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PubMed1993

Identification of sleep disruption and sleep disordered breathing from the systolic blood pressure profile.

BACKGROUND: Respiratory sleep studies are frequently performed to identify sleep disruption resulting from upper airway obstruction. Traditional polysomnographic studies may not detect brief recurrent sleep disruption and thus fail to recognise a significant problem when apnoea, hypopnoea, or arterial desaturation are not present. Arousal from sleep causes a transient blood pressure rise, and each inspiration causes a transient blood pressure fall. This study assesses whether these blood pressure changes are a useful indirect marker of disturbed sleep, obstructed sleep apnoea, and snoring related sleep disturbance. METHODS: Computer algorithms were developed to identify blood pressure falls caused by inspiration and rises related to arousal from 286 sleeping blood pressure samples of a consistent respiratory state drawn from 51 polysomnographic studies. From these samples, normal ranges for the number of arousal related systolic rises and the average size of the inspiratory falls were established. These were then applied prospectively to all night unedited blood pressure recordings from a further 20 subjects. RESULTS: The size of the inspiratory falls in blood pressure progressively increased from normal sleep, through snoring, to frank obstructive sleep apnoea. The 95th centile of normal was 12.5 mm Hg. The number of arousal related blood pressure rises also increased during obstructive sleep apnoea and periods of snoring with associated arousals, compared with normal undisturbed sleep, and all these periods of disturbed sleep included more than 30 such rises per hour. When these blood pressure features were examined in the 20 subjects studied prospectively, the six with a sleep related breathing disorder could all have been identified from their systolic blood pressure profile alone. CONCLUSIONS: The systolic blood pressure profile may be helpful in identifying patients with obstructive sleep apnoea, snoring with arousals, or other sleep disruption syndromes.

Adult↗
PubMed2005

[Sleeping habits and sleep disorders during adolescence: relation to school performance].

OBJECTIVE: To determine the prevalence of sleep disorders in adolescence. To describe sleeping habits of adolescents in relation to sleep disorders and associated factors. To determine the relation between sleep disorders/inappropiate sleeping habits and school performance. DESIGN: Observational, descriptive, cross-sectional study. SETTING: Secondary school of Cuenca (city in Spain). PARTICIPANTS: 1293 school children of first and fourth curses of secondary education. MAIN MEASURES: Structured questionnaire with opened and closed questions on sleeping habits during weekdays and at weekends and sleep disorders to be answered by the adolescents anonymously and on their own. Student's school performance with relation with to sleeping habits and sleep disorders were determined. RESULTS: 1155 students out of 1293 (response rate 89.33%) answered the questionnaire, 537 (45.9%) boys and 618 (54.1%) girls, 14 years old on average (between 11-18 years). On weekdays students went to bed at 23.17 h and got up at 7.46 h (average sleeping time =8 hours and 18 minutes). At weekends they went to bed at 1.02 h and got up at 10.42 h (average sleeping time =9 hours and 40 minutes). 45.4% of students said to sleep badly on Sunday night's. On average the number of subjects failed in class is higher with adolescents who complain about sleep (2.28 vs 1.91; P=.04), who are tired at waking up time (2.17 vs 1.97; P=.048) and who have morning sleepiness (2.17 vs 1.75; P=.004). CONCLUSIONS: Schools hours cause deficit sleeping time during weekdays which is partly made up for at weekend. At weekends there is an interruption of the adolescent's sleeping habits. School performance of adolescents with sleep disorders is lower.

Adolescent↗
PubMedDate not supplied

Interaction between feeding method and co-sleeping on maternal-newborn sleep.

BACKGROUND: Previous studies have demonstrated that breastfed newborns spend more time awake than bottle-fed newborns, breastfeeding mothers have more fragmented sleep than bottle-feeding mothers, and mother-newborn sleeping arrangements may affect the sleep/wake pattern of mother-newborn pairs. OBJECTIVE: To address the unsolved question of whether there is an interaction between type of feeding and sleeping arrangements that affects postpartum sleep during the 4th postpartum week. DESIGN: Correlational, two-way design using feeding method and location of newborn at night as independent variables, and sleep patterns as the dependent variables. SETTING: Patient's home during 4th week after giving birth. PATIENTS/PARTICIPANTS: First-time mothers and their newborns (n = 33). MAIN OUTCOME MEASURES: Amount of total sleep, amount of night sleep, number of night awakenings, and number of sleep periods in 24 hours using a modified version of the self-report sleep instrument by Barnard and Eyres. RESULTS: Breastfed newborns had less total sleep per day than bottle-fed newborns, and breastfeeding mothers had more sleep periods in 24 hours than bottle-feeding mothers. Breastfeeding mothers slept more than bottle-feeding mothers when co-sleeping, but bottle-feeding mothers' sleep was unaffected by location of newborn. Average total sleep for 4-week-old newborns was about 14 hours daily. CONCLUSIONS: More sleep was obtained when breastfeeding mothers slept with the newborn. Methods or devices that allow breastfeeding mothers and newborns to sleep next to each other in complete safety need to be developed.

