[Nocturnal sleep patterns during treatment of hydrocephalus]. / Zachowanie sie snu nocnego w czasie leczenia wodoglowia.

By polygraphic methods the authors studied the sleep patterns during treatment of patients with subtentorial tumours causing hydrocephalus. Sleep recording was carried out in three stages of treatment: 1) before insertion of ventriculo-atrial valve, (7 investigations), 2) on the 7th day after valve insertion (7 investigations), 3) two months after removal of the posterior fossa tumour (3 investigations). The control group included patients with peripheral nerve injury in whom sleep recording was done before and after surgical treatment. In cases with hydrocephalus and raised CSF pressure before valve insertion the cyclic pattern of sleep was disintegrated, showing long periods of light sleep (phase 1 + 2) interrupted by long periods of alertness, during sleep, mostly with elimination of the remaining sleep components. The decrease of CSF pressure after valve implantation was parallelled by partial normalization of sleep pattern, that is shortening of the light sleep phase and reduction of the number of alertness during sleeping hours, as well as prolongation of the phases of deep sleep and appearance of paradoxical sleep. However, only removal of the tumour from the posterior fossa made possible approximation of sleep elements to those in the control group. Sleep disintegration of varying intensity in patients with hydrocephalus may be reversible, the rate of normalization of sleep depends on the intensity of sleep disturbances in the initial stage of the disease, but return to nearly normal sleep is possible only after removal of the subtentorial tumour.

[Clinico-theoretical aspects of cerebrospinal fluid pressure changes associated with sleep analysis in patients with hydrocephalus caused by posterior fossa tumors]. / Aspekty kliniczno-poznawcze zmian cisnienia plynu mózgowo-rdzeniowego w polaczeniu z badaniami snu u chorych z wodoglowiem spowodowanym guzami tylnej jamy czaszkowej.

In 6 patients treated for hydrocephalus caused by posterior fossa tumours simultaneous continuous measurement of intraventricular cerebrospinal fluid pressure and all-night polygraphic sleep recording were carried out before and after implantation of ventriculoatrial valve. It was observed that in patients with hydrocephalus and raised CSF pressure electrography demonstrated a breakdown of the cyclic sleep pattern with increased duration of light sleep and higher number of awakening episodes, and with reduced amount of deep sleep and nearly complete absence of REM sleep. The degree of sleep disturbances seemed to be correlated with increased value of CSF pressure. In that period discrepancies were observed between the sleep record suggesting waking and the behaviour of the patient who was asleep at that time. With normalization of CSF pressure record (after valve implantation) an improvement of sleep pattern was observed which approached the normal one.

[Results of polygraphic nocturnal sleep recording in patients with supratentorial brain tumors prior to and following surgery]. / Ocena wyników badania poligraficznego snu nocnego u chorych z guzami nadnamiotowymi mózgu w okresie przed i pooperacyjnym.

The purpose of the study was to establish the influence exerted by a supratentorial brain tumour on the EEG correlates of sleep, and to compare the results before and after operation. Five patients were studied (aged 38 to 59 years) who were treated surgically for supratentorial expanding lesions: two cases of meningioma (in left parietal area), two cases of glioma (right parietal area and occipital area) and one case of intracerebral haematoma. The control group comprised 5 patients operated upon for lesions of the peripheral nerves of extremities. In the patients with supratentorial brain tumours and after their removal the following sleep parameters were unchanged: total sleep duration, number of awakening during sleep, latency time of the first REM phase and stage 3 NREM (deep and superficial sleep). The amount of REM sleep increased after tumour removal. REM-sleep density was selectively and permanently disturbed. In presence of tumour REM-sleep density was found in traces only, after tumour removal it increased but showed a permanent high-grade deficit in relation to controls.

[Comparison of results of polygraphic sleep studies and cerebrospinal fluid pressure records in patients following removal of supratentorial expanding lesions]. / Porównanie wyników badania poligraficznego snu z zapisem cisnienia plynu mózgowo-rdzeniowego u chorych po usunieciu przyczyny nadnamiotowego ucisku mózgu.

In 4 patients operated upon for supratentorial brain tumors the authors carried out on the 3rd day after the operation polygraphic recording of nocturnal sleep with simultaneous measurements of cerebrospinal fluid pressure in the ventricular system by the method of Lundberg. A comparison of polygraphic records of nocturnal sleep with parallel measurements of intraventricular pressure demonstrated that all REM phases were associated with a rise in intraventricular pressure, while during phases 3 and 4 of sleep (NREM) the intraventricular pressure was always lower. In the remaining sleep phases 1,2 NREM and during episodes of nocturnal awakening no unequivocal consistencies were found.

[Effect of stress on sleep characteristics in humans]. / Wplyw stresu na charakterystyke snu u ludzi

Earlier investigations of Baekeland et al. (1968) showed that stress conditions change the characteristic features of sleep. It was the aim of this work to compare the effect of pre-examination stress and preoperative stress on the characteristic features of sleep. Three groups of 5 individuals each were studied: students, patients and controls aged from 20 to 45 years. In all patients psychological investigations by the test of Cattel were carried out before each polygraphic recording. These investigations confirmed presence of anxiety prior to falling asleep in the groups of students and patients and its effect on the subsequent sleep. The most significant changes during stress were observed in paradoxical sleep (REM). The amount of this sleep is reduced during stress while its intensity increases significantly (phasic REM sleep period). Persistence of disturbances of sleep depends on the duration of stress stimulus. The stress reaction connected with examination was short-lasting and disappeared after passing the examination. In the group of patients the stress reaction was prolonged on the average 33 days after the operation.