León Rosenthal

SleepMed

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Timothy Roehrs

Henry Ford Health System

Thomas Roth

New York Psychoanalytic Society and Institute

Ryan Day

University of Florida

Mary Lou Syron

Henry Ford Hospital

Christopher Bishop

Binghamton University

Peter Guido

Lovelace Health System

Diana C. Dolan

Henry M. Jackson Foundation

Thomas Röth

Henry Ford Hospital

Todd C. Helmus

RAND Corporation

Frank Zorick

Henry Ford Hospital

Cooperative Institutions

Henry Ford Hospital

Universidad Nacional Autónoma de México

Henry Ford Health System

Wayne State University

Universidad Autónoma Metropolitana

Clínica Santa María

Instituto Nacional de Psiquiatría

Hospital General de México

University of North Texas

Halliburton (United Kingdom)

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Tolerance to Daytime Sedative Effects of H1 Antihistamines

Journal of Clinical Psychopharmacology (2002)

Gary S. Richardson Timothy Roehrs León Rosenthal Gail Koshorek Thomas Roth

Sedation is the principal side effect of firstgeneration H1 antihistamines, and recent studies have suggested that this side effect should limit the clinical application of these drugs. The sedative effect also underlies the use of these first-generation drugs as nonprescriptive remedies for insomnia. In both cases, the potential for tolerance to the sedative effect of these drugs is an important issue for which there are few objective data. In the study reported here, 15 healthy men age 18 to 50 years received either diphenhydramine 50 mg or placebo twice a day for 4 days in a randomized, double-blind, crossover trial design. Dependent measures included objective and subjective assessments of sleepiness and computer-based tests of psychomotor performance. Both objective and subjective measures of sleepiness showed significantly higher levels on day 1 for diphenhydramine compared to placebo. By day 4, however, levels of sleepiness on diphenhydramine were indistinguishable from placebo. Similarly, diphenhydramine produced significant impairment of performance that was completely reversed by day 4. These data provide the first objective confirmation that tolerance develops to the sedative effect of a prototypical first-generation H1 antihistamine, diphenhydramine. On this dosing regimen, tolerance was complete by the end of 3 days of administration. While other antihistamines and dosing regimens may differ, these results suggest that tolerance to the sedation produced by these drugs develops with remarkable rapidity.

Crossover study

10.1097/00004714-200210000-00012

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Citations (207)

Psychometric evaluation of daytime sleepiness and nocturnal sleep onset scales in a representative community sample

Biological Psychiatry (1999)

Eric O. Johnson Naomi Breslau Thomas Roth Timothy Roehrs León Rosenthal

Chronotype

Somnolence

10.1016/s0006-3223(98)00111-5

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Citations (50)

The Frequency of Multiple Sleep Onset REM Periods Among Subjects With No Excessive Daytime Sleepiness

SLEEP (1996)

Christopher Bishop León Rosenthal Todd C. Helmus Timothy Roehrs Thomas Roth

The multiple sleep latency test (MSLT) is a valuable tool in the assessment of excessive daytime sleepiness (EDS). Additionally, multiple sleep onset rapid eye movement periods (SOREMPs) are a frequent occurrence in patients with narcolepsy. To date, however, few studies have evaluated the frequency of SOREMPs in a population of healthy control subjects. Subjects participating in a variety of sleep studies were screened with a nocturnal clinical polysomnogram, followed by the MSLT. Subjects were required to be drug free and have no sleep-related symptoms or medical or psychiatric conditions. Of the 139 subjects who were screened, 24 (17%) had two or more SOREMPs. These individuals were more likely to be male, younger, and sleepier than those with one or zero SOREMPs. The etiology of two or more SOREMPs in healthy controls was not apparent from the clinical or polysomnographic evaluation. Although it is possible that these findings are early signs of narcolepsy, subjects reported being free of any sleep-related complaints. Further investigations into the determinants of multiple SOREMPs and their reliability among asymptomatic populations are warranted.

Sleep

10.1093/sleep/19.9.727

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Citations (106)

Sleepiness and the reinforcing and subjective effects of methylphenidate.

