Skip to main content
SpringerLink
Log in

Sleep and Hypnotic Drugs

  • Review Article
  • Published:
Drugs Aims and scope Submit manuscript

Summary

In recent years the effectiveness of hypnotic drugs has had to be assessed in terms of a greatly increased knowledge of the physiology and pathology of sleep. The normal pattern of sleep and wakefulness involves a cyclic alternation between three rather than two basically dissimilar states of the brain and body — alert wakefulness, rapid-eye-movement (REM) sleep and non-rapid-eye-movement (NREM) sleep. The pattern of this alternation in individual people results from the interaction of many influences — biological (including genetic, early developmental and later degenerative influences), psychological, social and environmental factors, various physical and psychiatric disorders, and most drugs which affect the central nervous system. The quality of sleep is not related in any simple or constant manner either to its duration or to the proportions of time spent in each stage of sleep. Among the disorders of sleep, insomnia is a far more common problem of medical management than are enuresis, narcolepsy, somnambulism or nightmares.

With a few exceptions, most hypnotic drugs now in widespread use cease to be effective in treating insomnia after the first few nights. However, the ineffective treatment is often continued because insomnia will be even worse during the initial period of drug withdrawal. These factors and the toxicity of hypnotic drugs when taken in overdose make the long-term treatment of insomnia more difficult than was previously supposed. Barbiturates should no longer be prescribed. Some of the non-barbiturates, such as glutethimide and methaqualone, have no advantage over the barbiturates. The benzodiazepine hypnotics, nitrazepam and flurazepam, are less toxic in overdose and are relatively effective in treating insomnia. Chloral hydrate and its derivatives are useful alternative drugs for short-term use. Measures to improve sleep without drugs deserve greater emphasis than they have had in the past.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Agnew, H.W., Webb, W.B. and Williams, R.L.: Comparison of stage four and 1-REM sleep deprivation. Perceptual and Motor Skills 24: 851–858 (1967).

    Article  PubMed  Google Scholar 

  • Akimoto, H., Honda, Y. and Takahashi, Y.: Pharmacotherapy in narcolepsy. Diseases of the Nervous System 21: 704–706 (1960).

    PubMed  CAS  Google Scholar 

  • Algeri, E.J., Katsas, G.G., Luongo, M.A.: Determination of ethchlorvynol in biologic mediums and report of two fatal cases. American Journal of Clinical Pathology 38: 125–130 (1962).

    PubMed  CAS  Google Scholar 

  • Aserinsky, E. and Kleitman, N.: Regularly occurring periods of eye motility, and concomitant phenomena, during sleep. Science 118: 273–274 (1953).

    Article  PubMed  CAS  Google Scholar 

  • Bare, W.W. and Pepino, A.T.: A new tablet form of chloral hydrate (WM-1127) in the treatment of insomnia in the aged. American Geriatric Society Journal 9: 686–693 (1961).

    Google Scholar 

  • Barraclough, B.M.: Are there safer hypnotics than barbiturates? Lancet 1: 57–58 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Baxter, B.L. and Gluckman, M.I.: Iprindole — An antidepressant which does not block REM sleep. Nature 223: 750–752 (1969).

    Article  PubMed  CAS  Google Scholar 

  • Bergamasco, B., Bergcmini, L., Doriguzzi, T. and Fabiani, D.: EEG sleep patterns as a prognostic criterion in post-traumatic coma. Electroencephalography and Clinical Neurophysiology 24: 374–377 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Bieger, R., de Jonge, H. and Loelinger, E.A.: Influence of nitrazepam on oral anticoagulation with phenprocoumon. Clinical Pharmacology and Therapeutics 75: 361–365 (1972).

    Google Scholar 

  • Bond, A.J. and Lader, M.H.: Residual effects of hypnotics. Psychopharmacologia 25: 117–132 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Březinová, V. and Oswald, I.: Sleep after a bedtime beverage. Brit. med. J. 2: 431–433 (1972).

