![]() Psychophysiology 18:107–113Ĭarskadon M, Harvey K, Duke P, Anders T, Litt I, Dement W (1980 a) Pubertal changes in daytime sleepiness. Sleep 5:361–371Ĭarskadon M, Dement W (1981) Cumulative effects of sleep restriction on daytime sleepiness. Neurobiol Aging 3:321–327Ĭarskadon MA, Seidel WF, Greenblatt DJ, Dement WC (1982 b) Daytime carryover of triazolam and flurazepam in elderly insomniacs. Addison-Wesley, Menlo Park, CA, pp99–125Ĭarskadon M, Brown E, Dement WC (1982 a) Sleep fragmentation in the elderly: relationship to daytime sleep tendency. In: Guilleminault C (ed) Sleeping and waking disorders: Indications and techniques. Br J Clin Pharmacol 8:7–13īřezinová V, Catterall J, Douglas N, Calverley P, Flenley D (1982) Night sleep of patients with chronic ventilatory failure and age matched controls: number and duration of the EEG episodes of intervening wakefulness and drowsiness. Sleep 6:156–163īreimer D (1979) Pharmacokinetics and metabolism of various benzodiazepines used as hypnotics. Sleep 2:1–207īliwise D, Seidel W, Karacan I, Mitler M, Roth T, Zorick F, Dement W (1983) Daytime sleepiness as a criterion in hypnotic medication trials: comparison of triazolam and flurazepam. Prepared by the Sleep Disorders Classification Commitee (HP Roffwarg, Chairman). Sleep 4:349–358Īssociation of Sleep Disorders Centers (1979) Diagnostic classification of sleep and arousal disorders, 1st ed. Psychophysiology 2:263–266Īncoli-Israel S, Kripke D, Mason W, Messin S (1981) Sleep apnea and nocturnal myoclonus in a senior population. Key WordsĪgnew HW, Webb WB, Williams RL (1966) The first night effect: an EEG study of sleep. Triazolam improved not only nighttime sleep but also daytime alertness. ![]() The long-acting benzodiazepine, flurazepam, impaired daytime alertness although nocturnal sleep was improved. Daytime effects were most closely related to half-life. The effect of flurazepam and triazolam on sleep (improvement) was essentially the same. ![]() About one-third could be classified as fully alert all day long in spite of their complaints. In general, chronic insomniacs showed all degrees of daytime alertness regardless of nocturnal sleep parameters. The criteria of hypnotic efficacy and the effects of triazolam and flurazepam on sleep and daytime alertness have been investigated in normals, chronic insomniacs and the elderly. Moreover, there is an apparent disparity between subjective and objective sleep parameters with, for example, objectively disturbed sleep in noncomplaining subjects. Psychiatric and psychophysiological disorders have been shown to be the most frequent causes of disorders of initiating and maintaining sleep. Most investigations to date have been geared towards the problem of chronic insomnia and yet we are all likely to suffer from transient insomnia at some point. The dimensions, daytime consequences and longitudinal aspects of insomnia are considered. This paper reviews a number of issues in the diagnosis and treatment of insomnia. Insomnia can be seen as a perception of disturbed sleep with daytime consequences, but is essentially also a symptom. Adequacy of sleep and energetic wakefulness next day are interacting phases in this cycle. Sleep and wakefulness are complementary phases in the daily cycle of human existence. ![]() This profile changes in the predicted direction with acute total and partial sleep deprivation, chronic sleep deprivation, sleep satiation, and in comparisons between hypersomnia patients and controls. Multiple assessments of sleep latency yield a profile of sleepiness across the day. Can these daytime changes be documented objectively? In the past several years, the Multiple Sleep Latency Test (MSLT) has been developed and validated as an objective quantitative measure of sleepiness. This is because experimental or clinical sleep disturbance is usually followed by annoying symptoms of fatigue and sleepiness the following day. Most people attribute a restorative function to sleep. ![]()
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