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Human Sleep

Research and Clinical Care

Buch | Hardcover

456 Seiten

1987
Kluwer Academic / Plenum Publishers (Verlag)
978-0-306-42627-8 (ISBN)

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Sleep plays an important role in the history of the neurosciences. On Easter Monday in 1920, Otto Loewi was awakened in the night by a dream in which he conceived of neurotransmitters communicating across the synapse. He quickly made notes, but in the morning he could not understand his scribbles. The following night, the dream came again. He wrote down his thoughts more carefully and, the next day, conducted the crucial experiment that launched modern neu- rophysiology (Koelle, 1986). Since the beginning of the modern era of sleep research in the 1950s, we have used the principles of neurotransmission to explore the regulation of sleep. Without resorting excessively to comments on blind men and elephants, however, it is fair to say that the phenomena of sleep and waking can be approached from many perspectives. Among other things, sleep is a process that can be described electri- cally, an experience that so far defies physiological measurements, and a social behavior. In this book, I have tried to describe the physiology and pharmacology of sleep (Part I) and to relate them to clinical sleep disorders (Part II).
Having neither the skill nor the grandiosity of Rous- seau, I have made no attempt to write an encyclopedia of all that is known on the subject. Rather, I think of this book as more of a snap- shot, giving a picture of where we are, and it is hoped, a history of how we got here.

