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Papers by Neil Stanley

Research paper thumbnail of Actigraphy in human psychopharmacology: a review

Human Psychopharmacology-clinical and Experimental, 2003

Over the last 25 years wrist actigraphy has predominantly been used in sleep research and chronob... more Over the last 25 years wrist actigraphy has predominantly been used in sleep research and chronobiology where the technique has proved useful in the measurement of sleep and the characterisation of the sleep/wake cycle. Whilst there are a large number of studies published that have used actigraphy, there have only been relatively few studies that have shown that the technique is capable of measuring drug-induced changes in nocturnal and/or diurnal behaviour. Thus the use of actigraphy to measure drug effects in clinical trials has up till now remained on the periphery of psychopharmacology. However this may be because of the disparate nature of the studies published rather than lack of usefulness. This paper reviews the relevant literature and in doing so concludes that there is a convincing body of evidence for the utility of actigraphy as a technique in human psychopharmacology.

Research paper thumbnail of Impact of Nocturia on Sleep and Energy

European Urology Supplements, Apr 1, 2007

Sleep is a vital element in a human's general health. However, sleep may lose its ''healing'' fun... more Sleep is a vital element in a human's general health. However, sleep may lose its ''healing'' function, especially through ageing. Sleep in the elderly is characterised by less restorative sleep and more frequent awakenings. One of the main causes of sleep impairment in this population, besides ageing, is nocturia. The aetiology of nocturia includes several factors, among others somatic diseases, age-related endocrine alterations, bladder outlet obstruction, and detrusor overactivity (often associated with benign prostatic hyperplasia) and sleep apnoea. Because most of these factors are often prevalent in the elderly, nocturia is often considered as a normal consequence of ageing. However, lack of sleep due to the frequent nocturnal awakenings may have deleterious effects on general health status. Indeed, data not only from nocturia, but also from many pain or pruritus-associated diseases, clearly demonstrate that disturbance of the normal sleep pattern results in poor quality of sleep, which, in turn, leads to poor quality of life. Frequent nocturnal awakenings may induce diminished vitality, increased susceptibility for diseases, impaired cognitive performance and alertness, depression, and even a higher mortality. Moreover, patients who have nocturia have an increased risk for accidents, falls, and fractures, especially the elderly, who often already have impaired motor and cognitive functioning. Hence, nocturia should not be seen as just another age-related problem but, considering the substantial impact it can have on the quality of sleep and quality of life, it should be recognised as a condition that needs to be taken seriously and treated appropriately.

Research paper thumbnail of Selective SWS/SWA deprivation is associated with increased daytime sleep propensity in young, middle-aged and older men and women

Research paper thumbnail of A short device-based questionnaire 'sleephubs check-up' to engage the general population in understanding more about their sleep

Research paper thumbnail of P.8.a.007 Association between individual differences in slow wave sleep, slow wave activity and sleep continuity in young, middle-aged and older men and women

European Neuropsychopharmacology, 2006

Research paper thumbnail of Effects of three doses of 3-indole pyruvic acid on subjective and objective measures of sleep and early morning performance

Human Psychopharmacology-clinical and Experimental, May 1, 1996

The effects of 3‐indole pyruvic acid (IPA) on sleep and morning after performance were investigat... more The effects of 3‐indole pyruvic acid (IPA) on sleep and morning after performance were investigated in 10 volunteers with previous complaints of mild insomnia. Three doses of IPA (100, 200 and 300 mg) were compared to placebo to assess their effect on sleep, cognitive function and psychomotor performance. The psychometric battery consisted of tests of Critical Flicker Fusion, Choice Reaction Time, Short Term Memory and Compensatory Tracking. The Leeds Sleep Evaluation Questionnaire was also administered shortly after waking the morning following medication. Results show that IPA had no significant effects on any aspect of sleep architecture. However, sleep efficiency was significantly higher on night 1 when subjects had taken 200 or 300 mg IPA compared to those who had received either placebo or 100 mg IPA. No further effects were found on subsequent nights with any of the treatments. There were no morning after effects of IPA on cognitive function or psychomotor performance. The ‘first night’ effect of sleeping in an unfamiliar environment possibly caused transient insomnia in the subjects and while this effect was not mitigated by placebo or 100 mg IPA, 200 and 300 mg IPA seem to exert sufficient hypnotic effects to overcome the sleep disturbance. These results suggest that the two higher doses of IPA exert a mild hypnotic action, perhaps by relieving the stress experienced in situations that are liable to cause transient insomnia.

Research paper thumbnail of Pregabalin, a novel alpha2-delta ligand for the treatment of neuropathic pain, shows evidence of a positive cognitive and psychomotor profile in healthy volunteers

Research paper thumbnail of Sleep profiles and mood States during an expedition to the South Pole

Wilderness & Environmental Medicine, 2007

Objectives: To investigate sleep parameters and mood profiles of a female explorer traveling solo... more Objectives: To investigate sleep parameters and mood profiles of a female explorer traveling solo and unaided to the South Pole during the winter. Methods: During the 44-day expedition, global activity and sleep were assessed using a wrist actigraph (AW) worn on the non-dominant wrist. Mood was assessed using an adapted Profile of Mood States questionnaire. Pre-and post-expedition physiological profiles were conducted to assess body composition, strength and power and aerobic capacity. Results: The AW data revealed decreasing sleep duration throughout the expedition, with an average sleep time of 5 hours (range: 8hr 14mins -1hr 42mins), with sleep times consistently below 3 hours during the final third of the expedition. Mood responses indicated a progressive reduction in vigour and increase in fatigue. Sleep time was positively related to vigour and inversely related to depression and fatigue, a finding that is consistent with the notion that positive feelings (high vigour and low fatigue) are linked with sleep. Conclusions: This account provides insight to help understand the limits of human tolerance and may be directly applicable when planning future expeditions of this nature.

