Pierre A Beitinger

Max Planck Institute of Psychiatry, München, Bavaria, Germany

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Publications (22)52.34 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: Until recently, neuroscience has given sleep research and discovery of better treatments of sleep disturbances little attention, despite disturbed sleep has overwhelming impact on human health. Sleep is a complex phenomenon in which specific psychological, electrophysiological, neurochemical, endocrinological, immunological and genetic factors are involved. The brain as both the generator and main object of sleep is obviously of particular interest, which makes a neuroscience-driven view the most promising approach to evaluate clinical implications and applications of sleep research. Polysomnography as the gold standard of sleep research, complemented by brain imaging, neuroendocrine testing, genomics and other laboratory measures can help to create composite biomarkers that allow to maximize the effects of individualized therapies while minimizing adverse effects. Here we review the current state of the neuroscience of sleep, sleep disorders and sleep therapeutics and will give some leads to promote the discovery and development of sleep medicines that are better than those we have today.
    Pharmacology [?] Therapeutics 11/2013; · 7.79 Impact Factor
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    ABSTRACT: In a retrospective cohort study undertaken in 12 European countries, 249 female narcoleptic patients with cataplexy (n = 216) and without cataplexy (n = 33) completed a self-administrated questionnaire regarding pregnancy and childbirth. The cohort was divided further into patients whose symptoms of narcolepsy started before or during pregnancy (308 pregnancies) and those in whom the first symptoms of narcolepsy appeared after delivery (106 pregnancies). Patients with narcolepsy during pregnancy were older during their first pregnancy (P < 0.001) and had a higher body mass index (BMI) prior to pregnancy (P < 0.01). Weight gain during pregnancy was higher in narcoleptic patients with cataplexy (P < 0.01). More patients with narcolepsy-cataplexy during pregnancy had impaired glucose metabolism and anaemia. Three patients experienced cataplexy during delivery. The rate of caesarean sections was higher in the narcolepsy-cataplexy group compared to the narcolepsy group (P < 0.05). The mean birth weight and gestational age of neonates were within the normal range and did not differ across groups. Neonatal care was affected adversely by symptoms of narcolepsy in 60.1% of those with narcolepsy during pregnancy. This study reports more obstetric complications in patients with narcolepsy-cataplexy during pregnancy; however, these were not severe. This group also had a higher BMI and higher incidence of impaired glucose metabolism during pregnancy. Caesarian section was conducted more frequently in narcolepsy-cataplexy patients, despite cataplexy being a rare event during delivery. Furthermore, symptoms of narcolepsy may render care of the infant more difficult.
    Journal of Sleep Research 04/2013; · 3.04 Impact Factor
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    ABSTRACT: Obesity is a common feature of narcolepsy. In addition, an increased occurrence of non-insulin dependent diabetes has been reported. So far, it is not known whether glucose metabolism in narcolepsy is disturbed due to, or independently of obesity. Case-control study. Sleep medicine clinic at a research institute. We studied 17 patients with narcolepsy/cataplexy compared to 17 healthy controls matched for age, sex, and body mass index (BMI). A 75-g oral glucose tolerance test was performed. Glucose tolerance was determined by computing plasma glucose curve following oral glucose challenge for 240 minutes; insulin sensitivity and insulin secretion by homeostasis model assessment and minimal model analysis. Standard outcome measures and indices of the oral glucose tolerance test did not differ between the patient group and the group of control subjects. In this study, no clinically relevant pathologic findings in the glucose metabolism of narcoleptic patients compared to weight matched controls were found. Thus, narcolepsy is unlikely to be a risk factor per se for impaired glucose tolerance or diabetes.
    Sleep 02/2012; 35(2):231-6. · 5.10 Impact Factor
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    ABSTRACT: Recent epidemiological and experimental data suggest a negative influence of shortened or disturbed night sleep on glucose tolerance. Due to the high prevalence of sleep disorders this might be a major health issue. However, no comparative studies of carbohydrate metabolism have been conducted in clinical sleep disorders. We performed oral glucose tolerance tests (OGTT) and assessed additional parameters of carbohydrate metabolism in patients suffering from obstructive sleep apnea syndrome (OSAS, N = 25), restless legs syndrome (RLS, N = 18) or primary insomnia (N = 21), and in healthy controls (N = 33). Compared to controls, increased rates of impaired glucose tolerance were found in OSAS (OR: 4.9) and RLS (OR: 4.7) patients, but not in primary insomnia patients (OR: 1.6). In addition, HbA1c values were significantly increased in the same two patient groups. Significant positive correlations were found between 2-h plasma glucose values measured during the OGTT and the apnea-arousal-index in OSAS (r = 0.56; p<0.05) and the periodic leg movement-arousal-index in RLS (r = 0.56, p<0.05), respectively. Sleep duration and other quantitative aspects of sleep were similar between patient groups. Our findings suggest that some, but not all sleep disorders considerably compromise glucose metabolism. Repeated arousals during sleep might be a pivotal causative factor deserving further experimental investigations to reveal potential novel targets for the prevention of metabolic diseases.