    Article  PubMed  Google Scholar 

  • Broughton, R.J.: Sleep disorders: Disorders of arousal? Science 159: 1070–1078 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Clift, A.D.: Factors leading to dependence on hypnotic drugs. British Medical Journal 3: 614–617 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Commonwealth Director General of Health: Annual report 1968–1969, Canberra (1969).

  • Darcy, L.: Delirium tremens following withdrawal of nitrazepam. Med. J. Aust. 2: 450 (1972).

    PubMed  CAS  Google Scholar 

  • Dement, W.: The effect of dream deprivation. Science 131: 1705–1707 (1960).

    Article  PubMed  CAS  Google Scholar 

  • Dement, W. and Kleitman, N.: Cyclic variation in EEG during sleep and their relation to eye movements, body motility, and dreaming. Electroencephalography and Clinical Neurophysiology 9: 673–690 (1957).

    Article  PubMed  CAS  Google Scholar 

  • de Silva, J.A.F., Koechlin, B.A. and Bader, G.: Blood level distribution patterns of diazepam and its major metabolite in man. Journal of Pharmaceutical Sciences 55: 692–702 (1966).

    Article  PubMed  Google Scholar 

  • Detre, T.: Sleep disorder and psychosis. Journal of the Canadian Psychiatric Association 11 (Suppl.): S169 (1966).

    Google Scholar 

  • Dunleavy, D.L.F. and Oswald, I.: Phenelzine, mood response, and sleep. Archives of General Psychiatry 28: 353–356 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Dunlop, D.: The use and abuse of psychotropic drugs. Proceedings of the Royal Society of Medicine 63: 19–21 (1970).

    Google Scholar 

  • Empson, J.A.C.: Does electrosleep induce natural sleep? Electroencephalography and Clinical Neurophysiology 35: 663–664 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Evans, J.I. and Lewis, S.A.: Drug withdrawal state. An EEG sleep study. Archives of General Psychiatry 7. 9: 631–634 (1968).

    Article  Google Scholar 

  • Feinberg, I.: Sleep in organic brain conditions; in Kales. Sleep Physiology and Pathology, p. 131 (Lippincott, Philadelphia 1969).

    Google Scholar 

  • Feinberg, I. and Carlson, V.R.: Sleep variables as a function of age in man. Archives of General Psychiatry 18: 239–250 (1968).

    Article  Google Scholar 

  • Feinblatt, H.M.: A new tranquilizing soporific for insomnia. The value and safety of methapyrilene and scopolamine in combination. Journal of Gerontology 73: 48–51 (1958).

    Google Scholar 

  • Fend, V., Koski, G. and Pappenheimer, J.R.: Factors in cerebrospinal fluid from goats that affect sleep and activity in rats. Journal of Physiology 216: 565–569 (1971).

    Google Scholar 

  • Fisher, C.F., Kahn, E., Edwards, A. and Davis, D.M.: A psychophysiological study of nightmares and night terrors: The suppression of stage 4 night terrors with diazepam. Archives of General Psychiatry 28: 252–259 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Gastaut, H., Lob, H. and Papy, J.J.: Action of Mogadon on the stages of REM sleep. Electroencephalography and Clinical Neurophysiology 23: 288 (1967).

    PubMed  CAS  Google Scholar 

  • Goldstein, L., Stoltzfus, N.W. and Smith, R.R.: Analysis of the effects of methaqualone and glutethimide on sleep in insomniac subjects. Research Communications on Chemical Pathology and Pharmacology 2: 927–933 (1971).

    CAS  Google Scholar 

  • Greenberg, R., Pearlman, C., Fingar, R., Kantrowitz, J. and Kawliche, S.: The effects of dream deprivation: Implications fora theory of the psychological function of dreaming. British Journal of Medical Psychology 43: 1–11 (1970).

    Article  PubMed  CAS  Google Scholar 

  • Haider, I. and Oswald, I.: Effects of amylobarbitone and nitrazepam on the electrodermogram and other features ot sleep. British Journal of Psychiatry 776: 519–522 (1971).

    Article  Google Scholar 

  • Hartmann, E.: The Functions of Sleep (Yale University Press, New Haven 1973).

