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The lasting legacy of Charles Fisher (1908–1988), pioneering sleep laboratory scientist and sleep medicine psychiatrist
Full text linkCharles Fisher is a pioneering historical figure in sleep laboratory research and sleep medicine who distinguished himself in nine areas: (1) he first documented nocturnal sleep-onset rapid eye movement (REM) sleep periods in narcoleptic patients; (2) he published the first case of polysomnography (PSG) documented acute REM sleep behavior disorder (RBD) that was triggered by sudden withdrawal from a monoamine oxidase inhibitor in 1978, 8 years before the formal identification of RBD; (3) he worked with Roffwarg and Dement on the early delineation of the ontogeny of the human sleep cycle; (4) he first demonstrated that benzodiazepine (diazepam) therapy was effective in controlling night terrors together with suppression of stage 4 non-rapid eye movement (NREM) sleep, and he was also an early investigator of night terrors as phenomena emerging from stage 4 NREM sleep, without dreaming, as had been traditionally assumed; (5) he collaborated with another pioneering sleep medicine physician, William C. Dement on studies focused on REM sleep deprivation and dreaming at Fisher’s Mt. Sinai Hospital sleep laboratory in New York City; (6) he published the first PSG-documented case of sleep-related (psychogenic) dissociative disorder in 1976; (7) he first documented that typical nightmares (“anxiety dreams”) occurred during REM sleep; (8) he conducted some of the earliest research, beginning in 1965, that documented cycles of nocturnal penile tumescence emerging in conjunction with REM sleep cycles; and (9) he conducted similar early studies of female sexual arousal during sleep that occurred predominantly in REM sleep
Increased chin muscle tone during all sleep stages in children taking selective serotonin reuptake inhibitor antidepressants and in children with narcolepsy type 1
No full textStudy Objectives: To assess if selective serotonin reuptake inhibitor (SSRI) antidepressants are able to modify the chin electromyogram (EMG) tone during sleep also in children. Methods: Twenty-three children and adolescents (12 girls, mean age 14.1 years, SD 2.94) under therapy with antidepressant for their mood disorder were consecutively recruited and had a PSG recording. Twenty-one were taking were taking SSRI and treatment duration was 2-12 months. An age- and sex matched group of 33 control children (17 girls, mean age 14.2 years, SD 2.83) and 24 children with narcolepsy type 1 (12 girls, mean age 13.7 years, SD 2.80) were also included. The Atonia Index was then computed for each NREM sleep stage and for REM sleep, also all EMG activations were counted. Results: Atonia Index in all sleep stages was found to be significantly reduced in children with narcolepsy followed by the group taking SSRI antidepressants and the number of EMG activations was also increased in both groups. Fluoxetine, in particular, was found to be significantly associated with reduced Atonia index during NREM sleep stages N1, N2, and N3, and with an increased number of EMG activations/hour during sleep stage N3. Conclusions: Similarly to adults, SSRI antidepressants are able to modify the chin EMG tone in children during REM sleep, as well as during NREM sleep stages. Different pharmacological properties of the different SSRI might explain the differential effect on chin tone during sleep found in this study
Frequency of antidepressant use and clinical characteristics of children and adolescents undergoing polysomnography: an observational study
No full textBackground Antidepressants are increasingly used in children for various psychiatric disorders but also for sleep disorders such as insomnia; however, it is currently unknown how many children undergoing polysomnography (PSG) are taking anti-depressants. The aims were: to determine the frequency of use of antidepressants in paediatric patients referred for PSG, to identify the most common antidepressants used, to investigate the reasons for their use, and to analyse the PSG parameters found in children taking antidepressants.
Method An observational cross-sectional retrospective chart review of all children undergoing PSG at Seattle Children’s Hospital from 6/14/2020 to 12/8/2022 was carried out. Clinical features (such as diagnosis, especially psychiatric), sleep disorders (such as insomnia and restless sleep), and class of antidepressant used [selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCA), or atypical antidepressants], and PSG parameters were collected for further analysis.
Results Among 3,371 patients who underwent PSG during the study, 367 children were selected who were taking one antidepressant only (154 boys and 213 girls, mean age was 13.7 ± years 3.69). A significantly decreased sleep stage N3 was found in girls, who were older than boys. Children with insomnia had longer sleep latency than children without, but more N3. There was a prolonged rapid eye movement (REM) sleep latency in children with attentiondeficit/hyperactivity disorder and children with autism. REM latency was longer and REM percentage smaller in children taking SNRIs. Periodic leg movement index ≥ 5/hour was found in a higher number of children taking SSRIs or SNRIs (24.9%) than in subjects taking TCA or atypical antidepressants (13.3%) (chi-square 5.29, p = 0.013).