Experimental and Clinical Psychopharmacology (1999)

Timothy Roehrs Kate Papineau León Rosenthal Thomas Roth

On 4 days, 6 volunteers received 10 mg methylphenidate or placebo at 0900 after 4 or 8 hr time in bed (TIB) and then on 4 days after 4 or 8 hr TIB chose their preferred capsule. On sampling days, 4 hr TIB increased multiple sleep latency test (MSLT) scores and Fatigue scale scores on the Profile of Mood States (POMS). In both TIBs, the drug increased the MSLT and POMS Vigor and Tension scale scores. It reduced POMS Fatigue scores and improved divided attention performance to a greater extent after 4 versus 8 hr. Drug was chosen on 88% of days after 4 hr, but only 29% of days after 8 hr. Preference for the drug depends on sleepiness and is mediated by performance-enhancing and fatigue-altering effects.

10.1037//1064-1297.7.2.145

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Citations (54)

Physiologic Processes During Sleep

León Rosenthal

This chapter contains sections titled: The NREM–REM Cycle Circadian and Homeostatic Determinants of Sleep Regulation of NREM Sleep Regulation of REM Sleep Normal Autonomic Changes in Sleep The Function of Sleep Conclusion Additional Reading

Sleep

Neuroscience of sleep

10.1002/0471751723.ch3

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Citations (7)

Nocturnal sleep latencies among alert, alert-deprived and sleepy subjects

Electroencephalography and Clinical Neurophysiology (1996)

Todd C. Helmus León Rosenthal Christopher Bishop Timothy Roehrs Shana Krsevska

Sleep

10.1016/0921-884x(96)95197-8

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Citations (3)

A Factor Replication of the Sleep-Wake Activity Inventory (SWAI) in a Mexican Population

SLEEP (1997)

Matilde Valencia‐Flores León Rosenthal Violeta A. Castaño Rosa M. Campos Patricia Vergara

The purpose of this study was to describe the factor structure of the Sleep-Wake Activity Inventory (SWAI) in a Mexican population. In a sample of 722 Mexican college students, we replicated five of the six factors originally described in the SWAI. Retained factors included: excessive daytime sleepiness (similarity coefficient of 0.735), psychic distress (0.609), social desirability (0.638), individual's ability to relax (0.864), and nocturnal sleep (0.660). These results confirm the factor structure and extend the possible utility of the SWAI in a siesta culture.

Replication

Sleep

10.1093/sleep/20.2.111

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Citations (8)

Daytime CPAP Titration

CHEST Journal (1998)

León Rosenthal Keith Nykamp Peter Guido Mary Lou Syron Ryan Day

10.1378/chest.114.4.1056

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Citations (27)

The alerting effects of dexamethasone

Psychophysiology (2003)

Renata Meixner Rebecca Gerhardstein Ryan Day Keith Nykamp Mary Lou Syron

Abstract The purpose of this study was to characterize the level of sleepiness/alertness following the nocturnal administration of dexamethasone. Thirteen healthy men participated in this study. Following the initial screening, dexamethasone (4 mg) or placebo was administered at 22:30 hr in a randomized double‐blind procedure. Subjects were given nap opportunities at 23:00, 1:00, 3:00, 4:30, 5:30, 7:30, 9:30, 11:30, 13:30, 15:30, 17:30, and 19:30 hr. The administration of dexamethasone resulted in an overall lengthening of sleep latency. Although the two groups displayed comparable latencies to stage 1 for the 23:00–7:30 hr nap opportunities, the administration of dexamethasone resulted in significantly longer latencies on the 9:30–19:30 hr nap opportunities. Consistent with these results, participants reported significantly greater levels of alertness on the Stanford Sleepiness Scale. The results of this study revealed greater levels of daytime alertness following the nocturnal administration of dexamethasone.

Alertness

Nap

10.1111/1469-8986.00027

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Citations (13)

The reliability of the diagnostic features in patients with narcolepsy

Biological Psychiatry (1996)

Michael Folkerts León Rosenthal Timothy Roehrs Shana Krstevska Anjana Murlidhar

10.1016/0006-3223(95)00383-5

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Citations (45)