    Google Scholar 

  • Hartmann, E. and Cravens, J.: The effects of long term administration of psychotropic drugs on human sleep: V. The effects of chloral hydrate. Psychopharmacologia (Berl.) 33: 219–232 (1973a).

    Article  CAS  Google Scholar 

  • Hartmann, E. and Cravens, J.: The effects of long term administration of psychotropic drugs on human sleep: III. The effects of amitriptyline. Psychopharmacologia (Berl.) 33: 185–202 (1973b).

    Article  CAS  Google Scholar 

  • Hartmann, E. and Cravens, J.: The effects of long term administration of psychotropic drugs on human sleep: IV. The effects of chlorpromazine. Psychopharmacologia (Berl.) 33: 203–218 (1973c).

    Article  CAS  Google Scholar 

  • Hersen, M.: Personality characteristics of nightmare sufferers. Journal of Nervous and Mental Diseases 753: 27–31 (1971).

    Google Scholar 

  • Isbell, H. and Chrusciel, T.J.: Dependence liability of ‘non-narcotic’ drugs. Bulletin of World Health Organization 43 (Suppl.): 49 (1970).

    Google Scholar 

  • Johns, M.W.: Methods for assessing human sleep. Archives of Internal Medicine 727: 484–492 (1971).

    Article  Google Scholar 

  • Johns, M.W.: Factor analysis of subjectively reported sleep habits and the nature of insomnia. Psychological Medicine (in press, 1974).

  • Johns, M.W., Bruce, D.W. and Masterton, J.P.: Psychological correlates of sleep habits reported by healthy young adults. British Journal of Medical Psychology 47: 181–187 (1974a).

    Article  PubMed  CAS  Google Scholar 

  • Johns, M.W., Eagan, P., Gay, T.J.A. and Masterton, J.P.: Sleep habits and symptoms in male medical and surgical patients. British Medical Journal 2: 509–512 (1970).

    Article  PubMed  CAS  Google Scholar 

  • Johns, M.W., Gay, T.J.A., Goodyear, M.D.E. and Masterton, J.P.: Sleep habits of healthy young adults: Use of a sleep questionnaire British Journal of Preventive and Social Medicine 25: 236–241 (1971a).

    PubMed  CAS  Google Scholar 

  • Johns, M.W., Gay, T.J.A.: Masterton, J.P. and Bruce, D.W.: Relationship between sleep habits, adrenocortical activity and personality. Psychosomatic Medicine 33: 499–508 (1971b).

    PubMed  CAS  Google Scholar 

  • Johns, M.W., Hepburn, M. and Goodyear, M.D.E.: Use of hypnotic drugs by hospital patients. Medical Journal of Australia 2: 1323–1327 (1971c).

    PubMed  CAS  Google Scholar 

  • Johns, M.W., Large, A.A., Masterton, J.P. and Dudley, H.A.F.: Sleep and delirium after open heart surgery. British Journal of Surgery 61: 477–381 (1974b).

    Article  Google Scholar 

  • Johns, M.W. and Masterton, J.P.: Effects of flurazepam on sleep in the laboratory. Pharmacology 77: 358–364 (1974).

    Article  Google Scholar 

  • Johnson, L.C.: Are stages of sleep related to waking behaviour? American Scientist 61: 326–338 (1973).

    PubMed  CAS  Google Scholar 

  • Johnson, L.C., Burdick. J.A. and Smith, J.: Sleep during alcohol intake and withdrawal in the chronic alcoholic. Archives of General Psychiatry 22: 406–418 (1970).

    Article  PubMed  CAS  Google Scholar 

  • Jones, H.S. and Oswald, I.: Two cases of healthy insomnia. Electroencephalography and Clinical Neurophysiology 24: 378 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Jouvet, M.: Neurophysiology of the states of sleep. Physiological Reviews 47: 117–177 (1967).

    PubMed  CAS  Google Scholar 

  • Jouvet, M.: Biogenic amines and the states of sleep. Science 163: 32–41 (1969).