Research paper thumbnail of Sleep Profiles and Mood States During an Expedition to the South Pole

Wilderness & Environmental Medicine, 2007

Objectives: To investigate sleep parameters and mood profiles of a female explorer traveling solo... more Objectives: To investigate sleep parameters and mood profiles of a female explorer traveling solo and unaided to the South Pole during the winter. Methods: During the 44-day expedition, global activity and sleep were assessed using a wrist actigraph (AW) worn on the non-dominant wrist. Mood was assessed using an adapted Profile of Mood States questionnaire. Pre-and post-expedition physiological profiles were conducted to assess body composition, strength and power and aerobic capacity. Results: The AW data revealed decreasing sleep duration throughout the expedition, with an average sleep time of 5 hours (range: 8hr 14mins -1hr 42mins), with sleep times consistently below 3 hours during the final third of the expedition. Mood responses indicated a progressive reduction in vigour and increase in fatigue. Sleep time was positively related to vigour and inversely related to depression and fatigue, a finding that is consistent with the notion that positive feelings (high vigour and low fatigue) are linked with sleep. Conclusions: This account provides insight to help understand the limits of human tolerance and may be directly applicable when planning future expeditions of this nature.

Research paper thumbnail of Effects of Fluoxetine and Dothiepin on 24-Hour Activity in Depressed Patients

Neuropsychobiology, 1999

Psychomotor retardation is a recognised symptom of depressive illness, and improvement in psychom... more Psychomotor retardation is a recognised symptom of depressive illness, and improvement in psychomotor function is associated with the amelioration of the severity of depressive symptoms. Actigraphy permits behavioural activity to be continuously assessed, allowing changes in psychomotor activity to be monitored over time. A randomised, parallel-group, double-blind study was conducted in 14 general practice patients with a diagnosis of major depression. This pilot study was designed to investigate the utility of actigraphy in this patient population and to investigate possible differences between fluoxetine and dothiepin in their effects on 24-hour behavioural activity monitored for the first 10 days of treatment. Patients taking dothiepin (75 mg rising to 150 mg in the second week, nocte) were found to be significantly (p < 0.05) less active over the course of the day compared to those treated with fluoxetine (20 mg, mane). This lower level of behavioural activity in the dothiepin group was particularly noticeable in the early morning (06:00-08:00 h).

Research paper thumbnail of The future of sleep staging

Human Psychopharmacology-clinical and Experimental, 1996

... Research Article. The future of sleep staging. Neil Stanley. Article first published online: ... more ... Research Article. The future of sleep staging. Neil Stanley. Article first published online: 4 DEC 1998. ... First page of article. Get PDF (389K). More content like this. Find more content: like this article. Find more content written by: Neil Stanley. ...

Research paper thumbnail of Residual effects of zaleplon and zolpidem following middle of the night administration five hours to one hour before awakening

Human Psychopharmacology-clinical and Experimental, 2001

The objective was to assess residual effects of zaleplon and zolpidem after a middle of the night... more The objective was to assess residual effects of zaleplon and zolpidem after a middle of the night administration. This was a randomized, double-blind, placebo-controlled, crossover study, conducted in 40 healthy young male and female subjects. Subjects were awakened in the middle of the night and administered either placebo or zaleplon 10 or 20 mg or zolpidem 10 mg. A battery of objective tests exploring psychomotor and cognitive functions such as critical flicker fusion (CFF), choice reáction time (CRT), digit symbol substitution test (DSST), and memory tests (Sternberg memory scanning and a word list) were administered immediately after morning waking. Zaleplon 10 mg was devoid of residual effects whatever – the time of dosing – except a minimal but significant decrease in DSST scores when administered 1 h before awakening. Zaleplon 20 mg produced significant residual effects on performance (increase in CRT, and decrease in CFF threshold and in DSST scores) and memory (decrease in immediate and delayed free recall of words) only when administered 1 h before awakening. In contrast, zolpidem 10 mg produced significant detrimental residual effects on CRT and delayed free recall of words, when administered up to 5 h before waking, on DSST and Sternberg when administered up to 3 h before awakening and on CFF when administered 1 h before awakening. The residual effects of zolpidem 10 mg were more marked than those observed after zaleplon 20 mg. The present results demonstrate that zaleplon 10 mg has no or minimal residual effects when administered in the middle of the night as little as 1 h before waking. The lack of clinically significant residual effects with zaleplon may be explained by its unique pharmacokinetic (rapid elimination half-life) and pharmacodynamic (selective binding for GABAA receptors with the α1 subunit, dissociation between sleep inducing properties and impairment of cognitive functions) profiles. Copyright © 2001 John Wiley & Sons, Ltd.