I Physiology and Pharmacology of Sleep.- 1 An Introduction to Sleep Studies.- Techniques of Human Sleep Studies.- Polysomnography.- Stages of Sleep.- Waking.- Non-REM Sleep.- REM Sleep.- The REM-Non-REM Cycle.- Sleep Stages and Age.- Effects of Temporal Variables on Sleep.- Physiological Variables in Sleep Stages.- Sleep Deprivation.- Total Sleep Deprivation.- Selective Sleep Stage Deprivation.- Natural Long, Short, and Variable Sleepers.- Regulation of Sleep.- Passive versus Active Regulation.- Neurotransmitters.- Models of Sleep Regulation.- Circulating Humors and Sleep.- Hypnotics.- Summary.- 2 Pharmacology and Neurotransmitters in Sleep.- Serotonin and Sleep.- L-Tryptophan.- 5-Hydroxytryptophan.- Parachlorophenylalanine.- Methysergide.- Lysergic Acid Diethylamide.- Fluoxetine.- Quipazine and Fenfluramine.- Ritanserin.- Ventricular Fluid 5-HIAA.- Dopamine.- L-Dihydroxyphenylalanine (L-DOPA).- Dopamine Receptor Agonists and Antagonists.- Pimozide.- Other Studies of Dopamine and Sleep.- Norepinephrine.- Alpha-Methyl-Paratyrosine (AMPT).- Alpha-Methyldopa.- Adrenergic Receptor Blockers.- Other Drugs Influencing Amines.- Reserpine.- Amphetamines.- Chlorpromazine.- Tricyclic Antidepressants.- Monoamine Oxidase Inhibitors.- Endogenous MAO and Biogenic Amines.- The Cholinergic System.- Muscarinic.- Nicotinic Agonists.- Gamma-Aminobutyric Acid.- Adenosine.- Circulating Sleep Factors.- Arginine Vasotocin (AVT).- Delta Sleep-Inducing Peptide (DSIP).- Muramyl Dipeptide (MDP).- Steroids.- Cholecystokinin (CCK).- Discussion.- Serotonin.- Dopamine.- Norepinephrine.- Acetylcholine.- Circulating Sleep Factors.- Gamma-Aminobutyric Acid.- Interaction between Transmitters.- 3 Pharmacological Treatment of Insomnia.- Aspects of Insomnia.- Pharmacology of Hypnotics.- Barbiturates.- Benzodiazepines.- Nonbarbiturate, Nonbenzodiazepine Hypnotics.- Efficacy Studies of Hypnotics.- Flurazepam.- Temazepam.- Triazolam.- Residual Daytime Effects.- General Issues.- Data on Performance and Wakefulness.- The Elderly.- Benzodiazepines and Respiration.- Reliance and Dependence.- Hypnotics and Alcohol.- Hypnotics and Acute Time Shifts.- Clinical Recommendations.- Conclusions.- 4 The Benzodiazepine Receptor and Sleep.- Pharmacological Probes of the BZ Recognition Site.- Studies with Beta-Carbolines.- The B10 Enantiomers.- Do Alterations in Calcium Flux Mediate Some Pharmacological Effects of BZs?.- Dihydropyridines and Diazepam-Stimulated Calcium Uptake into Synaptosomes.- Nifedipine Blocks Sleep Induction by Flurazepam.- BAY K 8644 Enhances Hypnotic Effect of Flurazepam.- The Relation of Barbiturates and Ethanol to the BZ Receptor Complex.- Effects of PB and Ethanol on Ion Channels.- Chloride Channel Function: Ethanol and PB Toxicity.- Relation of PB to BZ Recognition Site Function: Hypnotic, Anticonvulsant, and Anxiolytic Properties.- Heterogeneity of BZ Receptors.- Issues for the Future.- Endogenous Compounds.- Separation of Pharmacological Properties.- Summary.- 5 Neuroendocrinology and Sleep.- Basic Concepts in Neuroendocrinology.- Growth Hormone.- Secretion in Sleep and Waking.- Effect of Alterations in Neurotransmitter Function on GH Secretion.- Locus of Drug Effect.- Somatostatin.- Secretion of GH in Psychiatric Patients.- Secretion of GH in Disease.- Aging and GH.- Effects of GH Administration.- The Pituitary-Adrenal Axis.- Relation to the Sleep-Waking Cycle.- Sleep-Related Cortisol Secretion in Disease.- Effects of Cortisol and ACTH on Sleep.- Prolactin.- Relation of PRL to Other Hormones.- Drugs and Sleep-Related PRL Secretion.- Sleep-Related PRL Secretion in Disease.- Follicle-Stimulating Hormone and Luteinizing Hormone.- Relation of LH and FSH Secretion to Sleep.- Relation of Testosterone Secretion to Sleep.- Effects of Sex Hormones on Sleep.- Sleep-Related FSH and LH Secretion in Disease.- Thyroid-Stimulating Hormone.- TSH Secretion and Sleep.- Sleep in Hyperthyroidism and Hypothyroidism.- Central Nervous System Actions of TRH.- Antidiuretic Hormone and Renin.- ADH and Renin Secretion during Sleep.- Effects of ADH on Sleep.- Melatonin.- Summary.- II Pathology of Sleep.- 6 Sleep-Related Breathing Disorders.- Snoring.- Incidence of Sleep Apnea Syndromes.- Regulation of Respiration in Sleep.- Methods of Recording and Measuring Sleep-Related Respiration.- Clinical Syndromes.- Obstructive Sleep Apnea.- Central Sleep Apnea.- Mixed Apneas.- Hypoventilation Syndromes.- Treatment.- Obstructive Sleep Apnea.- Central Sleep Apnea.- Adjunctive Treatment and Precautions.- Questions for the Future.- Summary.- 7 Narcolepsy and Disorders of Excessive Sleepiness.- Definition.- Excessive Daytime Sleepiness and Sleep Attacks.- Cataplexy.- Sleep Paralysis.- Hypnogogic and Hypnopompic Hallucinations.- Disordered Nocturnal Sleep.- Automatic Behavior.- Psychosocial Consequences.- Performance Deficits.- Disordered Physiology.- Natural History.- Epidemiology and Genetics.- Etiology.- Animal Models of Narcolepsy.- Diagnosis.- Sleep Laboratory Findings.- Narcolepsy with Other Sleep Disorders.- Clinical Evaluation.- Other Disorders of Excessive Daytime Sleepiness.- Idiopathic Central Nervous System Hypersomnolence.- Sleep Drunkenness.- Insufficient Sleep Syndrome.- Hypersomnolence Associated with Medical or Toxic Conditions.- "Secondary Narcolepsy".- Excessive Sleepiness in Depression.- Pharmacotherapy of Narcolepsy.- Stimulants.- Antidepressants.- Monoamine Oxidase Inhibitors.- Serotonin Antagonists and Agonists.- Gamma-Hydroxybutyrate.- Propranolol.- Opiates.- Other Treatments.- Summary.- 8 Alcohol, Alcoholism, and the Problem of Dependence.- Animal Studies.- Ethanol and the Sleep EEG.- Effects of Prior Exposure to Ethanol.- Behavioral Measures of Sleep in Long- and Short-Sleeping Mice.- Ethanol and Neurotransmitters.- Ethanol in Normal Human Subjects.- Effects of Ethanol in Chronic Alcoholics.- Sleep in "Dry" Alcoholics.- Response to Ethanol.- Sleep during Acute Withdrawal.- REM Sleep Rebound.- Experimental Approaches to Ethanol Toxicity and Withdrawal.- Ethanol and Hypnotics.- Ethanol and Sleep Apnea.- Summary.- 9 Affective Disorders.- Observations of Patients.- Symptomatic Depressed Patients Compared to Controls.- Longitudinal Studies.- Sleep and the Switch Process in Bipolar Patients.- Theories of Sleep in Depression.- REM Deprivation.- Extended Sleep and Sleep Satiety.- Circadian View of Depression.- Implications of the Two-Process Model.- Reciprocal Interaction Model.- Pharmacological Models.- Manipulations of Sleep as Treatments for Depression.- REM Sleep Deprivation.- Total Sleep Deprivation.- Partial Sleep Deprivation.- Advance of the Sleep-Wake Cycle.- Summary.- 10 Circadian Rhythms and Sleep.- Background.- Models of Sleep-Wake Regulation.- Disorders of the Sleep-Wake Schedule.- Transient Disturbance.- Persistent Disturbance.- Pharmacology.- Use of Hypnotics in Acute Phase Shifts.- Circadian Rhythm Alteration by Drugs.- Summary.- 11 Nocturnal Myoclonus and the Restless Legs Syndrome.- Nocturnal Myoclonus.- Prevalence.- Relation to Sleep Disturbance.- Drugs Associated with Myoclonus.- Differential Diagnosis.- Treatment.- Restless Legs Syndrome.- Clinical Features.- Treatment.- Summary.- 12 Chronic Insomnia.- Persistent Psychophysiological DIMS.- Subjective DIMS without Objective Findings.- Other Forms of Chronic Insomnia.- Qualities Associated with Insomnia.- Daytime Sleepiness.- Daytime Performance.- Sleep Studies of Insomniacs.- The Subjective Experience of Insomniacs.- Is Poor Sleep the Same as "Light" Sleep?.- Insomniacs' Perception of Habitual Sleep.- Treatment of Insomnia.- Nonpharmacological Techniques.- Sleep Hygiene.- A Program for Patients.- Summary.

Erscheint lt. Verlag	31.12.1987
Zusatzinfo	biography
Verlagsort	Dordrecht
Sprache	englisch
Gewicht	810 g
Themenwelt	Medizin / Pharmazie ► Medizinische Fachgebiete ► Neurologie
ISBN-10	0-306-42627-7 / 0306426277
ISBN-13	978-0-306-42627-8 / 9780306426278
Zustand	Neuware