    Article  PubMed  CAS  Google Scholar 

  • Kahn, M., Baker, B. and Weiss, J.M.: Treatment of insomnia by relaxation training. Journal of Abnormal Psychology 73: 556–558 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Kales, A.: Psychophysiological studies of insomnia. Annals of Internal Medicine 71: 625–629 (1969).

    Google Scholar 

  • Kales, A., Allen, C., Scharf, M.B. and Tan, T-L.: Hypnotic drugs and their effectiveness: All-night EEG studies of insomniac subjects. Archives of General Psychiatry 23: 226–232 (1970a).

    Article  PubMed  CAS  Google Scholar 

  • Kales, A., Bixler, E.O., Tan, T-L., Scharf, M.B. and Kales, J.D.: Chronic hypnotic use: Ineffectiveness. drug withdrawal insomnia and hypnotic drug dependence. Journal of the American Medical Association 227: 513–518 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Kales, A. and Kales, J.D.: Sleep disorders. New England Journal of Medicine 290: 487–499 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Kales, A., Kales, J.D., Scharf, M.B. and Tan. T-L.: Hypnotics and altered sleep-dream patterns. II. All-night EEG studies of chloral hydrate, flurazepam and methaqualone. Archives of General Psychiatry 23: 219–225 (1970b).

    Article  PubMed  CAS  Google Scholar 

  • Kales, A., Paulson, M.J., Jacobson, A. and Kales, J.D.: Somnambulism: Psychophysiological correlates. II. Psychiatric interviews, psychological testing and discussion. Archives of General Psychiatry 14: 595–604 (1966).

    Article  PubMed  CAS  Google Scholar 

  • Kales, A., Preston, T.A., Tan, T-L and Allen, C.: Hypnotics and altered sleep-dream patterns. I. Allnight EEG studies of glutethimide, methyprylon and pentobarbital. Archives of General Psychiatry 23: 211–218 (1970c).

    Article  PubMed  CAS  Google Scholar 

  • Kales, J.D.; Kales, A.; Bixler, E.O. and Slye, E.S.: Effects of placebo and flurazepam on sleep patterns in insomniac subjects. Clinical Pharmacology and Therapeutics 12: 691–697 (1971).

    PubMed  CAS  Google Scholar 

  • Karacan, I., Williams, R.L., Hunch, C.J., McCaulley, M. and Heine, M. W.: Some implications of the sleep patterns of pregnancy for postpartum emotional disturbances. British Journal of Psychiatry 115: 929–935 (1969a).

    Article  PubMed  CAS  Google Scholar 

  • Karacan, I., Williams, R.L., Littell, R.C. and Salis, P.J.: Insomniacs: Unpredictable and idiosyncratic sleepers; in Koella and Levin Sleep — Physiology, Biochemistry, Psychology, Pharmacology, Clinical Implications, p. 120 (Karger, Basel 1973).

    Google Scholar 

  • Karacan, I., Williams, R.L. and Taylor, W.J.: Sleep characteristics of patients with angina pectoris. Psychosomatics 10: 280–284 (1969b).

    PubMed  CAS  Google Scholar 

  • Karacan, I., Wolff, S.M., Williams, R.L., Hursch, C.J. and Webb, W.B.: The effect of fever on sleep and dream patterns. Psychosomatics 9: 331–339 (1968).

    PubMed  CAS  Google Scholar 

  • Katz, J.: Enuresis and encopresis. Medical Journal of Australia 1: 127–130 (1972).

    PubMed  CAS  Google Scholar 

  • Kay, D.C., Jasinski, D.R., Eisenstein, R.B. and Kelly, D.A.: Quantified human sleep after pentobarbital. Clinical Pharmacology and Therapeutics 13: 221–231 (1972).

    PubMed  CAS  Google Scholar 

  • King, C.D.: The pharmacology of rapid eye movement sleep. Advances in Pharmacology and Chemotherapeutics 9: 1–91 (1972).

    Article  Google Scholar 

  • Kleitman, N: Sleep and Wakefulness. 2nd Edition (University of Chicago Press, Chicago 1963).