    PLoS ONE 01/2010; 5(3):e9444. · 3.73 Impact Factor
  • PLoS ONE, v.5 (2010). 01/2010;
  • M.A. Dalal, R. Wehrle, P.A. Beitinger, T.C. Wetter
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    ABSTRACT: Hypersomnia is known to be associated with symptoms, such as excessive daytime sleepiness, headache, and decreases in vigilance. We report for the first time a patient who initially presented with symptoms for idiopathic hypersomnia but after a thorough diagnostic evaluation was diagnosed as suffering from Lyme disease. This finding stresses the need to potentially include diagnostic tools, like lumbar puncture, in diagnostic procedures, in order to rule out inflammatory diseases of the central nervous system mimicking hypersomnia symptoms. Hypersomnie geht häufig mit Symptomen wie Tagesschläfrigkeit, Kopfschmerzen und Abnahme der Vigilanz einher. Hier wird erstmals über eine Patientin berichtet, bei der Symptome wie bei einer idiopathischen Hypersomnie vorlagen, die sich aber nach genauer diagnostischer Abklärung als Neuroborreliose herausstellten. Dies unterstreicht die Notwendigkeit, ggf. auch diagnostische Maßnahmen wie eine Lumbalpunktion durchzuführen, um entzündliche Erkrankungen des Zentralnervensystems, welche die Symptome der Hypersomnie imitieren können, auszuschließen. KeywordsLyme borreliosis-Hypersomnia-Polysomnogram-Lyme disease-Lumbar puncture SchlüsselwörterNeuroborreliose-Hypersomnie-Polysomnographie-Lumbalpunktion
    Somnologie - Schlafforschung und Schlafmedizin 01/2010; 14(1):67-69.
  • 01/2010;
  • M. A. Dalal, R. Wehrle, P. A. Beitinger, T. C. Wetter
    Somnologie - Schlafforschung und Schlafmedizin 01/2010; 14(1):67-69.
  • Pharmacopsychiatry, v.42, 211-211 (2009). 01/2009;
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    ABSTRACT: We have developed and validated the Munich Parasomnia Screening (MUPS) questionnaire, a self-rating instrument with 21 items assessing the lifetime prevalence and current frequency of parasomnias and nocturnal behaviors in adult persons. The MUPS was developed with psychiatric patients (total n = 74). For the validation study the MUPS was given to three large groups, i.e. psychiatric patients (n = 65), sleep-disordered patients (n = 50), and healthy controls (n = 65). In a randomly chosen subset of 20 % of these subjects the MUPS was compared to the information obtained in a detailed clinical interview with a sleep medicine expert. Validity was assessed for lifetime prevalence of any frequency for each of the 21 nocturnal behaviors. For the individual items of the MUPS sensitivity was equal to or above 90 % for all but two of 21 items and specificity was above 80 % for all items and above 90 % for 19 of 21 items. More importantly, concerning the use of the MUPS in clinical practice, positive and negative predictive values of the single items were high for the majority of items. The MUPS appears to be an easy to use and valid instrument in the recognition of nocturnal behaviors and parasomnias. Ziel dieser Studie war die Entwicklung und Validierung eines Screeninginstrumentes zur Erfassung der Lebenszeitprävalenz und Häufigkeit von Parasomnien und nächtlichen Verhaltensweisen (Münchner Parasomnie-Screening – MUPS). Bei diesem Fragebogen handelt es sich um ein Selbstbeurteilungsinventar für Erwachsene, das 21 Merkmale umfasst. Die Entwicklung des MUPS wurde an Patienten mit psychiatrischen Störungen (Gesamtanzahl: n = 74) durchgeführt. Die Validierung erfolgte bei drei Gruppen: Patienten mit psychiatrischen Störungen (n = 65), Patienten mit Schlafstörungen (n = 50) sowie gesunden Personen (n = 65). In einer zufällig ausgewählten Stichprobe von 20 % aller Befragten wurde der MUPS mit den Ergebnissen eines ausführlichen klinischen Interviews, das von einem schlafmedizinischen Experten durchgeführt wurde, verglichen. Die Validität wurde für jede der 21 erfassten nächtlichen Verhaltensweisen hinsichtlich der Lebenszeitprävalenz bestimmt. Die Sensitivität war bei 19 von 21 Merkmalen größer oder gleich 90 %, die Spezifität war für alle Items größer als 80 % bzw. für 19 von 21 Items größer als 90 %. Von noch größerer Bedeutung im Hinblick auf die Verwendung des MUPS in der schlafmedizinischen Praxis ist es, dass der positive und negative prädiktive Wert für die Mehrzahl der Items hoch war. Zusammenfassend ist der MUPS ein valides und einfach anwendbares Screeninginstrument zur Erfassung von Parasomnien und nächtlichen Verhaltensweisen.
