Brian L. Weiss

First night effect revisited: a clinical note.

It has been a nearly universal practice among sleep researchers not to use the first night or two of recordings because of “adaptational artifact.” Since this custom is costly and might result in the inadvertent loss of valuable data, this study examines the records of the first two nights and compares them with records obtained in subsequent recordings (third and fourth nights). Thirty-five psychiatric inpatients were studied for four consecutive nights. Several diagnostic groups were represented: psychotic (N = 7) and non psychotic (N = 12) unipolar depressives and non psychotic bipolar (N = 5) depressives, schizophrenia (N = 7) and others (N = 4). Results indicate a striking constancy in nearly all sleep parameters when nights 1 and 2 were compared to nights 3 and 4 for the entire sample. Of the 26 sleep parameters investigated, only sleep latency differed significantly on the latter two nights. Similarly, no significant differences were found in comparing nights 1 and 2 to nights 3 and 4 in any of the diagnostic subgroups. The implications of these findings to inpatient and outpatient sleep research are discussed.

Activity Sensors for Use in Psychiatric Evaluation

The need for objective methods of patient evaluation has long been recognized in clinical psychiatry. While the relationship between mood states and motor activity has been observed for many years, this relationship was never accurately defined due to the imprecise nature of the available observational techniques. This report describes two activity sensors and their related systems which objectively measure motor activity levels and patterns without affecting the patients movements.

An objective measure of REM activity

Recent emphasis on REM sleep abnormalities has begun to yield significant differences between “normals” and patients with affective syndromes or schizophrenia. In our efforts to objectively quantitate aspects of REM sleep during all-night studies in psychiatric patients, we have developed the “REM analyzer” for automatic on-line measurement. As a practical application of the REM analyzer, 20 psychiatric patients (12 inpatients and 8 outpatients) were studied. Both cross-sectional and longitudinal-sleep studies were obtained; predrug and drug periods were also compared. From the REM analyzer, the number of rapid eye movements during each REM period (Cn) and the sum of their integrals during each REM period (In) were recorded. The ratio I/C was named “REM weight” (the “average rapid-eye-movement area“). The objective measures of REM sleep which highly correlate with a number of visual methods of defining REM sleep and with diagnostic and therapeutic implications in affective and schizophrenic disorders are discussed in this paper. The method appears particularly suitable for the differentiation of tonic and phasic components of REM sleep and, thus, for the investigation of REM suppression-compensation models.