    Google Scholar 

  • Kohler, W.C., Coddington, R.D. and Agnew, H.W.: Sleep patterns in 2-year-old children. Journal of Pediatrics 72: 228–233 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Krieger, D.T. and Glich, S.M.: Growth hormone and cortisol responsiveness in Cushing’s syndrome. American Journal of Medicine 52: 25–40 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Kupfer, D.J., Wyatt, R.J., Scott, J. and Snyder, F.: Sleep disturbance in acute schizophrenic patients. American Journal of Psychiatry 126: 1213–1223 (1970).

    PubMed  CAS  Google Scholar 

  • Lewis, S.A.: Comparative effects of some amphetamine derivatives on human sleep; in Costa and Garattini Amphetamines and Related Compounds, p.873 (Raven Press, New York 1970).

    Google Scholar 

  • Malpas, A., Legg, N.J. and Scott, D.F.: Effects of hypnotics on anxious patients. British Journal of Psychiatry 124: 482–484 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Matthew, H., Proudfoot, A.T., Aitken, R.C.B., Raeburn, J.A. and Wright, N: Nitrazepam — A safe hypnotic. Brit. med. J. 3: 23–25 (1969).

    Article  PubMed  CAS  Google Scholar 

  • Meddis, R., Pearson, A.J.D. and Langford, G.: An extreme case of healthy insomnia. Electroencephalography and Clinical Neurophysiology 35: 213–214 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Mendels, J. and Hawkins, D.R.: Sleep and depression. Archives of General Psychiatry 19: 445–452 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Miller, P.R., Champelli, J.W. and Dinello, F.A.: Imipramine in the treatment of enuretic school children: A double-blind study. American Journal of the Diseases of Childhood 115: 17–20 (1968).

    CAS  Google Scholar 

  • Naitoh, P., Pasnau, R.O. and Kollar, E.J.: Psychophysiological changes after prolonged deprivation of sleep. Biological Psychiatry 3: 309–320 (1971).

    PubMed  CAS  Google Scholar 

  • Nicolis, F.B. and Silvestri, L.G.: Hypnotic activity of placebo in relation to severity of insomnia: A quantitative evaluation. Clinical Pharmacology and Therapeutics 8: 841–848 (1967).

    PubMed  CAS  Google Scholar 

  • Nowlin, J.B., Troyer, W.G., Collins, S.W., Silverman, G., Nichols, C.R., McIntosh, H.D., Estes, E.H. and Bogdonoff, M.D.: The association of nocturnal angina pectoris with dreaming. Annals of Internal Medicine 63: 1040–1046 (1965).

    PubMed  CAS  Google Scholar 

  • Oliver, R.G. and Hetzel, B.S.: Rise and fall of suicide rates in Australia: Relation to sedative availability. Medical Journal of Australia 2: 919–923 (1972).

    PubMed  CAS  Google Scholar 

  • Orme, M., Breckenridge, A. and Brooks, R.V.: Interaction of benzodiazepines with warfarin. British Medical Journal 3: 611–614 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Oswald, I.: Drugs and sleep. Pharmacological Reviews 20: 273–303 (1968).

    PubMed  CAS  Google Scholar 

  • Oswald, I.: Sleep, the great restorer. New Scientist 46: 170–172 (1970).

    Google Scholar 

  • Oswald, I., Dunleavy, D.L.F. and Strong, J.A.: Hyperthyroidism and the sleeping brain. Hormones 3: 278–281 (1972).

    Google Scholar 

  • Oswald, I. and Priest, R.G.: Five weeks to escape the sleeping-pill habit. British Medical Journal 2: 1093–1095 (1965).

    Article  PubMed  CAS  Google Scholar 

  • Oswald, I., Taylor, A.M. and Treisman, M.: Discriminative responses to stimulation during human sleep. Brain 83: 440–453 (1960).

    Article  PubMed  CAS  Google Scholar 

  • Parish, P.A.: The prescribing of psychotropic drugs in general practice. Journal of the Royal College of General Practitioners 21 (Suppl.): 1 77 (1971).