Bottle Feeding↗
PubMedDate not supplied

Cholecystokinin-B (CCK-B) receptor antagonists improve "aged" sleep: a new class of sleep modulators?

Sleep disorders are a major, although often minimized and underdiagnosed, medical problem. Current therapy is based on the use of hypnotics, mainly benzodiazepines, which disrupt the sleep pattern often suppressing rapid-eye-movement (REM) sleep. Here, new types of pharmacological tools such as cholecystokinin (CCK) receptor antagonists are examined. In particular, since the awake-sleep rhythm is mainly altered in old age in humans, the influence of these compounds over REM and non-REM sleep has been studied in aged rats (21 months) vs. young rats (5 months) prepared for electroencephalographic (EEG) recordings. Basal EEG data indicated that REM and non-REM sleep was reduced in aged rats vs. young rats. GV-150013, a selective CCK-B receptor antagonist, was found to increase REM sleep, as well as non-REM sleep, and therefore total sleep (non-REM + REM) mainly in aged rats. The dose-range of activity (0.5-60 micrograms/kg) together with the evidence that another CCK-B receptor antagonist, L-365,260 (5 micrograms/kg) increased, while devazepide (a CCK-A receptor antagonist; 20 micrograms/kg) decreased non-REM sleep and total sleep time, support the original hypothesis that the activity of GV-150013 on sleep progress through CCK-B receptors. Furthermore, no tolerance was detected after chronic treatments with GV-150013. In contrast, typical EEG modifications (decrease of REM) and the development of tolerance towards benzodiazepines were monitored following chronic treatment with triazolam (400 micrograms/kg). These results suggest that the CCKergic compounds studied are involved via a different mechanism of action than benzodiazepines in the modulation of the awake-sleep rhythm. A further observation is that the total sleep time recorded in aged rats after treatment with GV-150013 reached the value of the total sleep time of young untreated rats also prepared for EEG. Finally, this work suggests that CCK receptor antagonists, GV-150013 in particular, are more effective in aged resulting in an improvement of sleep quality towards that of young rats.

Adamantane↗
PubMed2005

REM sleep behavior disorder and REM sleep without atonia in patients with progressive supranuclear palsy.

STUDY OBJECTIVE: To compare sleep characteristics, rapid eye movement (REM) sleep without atonia, and REM sleep behavior disorder (RBD) in patients with progressive supranuclear palsy (tauopathy), patients with Parkinson's disease (a synucleinopathy), and control subjects. DESIGN: Sleep interview, overnight polysomnography, and Multiple Sleep Latency Tests. PATIENTS: Forty-five age- and sex-matched patients with probable progressive supranuclear palsy, (n=15, aged 68 +/- 8 years, 7 men), patients with Parkinson disease (n=15), and control subjects (n=15). SETTINGS: Tertiary-care academic hospital. INTERVENTION: N/A. RESULTS: Compared to the 2 other groups, patients with progressive supranuclear palsy had a longer duration of wakefulness after sleep onset and twice as much sleep fragmentation and percentage of stage 1 sleep but had similar apnea-hypopnea indexes, periodic leg movements indexes, and mean daytime sleep latencies. REM sleep percentage was as low in patients with progressive supranuclear palsy (8% +/- 6% of total sleep time) as in patients with Parkinson disease (10% +/- 4%), versus 20% +/- 6% in controls (analysis of variance, P < .0001). Interestingly, patients with progressive supranuclear palsy had percentages of REM sleep without atonia (chin muscle activity: 33% +/- 36% of REM sleep) similar to those of patients with Parkinson disease (28% +/- 35%) and dramatically higher than those of controls (0.5% +/- 1%, analysis of variance, P = .008). Four (27%) patients with progressive supranuclear palsy had more than 50% REM sleep without atonia (as did a similar number of patients with Parkinson disease), and 2 of them (13%, vs 20% of patients with Parkinson disease) had clinical RBD. The four patients with progressive supranuclear palsy with excessive daytime sleepiness slept longer at night than the 11 patients with progressive supranuclear palsy who were alert (442 +/- 14 minutes vs 312 +/- 74 minutes, student t tests, P = .004), suggesting a primary nonnarcoleptic hypersomnia. CONCLUSION: REM sleep without atonia and RBD were as frequent in patients with progressive supranuclear palsy as in patients with Parkinson disease. It suggests that the downstream cause of parkinsonism, rather than its primary neuropathology (synucleinopathy vs tauopathy), is a key factor for REM sleep behavior disorder.

