Human Sleep: Research and Clinical Care (1987)

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 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 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.