  • Parsons, T.W. and Thomson, T.J.: Methaqualone as a hypnotic. British Medical Journal 1: 171–173 (1961).

    Article  PubMed  CAS  Google Scholar 

  • Przybyla, A.C. and Wang, DC: Locus of central depressant action of diazepam. Journal of Pharmacology and Experimental Therapeutics 163: 439–447 (1968).

    PubMed  CAS  Google Scholar 

  • Rechtschaffen, A. and Roth, B.: Nocturnal sleep of hypersomniacs. Activitas Nervosa Superior (Praha) 11: 229–233 (1969).

    CAS  Google Scholar 

  • Rechtschaffen, A., Verdone, P. and Wheaton, J.: Reports of mental activity during sleep. Archives of General Psychiatry 9: 536–547 (1963).

    Article  PubMed  CAS  Google Scholar 

  • Remmer, H: Tolerance to barbiturates by increased breakdown; in Steinberg Scientific Basis of Drug Dependence, p.111 (Churchill, London 1969).

    Google Scholar 

  • Rickels, K. and Bass, H.: A comparative, controlled clinical trial of seven hypnotic agents in medical and psychiatric in-patients. American Journal of Medical Science 245: 142–152 (1963).

    Article  CAS  Google Scholar 

  • Ridley, C.M.: Bullous lesions in nitrazepam overdose. British Medical Journal 3: 28 (1971).

    Article  PubMed  CAS  Google Scholar 

  • Robin, I.G: Snoring. Proceedings of the Royal Society of Medicine 61:37 (1968).

    Google Scholar 

  • Roffwarg, HP., Muzio, J.N. and Dement, W.C.: Ontogenetic development of the human sleepdream cycle. Science 152: 604–619 (1966).

    Article  PubMed  CAS  Google Scholar 

  • Rohmer, F., Kurtz, D., Feuerstein, J., Oberling, F. and Mehdaoui, M.: L’EEG de sommeil des cardiaques. Electroencephalography and Clinical Neurophysiology 22: 348–364 (1967).

    Article  PubMed  CAS  Google Scholar 

  • Rosenblatt, G., Hartmann, E. and Zwilling, G.R.: Cardiac irritability during sleep and dreaming. Journal of Psychosomatic Research 17: 129–134 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Rosenthal, S.H. and Wulfsohn, N.L.: Electrosleep — A clinical trial. American Journal of Psychiatry 127: 533–534 (1970).

    PubMed  CAS  Google Scholar 

  • Sagales, T., Erill, S. and Domino, E.F.: Differential effects of scopolamine and chlorpromazine on REM and NREM sleep in normal male subjects. Clinical Pharmacology and Therapeutics 10: 522–529 (1969).

    PubMed  CAS  Google Scholar 

  • Sambrooks, J.E., MacCulloch, M.J., Birtles, C.J. and Smallman, C.: Assessment of the effects of flurazepam and nitrazepam on visuo-motor performance using an automated assessment technique. Acta Psychiatrica Scandinavica 48: 443–454 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Shapiro, S., Stone, D., Lewis, G.P. and Jick, H.: Clinical effects of hypnotics. II. An epidemiologic study. Journal of the American Medical Association 209: 2016–2020 (1969).

    Article  PubMed  CAS  Google Scholar 

  • Sharpless, S.K.: Hypnotics and sedatives; in Goodman The pharmacological Basis of Therapeutics, 4th ed, p.98 (Macmillan, London 1970).

    Google Scholar 

  • Takahashi, S. and Gjessing, L.R.: Studies on periodic catatonia. III. Longitudinal sleep study with urinary excretion of catecholamines. Journal of Psychiatric Research 9: 123–139 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Taub, J.M. and Berger, R.J.: Performance and mood following variations in the length and timing of sleep. Psychophysiology 10: 559–570 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Thakkar, M.K and Lasser, R.P.: Scopolamine intoxication from non-prescription sleeping pill. New York State Journal of Medicine 12: 725–726 (1972).

    Google Scholar 

  • Torda, H.M.: Biochemical and bioelectric processes related to sleep, paradoxical sleep, and arousal. Psychological Reports 24: 807–824 (1969).

