正常人服用扎来普隆在噪声干扰下的催眠效果观察

目的利用强噪声干扰造成情景性失眠,比较不同剂量扎来普隆的催眠效果。方法在模拟歼-6飞机噪声干扰环境中(约95dB),观察8名健康青年男性志愿者于14:00交叉服用扎来普隆10mg、15mg以及安慰剂后4h多导睡眠图的变化,指标包括睡眠潜时(SL)、睡眠效率(SE)、睡眠结构(各期慢波和快速眼动睡眠百分比)。觉醒后进行睡眠质量和嗜睡感的主观评价。采用单因素方差分析进行数据的统计处理。结果与安慰剂组相比,扎来普隆10mg组的SL明显缩短(F=9.48,P<0.05),主观睡眠质量分值和睡眠深度分值显著提高(F=14.89,P<0.01;F=10.67,P<0.05);而扎来普隆15mg组SL明显缩短(F=16.35,P<0.01),SE明显提高(F=17.43,P<0.01),快速眼动睡眠百分比显著增加(F=18.15,P<0.01),主观睡眠质量分值和睡眠深度分值亦显著增加(F=20.58,P<0.01;F=18.27,P<0.01)。服用各组药物觉醒后均无明显的主观嗜睡感和其它不良反应。结论扎来普隆的催眠效果具有一定的剂量相关特性,为提高催眠效果可将服药剂量由常用量10mg增加至15mg。     

Relationship of brain ethanol metabolism to the hypnotic effect of ethanol. II: Studies in selectively bred rats and mice

BACKGROUND: To clarify the role of brain acetaldehyde in the hypnotic effect of ethanol, we compared the ethanol-oxidizing capacity (rate of acetaldehyde accumulation) and catalase and aldehyde dehydrogenase activity in the brains of animals genetically selected for different sensitivities to the hypnotic effect of ethanol. METHODS: We used high, low, or control alcohol-sensitive rats (HAS, LAS, and CAS) and short- and long-sleep mice (SS and LS), as well as SS x LS recombinant inbred mice with known strain differences in mean duration of ethanol-induced sleep. We studied the rate of accumulation of acetaldehyde from ethanol in brain homogenates of these animals and correlated those values with their hypnotic sensitivity to ethanol. RESULTS: Acetaldehyde accumulation from ethanol was significantly higher in the brain homogenates from HAS rats and LS mice with high sensitivity to the hypnotic effect of ethanol in vivo, compared with LAS rats and SS mice with low sensitivity to ethanol. A correlation was found between the duration of ethanol-induced sleep and the in vitro rate of accumulation of ethanol-derived acetaldehyde in the brains of recombinant SS x LS mice strains. There was no correlation of sleep time with brain catalase levels. There were no line differences in brain catalase or aldehyde dehydrogenase or in alcohol or aldehyde dehydrogenase activity in livers of LAS, CAS, and HAS rats or in SS and LS mice. CONCLUSIONS: A correlation between the brain acetaldehyde accumulation, but not catalase levels, and the central effect of ethanol was demonstrated in animals genetically differing in initial sensitivity to the hypnotic effect of ethanol.     

Safety of ramelteon in individuals with mild to moderate obstructive sleep apnea

Ramelteon is a selective MT₁/MT₂-receptor agonist indicated for insomnia treatment. Because it has no depressant effects on the nervous system, it is not expected to affect the control of breathing. The potential effects of ramelteon on apneic and hypopneic events and arterial oxygen saturation (SaO₂) in individuals with obstructive sleep apnea were assessed. In this double-blind, randomized, crossover study, 26 adults with mild to moderate obstructive sleep apnea received ramelteon 16 mg and placebo for one night each, with a 5- to 12-day washout period between treatments. Treatments were administered 30 min before habitual bedtime. Respiratory effort was monitored using respiratory inductance plethysmography, SaO₂ was measured by pulse oximetry, and sleep onset and duration were measured by polysomnography and post-sleep questionnaire. Post-sleep questionnaire also measured next-day residual effects. The primary measure was apnea–hypopnea index. Apnea–hypopnea index was similar in ramelteon and placebo groups (11.4 vs 11.1, respectively; CI = −2.1, 2.6, P = 0.812). Ramelteon had no effect on the number of central, obstructive, or mixed apnea episodes. No significant differences were observed in SaO₂ for the entire night between ramelteon and placebo (95.1 vs 94.7%; P = 0.070). Ramelteon did not meaningfully affect sleep when evaluated by polysomnography and post-sleep questionnaire. Compared with placebo, ramelteon had no significant effect on next-day residual effects. Adverse events were reported by three subjects in the ramelteon group: headache (n = 2) and urinary tract infection (n = 1). No adverse events were reported with placebo. Ramelteon was well-tolerated and, as expected, did not worsen sleep apnea when administered to subjects with mild to moderate obstructive sleep apnea.     

