cardiovascular-agents and Sleep-Wake-Disorders

Drug-induced sleep disorders are classified into the following subtypes: a) insomnia, b) hypersomnia, c) pathological sleep d) others, those caused by medicine which can effect on circadian rhythm or sleep apnea. This paper described the relationship between several medical agents (neuroleptics, anti-depressants, anti-anxietics, anti-convulsants, psychostimulants, and drugs other than CNS-effective agents) and those effect on sleep and sleep stages. In the medicated patients, medical drugs are mainly responsible for their insomnia. However, it is sometimes difficult to find these drugs. The pathological sleep (i.e., delirium) are often developed following the drug-induced insomnia. Medication against insomnia (i.e., benzodiazepines) often exacerbates the pathological sleep. Therefore, common types of insomnia, drug-induced insomnia and pathological sleep should carefully be discriminated. Drug-induced rhythm-disorders and drug-induced sleep apnea remain to be studied. Future studies may clarify the effects of several drugs on these two disorders.

Topics: Anticonvulsants; Antiparkinson Agents; Cardiovascular Agents; Central Nervous System Stimulants; Histamine Antagonists; Hormones; Humans; Psychotropic Drugs; Sleep Wake Disorders

Multiple sclerosis (MS) is a multifocal demyelinating disease of the central nervous system, leading to chronic disability. Fatigue is a common and distressing symptom of MS which is unrelated to its clinical form, stage of development, the degree of disability, or the lesion load on magnetic resonance imaging. Fatigue in MS is associated with excessive daytime sleepiness and autonomic dysfunction. Recently it has been reported that the wakefulness-promoting drug modafinil may relieve fatigue in MS patients and ameliorate the associated cognitive difficulties. However, it is not clear to what extent the anti-fatigue effect of modafinil may be related to its alerting and sympathetic activating effects. We addressed this question by comparing three groups of subjects, MS patients with fatigue, MS patients without fatigue and healthy controls, matched for age and sex, on measures of alertness (self-ratings on the Epworth and Stanford Sleepiness Scales and on a battery of visual analogue scales; critical flicker fusion frequency; Pupillographic Sleepiness Test; choice reaction time) and autonomic function (systolic and diastolic blood pressure, heart rate, pupil diameter), and by examining the effect of a single dose (200 mg) of modafinil on these measures. MS patients with fatigue, compared with healthy controls, had reduced level of alertness on all the tests used; MS patients without fatigue did not differ from healthy controls. MS patients with fatigue had a reduced level of cardiovascular sympathetic activation compared to the other two groups. Modafinil displayed alerting and sympathomimetic effects in all three groups of subjects. As fatigue in MS is associated with reduced levels of alertness and sympathetic activity, modafinil may exert its anti-fatigue effect in MS by correcting these deficiencies. The anti-fatigue effect of modafinil may reflect the activation of the noradrenergic locus coeruleus (LC), since there is evidence that this wakefulness-promoting nucleus is damaged in MS, and that modafinil, probably via the dopaminergic system, can stimulate the LC. This article is part of a Special Issue entitled 'Cognitive Enhancers'.

Topics: Adult; Arousal; Autonomic Nervous System; Benzhydryl Compounds; Cardiovascular Agents; Central Nervous System Stimulants; Cross-Over Studies; Double-Blind Method; Fatigue; Female; Humans; Male; Middle Aged; Modafinil; Multiple Sclerosis; Nootropic Agents; Psychomotor Performance; Sleep Stages; Sleep Wake Disorders; Sympathetic Nervous System; Sympathomimetics

Topics: Aged; Anxiety; Cardiovascular Agents; Depression; Female; Heart Diseases; Humans; Male; Middle Aged; Sleep Wake Disorders; Surveys and Questionnaires

Topics: Anticonvulsants; Cardiovascular Agents; Chronic Disease; Humans; Hypnotics and Sedatives; Meprobamate; Muscle Relaxants, Central; Phenobarbital; Piperidones; Secobarbital; Sleep Wake Disorders

Topics: Barbiturates; Cardiovascular Agents; Ergot Alkaloids; Oxytocics; Scopolamine; Sleep Wake Disorders

Topics: Barbiturates; Biomedical Research; Cardiovascular Agents; Ergot Alkaloids; Scopolamine; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders