This chapter focuses primarily on the co-occurrence of sleep disturbance and chronic, non-malignant pain. As might be expected, in chronic painful conditions such as rheumatoid arthritis poor sleep becomes a significant, pronounced, and enduring patient complaint. While there may be some...

Ancient human cultures have developed diverse forms of a device that, based on sensory stimulation, is used to put babies to sleep: the rocking cradle. Vestibular and somatosensory stimulation produced by the rocking movements, complemented by eye closure and other stimulation such as...

Hypnotic drugs are consumed mainly by chronic users, who often take hypnotics for years continuously. Two studies of the American Cancer Society, each involving over 1 million subjects followed prospectively for 6 years, showed that hypnotic use predicted increased mortality after control for...

Elderly patients, among others, will often describe the benefits they derive from taking sleeping pills.1 Their physicians feel obliged to reduce or take them off such medication. Most medical experts will support such efforts, especially in the elderly fearing the increased risk of falls and...

Benzodiazepines are commonly used to provide sedation for infants and children undergoing intensive care or di agnostic and therapeutic procedures in a variety of clinical settings. This chapter focuses on Midazolam as representative of this class of drug. Midazolam provides sedation by...

Fatigue, daytime sleepiness, and hypersomnia are commonly associated with affective illnesses. In major depressive disorder, they not only accompany the acute episode, but also frequently precede its onset. These symptoms also often complicate the recovery phase itself. In this chapter, the...

Frightening dreams are reported from all stages of sleep.1 The night terrors associated with arousal from deep sleep (stages 3 & 4) are characterized by autonomic discharge, extreme fear, difficult arousal and easy return to sleep. Nightmares are the bad, anxiety dreams often associated with...

Living in a complex and dangerous environment as humans have for most of our evolutionary history requires one to possess effective mechanisms of arousal, both consciousness and emotional, in order to meet the demands of the environment. An organism needs to be able to arouse behaviorally in...

The present chapter contains the discussion of the very complicated and controversial topic of brain monoam ines activity in REM sleep in relationships with the main REM sleep functions. The author is going to present many contradictory experimental data in this area. He will make an attempt...

Drugs, such as sedative-hypnotics and anesthetics, are able to strongly regulate the vigilance state by affecting the main fast inhibitory neurotransmitter receptor system in the brain, the GABAA receptor system. Agonists, such as classical benzodiazepines, are today the most widely used...

Rapid eye movement sleep is a unique paradoxical state within sleep period. Normally it follows deep sleep, is maintained for varying duration and may terminate in either sleep or wake state. During REM sleep some neurons increase firing, the REM-ON neurons, while some others cease firing,...

Sleep is a normal restorative function. What is not clear is how much sleep we need and what constitutes “normal sleep”. Complaints of sleeping difficulty are extremely common with probably about a third of the population experiencing difficulty at any one time. It is suggested that 10...

The typical behavioral characteristics of the night eating syndrome have been described as morning anorexia, evening hyperphagia and insomnia. The neuroendocrine characteristics have been described as changes in the circadian rhythm by an attenuation in the nocturnal rise of the plasma...

Among the proposed functions of dreaming in human be ing, the most research supports are mood-regulation, problem-solving, learning, and memory construction. Recent imaging techniques have provided meaningful information on functional neuroanatomy and neurophysiology of REM sleep and...

The class of antidepressants known as SSRIs (selective serotonin reuptake inhibitors) is a major part of the treatment armamentarium in psychiatric practice. These drugs were licensed for use first in major depression, and subsequently various SSRIs have received licences in anxiety...

The major hormone of the circadian system, melatonin, plays an important role in hu man sleep regulation, acting via both circadian and homeostatic mechanisms. Melato nin treatment can be used to treat chronic insomnias of different origin and circadian sleep disorders. However, if...

Visual analog scales (VAS) and diary cards are used to measure changes in patients’ sleep quality in clinical trials and practice. In this study we compared the 2 methods for assessing changes in sleep quality in patients with insomnia.

The catecolaminergic, serotonergic and histaminergic projections arises from different nucleus groups in different regions of the brain (Fig. 1). They have an important role in the control of behavioral state, body temperature, reproduction and other vital functions. Among these,...

Alzheimer’s disease (AD) patients show a greater disrup tion of the circadian sleep-wake cycle as compared to simi larly aged non-demented controls. When this occurs demented patients spend their nights in a state of frequent restlessness and their days in a state of frequent sleepiness....

The current first-line treatment for patients with winter seasonal affective disorder (SAD) is bright-light therapy, that is exposure to strong artificial light visible to the eye. Patients at risk of light-induced eye damage, such as those using photosensitizing medication, need to consult...

This chapter details the pattern of sleep disturbances asso ciated with chronic medical conditions. It illustrates the disturbances in sleep architecture manifested by a number of medical conditions as detailed by EEG or polysomnography. Sleep disturbances are common with a number of medical...

The pineal hormone, melatonin, can exert sedative/hyp notic, anxiolytic and other neuropharmacological effects in experimental animals. Usually, these effects are produced by large pharmacological doses of melatonin, which are known to interact with benzodiazepine (BZ) receptors in the...

Besides the obstructive sleep apnea/hypopnea syndrome, the most prevalent cause of hypersomnia, other disorders may be the cause of more severe hypersomnia. These include primary disorders of the central nervous system and hypersomnia associated with various medical disorders. Among the...

Poor sleep quality often results in decreased alertness, drowsi ness and sleepiness the following day. Pharmacological treatment of sleep complaints can aggravate these effects, resulting in impaired performance at work and during daily activities such as driving a car. The first hypnotics,...

Restless leg syndrome (RLS) was described as a distinctive sensory-motor phenomenon by Willis in 1672. Ekbom is credited for giving it its current name and identifying its broad clinical presentation. Clinical Features Restless legs syndrome (RLS) together with comorbid periodic limb...

The above quote crystallizes who we, as individuals, are. We are a species with the ability to remember, especially those moments in life that stand out and that act as guides in our path through the maze of life. In patients with head injuries, these guides become absent and the maze...

The importance of timing medications is noted in the context of the effects of psychotropic drugs. The information here assembled as yet is examined mostly by inspection with the unaided eye and conventional (rather than time series-related) statistics. An effect of time, shown by an analysis...

Insomnia is a common feature in schizophrenia. The sleep disturbance of either never-medicated or previously treated schizophrenia patients is characterized by an increase of stage 2 sleep latency and wake time after sleep onset, and a reduction of total sleep time and sleep efficiency. In...

Patients with Epilepsy often complain of sleep difficulties: sleep disruption and excessive daytime sleepiness (EDS) are common symptoms. Less frequently patients complain about insomnia. Difficulties on the study of sleep-epilepsy interactions come out because seizures themselves disrupt...