Aged↗
PubMed1994

Sleep cycles and alpha-delta sleep in fibromyalgia syndrome.

OBJECTIVE: Fibromyalgia syndrome (FMS) is a musculoskeletal disorder characterized by generalized pain, localized tender points, chronic fatigue and nonrestorative sleep. Since sleep disturbances frequently occur in FMS and alpha intrusion in nonrapid eye movement (NREM) sleep probably associates with the nonrefreshing sleep, we prospectively studied the delta and alpha activity and alpha-delta ratio across sleep cycles, performing polysomnography in 10 patients with FMS and in 14 healthy control subjects. METHODS: Night long polysomnography recordings were performed in all subjects. Sleep scoring was done visually according to Rechtschaffen and Kales criteria. By means of spectral analysis the conventional electroencephalogram (EEG) frequency bands were automatically computed for the all night recordings. For alpha and delta power the integrated and normalized values were calculated for each sleep cycle, the evolution of these activities across successive sleep cycles was studied. RESULTS: Alpha-delta patterns occurred in almost all the patients who had also superficial and fragmented sleep with increased awakenings and reduced REM and slow wave sleep. Delta decay across sleep cycles was different in FMS and alpha activity was greater and declined, whereas the controls were persistently low throughout their sleep. Alpha-delta ratio increased progressively in successive sleep cycles; this was again different from controls. CONCLUSION: Patients with FMS presented a high frequency of subjective sleep disturbances, an increased incidence of alpha EEG NREM sleep and clear abnormalities in sleep cycle organization.

Adult↗
PubMed1990

Sleep and arousal patterns of co-sleeping human mother/infant pairs: a preliminary physiological study with implications for the study of sudden infant death syndrome (SIDS).

The prevailing research design for studying infant sleep erroneously assumes the species-wide normalcy of solitary nocturnal sleep rather than a social sleeping environment. In fact, current clinical perspectives on infant sleep, which are based exclusively on studies of solitary sleeping infants, may partly reflect culturally induced rather than species-typical infant sleep patterns which can only be gleaned, we contend here, from infants sleeping with their parents--the context within which, and for well over 4 million years, the hominid infant's sleep, breathing, and arousal patterns evolved. Our physiological study of five co-sleeping mother-infant pairs in a sleep lab is the first study of its kind to document the unfolding sleep patterns of mothers and infants sleeping in physical contact. Our data show that co-sleeping mothers and infants exhibit synchronous arousals, which, because of the suspected relationship between arousal and breathing stability in infants, have important implications for how we study environmental factors possibly related to some forms of the sudden infant death syndrome (SIDS). While our data show that co-sleeping mothers and infants also experience many moments of physiological independence from each other, it is clear that the temporal unfolding of particular sleep stages and awake periods of the mother and infant become entwined and that on a minute-to-minute basis, throughout the night, much sensory communication is occurring between them. Our research acknowledges the human infant's evolutionary past and considers the implications that nocturnal separation (a historically novel and alien experience for them) has for maternal and infant well-being in general and SIDS research strategies in particular.

Adult↗
PubMed2004

Sleep health, lifestyle and mental health in the Japanese elderly: ensuring sleep to promote a healthy brain and mind.

The Ministry of Health, Labor and Welfare in Japan proposed a plan called "Health Japan 21," which adopted sleep as one of the specific living habits needing improvement. This has led to increased interest in mental health needs at community public health sites. In addition, it was reported from a recent 2000 survey that one in five Japanese, and one in three elderly Japanese, suffer from insomnia. Insomnia is becoming a serious social problem; so much so that alarm bells are ringing with insomnia listed as one of the refractory diseases of the 21st century. Against this background, in January 2001, Japan began a national project called "Establishing a Science of Sleep." This article is an overview of sleep and health in the elderly, sleep mechanisms and the characteristics of insomnia among the elderly. At the same time, it introduces the scientific basis for lifestyle guidance that is effective for ensuring comfortable sleep, an essential condition for a healthy, energetic old age, with actual examples from community public health sites. The present authors reported that a short nap (30 min between 1300 and 1500 h) and moderate exercise such as walking in the evening are important in the maintenance and improvement of sleep quality. The study was to examine the effects of short nap and exercise on the sleep quality and mental health of elderly people. "Interventions" by short nap after lunch and exercise with moderate intensity in the evening were carried out for 4 weeks. After the "intervention," wake time after sleep onset significantly decreased and sleep efficiency significantly increased, showing that sleep quality was improved. The frequency of nodding in the evening significantly decreased. As a result, the frequency of nodding before going to sleep decreased, and the quality of nocturnal sleep was improved. Present results demonstrated that the proper awakening maintenance during evening was effective in improving sleep quality. After the "intervention," mental health also improved with improving sleep quality. Furthermore, physical health also improved with improving sleep quality. These results suggest that this "intervention" technique is effective for the quality of life (QOL) and the activity of daily living (ADL) of elderly people.