Research paper thumbnail of Residual effects of zaleplon and zolpidem following middle of the night administration five hours to one hour before awakening

Human Psychopharmacology-clinical and Experimental, 2001

The objective was to assess residual effects of zaleplon and zolpidem after a middle of the night... more The objective was to assess residual effects of zaleplon and zolpidem after a middle of the night administration. This was a randomized, double-blind, placebo-controlled, crossover study, conducted in 40 healthy young male and female subjects. Subjects were awakened in the middle of the night and administered either placebo or zaleplon 10 or 20 mg or zolpidem 10 mg. A battery of objective tests exploring psychomotor and cognitive functions such as critical flicker fusion (CFF), choice reáction time (CRT), digit symbol substitution test (DSST), and memory tests (Sternberg memory scanning and a word list) were administered immediately after morning waking. Zaleplon 10 mg was devoid of residual effects whatever – the time of dosing – except a minimal but significant decrease in DSST scores when administered 1 h before awakening. Zaleplon 20 mg produced significant residual effects on performance (increase in CRT, and decrease in CFF threshold and in DSST scores) and memory (decrease in immediate and delayed free recall of words) only when administered 1 h before awakening. In contrast, zolpidem 10 mg produced significant detrimental residual effects on CRT and delayed free recall of words, when administered up to 5 h before waking, on DSST and Sternberg when administered up to 3 h before awakening and on CFF when administered 1 h before awakening. The residual effects of zolpidem 10 mg were more marked than those observed after zaleplon 20 mg. The present results demonstrate that zaleplon 10 mg has no or minimal residual effects when administered in the middle of the night as little as 1 h before waking. The lack of clinically significant residual effects with zaleplon may be explained by its unique pharmacokinetic (rapid elimination half-life) and pharmacodynamic (selective binding for GABAA receptors with the α1 subunit, dissociation between sleep inducing properties and impairment of cognitive functions) profiles. Copyright © 2001 John Wiley & Sons, Ltd.

Research paper thumbnail of Effects of Fluoxetine and Dothiepin on 24Hour Activity in Depressed Patients

Neuropsychobiology, 1999

Psychomotor retardation is a recognised symptom of depressive illness, and improvement in psychom... more Psychomotor retardation is a recognised symptom of depressive illness, and improvement in psychomotor function is associated with the amelioration of the severity of depressive symptoms. Actigraphy permits behavioural activity to be continuously assessed, allowing changes in psychomotor activity to be monitored over time. A randomised, parallel-group, double-blind study was conducted in 14 general practice patients with a diagnosis of major depression. This pilot study was designed to investigate the utility of actigraphy in this patient population and to investigate possible differences between fluoxetine and dothiepin in their effects on 24-hour behavioural activity monitored for the first 10 days of treatment. Patients taking dothiepin (75 mg rising to 150 mg in the second week, nocte) were found to be significantly (p < 0.05) less active over the course of the day compared to those treated with fluoxetine (20 mg, mane). This lower level of behavioural activity in the dothiepin group was particularly noticeable in the early morning (06:00-08:00 h).

Research paper thumbnail of Benzodiazepine-induced reduction in activity mirrors decrements in cognitive and psychomotor performance

Human Psychopharmacology-clinical and Experimental, 2008

ObjectiveTo assess whether actigraphy is sensitive to benzodiazepine-induced changes in cognitive... more ObjectiveTo assess whether actigraphy is sensitive to benzodiazepine-induced changes in cognitive and psychomotor performance and sleep.To assess whether actigraphy is sensitive to benzodiazepine-induced changes in cognitive and psychomotor performance and sleep.MethodsHealthy young volunteers (n = 23; 11 males), were randomised to a double-blind, placebo-controlled, crossover trial. Actigraphy was used to record motor activity continuously. Following dosing at 18.00 h with 2.5 mg lorazepam (LZP), psychomotor and cognitive assessments were made at hourly intervals post-dose for 4 h and after sleep at 14.5 h post-dose.Healthy young volunteers (n = 23; 11 males), were randomised to a double-blind, placebo-controlled, crossover trial. Actigraphy was used to record motor activity continuously. Following dosing at 18.00 h with 2.5 mg lorazepam (LZP), psychomotor and cognitive assessments were made at hourly intervals post-dose for 4 h and after sleep at 14.5 h post-dose.ResultsActivity levels were significantly reduced after LZP for 5 h post-dose (p = 0.0104), during sleep (5–13 h) (p < 0.02) and the following morning, 13–14.5 h post-dose (p < 0.02). At the same time cognitive and psychomotor performance was also significantly impaired (p < 0.05). LZP also significantly increased actigraphic sleep efficiency and sleep per cent (p < 0.02).Activity levels were significantly reduced after LZP for 5 h post-dose (p = 0.0104), during sleep (5–13 h) (p < 0.02) and the following morning, 13–14.5 h post-dose (p < 0.02). At the same time cognitive and psychomotor performance was also significantly impaired (p < 0.05). LZP also significantly increased actigraphic sleep efficiency and sleep per cent (p < 0.02).ConclusionThis study showed that activity levels were significantly reduced following dosing with a benzodiazepine and these changes coincided with impairment of cognitive and psychomotor performance. Actigraphy, therefore, appears to be able to reflect the psychopharmacological effects of a benzodiazepine in changes in daytime function and nocturnal behaviour, which, without waking the subject, is beyond the power of conventional psychometrics. Copyright © 2008 John Wiley & Sons, Ltd.This study showed that activity levels were significantly reduced following dosing with a benzodiazepine and these changes coincided with impairment of cognitive and psychomotor performance. Actigraphy, therefore, appears to be able to reflect the psychopharmacological effects of a benzodiazepine in changes in daytime function and nocturnal behaviour, which, without waking the subject, is beyond the power of conventional psychometrics. Copyright © 2008 John Wiley & Sons, Ltd.

