Sleep and cerebrospinal fluid interleukin-1-like activity in the cat

Exogenous interleukin-1 (IL-1), applied intraventricularly, has been reported to enhance slow wave sleep. Here, we demonstrate that endogenous interleukin-1-like activity and IL-1 beta of the cat CSF increases during sleep in comparison to wake.     

Dysthymic disorder and rheumatic pain modulation disorder (fibrositis syndrome): a comparison of symptoms and sleep physiology

It has been suggested that "fibrositis" or rheumatic pain modulation disorder (RPMD) is a variant of depressive illness. Both disorders are associated with abnormalities in sleep physiology. Since the clinical features of RPMD do not meet all the criteria for a major depressive disorder, the symptoms and sleep physiology in subjects with dysthmic disorder (DSM III criteria) (N = 6), and RMPD (N = 6) were compared, in order to determine the similarity between the two groups. The sleep physiology in dysthymic disorder was first examined over three consecutive nights since a systematic evaluation of the sleep physiology in this group of disorders has not yet been reported. All dysthymic patients showed episodic bursts of high-amplitude (75-150 microvolts) theta (3-5 Hz) bursts in stage 2 sleep, and REM onset latency was abbreviated only on night 2. The theta bursts have not been previously reported, and may be an early marker of disorganization of non-REM sleep in the dysthymic subjects. The comparison of the two groups revealed that RPMD subjects reported more pre- and post-sleep pain (p less than 0.01), lighter sleep (p less than 0.01), and more physical ailments during sleep (p less than 0.01), and had more alpha (7-11.5 Hz) in non-REM sleep (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)     

REVIEW ARTICLE: Sleep and cytokine–immune functions in medical, psychiatric and primary sleep disorders

The role of disturbed sleep physiology and altered cytokine and immune functions are reviewed in infections and chronic debilitating systemic diseases where fatigue, an increased desire to sleep, dysphoria and impairment in cognition are common symptoms. Activation of cytokines, sleepiness and malaise occur during the acute phase response to bacterial or viral disease. Sleep and cytokine–immune functions are disturbed in chronic protozoal and viral disease e.gtrypanosomiasis, human immune deficiency viral disease. Sleep-related physiological disturbances may play a role in post-febrile illness, end-stage renal disease and cancer. Various sleep disturbances accompany the fatigue and malaise in such chronic autoimmune diseases as rheumatoid arthritis, systemic lupus erythematosis and multiple sclerosis. HLA DR2 and DBQ1*0602 may have implications for changes in sleep and increased IL-6 and TNF-α in the blood of patients with narcolepsy. The elevation of these cytokines in sleep apnea may be the result of disturbances in sleep or may be an aspect of the disorder. The cytokine–immune changes that occur in major mental illness such as depression or schizophrenia appear to be the result of the disturbances in sleep.     

Role of daytime hypoxemia in the pathogenesis of right heart failure in the obstructive sleep apnea syndrome

Although right heart failure is a recognized complication of obstructive sleep apnea, the incidence and pathogenesis of this complication have not been established. We therefore studied 50 consecutive patients with obstructive sleep apnea to determine the incidence of right heart failure and the factors involved in its development. Six patients (12%) were found to have right heart failure. There were no differences in the number of apneas between those with right heart failure (mean +/- SE, 30 +/- 10 per h sleep) and those without right heart failure (33 +/- 4 per h sleep). In contrast, mean nocturnal oxygen saturation was lower in patients with right heart failure (76 +/- 3%) than in those without right heart failure (90 +/- 1%; p less than 0.001). Furthermore, patients with right heart failure also had a substantially lower awake arterial PO2 (52 +/- 4 mmHg versus 75 +/- 2 mmHg; p less than 0.001) and a higher PCO2 (51 +/- 2 mmHg versus 36 +/- 1 mmHg; p less than 0.001) than those without right heart failure. Severe nocturnal hypoxemia in the absence of diurnal hypoxemia was not associated with right heart failure. Daytime hypoxemia in the patients with right heart failure was associated with a higher residual volume (p less than 0.001) and lower forced expiratory volume in one second (p less than 0.001) than in the patients without right heart failure. The findings suggest that sustained hypoxemia and/or hypercapnia over a 24-h period is a necessary prerequisite for the development of right heart failure in patients with obstructive sleep apnea, and that diffuse airway obstruction plays a major role in causing such hypoxemia.     

