Sleep and Biological Rhythms, Basic Mechanisms and Applications of Psychiatry
Sleep and Biological Rhythms, Basic Mechanisms and Applications of Psychiatry
J. Montplaisir and R. Godbout
New York: Oxford University Press, 240 pp., 1991
The editors are to be congratulated for assembling a collection of important papers by key Canadian and U.S. contributors dealing with fundamental mechanisms involved in biologic rhythms and sleep and their applications to psychiatry. This volume is a record of the proceedings of the Tenth Symposium of the Centre de Recherches en Science Neurologiques and the Departement de Psychiatrie of the Universite de Montreal.
The first part of the book is devoted to biologic rhythms. Robert Moore provides a brief overview of the role of the supra-chiasmatic nucleus (SCN) and its influence on circadian sleep-wake behavior. This theme is expanded by Benjamin Rusak who describes a complex hierarchical feedback model of photic and nonphotic behavioral oscillators that are linked to the SCN and circadian functions. Roger Broughton and colleagues briefly summarize aspects of the chronobiology of sleep. They focus attention on their studies of the extended sleep paradigm that indicate 24, 12, 3-4, and 1.5-2 hour periodicities in the human sleep-wake rhythm. Thomas Wehr’s chapter provides a superb detailed review of the reciprocal influences of sleep-wake physiology on affective disorders. The chapter by Charles Czeisler and associates on the use of a time isolation facility to measure human physiologic aspects of the endogenous circadian pace maker is followed by Lewy and colleagues’ review of their work on the influence of bright light on melatonin secretion and the light-dark cycle in patients with winter depression. This section on biologic rhythms concludes with Michael Terman and David Schlager’s description of a novel apparatus that simulates naturally graded dawn twilight exposures of light in treating winter depression.
The second part of the book on sleep follows the same format as the first part. The initial two chapters by Robert McCarley, and by Mircea Steriade and Denis Pare, detail descriptions of brainstem electrophysiologic and neurotransmitter mechanisms in rapid eye movement sleep in animals and possible implications for dreaming. James Krueger and colleagues provide an excellent brief overview of endogenous sleep neuro-modulating substances that involve aspects of the immune and neuroendocrine systems. Psychophysiologic features of sleep and wakefulness in chronic insomnia and the effects of hypnotics on sleep and waking cognitive function are reviewed by Wallace Mendelson. The final chapter by Roger Godbout, Jacques Montplaisir and associates addresses the purported mechanisms and current treatments of periodic movements in sleep and restless legs syndrome and narcolepsy.
The book suffers from the expected unevenness in presentations and overlap between chapters that characterize published proceedings of meetings. But students of the neurosciences and clinicians interested in key contemporary concepts in biologic psychiatry will find this a useful overview of the implications of chronobiology and sleep-wake physiology for fundamental behavioral states, affective and some sleep-related disorders.