Tokihisa Iwata

Plasma Norepinephrine in Sleep Apnea Syndrome

In 8 male patients suffering from sleep apnea syndrome, plasma norepinephrine (NE) levels were examined. At 22.00 and at 6.30 blood samples were obtained. In 3 cases, plasma NE levels displayed little changes between 22.00 and 6.30. In 2 cases, plasma NE levels at 6.30 increased 20% compared with those at 22.00. In 3 cases, plasma NE levels at 6.30 increased more than 40%. No significant correlation between apnea index and plasma NE levels was observed. Total time under 90% arterial oxygen saturation (SaO2) significantly correlated with the ratio of plasma NE levels at 6.30 to those at 22.00. In 2 cases of the 8 patients blood samples were drawn hourly (22.00-6.00) and at 6.30. In these 2 cases, when SaO2 decreased, plasma NE levels tended to increase. It is concluded that in sleep apnea syndrome plasma NE levels increased during sleep and did not correlate with apnea index but with oxygen desaturation.

A Treatment Trial of Delayed Sleep Phase Syndrome with Triazolam

Abstract: Triazolam causes a phase‐shift of the circadian rhythm of locomotor activity in golden hamsters. We attempted to treat two patients with delayed sleep phase syndrome (DSPS) with triazolam. In one male patient we administered triazolam when the sleep phase began to delay afkr chronotherapy. Triazolam combined with chronotherapy enabled him to normalize and stabilize his sleep‐wake cycle. But in the other female patient despite normalization of her sleep‐wake cycle, she became depressive and did not Continue taking the drug. In some cases triazalam is useful for the treatment of DSPS, but in others, triazolam induces a depressive state.

Body temperature monitoring in subjects with delayed sleep phase syndrome.

To clarify the circadian aspects of delayed sleep phase syndrome (DSPS) in 4 patients with DSPS, we recorded polysomnograms and rectal temperature before and after chronotherapy. The time interval (2.7 h) between sleep onset and rectal temperature minimum before chronotherapy was shorter than the time interval after chronotherapy (5.3 h). Before chronotherapy, the period of rectal temperature rhythm was 24.7 h. After chronotherapy, the period of rectal temperature rhythm was 24.0 h. These findings lead to the conclusion that in DSPS there is a weakened mechanism of entrainment similar to that in non-24-hour sleep-wake syndrome.