Research paper thumbnail of The future of sleep staging

Human Psychopharmacology: Clinical and Experimental, 1996

... Research Article. The future of sleep staging. Neil Stanley. Article first published online: ... more ... Research Article. The future of sleep staging. Neil Stanley. Article first published online: 4 DEC 1998. ... First page of article. Get PDF (389K). More content like this. Find more content: like this article. Find more content written by: Neil Stanley. ...

Research paper thumbnail of The future of sleep staging

Human Psychopharmacology: Clinical and Experimental, 1996

... Research Article. The future of sleep staging. Neil Stanley. Article first published online: ... more ... Research Article. The future of sleep staging. Neil Stanley. Article first published online: 4 DEC 1998. ... First page of article. Get PDF (389K). More content like this. Find more content: like this article. Find more content written by: Neil Stanley. ...

Research paper thumbnail of Exploring the Interdependence of Couples' Rest‐Wake Cycles: An Actigraphic Study

Chronobiology International, 2009

Within western societies, it is commonplace for couples to share a bed. Yet there has been remark... more Within western societies, it is commonplace for couples to share a bed. Yet there has been remarkably little research carried out on couples&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; sleep. This paper draws upon actigraphy, audio diary, and questionnaire data from both partners of 36 heterosexual couples (age 20-59 yrs) and aims to quantify the extent to which it is important to take into account the dyadic nature of sleep-wake cycles. It achieves this through two interrelated aims: to use hierarchical linear models to measure dyadic interdependence in actigraphically recorded variables, and to investigate how much of this dyadic interdependence truly results from couple dynamics. The variables with the most significant couple interdependency were actual bed time, sleep latency, light/dark ratio, and wake bouts. The paper concludes by suggesting that interdependence may be the defining feature of couples&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; sleep, and that we need to employ analytic approaches that both acknowledge this and are sensitive to the possibilities that not all aspects of sleep will behave in the same way.

Research paper thumbnail of Sleep profiles and mood States during an expedition to the South Pole

Wilderness & Environmental Medicine, 2007

Objectives: To investigate sleep parameters and mood profiles of a female explorer traveling solo... more Objectives: To investigate sleep parameters and mood profiles of a female explorer traveling solo and unaided to the South Pole during the winter. Methods: During the 44-day expedition, global activity and sleep were assessed using a wrist actigraph (AW) worn on the non-dominant wrist. Mood was assessed using an adapted Profile of Mood States questionnaire. Pre-and post-expedition physiological profiles were conducted to assess body composition, strength and power and aerobic capacity. Results: The AW data revealed decreasing sleep duration throughout the expedition, with an average sleep time of 5 hours (range: 8hr 14mins -1hr 42mins), with sleep times consistently below 3 hours during the final third of the expedition. Mood responses indicated a progressive reduction in vigour and increase in fatigue. Sleep time was positively related to vigour and inversely related to depression and fatigue, a finding that is consistent with the notion that positive feelings (high vigour and low fatigue) are linked with sleep. Conclusions: This account provides insight to help understand the limits of human tolerance and may be directly applicable when planning future expeditions of this nature.

Research paper thumbnail of A Double-Blind, Randomized, 26Week Study Comparing the Cognitive and Psychomotor Effects and Efficacy of 75 mg (37.5 mg b.i.d.) Venlafaxine and 75 mg (25 mg Mane, 50 mg Nocte) Dothiepin in Elderly Patients with Moderate Major Depression Being Treated in General Practice

Journal of Psychopharmacology, 2004

To investigate the efficacy and cognitive and psychomotor effects of venlafaxine and dothiepin in... more To investigate the efficacy and cognitive and psychomotor effects of venlafaxine and dothiepin in elderly patients with moderate major depression. A prospective, randomized, double-blind, parallel-group, active comparator controlled study was conducted. Eighty-eight patients (aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 60 years) were enrolled. Each patient received either venlafaxine (immediate release formulation) 37.5 mg twice per day or dothiepin 25 mg mane followed by 50 mg nocte for 26 weeks. Efficacy was assessed with the Montgomery-Asberg Depression Rating Scale and the Hamilton Depression Rating Scale. A psychometric test battery to assess cognitive function, activities of daily living and sleep consisted of Critical Flicker Fusion (CFF), Short-term Memory--Kim&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Game, Cognitive Failures Questionnaire, Milford Epworth Sleepiness Scale, Leeds Sleep Evaluation Questionnaire, and an Accident Scoring Questionnaire. Quality of Life Questionnaires (Short Form 36 and Quality of Life in Depression Scale) were also administered. Venlafaxine significantly (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) raised CFF scores compared to baseline but had no effect on any other measure. Dothiepin significantly (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) lowered CFF threshold, and increased ratings of both sedation and difficulty in waking. The results showed that venlafaxine at doses of 37.5 mg b.i.d. in elderly depressed patients is free from disruptive effects on cognitive function and psychomotor performance.

