Have we lost sleep? A reconsideration of segmented sleep in early modern England.

The theory that the people of the early modern period slept in well-defined segments of 'first' and 'second' sleeps has been highly influential in both scholarly literature and mainstream media over the past twenty years. Based on a combination of scientific, anthropological and textual evidence, the segmented sleep theory has been used to illuminate discussions regarding important aspects of early modern nocturnal culture; mainstream media reports, meanwhile, have proposed segmented sleep as a potentially 'natural' and healthier alternative to consolidated blocks of sleep. In this article, I re-examine the scientific, anthropological and early modern literary sources behind the segmented sleep theory and ask if the evidence might support other models of early modern sleep that are not characterised by segmentation, while acknowledging that construction of such models is by nature limited and uncertain. I propose a more diverse range of interpretations of early modern texts related to sleep, with important implications for medical and social history and literary scholarship.

Don Quijote de la Mancha y la descripción del sueño bifásico en la literatura española / Don Quixote de la Mancha and the description of biphasic sleep in Spanish literature

Introducción: El sueño bifásico o segmentado es el hábito de dormir un primer y un segundo sueño separados por una vigilia. El historiador Ekirch describe que así se dormía en los tiempos preindustriales antes de la potente iluminación artificial. Se basó en textos en diferentes idiomas, desde la Antigüedad hasta el siglo xx, pero llama la atención la ausencia de fuentes en español. Objetivo: Se revisó la literatura española en busca de referencias al sueño bifásico usando como palabras clave ‘primer sueño’ y ‘a los primeros gallos’. Desarrollo: En la segunda parte de Don Quijote de la Mancha (capítulo 68), Cervantes describe el sueño bifásico con notable acierto, correlacionando los biotipos de Quijote y Sancho con sus temperamentos y hábitos de sueño y alimentarios. Curiosamente, Ekirch cita el capítulo, pero no el sueño bifásico. En esta revisión reproduzco 11 textos en español (siglos xiii a xix), mayormente obras clásicas, que lo refieren, disponiendo sus fases en coincidencia con las horas en que se dividía la noche en la era preindustrial: 20:00-21:00 a 00:00, primer sueño; 00:00 a 03:00, vigilia; 03:00 a 06:00, segundo sueño. La Celestina aporta datos significativos. Estudios recientes probaron que este hábito es fisiológico y se adapta al estilo de vida que lo requiere. Conclusiones: Se identifican y citan por primera vez referencias al sueño bifásico en la literatura española, confirmando la hipótesis de Ekirch. El Quijote lo describe con mayor amplitud y agudeza.(AU)

Introduction: Biphasic or segmented sleep is the habit of sleeping a first and a second sleep separated by a watching. The historian A Ekirch found that this was how people slept in pre-industrial times before the powerful artificial lighting. He is based on texts in different languages, from Antiquity to the 20th century, but the absence of sources in Spanish is striking. Aim: Review the Spanish literature searching references of the biphasic sleep using the keywords ‘first sleep’ and ‘at the first cockcrow’. Development: In the Second Part of Don Quixote de la Mancha (Chapter 68), Cervantes describes biphasic sleep with remarkable success, correlating the biotypes of Quixote and Sancho with their temperaments and sleeping and eating habits. Strangely, Ekirch cites the chapter, but not biphasic sleep. In this review I reproduce eleven texts in Spanish (13th to 19th centuries), mostly classical works, which refer to it by arranging its phases in a way that coincides with the hours in which the night was divided in the pre-industrial era: 20:00-21:00 to 00:00, first sleep, 00:00 to 03:00, wakefulness; 03:00 to 06:00, second sleep. La Celestina provides significant data too. Recent studies proved that this habit is physiological, and it adapts to the lifestyle that requires it. Conclusions: References to biphasic sleep in Spanish literature are identified and cited for the first time, confirming Ekirch’s hypothesis. In Don Quixote, Cervantes describes it with great breadth and sharpness.

Oral desmopressin in nocturia with benign prostatic hyperplasia: A systematic review of the literature.

OBJECTIVE: To evaluate the effect of oral desmopressin in patients with nocturia associated with benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: With a rise of the use of oral desmopressin in the treatment of nocturia in patients with BPH, a systematic review was performed according to the Cochrane systematic reviews guidelines and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. RESULTS: The literature search yielded 18 studies. The studies were published between 1980 and 2017, and included 3072 patients. Eligible patients were men aged ≥50 years with lower urinary tract symptoms (LUTS) and persistent nocturia. There was a significant 43% reduction in nocturia after using desmopressin alone. Combined α-blockers and desmopressin lead to a decrease in the frequency of night voids by 64.3% compared to 44.6% when using α-blockers only. The first sleep period, significantly increased from 82.1 to 160.0 min and from 83.2 to 123.8 min when using desmopressin + α-blocker and α-blocker only, respectively. The desmopressin dose ranged from the lowest dose (0.05 mg) to the optimum dose (0.4 mg) at bed time. The incidence of hyponatraemia associated with desmopressin use was 4.4-5.7%. CONCLUSION: Low-dose oral desmopressin therapy alone is an effective treatment for nocturia associated with LUTS in patients with BPH. Oral desmopressin combined with α-blockers is well tolerated and beneficial for improving the International Prostate Symptom Score and nocturnal symptoms. All patients should be educated about the mechanism of desmopressin action to avoid treatment discontinuation due to adverse events.