Conclusions Child and adolescent psychiatrists should question about the effects on sleep (both positive and negative) after initiating therapy with antidepressant medications
Injurious REM sleep behaviour disorder in narcolepsy with cataplexy contributing to criminal proceedings and divorce.
No full textEffects of bupropion and SSRI antidepressants on leg movement activity and chin muscle tone during sleep in adolescents
No full textStudy Objectives: To evaluate the effects of bupropion on periodic limb movements during sleep (PLMS) and chin electromyography tone in children taking it for their mood disorder, compared to the effects of selective serotonin reuptake inhibitors (SSRIs) and of bupropion combined with SSRIs. Methods: Six adolescents (aged 16.0 ± 0.63 years) taking bupropion alone and 6 adolescents (aged 15.9 ± 1.36 years) taking bupropion in combination with an SSRI antidepressant were recruited, along with 10 adolescents (aged 16.2 ± 0.2 years) taking different SSRIs, and they were also enrolled together with 17 age- and sex-matched control patients (aged 15.5 ± 1.26 years). Polysomnographic studies were obtained, and participants’ leg movement activity during sleep and muscle tone were assessed quantitatively (atonia index) during all sleep stages. Results: Participants taking SSRIs showed PLMS indices significantly higher than those of control patients, whereas adolescents taking bupropion showed only slightly increased indexes of nonperiodic leg movements during sleep. No differences in PLMS were observed between adolescents taking bupropion alone or in association with SSRIs. The atonia index showed, within each sleep stage, the lowest values in the 2 groups taking SSRIs and the highest in the control patients; adolescents taking bupropion alone tended to show values slightly smaller than those of the control patients. Conclusions: We found that similar to adults, in adolescents SSRIs but not bupropion are associated with increased PLMS. Bupropion also seems to counteract the SSRI-induced increase of PLMS, when administered in combination; thus, the dopaminergic effect of bupropion seems to outmatch the antidopaminergic action of SSRIs. Conversely, bupropion does not counteract the effects of SSRIs on chin electromyography tone
Trazodone affects periodic leg movements and chin muscle tone during sleep less than selective serotonin reuptake inhibitor antidepressants in children
No full textSTUDY OBJECTIVES: To test the hypothesis that children taking trazodone have less leg movements during sleep (LMS) and higher rapid eye movement (REM) sleep atonia than children taking selective serotonin reuptake inhibitors (SSRIs) but more than normal controls. METHODS: Fifteen children (9 girls and 6 boys, mean age 11.7 years, standard deviation [SD] 3.42) taking trazodone (median dosage 50 mg/d, range 25-200 mg) for insomnia and 19 children (11 girls and 8 boys, mean age 13.7 years, SD 3.07) taking SSRIs for depression, anxiety, or both were consecutively recruited, as well as an age- and sex-matched group of 25 control children (17 girls and 8 boys, mean age 13.7 years, SD 3.11). LMS were scored and a series of parameters was calculated, along with the analysis of their time structure. The Atonia Index was then computed for each non-REM sleep stage and for REM sleep. RESULTS: Children taking trazodone exhibited slightly higher leg movement indices than controls but lower than those found in children taking SSRIs and their time structure was different. Chin electromyogram atonia in all sleep stages was not significantly altered in children taking trazodone but was decreased in children taking SSRIs, especially during non-REM sleep. CONCLUSIONS: In children, SSRIs but not trazodone are associated with a significantly increased number of LMS, including periodic LMS, and increased chin tone in all sleep stages. The assessment of periodic limb movement disorder and REM sleep without atonia might not be accurate when children are taking SSRIs because of their significant impact. CITATION: DelRosso LM, Mogavero MP, Bruni O, Schenck CH, Fickenscher A, Ferri R. Trazodone affects periodic leg movements and chin muscle tone during sleep less than selective serotonin reuptake inhibitor antidepressants in children. J Clin Sleep Med. 2022;18(12):2829-2836
Corrigendum to "Effects of long-term use of clonazepam on nonrapid eye movement sleep patterns in rapid eye movement sleep behavior disorder" [Sleep Med 14 (5) (2013) 399-406]
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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