Research paper thumbnail of Actigraphy in human psychopharmacology: a review

Human Psychopharmacology-clinical and Experimental, 2003

Over the last 25 years wrist actigraphy has predominantly been used in sleep research and chronob... more Over the last 25 years wrist actigraphy has predominantly been used in sleep research and chronobiology where the technique has proved useful in the measurement of sleep and the characterisation of the sleep/wake cycle. Whilst there are a large number of studies published that have used actigraphy, there have only been relatively few studies that have shown that the technique is capable of measuring drug-induced changes in nocturnal and/or diurnal behaviour. Thus the use of actigraphy to measure drug effects in clinical trials has up till now remained on the periphery of psychopharmacology. However this may be because of the disparate nature of the studies published rather than lack of usefulness. This paper reviews the relevant literature and in doing so concludes that there is a convincing body of evidence for the utility of actigraphy as a technique in human psychopharmacology.

Research paper thumbnail of Impact of Nocturia on Sleep and Energy

European Urology Supplements, Apr 1, 2007

Sleep is a vital element in a human's general health. However, sleep may lose its ''healing'' fun... more Sleep is a vital element in a human's general health. However, sleep may lose its ''healing'' function, especially through ageing. Sleep in the elderly is characterised by less restorative sleep and more frequent awakenings. One of the main causes of sleep impairment in this population, besides ageing, is nocturia. The aetiology of nocturia includes several factors, among others somatic diseases, age-related endocrine alterations, bladder outlet obstruction, and detrusor overactivity (often associated with benign prostatic hyperplasia) and sleep apnoea. Because most of these factors are often prevalent in the elderly, nocturia is often considered as a normal consequence of ageing. However, lack of sleep due to the frequent nocturnal awakenings may have deleterious effects on general health status. Indeed, data not only from nocturia, but also from many pain or pruritus-associated diseases, clearly demonstrate that disturbance of the normal sleep pattern results in poor quality of sleep, which, in turn, leads to poor quality of life. Frequent nocturnal awakenings may induce diminished vitality, increased susceptibility for diseases, impaired cognitive performance and alertness, depression, and even a higher mortality. Moreover, patients who have nocturia have an increased risk for accidents, falls, and fractures, especially the elderly, who often already have impaired motor and cognitive functioning. Hence, nocturia should not be seen as just another age-related problem but, considering the substantial impact it can have on the quality of sleep and quality of life, it should be recognised as a condition that needs to be taken seriously and treated appropriately.

Research paper thumbnail of Selective SWS/SWA deprivation is associated with increased daytime sleep propensity in young, middle-aged and older men and women

Research paper thumbnail of A short device-based questionnaire 'sleephubs check-up' to engage the general population in understanding more about their sleep

Research paper thumbnail of P.8.a.007 Association between individual differences in slow wave sleep, slow wave activity and sleep continuity in young, middle-aged and older men and women

European Neuropsychopharmacology, 2006

Research paper thumbnail of Effects of three doses of 3-indole pyruvic acid on subjective and objective measures of sleep and early morning performance

Human Psychopharmacology-clinical and Experimental, May 1, 1996

The effects of 3‐indole pyruvic acid (IPA) on sleep and morning after performance were investigat... more The effects of 3‐indole pyruvic acid (IPA) on sleep and morning after performance were investigated in 10 volunteers with previous complaints of mild insomnia. Three doses of IPA (100, 200 and 300 mg) were compared to placebo to assess their effect on sleep, cognitive function and psychomotor performance. The psychometric battery consisted of tests of Critical Flicker Fusion, Choice Reaction Time, Short Term Memory and Compensatory Tracking. The Leeds Sleep Evaluation Questionnaire was also administered shortly after waking the morning following medication. Results show that IPA had no significant effects on any aspect of sleep architecture. However, sleep efficiency was significantly higher on night 1 when subjects had taken 200 or 300 mg IPA compared to those who had received either placebo or 100 mg IPA. No further effects were found on subsequent nights with any of the treatments. There were no morning after effects of IPA on cognitive function or psychomotor performance. The ‘first night’ effect of sleeping in an unfamiliar environment possibly caused transient insomnia in the subjects and while this effect was not mitigated by placebo or 100 mg IPA, 200 and 300 mg IPA seem to exert sufficient hypnotic effects to overcome the sleep disturbance. These results suggest that the two higher doses of IPA exert a mild hypnotic action, perhaps by relieving the stress experienced in situations that are liable to cause transient insomnia.

Research paper thumbnail of Pregabalin, a novel alpha2-delta ligand for the treatment of neuropathic pain, shows evidence of a positive cognitive and psychomotor profile in healthy volunteers

Research paper thumbnail of Sleep profiles and mood States during an expedition to the South Pole

Wilderness & Environmental Medicine, 2007

Objectives: To investigate sleep parameters and mood profiles of a female explorer traveling solo... more Objectives: To investigate sleep parameters and mood profiles of a female explorer traveling solo and unaided to the South Pole during the winter. Methods: During the 44-day expedition, global activity and sleep were assessed using a wrist actigraph (AW) worn on the non-dominant wrist. Mood was assessed using an adapted Profile of Mood States questionnaire. Pre-and post-expedition physiological profiles were conducted to assess body composition, strength and power and aerobic capacity. Results: The AW data revealed decreasing sleep duration throughout the expedition, with an average sleep time of 5 hours (range: 8hr 14mins -1hr 42mins), with sleep times consistently below 3 hours during the final third of the expedition. Mood responses indicated a progressive reduction in vigour and increase in fatigue. Sleep time was positively related to vigour and inversely related to depression and fatigue, a finding that is consistent with the notion that positive feelings (high vigour and low fatigue) are linked with sleep. Conclusions: This account provides insight to help understand the limits of human tolerance and may be directly applicable when planning future expeditions of this nature.

