In the present study we investigated the effects of school starting time on daytime behavior and sleep. Eight-hundred and eleven 5th grade pupils (10-12 years old) from 28 classes in 18 schools throughout Israel were divided into "early risers" (N = 232) who started school at 07:10 (42%) at least 2 times a week, and "regular risers" (N = 340) who always started school at 08:00 (58%). The remaining 239 pupils started school between 7:20 and 07:55 (and also after 08:00), and were not included in the study. Self-administered questionnaires concerning sleep habits during school days, weekends, and holidays, daytime fatigue, sleepiness, and difficulties concentrating and paying attention in school were completed by all children. Mean sleep time of the "early risers" was significantly shorter than that of the "regular risers." Early risers complained significantly more about daytime fatigue and sleepiness, and about attention and concentration difficulties in school. Their complaints were independent of the reported hours of sleep. We conclude that early starting of school negatively affects total sleep time and, as a consequence, has a negative effect on daytime behavior. The implications of these findings to the ongoing controversy concerning sleep need in contemporary society are discussed.

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A boy referred at the age of 4 years because of obesity and under observation for 16 years, was found to be suffering from a hypothalamic syndrome of unknown origin characterized by progressive obesity, polyphagia, deficiency of growth and thyroid hormone, hyperprolactinemia, hypodipsia, hypernatremia and hyperosmolality without diabetes insipidus. At ages 11 and 16 there were 3 day episodes of spontaneous muscular weakness, hypersomnolence and hypothermia associated with central sleep apnea and severe bradycardia. Subsequently, decreased ventilatory responsiveness to carbon dioxide (CO2) was found as a consequence of blunted neural drive. Therapy with clomipramine HCl (AnafranilR Ciba-Geigy) for 6 months led to a normalization of serum sodium levels, pulse rate, ventilatory response to dioxide with no recurrence of the central apnea within 4 following years.

Background: There is accumulated evidence that plasma concentration of the sulfur-containing amino-acid homocysteine (Hcy) is a prognostic marker for cardiovascular morbidity and mortality. Both fasting levels of Hcy and post methionine loading levels are used as prognostic markers. The aim of the present study was to investigate the existence of a daily rhythm in plasma Hcy under strictly controlled nutritional and sleep-wake conditions. We also investigated if the time during which methionine loading is performed, i.e., morning or evening, had a different effect on the resultant plasma Hcy concentration.

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