催眠诱导方式与时间对大学生积极情绪的影响

目的:通过研究不同催眠诱导方式、催眠时间对大学生积极情绪的影响,为促进大学生心理健康提供有效方法。方法:招募90名广西大学大学生,根据3种催眠方式(直接催眠、间接催眠、自我催眠)和两种催眠时间(15分钟和30分钟)随机分为6组,催眠的前后分别填写情绪自评九点量表。结果:催眠对于大学生积极情绪有显著影响(t=8.025,P0.05)。在3种不同的催眠诱导方式中,间接催眠(1.68±0.98)效果好于直接催眠效果(1.13±1.74)。结论:催眠对大学生积极情绪具有正向作用,并且间接催眠能更好地调动大学生的积极情绪。     

Hypnosis in the management of persistent idiopathic orofacial pain--clinical and psychosocial findings

This controlled and patient blinded study tested the effect of hypnosis on persistent idiopathic orofacial pain (PIOP) in terms of clinical and psychosocial findings. Forty-one PIOP were randomized to active hypnotic intervention or simple relaxation as control for five individual 1-h sessions. Primary outcome was average pain intensity scored three times daily in a pain diary using visual analogue scale (VAS). Secondary outcome measures were pain quality assessed by McGill pain questionnaire (MPQ), psychological symptoms assessed by symptom check list (SCL), quality of life assessed by SF36, sleep quality, and consumption of analgesic. Data were compared between groups before and after treatment using ANOVA models and paired t-tests. The change in VAS pain scores from baseline to the last treatment (t4) was (33.1 ± 7.4%) in the hypnosis group and (3.2 ± 5.4%) in the control group (P < 0.03). In the hypnosis group, highly hypnotic susceptible patients had greater decreases in VAS pain scores (55.0 ± 12.3%) when compared to less susceptible patients (17.9 ± 6.7%) (P < 0.02). After the last treatment there were also statistically significant differences between groups in perceived pain area (MPQ) and the use of weak analgesics (P < 0.03). There were no statistically significant changes in SCL or SF36 scores from baseline to t4. In conclusion, hypnosis seems to offer clinically relevant pain relief in PIOP, particularly in highly susceptible patients. However, stress coping skills and unresolved psychological problems need to be included in a comprehensive management plan in order also to address psychological symptoms and quality of life.     

Cortex functional connectivity as a neurophysiological correlate of hypnosis: an EEG case study

Cortex functional connectivity associated with hypnosis was investigated in a single highly hypnotizable subject in a normal baseline condition and under neutral hypnosis during two sessions separated by a year. After the hypnotic induction, but without further suggestions as compared to the baseline condition, all studied parameters of local and remote functional connectivity were significantly changed. The significant differences between hypnosis and the baseline condition were observable (to different extent) in five studied independent frequency bands (delta, theta, alpha, beta, and gamma). The results were consistent and stable after 1 year. Based on these findings we conclude that alteration in functional connectivity of the brain may be regarded as a neuronal correlate of hypnosis (at least in very highly hypnotizable subjects) in which separate cognitive modules and subsystems may be temporarily incapable of communicating with each other normally.     