Research paper thumbnail of Sleep Profiles and Mood States During an Expedition to the South Pole

Wilderness & Environmental Medicine, 2007

Objectives: To investigate sleep parameters and mood profiles of a female explorer traveling solo... more Objectives: To investigate sleep parameters and mood profiles of a female explorer traveling solo and unaided to the South Pole during the winter. Methods: During the 44-day expedition, global activity and sleep were assessed using a wrist actigraph (AW) worn on the non-dominant wrist. Mood was assessed using an adapted Profile of Mood States questionnaire. Pre-and post-expedition physiological profiles were conducted to assess body composition, strength and power and aerobic capacity. Results: The AW data revealed decreasing sleep duration throughout the expedition, with an average sleep time of 5 hours (range: 8hr 14mins -1hr 42mins), with sleep times consistently below 3 hours during the final third of the expedition. Mood responses indicated a progressive reduction in vigour and increase in fatigue. Sleep time was positively related to vigour and inversely related to depression and fatigue, a finding that is consistent with the notion that positive feelings (high vigour and low fatigue) are linked with sleep. Conclusions: This account provides insight to help understand the limits of human tolerance and may be directly applicable when planning future expeditions of this nature.

Research paper thumbnail of Effects of Fluoxetine and Dothiepin on 24-Hour Activity in Depressed Patients

Neuropsychobiology, 1999

Psychomotor retardation is a recognised symptom of depressive illness, and improvement in psychom... more Psychomotor retardation is a recognised symptom of depressive illness, and improvement in psychomotor function is associated with the amelioration of the severity of depressive symptoms. Actigraphy permits behavioural activity to be continuously assessed, allowing changes in psychomotor activity to be monitored over time. A randomised, parallel-group, double-blind study was conducted in 14 general practice patients with a diagnosis of major depression. This pilot study was designed to investigate the utility of actigraphy in this patient population and to investigate possible differences between fluoxetine and dothiepin in their effects on 24-hour behavioural activity monitored for the first 10 days of treatment. Patients taking dothiepin (75 mg rising to 150 mg in the second week, nocte) were found to be significantly (p &lt; 0.05) less active over the course of the day compared to those treated with fluoxetine (20 mg, mane). This lower level of behavioural activity in the dothiepin group was particularly noticeable in the early morning (06:00-08:00 h).

Research paper thumbnail of The future of sleep staging

Human Psychopharmacology-clinical and Experimental, 1996

... Research Article. The future of sleep staging. Neil Stanley. Article first published online: ... more ... Research Article. The future of sleep staging. Neil Stanley. Article first published online: 4 DEC 1998. ... First page of article. Get PDF (389K). More content like this. Find more content: like this article. Find more content written by: Neil Stanley. ...

Research paper thumbnail of Residual effects of zaleplon and zolpidem following middle of the night administration five hours to one hour before awakening

Human Psychopharmacology-clinical and Experimental, 2001

The objective was to assess residual effects of zaleplon and zolpidem after a middle of the night... more The objective was to assess residual effects of zaleplon and zolpidem after a middle of the night administration. This was a randomized, double-blind, placebo-controlled, crossover study, conducted in 40 healthy young male and female subjects. Subjects were awakened in the middle of the night and administered either placebo or zaleplon 10 or 20 mg or zolpidem 10 mg. A battery of objective tests exploring psychomotor and cognitive functions such as critical flicker fusion (CFF), choice reáction time (CRT), digit symbol substitution test (DSST), and memory tests (Sternberg memory scanning and a word list) were administered immediately after morning waking. Zaleplon 10 mg was devoid of residual effects whatever – the time of dosing – except a minimal but significant decrease in DSST scores when administered 1 h before awakening. Zaleplon 20 mg produced significant residual effects on performance (increase in CRT, and decrease in CFF threshold and in DSST scores) and memory (decrease in immediate and delayed free recall of words) only when administered 1 h before awakening. In contrast, zolpidem 10 mg produced significant detrimental residual effects on CRT and delayed free recall of words, when administered up to 5 h before waking, on DSST and Sternberg when administered up to 3 h before awakening and on CFF when administered 1 h before awakening. The residual effects of zolpidem 10 mg were more marked than those observed after zaleplon 20 mg. The present results demonstrate that zaleplon 10 mg has no or minimal residual effects when administered in the middle of the night as little as 1 h before waking. The lack of clinically significant residual effects with zaleplon may be explained by its unique pharmacokinetic (rapid elimination half-life) and pharmacodynamic (selective binding for GABAA receptors with the α1 subunit, dissociation between sleep inducing properties and impairment of cognitive functions) profiles. Copyright © 2001 John Wiley & Sons, Ltd.

