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ABBOUD FM: Neurocardiogenic syncope N Engl J Med 328:1117, 1993 ALMQUIST A, GOLDENBERG IF, MILSTEIN S, et al: Provocation of bradycardia and hypotension by isoproterenol and upright posture in patients with unexplained syncope N Engl J Med 320:346, 1989 BANNISTER R, MATHIAS W (eds): Autonomic Failure: A Textbook of Clinical Disorders of the Autonomic Nervous System, 4th ed New York, Oxford University Press, 1999 BECHIR M, BINGGELI C, CORTI R, et al: Dysfunctional barore ex regulation of sympathetic nerve activity in patients with vasovagal syncope Circulation 107:1620 1625, 2003 COMPTON D, HILL PM, SINCLAIR JD: Weight-lifters blackout Lancet 2: 1234, 1973 ENGEL GL: Fainting, 2nd ed Spring eld, IL, Charles C Thomas, 1962 FRANK JI, ROPPER AH, ZUNIGA G: Vasodepressor carotid sinus syncope associated with a neck mass Neurology 42:1194, 1992 GASTAUT H, FISCHER-WILLIAMS M: Electro-encephalographic study of syncope: Its differentiation from epilepsy Lancet 2:1018, 1957 GOLDSTEIN DS, HOLMES C, FRANK SM, et al: Cardiac sympathetic dysautonomia in chronic orthostatic intolerance syndromes Circulation 106: 2358 2365, 2002 JARISCH A, ZOTERMAN Y: Depressor re exes from the heart Acta Physiol Scand 16:31, 1948 KAPOOR WN: Evaluation and management of the patient with syncope JAMA 268:2553, 1992 KAPOOR WN, KARPF M, MAHER Y, et al: Syncope of unknown origin JAMA 247:2687, 1982 KAUFMANN H: Neurally mediated syncope: Pathogenesis, diagnosis, and treatment Neurology 45(suppl 5):s12, 1995 KONTOS HA, RICHARDSON DW, NORVELL JE: Norepinephrine depletion in idiopathic orthostatic hypotension Ann Intern Med 82:336, 1975 KOSINSKI D, GRUBB BP, TEMESY-ARMOS P: Pathophysiologic aspects of neurocardiogenic syncope: Current concepts and new perspectives PACE 18:716, 1995 LEVIN B, POSNER JB: Swallow syncope: Report of a case and review of the literature Neurology 22:1086, 1972 LEVINE RJ: Epidemic faintness and syncope in a school marching band JAMA 238:2373, 1977 LEWIS T: A lecture on vasovagal syncope and the carotid sinus mechanism BMJ 1:873, 1932 LINZER M, PRITCHETT ELC, PONTINEN M, et al: Incremental diagnostic yield of loop electrocardiographic recorders in unexplained syncope Am J Cardiol 66:214, 1990 LINZER M, VARIA I, PONTINEN M, et al: Medically unexplained syncope: Relationship to psychiatric illness Am J Med 92:185, 1992 LIPSITZ LA: Orthostatic hypotension in the elderly N Engl J Med 321:952, 1989 LIPSITZ LA: Syncope in the elderly Ann Intern Med 99:92, 1983 LOW PA, OPFER-GEHRKING TL, TEXTOR SC, et al: Postural tachycardia syndrome (POTS) Neurology 45(suppl 5):19, 1995 MACDONALD DR, STRONG E, NIELSEN S, POSNER JB: Syncope from head and neck cancer J Neurooncol 1:257, 1983 MANOLIS AS: The clinical spectrum and diagnosis of syncope Herz 18: 143, 1993 MARK AL: The Bezold-Jarisch re ex revisited: Clinical implications of inhibitory re exes originating in the heart J Am Coll Cardiol 1:90, 1983 MATHIAS CJ, KEGUCHI K, BLEASDALE-BARR K, KIMBER JR: Frequency of family history in vasovagal syncope Lancet 352:33, 1998 MATHIAS CJ, KIMBER JR: Treatment of postural hypotension J Neurol Neurosurg Psychiatry 65:285, 1998 MEISSNER L, WIEBERS DO, SWANSON JW, O FALLON WM: The natural history of drop attacks Neurology 36:1029, 1986 MILSTEIN S, BUETIKOFER J, DUNNIGAN A, et al: Usefulness of disopyramide for prevention of upright tilt-induced hypotension-bradycardia Am J Cardiol 65:1339, 1990 OBERG B, THOREN P: Increased activity in left ventricular receptors during hemorrhage or occlusion of caval veins in the cat: A possible cause of the vasovagal reaction Acta Physiol Scand 85:164, 1972 ROSS RT: Syncope Philadelphia, Saunders, 1988 SCHOENBERG BS, KUGLITSCH JF, KARNES WE: Micturition syncope Not a single entity JAMA 229:1631, 1974.