    Somnologie - Schlafforschung und Schlafmedizin 01/2008; 12(1):56-65.
  • Pharmacopsychiatry 01/2007; 40(05). · 2.11 Impact Factor
  • Pharmacopsychiatry 01/2007; 40(05). · 2.11 Impact Factor
  • Pharmacopsychiatry 01/2007; 40(05). · 2.11 Impact Factor
  • Sleep Medicine - SLEEP MED. 01/2007; 8.
  • Experimental and Clinical Endocrinology & Diabetes - EXP CLIN ENDOCRINOL DIABETES. 01/2007; 115.
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    ABSTRACT: Narcolepsy is a disabling sleep disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis. Recent studies suggest that the immune system might play a pathogenic role pointing to a possible involvement of inflammatory cytokines. We investigated a sample of 30 patients with narcolepsy in comparison with 120 sex- and age-matched and 101 sex-, body mass index (BMI)-, and age-matched randomly selected normal controls. In these groups, plasma concentrations of tumor necrosis factor alpha (TNF-alpha) and its soluble receptors p55 and p75 (soluble TNF receptor [sTNF-R] p55 and sTNF-R p75) were measured using commercial enzyme-linked immunosorbent assays. The narcoleptic patients showed a significantly higher BMI compared with controls of the same age. Soluble TNF-R p75 levels were consistently elevated in the narcoleptic patients compared with their sex- and age-matched (P = .001) as well as sex-, BMI-, and age-matched counterparts (P = .003). Female narcoleptic patients exhibited higher sTNF-R p55 levels compared with their sex- and age-matched controls (P = .01), but this difference disappeared when comparing patients with sex-, BMI-, and age-matched normal controls. Tumor necrosis factor alpha levels did not differ significantly between groups. Narcoleptic patients show increased plasma levels of sTNF-R p75, suggesting a functional alteration of the TNF-alpha cytokine system, further corroborating a possible pathogenic role of the immune system in this sleep disorder.
    Archives of Internal Medicine 10/2006; 166(16):1739-43. · 11.46 Impact Factor
  • P A Beitinger, T Kirmeier, T Bronisch, T C Wetter
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    ABSTRACT: Carbamazepine is effective in the treatment of acute mania and in the prevention of episodes in bipolar disorder, and it may also be useful in depression, impulse-control disorder and withdrawal from alcohol and benzodiazepine dependence. A potentially life-threatening side effect is the anticonvulsant hypersensitivity syndrome. Here, we describe a patient who developed severe auditory hallucinations followed by a distinct hypersensitivity syndrome most likely induced by carbamazepine treatment.
    Pharmacopsychiatry 10/2006; 39(5):192-3. · 2.11 Impact Factor
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    ABSTRACT: Recent findings suggest an important role of subtle changes in the plasma levels of inflammatory cytokines within the brain-immune interplay. It is unclear how such changes are regulated in the absence of acute inflammatory or infectious stimuli. Endocrine systems are a good candidate, because innate immunity and the hypothalamo-pituitary-adrenal (HPA)-system are closely related: glucocorticoids have immunosuppressive properties and modulate cytokine release from stimulated mononuclear blood cells in vitro and the immune response in vivo, but it still remains unclear, whether they also modulate circulating cytokine levels in the absence of immunological stimuli. We measured the influence of 1.5 or 3.0 mg dexamethasone (DEX) per os at 09:00 or 21:00 hours on body temperature, cortisol plasma levels, differential white blood cell counts, and cytokine plasma levels in 40 healthy male volunteers using a double-blind, placebo-controlled study design. In addition to significant morning-evening differences in tympanic temperature and several immune parameters, we found that DEX-intake significantly increased tympanic temperature, decreased cortisol plasma levels, altered differential white blood cell counts and induced changes in unstimulated plasma cytokine levels. Whereas the levels of TNF-alpha and sTNF-R p75 were reduced, the levels of sTNF-R p55 increased after a transient decrease.
    Experimental and Clinical Endocrinology & Diabetes 07/2006; 114(6):322-8. · 1.56 Impact Factor
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    Diabetes Care 02/2006; 29(1):170. · 7.74 Impact Factor
  • P. A. Beitinger, R. Beitinger, S. Fulda, T. C. Wetter
    01/2006;