Research paper thumbnail of Residual effects of zaleplon and zolpidem following middle of the night administration five hours to one hour before awakening

Human Psychopharmacology-clinical and Experimental, 2001

The objective was to assess residual effects of zaleplon and zolpidem after a middle of the night... more The objective was to assess residual effects of zaleplon and zolpidem after a middle of the night administration. This was a randomized, double-blind, placebo-controlled, crossover study, conducted in 40 healthy young male and female subjects. Subjects were awakened in the middle of the night and administered either placebo or zaleplon 10 or 20 mg or zolpidem 10 mg. A battery of objective tests exploring psychomotor and cognitive functions such as critical flicker fusion (CFF), choice reáction time (CRT), digit symbol substitution test (DSST), and memory tests (Sternberg memory scanning and a word list) were administered immediately after morning waking. Zaleplon 10 mg was devoid of residual effects whatever – the time of dosing – except a minimal but significant decrease in DSST scores when administered 1 h before awakening. Zaleplon 20 mg produced significant residual effects on performance (increase in CRT, and decrease in CFF threshold and in DSST scores) and memory (decrease in immediate and delayed free recall of words) only when administered 1 h before awakening. In contrast, zolpidem 10 mg produced significant detrimental residual effects on CRT and delayed free recall of words, when administered up to 5 h before waking, on DSST and Sternberg when administered up to 3 h before awakening and on CFF when administered 1 h before awakening. The residual effects of zolpidem 10 mg were more marked than those observed after zaleplon 20 mg. The present results demonstrate that zaleplon 10 mg has no or minimal residual effects when administered in the middle of the night as little as 1 h before waking. The lack of clinically significant residual effects with zaleplon may be explained by its unique pharmacokinetic (rapid elimination half-life) and pharmacodynamic (selective binding for GABAA receptors with the α1 subunit, dissociation between sleep inducing properties and impairment of cognitive functions) profiles. Copyright © 2001 John Wiley & Sons, Ltd.

Research paper thumbnail of Effects of Fluoxetine and Dothiepin on 24Hour Activity in Depressed Patients

Neuropsychobiology, 1999

Psychomotor retardation is a recognised symptom of depressive illness, and improvement in psychom... more Psychomotor retardation is a recognised symptom of depressive illness, and improvement in psychomotor function is associated with the amelioration of the severity of depressive symptoms. Actigraphy permits behavioural activity to be continuously assessed, allowing changes in psychomotor activity to be monitored over time. A randomised, parallel-group, double-blind study was conducted in 14 general practice patients with a diagnosis of major depression. This pilot study was designed to investigate the utility of actigraphy in this patient population and to investigate possible differences between fluoxetine and dothiepin in their effects on 24-hour behavioural activity monitored for the first 10 days of treatment. Patients taking dothiepin (75 mg rising to 150 mg in the second week, nocte) were found to be significantly (p &lt; 0.05) less active over the course of the day compared to those treated with fluoxetine (20 mg, mane). This lower level of behavioural activity in the dothiepin group was particularly noticeable in the early morning (06:00-08:00 h).

Research paper thumbnail of Benzodiazepine-induced reduction in activity mirrors decrements in cognitive and psychomotor performance

Human Psychopharmacology-clinical and Experimental, 2008

ObjectiveTo assess whether actigraphy is sensitive to benzodiazepine-induced changes in cognitive... more ObjectiveTo assess whether actigraphy is sensitive to benzodiazepine-induced changes in cognitive and psychomotor performance and sleep.To assess whether actigraphy is sensitive to benzodiazepine-induced changes in cognitive and psychomotor performance and sleep.MethodsHealthy young volunteers (n = 23; 11 males), were randomised to a double-blind, placebo-controlled, crossover trial. Actigraphy was used to record motor activity continuously. Following dosing at 18.00 h with 2.5 mg lorazepam (LZP), psychomotor and cognitive assessments were made at hourly intervals post-dose for 4 h and after sleep at 14.5 h post-dose.Healthy young volunteers (n = 23; 11 males), were randomised to a double-blind, placebo-controlled, crossover trial. Actigraphy was used to record motor activity continuously. Following dosing at 18.00 h with 2.5 mg lorazepam (LZP), psychomotor and cognitive assessments were made at hourly intervals post-dose for 4 h and after sleep at 14.5 h post-dose.ResultsActivity levels were significantly reduced after LZP for 5 h post-dose (p = 0.0104), during sleep (5–13 h) (p < 0.02) and the following morning, 13–14.5 h post-dose (p < 0.02). At the same time cognitive and psychomotor performance was also significantly impaired (p < 0.05). LZP also significantly increased actigraphic sleep efficiency and sleep per cent (p < 0.02).Activity levels were significantly reduced after LZP for 5 h post-dose (p = 0.0104), during sleep (5–13 h) (p < 0.02) and the following morning, 13–14.5 h post-dose (p < 0.02). At the same time cognitive and psychomotor performance was also significantly impaired (p < 0.05). LZP also significantly increased actigraphic sleep efficiency and sleep per cent (p < 0.02).ConclusionThis study showed that activity levels were significantly reduced following dosing with a benzodiazepine and these changes coincided with impairment of cognitive and psychomotor performance. Actigraphy, therefore, appears to be able to reflect the psychopharmacological effects of a benzodiazepine in changes in daytime function and nocturnal behaviour, which, without waking the subject, is beyond the power of conventional psychometrics. Copyright © 2008 John Wiley & Sons, Ltd.This study showed that activity levels were significantly reduced following dosing with a benzodiazepine and these changes coincided with impairment of cognitive and psychomotor performance. Actigraphy, therefore, appears to be able to reflect the psychopharmacological effects of a benzodiazepine in changes in daytime function and nocturnal behaviour, which, without waking the subject, is beyond the power of conventional psychometrics. Copyright © 2008 John Wiley & Sons, Ltd.