SHY GM, DRAGER GA: A neurological syndrome associated with orthostatic hypotension: A clinical-pathologic study Arch Neurol 2:511, 1960 SOTERIADES ES, EVANS JC, LARSON MG, et al: Incidence and prognosis of syncope N Engl J Med 347:878, 2002 WALLIN BG: New aspects of sympathetic function in man, in Stalberg E, Young RR (eds): Clinical Neurophysiology London, Butterworth, 1981, pp 145 167 WALLIN BG, SUNDLOF G: Sympathetic out ow to muscles during vasovagal syncope J Auton Nerv Syst 6:287, 1982 WALLIN BG, WESTERBERG CE, SUNDLOF G: Syncope induced by glos-

In this illustration you will see three dialog boxes, one for the button, one to assign the OPEN_CHART_DIALOG command, and finally the dropdown to attach the CHART_ ITEM_1 The end result of this process is that we see the button for the Chart Type when we execute the Web report This is shown in the following illustration

sopharyngeal neuralgia: Sympathetic out ow to muscle Neurology 34: 522, 1984 WAXMAN MB, YAO L, CAMERON DA, et al: Isoproterenol induction of vasodepressor-type reaction in vasodepressor-prone persons Am J Cardiol 63:58, 1989 WEISS S, CAPPS RB, FERRIS EB JR, MUNRO D: Syncope and convulsions due to a hyperactive carotid sinus re ex: Diagnosis and treatment Arch Intern Med 58:407, 1936 WEISS S, FERRIS EB JR: Adams-Stokes syndrome with transient complete heart block of vagovagal re ex origin: Mechanism and treatment Arch Intern Med 54:931, 1934

Sleep, that familiar yet inexplicable condition of repose in which consciousness is in abeyance, is obviously not abnormal, yet it is most appropriately considered in connection with abnormal phenomena because there are a number of interesting and common irregularities of sleep, some of which approach serious extremes Everyone has had a great deal of personal experience with sleep, or lack of it, and has observed people in sleep, so it requires no special knowledge to understand something about this condition or to appreciate its importance to health and well-being The psychologic and physiologic bene ts of sleep have seldom been so eloquently expressed as in the words of Tristram Shandy:

Tis the refuge of the unfortunate the enfranchisement of the prisoner, the downy lap of the hopeless, the weary, the broken-hearted; of all the soft delicious functions of nature this is the chiefest; what a happiness it is to man, when the anxieties and passions of the day are over

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Physicians are often consulted by patients who suffer some derangement of sleep Most often the problem is one of sleeplessness, but sometimes it concerns excessive sleep or some peculiar phenomenon occurring in connection with sleep Certain points concerning normal sleep and the sleep-wake mechanisms are worth reviewing, since familiarity with them is necessary for an understanding of disorders of sleep A great deal of information about sleep and sleep abnormalities is now available as a result of the development, in relatively recent years, of the subspecialty of sleep medicine and the creation of a large number of centers for the diagnosis and treatment of sleep disorders Most disorders of sleep can be readily recognized and managed if one attends closely to the patient s description of his sleep disturbance Only complex or odd cases or those requiring the documentation of apneic episodes or seizures and other motor disorders during sleep need study in special sleep laboratories

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