Sleep
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To evaluate the degree to which sleep (REM vs. NREM) intrudes into wake and wake intrudes into sleep in narcolepsy, 103 patients with narcolepsy were compared to 105 patients with other diagnoses of disorders of excessive sleep (DOES). Narcoleptic patients had more frequent REM onsets on the multiple sleep latency test (MSLT) and nocturnal polysomnograms. ⋯ Nocturnal measures of REM pressure, percentage of REM, and REM latency excluding the REM onsets, did not differ among patient groups. With respect to the intrusion of wake into sleep, narcoleptic patients had more and longer awakenings compared with other DOES patients, but the distribution of wake into REM and NREM sleep did not differ among groups. These data suggest that narcolepsy is not exclusively a REM-related disorder, but involves an inability to sustain a specific neural state for periods comparable to those in normal subjects or other DOES patients.
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Comparative Study
A comparison of tracheal breath sounds, airflow, and impedance pneumography in the detection of childhood apnea.
Impedance respiratory monitoring is not capable of detecting obstructive apneas. We compared a microphone breath sound detector, coupled to the chest wall, with a standard impedance device in 10 sleeping infants and children in order to determine the ability of the breath sound detector to detect normal respirations and central and obstructive apneas. Airflow was used as a standard for all measurements. ⋯ There was no statistically significant difference between breath sounds and airflow in the ability of either technique to detect obstructive apnea. The use of a breath sound detector avoids unnecessary stimulation of a sleeping child, whose monitoring would otherwise require that two or three airflow sensing devices be taped on the face. Breath sound monitoring may represent an alternative to impedance and airflow techniques for evaluation of apnea in closely observed infants and children.
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Based on the methodological assumption that cognitive-psychological study of dream processes (psychoneirics) can be pursued in like manner as in cognitive-psychological study of speech processes (psycholinguistics) and on the substantive assumption that speech and dreaming may share some common production routines, a cognitive-psychological model of dream formation is proposed. A generalized psycholinguistic model of speech production is presented, and then each sequential stage of that model is examined for its aptness to the process of dream production. ⋯ This model is shown to be consistent with various formal properties of the dream, including its central paradox of controlled formal organization in the face of contents that may be "senseless," trivial, or obscure. The model also is shown to suggest several new research paradigms that might be employed both to test its own utility and to generate data more generally relevant to the question of how mental functions are organized during rapid eye movement sleep.