Research paper thumbnail of The future of sleep staging

Human Psychopharmacology: Clinical and Experimental, 1996

... Research Article. The future of sleep staging. Neil Stanley. Article first published online: ... more ... Research Article. The future of sleep staging. Neil Stanley. Article first published online: 4 DEC 1998. ... First page of article. Get PDF (389K). More content like this. Find more content: like this article. Find more content written by: Neil Stanley. ...

Research paper thumbnail of The future of sleep staging

Human Psychopharmacology: Clinical and Experimental, 1996

... Research Article. The future of sleep staging. Neil Stanley. Article first published online: ... more ... Research Article. The future of sleep staging. Neil Stanley. Article first published online: 4 DEC 1998. ... First page of article. Get PDF (389K). More content like this. Find more content: like this article. Find more content written by: Neil Stanley. ...

Research paper thumbnail of Exploring the Interdependence of Couples' Rest‐Wake Cycles: An Actigraphic Study

Chronobiology International, 2009

Within western societies, it is commonplace for couples to share a bed. Yet there has been remark... more Within western societies, it is commonplace for couples to share a bed. Yet there has been remarkably little research carried out on couples&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; sleep. This paper draws upon actigraphy, audio diary, and questionnaire data from both partners of 36 heterosexual couples (age 20-59 yrs) and aims to quantify the extent to which it is important to take into account the dyadic nature of sleep-wake cycles. It achieves this through two interrelated aims: to use hierarchical linear models to measure dyadic interdependence in actigraphically recorded variables, and to investigate how much of this dyadic interdependence truly results from couple dynamics. The variables with the most significant couple interdependency were actual bed time, sleep latency, light/dark ratio, and wake bouts. The paper concludes by suggesting that interdependence may be the defining feature of couples&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; sleep, and that we need to employ analytic approaches that both acknowledge this and are sensitive to the possibilities that not all aspects of sleep will behave in the same way.

Research paper thumbnail of Sleep profiles and mood States during an expedition to the South Pole

Wilderness & Environmental Medicine, 2007

Objectives: To investigate sleep parameters and mood profiles of a female explorer traveling solo... more Objectives: To investigate sleep parameters and mood profiles of a female explorer traveling solo and unaided to the South Pole during the winter. Methods: During the 44-day expedition, global activity and sleep were assessed using a wrist actigraph (AW) worn on the non-dominant wrist. Mood was assessed using an adapted Profile of Mood States questionnaire. Pre-and post-expedition physiological profiles were conducted to assess body composition, strength and power and aerobic capacity. Results: The AW data revealed decreasing sleep duration throughout the expedition, with an average sleep time of 5 hours (range: 8hr 14mins -1hr 42mins), with sleep times consistently below 3 hours during the final third of the expedition. Mood responses indicated a progressive reduction in vigour and increase in fatigue. Sleep time was positively related to vigour and inversely related to depression and fatigue, a finding that is consistent with the notion that positive feelings (high vigour and low fatigue) are linked with sleep. Conclusions: This account provides insight to help understand the limits of human tolerance and may be directly applicable when planning future expeditions of this nature.

Research paper thumbnail of A Double-Blind, Randomized, 26Week Study Comparing the Cognitive and Psychomotor Effects and Efficacy of 75 mg (37.5 mg b.i.d.) Venlafaxine and 75 mg (25 mg Mane, 50 mg Nocte) Dothiepin in Elderly Patients with Moderate Major Depression Being Treated in General Practice

Journal of Psychopharmacology, 2004

To investigate the efficacy and cognitive and psychomotor effects of venlafaxine and dothiepin in... more To investigate the efficacy and cognitive and psychomotor effects of venlafaxine and dothiepin in elderly patients with moderate major depression. A prospective, randomized, double-blind, parallel-group, active comparator controlled study was conducted. Eighty-eight patients (aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 60 years) were enrolled. Each patient received either venlafaxine (immediate release formulation) 37.5 mg twice per day or dothiepin 25 mg mane followed by 50 mg nocte for 26 weeks. Efficacy was assessed with the Montgomery-Asberg Depression Rating Scale and the Hamilton Depression Rating Scale. A psychometric test battery to assess cognitive function, activities of daily living and sleep consisted of Critical Flicker Fusion (CFF), Short-term Memory--Kim&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Game, Cognitive Failures Questionnaire, Milford Epworth Sleepiness Scale, Leeds Sleep Evaluation Questionnaire, and an Accident Scoring Questionnaire. Quality of Life Questionnaires (Short Form 36 and Quality of Life in Depression Scale) were also administered. Venlafaxine significantly (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) raised CFF scores compared to baseline but had no effect on any other measure. Dothiepin significantly (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) lowered CFF threshold, and increased ratings of both sedation and difficulty in waking. The results showed that venlafaxine at doses of 37.5 mg b.i.d. in elderly depressed patients is free from disruptive effects on cognitive function and psychomotor performance.