Use of alcohol and hypnotic medication as aids to sleep among the Japanese general population

OBJECTIVE: The present study was conducted to clarify the prevalence of the use of alcohol and hypnotic medication as sleep aids, and associated factors, in the general population in Japan. METHODS: The survey was conducted in June 2000, using self-administered questionnaires, targeting a population that was selected randomly from among 300 communities throughout Japan. A total of 18,205 responses indicating alcohol use and 16,804 responses indicating hypnotic medication use were analyzed. RESULTS: The prevalence of alcohol use as a sleep aid one or more times per week was 48.3% among men and 18.3% among women. The prevalence of the use of hypnotic medication one or more times per week was 4.3% among men and 5.9% among women. The prevalence of alcohol used as a sleep aid increased gradually for men and women up to age 55-59 years and 40-44 years, respectively, and then declined with increasing age thereafter. The prevalence of the use of hypnotic medication among both men and women showed a trend toward a gradual increase with age. The use of alcohol as a sleep aid was associated with "difficulty maintaining sleep," but no such problem was associated with the use of hypnotic medication. CONCLUSIONS: Alcohol is a more popular sleep aid than hypnotic medication. The factors associated with the use of alcohol and of hypnotic medication are different.     

催眠暗示心理疗法对复诊性病患者心理防御方式的影响

目的调查复诊性病患者的心理防御方式及催眠暗示心理疗法对其影响。方法350例复诊性病患者随机分成2组,每组175人。1组（A组）采用催眠暗示心理疗法＋常规治疗,另1组（B组）采用常规治疗,采用防御方式问卷（DSQ）进行测查,并与120例正常人作对照组进行比较分析。结果复诊性病患者2组治疗前不成熟防御方式明显高于正常对照组人群（P〈0．01）,成熟防御、中间防御及掩饰因子与正常人比较无明显差异（P〉0．05）;治疗后不成熟防御方式A组与B组比较有明显差异（P〈0．05）,当2组仍高于正常对照粗人群。结论复诊性病患者的心理防御方式存在异常,催眠暗示心理疗法能改善其心理防御方式。     

疏肝和胃颗粒的催眠和促胃肠动力作用实验研究

目的:研究疏肝和胃颗粒的催眠作用和促胃肠动力作用。方法:戊巴比妥钠阈剂量、阈下剂量催眠实验研究疏肝和胃颗粒的催眠作用;采用排便试验、小肠推进实验研究疏肝和胃颗粒对正常动物及硫酸阿托品致胃肠麻痹模型动物的胃肠运动情况。结果:疏肝和胃颗粒能显著延长小鼠戊巴比妥钠阈剂量睡眠时间,提高阈下剂量的入睡率;促进正常及硫酸阿托品造模动物的胃肠推进和排便。结论:疏肝和胃颗粒有确切的催眠和促胃肠动力作用,认为促胃肠动力作用可能是其催眠效应的部分机制,这反映了《素问.逆调论》“胃不和则卧不安”理论的科学性以及调节情志法治疗失眠的合理性。     

Changes in mismatch negativity across pre-hypnosis, hypnosis and post-hypnosis conditions distinguish high from low hypnotic susceptibility groups

The role of alterations in mismatch negativity (MMN) in hypnosis was examined by recording MMN of the auditory ERP at frontal (F3, Fz, and F4) and mastoid (M1 and M2) placements. Frontal MMN is believed to reflect activity in right anterior cortical generators, whereas MMN at mastoid leads reflects generators located bilaterally in the temporal auditory cortex. MMN recordings were obtained in 11 low and 12 high hypnotically susceptible participants in three successive blocks; pre-hypnosis, hypnosis and post-hypnosis. Frontal (but not temporal) MMN showed a significant quadratic trend across testing conditions. It increased during hypnosis and then dropped post-hypnosis for both susceptibility groups. Linear trends for frontal and temporal MMN showed directly opposite patterns of change in the interaction between hypnotic susceptibility and testing blocks. Frontal MMN built up linearly over the test blocks in high relative to low susceptibility participants. Temporal MMN showed the reverse pattern and increased linearly across test conditions in those with low relative to high hypnotic susceptibility.