A double-blind comparison of the effect of the antipsychotics haloperidol and olanzapine on sleep in mania

The effects of haloperidol and olanzapine on polysomnographic measures made in bipolar patients during manic episodes were compared. Twelve DSM-IV mania patients were randomly assigned to receive either haloperidol (mean ± SD final dosage: 5.8 ± 3.8 mg) or olanzapine (mean ± SD final dosage: 13.6 ± 6.9 mg) in a 6-week, double-blind, randomized, controlled clinical trial. One-night polysomnographic evaluation was performed before and after the haloperidol or olanzapine treatment. Psychopathology and illness severity were rated respectively with the Young Mania Rating Scale (YMRS) and the Clinical Global Impressions - Bipolar version (CGI-BP). There was a significant improvement in the YMRS and CGI-BP scores at the end of the study for both groups. Mixed ANOVA used to compare the polysomnographic measures of both drugs demonstrated significant improvement in sleep measures with olanzapine. In the olanzapine group, statistically significant time-drug interaction effects on sleep continuity measures were observed: sleep efficiency (mean ± SEM pre-treatment value: 6.7 ± 20.3 percent; after-treatment: 85.7 ± 10.9 percent), total wake time (pre-treatment: 140.0 ± 92.5 min; after-treatment: 55.2 ± 44.2 min), and wake time after sleep onset (pre-treatment: 109.7 ± 70.8 min; after-treatment: 32.2 ± 20.7 min). Conversely, improvement of polysomnographic measures was not observed for the haloperidol group (P > 0.05). These results suggest that olanzapine is more effective than haloperidol in terms of sleep-promoting effects, although olanzapine is comparatively as effective as haloperidol in treating mania. Polysomnography records should provide useful information on how manic states can be affected by psychopharmacological agents.

Sleep changes during chronic cold exposure showed that the homeostatic requirement of sleep is reduced in the medial preoptic area lesioned rats.

The effects of chronic exposure to a mildly cold ambient temperature (T(a)) of 18 degrees C on sleep wakefulness (S-W) and brain temperature (T(br)) were studied in the medial preoptic area (mPOA) lesioned male Wistar rats. Electroencephalogram (EEG), electrooculogram (EOG) and electromyogram (EMG) electrodes were chronically implanted to assess S-W, and a thermocouple above the dura to record the T(br). After three recordings (24 h each) of S-W and T(br) at 24 degrees C, N-methyl D-aspartic acid (NMDA) was intracerebrally injected to produce bilateral destruction of neurons in the mPOA. There was decreased sleep and increased T(br) even four weeks after the mPOA lesion. T(a) of the environmental chamber was then reduced to 18 degrees C, and the S-W and T(br) were again recorded for 24 h each on the 1st, 7th, 14th, 21st, and on 28th days of continuous exposure to the mild cold T(a). Exposure to the cold produced further decrease in sleep and increase in the T(br). However, sleep came back to the pre-exposure level by the 14th day. An increase in the duration of sleep episodes was responsible for the restoration of sleep during chronic cold exposure. The study showed that the requirement of sleep was reset at a lower level in the mPOA lesioned rats. The mPOA lesion affected the sleep maintenance and sleep initiation, though the latter became evident only during chronic cold exposure. The magnitude of the acute changes in T(br) and S-W were less in the lesioned rats, as compared to those observed in the normal rats exposed to similar cold T(a). On the basis of these observations, it could be proposed that the mPOA plays some role in cold induced changes in thermoregulation and sleep regulation. The T(br) remained elevated throughout the period of cold exposure. Resetting of the T(br), at a higher level may be part of the homeostatic readjustment to restore sleep.

Comparaçäo entre o eletrencefalograma de sono natural e o induzido por hidrato de cloral em relaçäo às alteraçöes paroxísticas e ao ritmo de base / Comparison between the EEG of natural sleep and the induced by chloral hydrate in relation to paroxystic changes and baseline rythm

Estudo das variaçöes do EEG paroxístico provocadas pelo uso do hidrato de cloral a 20 por cento, na dose de 50mg/Kg, na induçäo do sono em 50 crianças epilépticas de 1 a 12 anos de idade, em monoterapia ou sem anticonvulsivantes. Foi observado que o hidrato de cloral é capaz de induzir o sono sem efeitos colaterais e é capaz de modificar o EEG em sono, melhorando a organizaçäo dos fusos de sono e diminuindo os paroxismos generalizados