Sleep disturbance induced by substance P in mice

Substance P (SP) and neurokinins have been implicated in modulating pain and mood but little is known about their effect on sleep-wake behavior. The purpose of the present study was to examine the possible involvement of SP in sleep-wake mechanisms without activation of painful responses. Electrophysiological recordings of the sleep-wake cycle were conducted in C57BL/6J male mice that had intracerebral ventricular cannula inserted for drug administration. Initially, in order to determine the highest dose of SP that would not induce nociceptive response, 10 animals per group received administration of either SP doses or artificial cerebrospinal fluid (CSF-sham group) through the cannula and were assessed by the hot plate test. The sleep-wake cycle of two other groups of mice was recorded for 24 h before (baseline) and after receiving CSF (n=10) or SP-1 mM (n=11), dose that had been determined in the previous hot plate test. SP interfered with sleep, when compared to baseline and to sham group, by reducing sleep efficiency, increasing latency of sleep and the number of awakening bouts. To examine the reversal of SP effects, eight mice were administered with an NK1 receptor antagonist before SP administration. Prior administration of the NK1 antagonist prevented the disturbances in sleep. CONCLUSIONS: The results suggest that SP produces disturbances in sleep, likely mediated by the NK1 receptor.     

Making health data maps: a case study of a community/university research collaboration

This paper presents the main findings from a collaborative community/university research project in Canada. The goal of the project was to improve access to community health information, and in so doing, enhance our knowledge of the development of community health information resources and community/university collaboration. The project built on a rich history of community/university collaboration in Southeast Toronto (SETO), and employed an interdisciplinary applied research and action design. Specific project objectives were to: (1) develop via active community/university collaboration a geographic information system (GIS) for ready access to routinely collected health data, and to study logistical, conceptual and technical problems encountered during system development; and (2) to document and analyze issues that can emerge in the process of community/university research collaboration. System development involved iteration through community user assessment of need, development or refinement of the GIS, and assessment of the GIS by community users. Collaborative process assessment entailed analysis of archival material, interviews with investigators and participant observation. Over the course of the project, a system was successfully developed, and favorably assessed by users. System development problems fell into four main areas: maintaining user involvement in system development, understanding and integrating data, bringing disparate data sources together, and making use of assembled data. Major themes emerging from the community/university collaborative research process included separate community and university cultures, time as an important issue for all involved, and the impact of uncertainty and ambiguity on the collaborative process.     

Growth hormone and cortisol responses, tranquillizer usage, and their association with survival from myocardial infarction.

Sixty-six patients consecutively admitted to a Coronary Care Unit with a diagnosis of myocardial infarction were evaluated physically, psychologically, and neuroendocrinologically. Records were also kept of appetite and drug intake. Serum cortisol and growth hormone, physical, and mood variables were evaluated daily and the neuroendocrine measures were also taken serially at the time of removal from the cardiac monitor. At the end of the 2 years the patient's functional status was evaluated and the outcome correlated with the aforementioned indices. Three factors emerged as being significantly related to outcome. Survivors' appetites were significantly better than the appetities of nonsurvivors. Those who were alive at follow-up had taken significantly more minor tranquilizers than those who had died. Survivors had consistently lower levels of growth hormone than nonsurvivors and these differences were statistically significant for those samples taken at the time of removal from the monitor. The findings are incorporated in two new indices predictive of both survival and functional outcome.     

Oxygen distribution in squamous cell carcinoma metastases and its relationship to outcome of radiation therapy

Oxygen distribution was measured in 31 fixed lymph node metastases (mean diameter 4.4 cm +/- 0.8 cm) from squamous cell carcinoma of the head and neck by passing a needle electrode through each tumor under CT guidance. Thirteen tumors had uniform oxygen distribution with all measurements under 10 mm Hg. Six tumors had uniform oxygen distribution with all measurements above 10 mm Hg, and twelve tumors had variable oxygen distribution with measurements higher in the periphery than in the center. Response to radiation therapy was judged by changes in tumor volume 90 days following completion of therapy compared to pre-therapy volume. Eighteen tumors were considered complete responders (CR); eleven, non-responders (NR); two, partial responders (PR). No statistically significant difference in radiation dose or tumor size was seen in the PR and CR groups. Mean pO2 was 20.6 (+/- 4.4) mm Hg in the CR group and 4.7 (+/- 3.0) mm Hg in the NR group (p less than 0.001). Normalized pO2 content defined as the total tumor oxygen content normalized by dividing by the volume was 37.4 (+/- 8.2) mm Hg in the CR group and 8.2 (+/- 5.1) mm Hg in the NR group (p less than 0.001). The volume and oxygen levels of each tumor were tabulated and analyzed. Twelve tumors had greater than 26% of their volume containing a pO2 less than 8 mm Hg. Eleven of these were NR and one PR. Nineteen tumors had less than 26% of their volume containing a pO2 less than 8 mm Hg. Eighteen were CR and one PR (p less than 0.001). These data suggest that oxygen plays a significant role in human tumor response to radiation therapy. Oxygen measurements appear to allow separation of subgroups of patients with a poor prognosis who would most benefit from maneuvers to circumvent the hypoxic effect.     

Genetic dependence of the electroencephalogram bispectrum

The resting electroencephalogram of monozygotic twins and genetically unrelated controls was analyzed with the ordinary spectrum and with the bispectrum. Both the ordinary spectrum which measures linear EEG wave activity and the bispectrum which detects non-linear and correlated frequency activity had evidence for a genetic basis. It is suggested that there is a genetic basis for the process of EEG generation.