Benzodiazepines (BZDs) constitute the most widely used symptomatic treatment of in-rn somnia and anxiety. Many of these drugs are associated with adverse effects, such as rn daytime sedation and dependence with continued use. There is a concern about the rationale for and extent of benzodiazepine...

Today, a chronobiotic is defined as a substance capable of shifting the phase of the CTS\r\nand reentraining circadian rhythms that have been dissociated in the short-term, or\r\ndesynchronized in the long-term. The most widely recognized chronobiotic is melatonin.\r\nIts phase-shifting effects...

This chapter focuses primarily on the co-occurrence of sleepdisturbance and chronic, non-malignant pain. As mightbe expected, in chronic painful conditions such as rheumatoidarthritis poor sleep becomes a significant, pronounced,and enduring patient complaint. While there may be some...

Ancient human cultures have developed diverse forms of adevice that, based on sensory stimulation, is used to putbabies to sleep: the rocking cradle. Vestibular and somatosensorystimulation produced by the rocking movements,complemented by eye closure and other stimulation such as...

Hypnotic drugs are consumed mainly by chronic users,who often take hypnotics for years continuously. Twostudies of the American Cancer Society, each involvingover 1 million subjects followed prospectively for 6 years, showedthat hypnotic use predicted increased mortality after control for...

Elderly patients, among others, will often describe thebenefits they derive from taking sleeping pills.1 Theirphysicians feel obliged to reduce or take them off suchmedication. Most medical experts will support such efforts, especiallyin the elderly fearing the increased risk of falls and...

Benzodiazepines are commonly used to provide sedationfor infants and children undergoing intensive care or diagnostic and therapeutic procedures in a variety of clinicalsettings. This chapter focuses on Midazolam as representativeof this class of drug. Midazolam provides sedation by...

Fatigue, daytime sleepiness, and hypersomnia are commonlyassociated with affective illnesses. In major depressivedisorder, they not only accompany the acute episode, butalso frequently precede its onset. These symptoms also often complicatethe recovery phase itself. In this chapter, the...

Frightening dreams are reported from all stages of sleep.1The night terrors associated with arousal from deep sleep(stages 3 & 4) are characterized by autonomic discharge,extreme fear, difficult arousal and easy return to sleep. Nightmaresare the bad, anxiety dreams often associated with...

Living in a complex and dangerous environment as humanshave for most of our evolutionary history requires one topossess effective mechanisms of arousal, both consciousnessand emotional, in order to meet the demands of the environment.An organism needs to be able to arouse behaviorally in...

The present chapter contains the discussion of the verycomplicated and controversial topic of brain monoamines activity in REM sleep in relationships with the mainREM sleep functions. The author is going to present many contradictoryexperimental data in this area. He will make an attempt...

Drugs, such as sedative-hypnotics and anesthetics, are ableto strongly regulate the vigilance state by affecting themain fast inhibitory neurotransmitter receptor systemin the brain, the GABAA receptor system. Agonists, such as classicalbenzodiazepines, are today the most widely used...

Rapid eye movement sleep is a unique paradoxical statewithin sleep period. Normally it follows deep sleep, ismaintained for varying duration and may terminate ineither sleep or wake state. During REM sleep some neurons increasefiring, the REM-ON neurons, while some others ceasefiring,...

Sleep is a normal restorative function. What is not clear ishow much sleep we need and what constitutes “normalsleep”.Complaints of sleeping difficulty are extremely common withprobably about a third of the population experiencing difficultyat any one time. It is suggested that 10...

The typical behavioral characteristics of the night eatingsyndrome have been described as morning anorexia,evening hyperphagia and insomnia. The neuroendocrinecharacteristics have been described as changes in the circadianrhythm by an attenuation in the nocturnal rise of the plasma...

Among the proposed functions of dreaming in human being, the most research supports are mood-regulation,problem-solving, learning, and memory construction.Recent imaging techniques have provided meaningful informationon functional neuroanatomy and neurophysiology of REMsleep and...

The class of antidepressants known as SSRIs (selectiveserotonin reuptake inhibitors) is a major part of thetreatment armamentarium in psychiatric practice. Thesedrugs were licensed for use first in major depression, and subsequentlyvarious SSRIs have received licences in anxiety...

The major hormone of the circadian system, melatonin, plays an important role in human sleep regulation, acting via both circadian and homeostatic mechanisms. Melatonin treatment can be used to treat chronic insomnias of different origin and circadiansleep disorders. However, if...

Visual analog scales (VAS) and diary cards are used to measure changes in patients’ sleepquality in clinical trials and practice. In this study we compared the 2 methods forassessing changes in sleep quality in patients with insomnia.

The catecolaminergic, serotonergic and histaminergicprojections arises from different nucleus groups in differentregions of the brain (Fig. 1). They have an importantrole in the control of behavioral state, body temperature, reproductionand other vital functions. Among these,...

Alzheimer’s disease (AD) patients show a greater disruption of the circadian sleep-wake cycle as compared to similarly aged non-demented controls. When this occurs dementedpatients spend their nights in a state of frequent restlessnessand their days in a state of frequent sleepiness....

The current first-line treatment for patients with winterseasonal affective disorder (SAD) is bright-light therapy,that is exposure to strong artificial light visible to theeye. Patients at risk of light-induced eye damage, such as thoseusing photosensitizing medication, need to consult...

This chapter details the pattern of sleep disturbances associated with chronic medical conditions. It illustrates thedisturbances in sleep architecture manifested by a numberof medical conditions as detailed by EEG orpolysomnography. Sleep disturbances are common with a numberof medical...

The pineal hormone, melatonin, can exert sedative/hypnotic, anxiolytic and other neuropharmacological effectsin experimental animals. Usually, these effects are producedby large pharmacological doses of melatonin, which areknown to interact with benzodiazepine (BZ) receptors in the...

Besides the obstructive sleep apnea/hypopnea syndrome, the mostprevalent cause of hypersomnia, other disorders may be the causeof more severe hypersomnia. These include primary disorders ofthe central nervous system and hypersomnia associated with variousmedical disorders. Among the...

Poor sleep quality often results in decreased alertness, drowsiness and sleepiness the following day. Pharmacologicaltreatment of sleep complaints can aggravate these effects,resulting in impaired performance at work and during daily activitiessuch as driving a car. The first hypnotics,...

Restless leg syndrome (RLS) was described as a distinctivesensory-motor phenomenon by Willis in 1672. Ekbomis credited for giving it its current name and identifyingits broad clinical presentation.Clinical FeaturesRestless legs syndrome (RLS) together with comorbid periodiclimb...

The above quote crystallizes who we, as individuals, are.We are a species with the ability to remember, especiallythose moments in life that stand out and that act as guidesin our path through the maze of life. In patients with headinjuries, these guides become absent and the maze...

The importance of timing medications is noted in thecontext of the effects of psychotropic drugs. The informationhere assembled as yet is examined mostly by inspectionwith the unaided eye and conventional (rather thantime series-related) statistics. An effect of time, shown by an analysis...

Insomnia is a common feature in schizophrenia. The sleepdisturbance of either never-medicated or previously treatedschizophrenia patients is characterized by an increase of stage2 sleep latency and wake time after sleep onset, and a reductionof total sleep time and sleep efficiency. In...

Patients with Epilepsy often complain of sleep difficulties:sleep disruption and excessive daytime sleepiness (EDS)are common symptoms. Less frequently patients complainabout insomnia. Difficulties on the study of sleep-epilepsy interactionscome out because seizures themselves disrupt...