Post-graduate theses
Current Record: 1203 of 1266
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| Identifier |
uch.med.msc//2004savvidou |
| Title |
Arousal indices, cognitive function and effects of modafinil in Sleep Apnea patients: a pilot double-blind, placebo-controlled study for the validity of a modified Pupillary Sleepiness Test |
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Author
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Σαββίδου, Κυριακή
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| Abstract |
The present project attempts to clarify the effects of the cognitive and vigilance enhancer drug modafinil on indices that measure daytime sleepiness and obstructive sleep apnea (OSA) and the validity of a modified pupillary test for the objective measurement of daytime somnolence. The research was conducted in sleep-apnea patients of all severities that had not received any treatment before and during this study. The results first of all suggest that the new pupillary sleepiness test (PST) is a quite sensitive tool for the assessment of daytime sleepiness. Pupil diameter, which is measured by this test, seems to be larger during alertness (morning hours) and much decreased during sleepiness and fatigue (in the afternoon). Moreover, polysomnographic (PSG) indices of the severity of sleep apnea a sleep disorder that includes daytime sleepiness - are significantly correlated with pupil size, under the effect of somnolence. Thus, the more severe sleep apneics appear to have the smaller pupils. However, subjective tests that measure sleepiness (Epworth Sleepiness Scale, ESS) show a relationship with pupil diameter of sleepy patients but only under the effect of body indices, which means that fat people have the tendency to feel sleepier than people who are not fat. Treatment of apneics with the wake-promoting drug modafinil increases significantly pupil diameter. The effect of modafinil on pupil size was greater in the more severe sleep apneics and in patients with the higher subjective sleepiness (ESS). After partialling out the effect of body fat indices, modafinils effect correlated even more significantly with subjective sleepiness. So, PST seems to be affected by the vigilance-enhancing drug modafinil. Modafinil has been also found to reduce the amplitude of light reflex, while causing no effect on the 75% recovery time (return of pupil on the 75% of its initial diameter) or cardiovascular parameters. These findings demonstrate that the drug increases central parasympathetic activity but does not affect the sympathetic tone. Finally, modafinil seems to improve patients performance on neuropsychological tests (RTI, RVIP, SoC), which depend on mechanisms that induce alertness.
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| Language |
English |
| Issue date |
2004-12-01 |
| Collection
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School/Department--School of Medicine--Department of Medicine--Post-graduate theses
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Type of Work--Post-graduate theses
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| Permanent Link |
https://elocus.lib.uoc.gr//dlib/c/b/8/metadata-dlib-2004savvidou.tkl
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| Views |
161 |
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