HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 3 2010Maria-Antonia Quera-Salva Abstract Background Disturbance of sleep,wake cycles is common in major depressive disorder (MDD), usually as insomnia, but also as hypersomnia or reduced daytime alertness. Agomelatine, an MT1 and MT2 receptor agonist and 5-HT2C receptor antagonist, represents a novel approach in MDD, with proven antidepressant efficacy and a positive impact on the sleep,wake cycle. We review the effects of agomelatine 25/50,mg/day on objective and subjective measures of the sleep,wake cycle in MDD. Subjective measures Agomelatine improved all aspects of the sleep,wake cycle from as early as 1 week in randomized trials versus selective serotonin reuptake inhibitors and venlafaxine, particularly getting off to sleep and quality of sleep, with an improvement in daytime alertness. Objective measures Agomelatine's effect on sleep architecture in MDD has been measured by polysomnography (PSG). There were significant improvements in sleep efficiency, slow-wave sleep (SWS), and the distribution of delta activity throughout the night, but no change in amount or latency of rapid eye movement (REM) sleep. Furthermore, the slow-wave sleep was resynchronized to the first sleep cycle of the night. Conclusion Agomelatine, a novel antidepressant, improves disturbed sleep,wake cycles in MDD. The improvement of both nighttime sleep and daytime functioning with agomelatine are promising features of this antidepressant regarding the management of MDD. Copyright © 2010 John Wiley & Sons, Ltd. [source] Comparing effects of methylphenidate, sertraline and placebo on neuropsychiatric sequelae in patients with traumatic brain injuryHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 2 2005Hoon Lee Abstract Background This study aimed to investigate the effects of methylphenidate and sertraline compared with placebo on various neuropsychiatric sequelae associated with traumatic brain injury (TBI). Methods This was a 4 week, double-blind, parallel-group trial. Thirty patients with mild to moderate degrees of TBI were randomly allocated to one of three treatment groups (n,=,10 in each group) with matching age, gender and education, i.e. methylphenidate (starting at 5,mg/day and increasing to 20,mg/day in a week), sertraline (starting at 25,mg/day and increasing to 100,mg/day in a week) or placebo. At the baseline and at the 4 week endpoint, the following assessments were administered: subjective (Beck Depression Inventory) and objective (Hamilton Depression Rating Scale) measures of depression; Rivermead Postconcussion Symptoms Questionnaire for postconcussional symptoms; SmithKline Beecham Quality of Life Scale for quality of life; seven performance tests (Critical Flicker Fusion, Choice Reaction Time, Continuous Tracking, Mental Arithmetic, Short-Term memory, Digit Symbol Substitution and Mini-Mental State Examination); subjective measures of sleep (Leeds Sleep Evaluation Questionnaire) and daytime sleepiness (Epworth Sleepiness Scale). All adverse events during the study period were recorded and their relationships to the drugs were assessed. Results Neuropsychiatric sequelae seemed to take a natural recovery course in patients with traumatic brain injury. Methylphenidate had significant effects on depressive symptoms compared with the placebo, without hindering the natural recovery process of cognitive function. Although sertraline also had significant effects on depressive symptoms compared with the placebo, it did not improve many tests on cognitive performances. Daytime sleepiness was reduced by methylphenidate, while it was not by sertraline. Conclusions Methylphenidate and sertraline had similar effects on depressive symptoms. However, methylphenidate seemed to be more beneficial in improving cognitive function and maintaining daytime alertness. Methylphenidate also offered a better tolerability than sertraline. Copyright © 2005 John Wiley & Sons, Ltd. [source] Daytime sleepiness during Ramadan intermittent fasting: polysomnographic and quantitative waking EEG studyJOURNAL OF SLEEP RESEARCH, Issue 2 2003Rachida Roky Summary During the lunar month of Ramadan, Muslims abstain from eating, drinking and smoking from sunrise to sunset. We reported previously that Ramadan provokes a shortening in nocturnal total sleep time by 40 min, an increase in sleep latency, and a decrease in slow-wave sleep (SWS) and rapid eye movement (REM) sleep duration during Ramadan. During the same study, the effects of Ramadan intermittent fasting on daytime sleepiness were also investigated in eight healthy young male subjects using a quantitative waking electroencephalograph (EEG) analysis following the multiple sleep latency test (MSLT) procedure. This procedure was combined with subjective alertness and mood ratings and was conducted during four successive experimental sessions: (1) baseline (BL) 15 days before Ramadan, (2) beginning of Ramadan (R11) on the 11th day of Ramadan, (3) end of Ramadan (R25) on the 25th day of Ramadan, (4) recovery 2 weeks after Ramadan (AR). During each session, four 20-min nap opportunities (MSLTs) were given at 10:00, 12:00, 14:00 and 16:00 h and were preceded by rectal temperature readings. Nocturnal sleep was recorded before each daytime session. Subjective daytime alertness did not change in R25 but decreased in R11 at 12:00 h, and subjective mood decreased at 16:00 h, both in R11 and R25. During the MSLT, mean sleep latency decreased by an average of 2 min in R11 (especially at 10:00 and 16:00 h) and 6 min in R25 (especially at 10:00 and 12:00 h) compared with BL. There was an increase in the daily mean of waking EEG absolute power in the theta (5.5,8.5 Hz) frequency band. Significant correlations were found between sleep latency during the MSLT and the waking EEG absolute power of the fast alpha (10.5,12.5 Hz), sigma (11.5,15.5 Hz) and beta (12.5,30 Hz) frequency bands. Sleep latency was also related to rectal temperature. In conclusion, Ramadan diurnal fasting induced an increase in subjective and objective daytime sleepiness associated with changes in diurnal rectal temperature. [source] Positional Therapy for Obstructive Sleep Apnea Patients: A 6-Month Follow-Up StudyTHE LARYNGOSCOPE, Issue 11 2006Arie Oksenberg PhD Abstract Background: Approximately half of obstructive sleep apnea (OSA) patients are positional (i.e., the majority of their breathing abnormalities during sleep appear in the supine posture). Little information exists as to whether avoiding the supine posture during sleep (positional therapy) is a valuable form of therapy for these patients. Aim: To assess the use of positional therapy (by the tennis ball technique [TBT]) during a 6 month period in 78 consecutive positional OSA patients. Methods: Demographic, polysomnographic, and self-reported questionnaire data on the use of the TBT were analyzed. Results: Of the 50 patients who returned the questionnaire, 19 (38%) (group A) said they were still using the TBT, and 12 (24%) (group B) said they used it initially and stopped using it within a few months but were still avoiding the supine position during sleep. Nineteen patients (38%) (group C) stopped using the TBT within a few months but did not learn how to avoid the sleep supine posture. Patients still using the TBT showed a significant improvement in their self-reported sleep quality (P < .005) and daytime alertness (P < .046) and a decrease in snoring loudness (P < .001). Patients of groups A and B were older than patients who did not comply with this therapy (P < .001). The main reason for patients stopping the use of the TBT in group C was that using it was uncomfortable. Conclusions: Positional therapy appears to be a valuable form of therapy mainly for some older aged positional OSA patients. [source] | ||||||||||