Sleep in bipolar patients.

BACKGROUND: Sleep disturbance has been described in bipolar disorder (BPD). Specific complaints may include frequent nighttime awakenings, poor quality of sleep, reduction in total sleep time, and nightmares. Most patients with BPD also report insomnia when in depression, but a significant percentage of patients report hypersomnia symptoms with prolonged nighttime sleep, difficulty in wakening, and excessive daytime sleepiness. OBJECTIVES: The present study aims to investigate whether bipolar patients with sleep disorders presented impairment in quality of life, disability, and global function. METHODS: One hundred ninety bipolar patients type-I diagnosed by application of Structured Clinician Interview for DSM-IV Disorders (SCID), were distributed in two groups based on absence or presence of sleep disorders. Quality of life, disability, and global dysfunction were evaluated using the Health Organization's Quality of Life instrument (WHOQOL-Brief), the Sheehan Disability Scale, and the Global Assessment of Functioning (GAF), respectively. RESULTS: Sleep complaints have negative influence on general quality of life, observed by decreased scores in WHOQOL and GAF domains and increased Sheehan scores, indicating the importance of maintenance of normal sleep in bipolar patients. CONCLUSION: Our results suggest that sleep complains impair quality of life and global function. Collectively, further studies are warranted to investigate the impairment of sleep disturbance on others neurotrophic factors and neurochemical pathways.

Electrophysiological correlates of sleep disturbance induced by acute and chronic administration of D-amphetamine.

Sleep disturbance is the strongest predictor of manic relapse and is considered one of the most important objective measures of treatment response in bipolar disorder (BD). However, the neurobiological mechanisms underlying sleep disturbance in BD are poorly understood. The administration of psychostimulants to rodents can trigger a number of manic-like behaviors. Therefore, the present study aims to investigate the effects of single and repeated D-amphetamine (AMPH) administration on sleep patterns in rats. Sleep was continuously monitored during light periods after single and repeated (7 days) injections of AMPH (2 mg/kg, i.p.) or saline in adult Wistar rats using electrocorticogram and electromyographic recordings. Acute injections of AMPH suppressed sleep for the first 2 h, and were followed by a gradual increase in the amount of sleep. Both slow wave sleep (SWS) and paradoxical sleep (PS) were compromised. Repeated exposure to AMPH led to a drastic disruption of the sleep-wake cycle that was mainly characterized by a decrease of PS during all time-points recorded in comparison to the saline group. Furthermore, both acute and chronic AMPH administration induced longer latencies to both SWS and PS. These findings suggest that AMPH produces profound sleep disturbances and decreases PS sleep. Given that some of these abnormalities are observed in individuals with BD, this animal model can provide a means to investigate neurobiological aspects of sleep disturbance in BD, as well as their response to mood stabilizers.

Asma pré-menstrual: realidade ou ficção? / Premenstrual asthma: reality or fiction?

A asma pré-menstrual foi descrita pela primeira vez no princípio do século passado e, desde então, muito se tem pesquisado a respeito desta patologia Esta se apresenta com os sinais clássicos de hiper-responsividade brônquica, aumento da secreção e constrição da musculatura, porém, chama a atenção sua relação com o período menstrual. Este trabalho propõe uma revisão atualizada da literatura, a fim de chamar a atenção do médico para sua ocorrência e ressaltar a importância de futuras investigações sobre o tema.

The premenstrual asthma was described for the firs time at the beginning of the last century and after that a lot have been worked about that. Fisipathology is the same of the classical asthma (bronquial hyperreactivity, increase production of secretion and muscular constriction), but with a special link with menstrual period. This paper is a review of the literature, with the purpose of make physicians think about it and stimulate research about it.