    Article  PubMed  CAS  Google Scholar 

  • Tune, G.S.: The influence of age and temperament on the adult human slsep-wakefulness pattern. British Journal of Psychology 60: 431–441 (1969).

    Article  PubMed  CAS  Google Scholar 

  • Vogel, G.W.: REM deprivation. III. Dreaming and psychosis. Archives of General Psychiatry 18: 312–329 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Ward, J.A.: Alterations of sleep patterns in psychiatric disorder. Canadian Psychiatric Association Journal 13: 249–257 (1968).

    PubMed  CAS  Google Scholar 

  • Webb, W.B.: Selective and partial deprivation of sleep; in Koella and Levin Sleep — Physiology, Biochemistry, Psychology, Pharmacology, Clinical Implications, p.176 (Karger, Basel 1973).

    Google Scholar 

  • Webb, W.B. and Agnew, H.W.: Measurement and characteristics of nocturnal sleep. Progress in Clinical Psychology 8: 2–27 (1968).

    Google Scholar 

  • Westerholm, B.: Consumption of psychotropic drugs in Sweden. Activitas Nervosa Superior (Praha) 15: 156–157 (1973).

    CAS  Google Scholar 

  • Wheeler, E.O. and White, P.D.: Insomnia due to left ventricular heart failure unrecognized as such and inadequately treated. Journal of the American Medical Association 129: 1158–1159 (1945).

    Article  PubMed  CAS  Google Scholar 

  • Whitlock, F.A.: The syndrome of barbiturate dependence. Medical Journal of Australia 2: 391–396 (1970).

    PubMed  CAS  Google Scholar 

  • Wilkinson, R.T.: Sleep deprivation; in Edholm The Physiology of Survival, p.39 (Academic Press, London 1965).

    Google Scholar 

  • Wilkinson, R.T.: Sleep deprivation: Performance tests for partial and selective sleep deprivation. Progress in Clinical Psychology 8: 28–43 (1968).

    Google Scholar 

  • Williams, E.S.: Sleep and wake fulness at high altitudes. British Medical Journal 1: 197–198 (1959).

    Article  PubMed  CAS  Google Scholar 

  • Wise, C.C., Berger, B.D. and Stein, L.: Benzodiazepines: Anxiety-reducing activity by reduction of serotonin turnover in the brain. Science 177: 180–183 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Woods, L.W., Tyce, F.A.J. and Bickford, R.G.: Electric sleep-producing devices, an evaluation using EEG monitoring. American Journal of Psychiatry 122: 153–158 (1965).

    PubMed  CAS  Google Scholar 

  • Wyatt, R.J., Fram, D.H., Buchbinder, R. and Snyder, F.: Treatment of intractable narcolepsy with monoamine oxidase inhibitor. New England Journal of medicine 285: 987–991 (1971a).

    Article  PubMed  CAS  Google Scholar 

  • Wyatt, R.J., Fram, D.H., Kupfer, DJ. and Snyder, F.: Total prolonged drug-induced REM sleep suppression in anxious-depressed patients. Archives of General Psychiatry 24: 144–155 (1971b).

    Google Scholar 

  • Yules, R.B., Freedman, D.K. and Oiandler, K.A.: The effect of ethyl alcohol on man’s electroencephalographic sleep cycle. Electroencephalography and Clinical Neurophysiology 20: 109–111 (1966).

    Article  PubMed  CAS  Google Scholar 

  • Zimmerman, W.B.: Sleep mentation and auditory awakening thresholds. Psychophysiology 6: 540 (1970).

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. MRC Environmental Physiology Research Unit (Annexe), London School of Hygiene and Tropical Medicine, 242 Pentonville Road, London, N1 9LB, England

    M. W. Johns

Authors
  1. M. W. Johns
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

See subject index in each issue for further indexing terms.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Johns, M.W. Sleep and Hypnotic Drugs. Drugs 9, 448–478 (1975). https://doi.org/10.2165/00003495-197509060-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-197509060-00004

Key Words

Search

Navigation