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Sleep Disorders Center (Drs. Guilleminault, Miles, and van den Hoed) and the Nancy Pritzker Laboratory of Behavioral Neurochemistry (Dr. Faull), Stanford University Medical Center, Stanford University School of Medicine, Stanford. CA.
Twenty patients complaining of excessive daytime somnolence (EDS) secondary to significant head trauma were studied objectively. Several polygraphic recording protocols were performed over the 12-year study period. Eighteen of the 20 patients were objectively sleepy, 8 of them presented mixed sleep apnea syndrome that fragmented their sleep, 5 patients' sleep-related breathing problems improved over time, 9 patients presented daytime somnolence, and 1 reported abrupt bouts of muscle weakness and had two sleep onset rapid eye movement (REM) periods during daytime testing. Cerebrospinal fluid analysis for specific neurotransmitter metabolites' evaluation, pre- and postprobenecid, did not differentiate posttraumatic EDS patients from narcoleptics or other patients with EDS. Two patients (one with organic brain syndrome, the other depressed) reported subjective sleepiness, not confirmed by objective data. Objective testing in posttraumatic sleepiness is recommended because of the plurality of problems and medicolegal implications.
Address correspondence and reprint requests to Dr. Guilleminault, Sleep Disorders Center, Stanford University School of Medicine, Stanford, CA 94305.
This research was performed with support from Public Health Service Grant R-R 82 from the General Clinical Research Centers, from a fellowship from Société Médicale des Hôpitaux de Paris (1971), and from INSERM to Christian Guilleminault.
Accepted for publication March 22, 1983.
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