Activities of Daily Living↗
PubMed2000

The effect of arousals during sleep onset on estimates of sleep onset latency.

It is well established that insomniacs overestimate sleep-onset latency. Furthermore, there is evidence that brief arousals from sleep may occur more frequently in insomnia. This study examined the hypothesis that brief arousals from sleep influence the perception of sleep-onset latency. An average of four sleep onsets was obtained from each of 20 normal subjects on each of two nonconsecutive, counterbalanced, experimental nights. The experimental nights consisted of a control night (control condition) and a condition in which a moderate respiratory load was applied to increase the frequency of microarousals during sleep onset (mask condition). Subjective estimation of sleep-onset latency and indices of sleep quality were assessed by self-report inventory. Objective measures of sleep-onset latency and microarousals were assessed using polysomnography. Results showed that sleep-onset latency estimates were longer in the mask condition than in the control condition, an effect not reflected in objective sleep-stage scoring of sleep-onset latency. Furthermore, an increase in the frequency of brief arousals from sleep was detected in the mask condition, and this is a possible source for the sleep-onset latency increase perceived by the subjects. Findings are consistent with the concept of a physiological basis for sleep misperception in insomnia.

Adult↗
PubMed1984

Differential sleep-promoting effects of five sleep substances nocturnally infused in unrestrained rats.

Sleep-inducing and sleep-maintaining effects of five different putative sleep substances were compared by the same nocturnal 10-hr intracerebroventricular infusion technique in otherwise saline-infused, freely moving male rats. Delta-sleep-inducing peptide (2.5 nmol), which induces electroencephalogram delta (slow)-wave patterns, was rapidly effective in increasing both slow-wave sleep and paradoxical sleep but the effects were not long-lasting. Muramyl dipeptide (2 nmol) induced excessive slow-wave sleep in the middle of the infusion period, accompanying a simultaneous elevation of brain temperature. However, paradoxical sleep was not affected. Component B of sleep-promoting substance (2 brainstem equivalents), a partially purified extract from rats deprived of sleep for 24-hr, was markedly effective in inducing and maintaining both kinds of sleep. Prostaglandin D2 (0.36 nmol) was more effective in enhancing sleep at the later period of the infusion period. Uridine (10 pmol) caused a mild but long-lasting increase in sleep, especially in paradoxical sleep. Thus, each substance exhibited compound-specific sleep-modulating properties.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1986

Ear oximetry to detect apnea and differentiate rapid eye movement (REM) and non-REM (NREM) sleep. Screening for the sleep apnea syndrome.

Ear oximetry is commonly employed in screening patients for the sleep apnea syndrome, but the lack of objective information regarding the duration of sleep, including the presence of rapid-eye-movement (REM) sleep, is a major limitation. Based on the premise that both apnea and sleep-state-dependent changes in ventilation give rise to distinctive patterns in the arterial oxygen saturation, we developed a systematic technique to analyze ear oximetric tracings for wakefulness, REM sleep, and non-REM (NREM) sleep. Fifty-four patients were studied by both all-night polysomnography and ear oximetry. A careful comparison of ear oximetric data for sleep states and apnea was then made, using polysomnography as the correct classification to determine sensitivity, specificity, predictive value positive, and predictive value negative of the ear oximetric tracings. When classification of sleep state was compared, ear oximetry correctly classified 280.5 (82 percent) of 340.9 hours of sleep that was either REM or NREM sleep. The sensitivity for classifying NREM sleep was 0.85, for REM sleep was 0.70, and for wakefulness was 0.49. The sensitivity by ear oximetry for apnea was 0.80, with a predictive value negative of 0.87. We conclude that although polysomnography must be performed for definitive evaluation, ear oximetry is a valuable screening test for sleep apnea because the presence or absence of apnea can be determined, total duration of sleep can be estimated, and NREM vs REM sleep can be differentiated.

Adult↗
PubMed1986

Sleep deprivation in healthy elderly men and women: effects on mood and on sleep during recovery.

Elderly women had better recovery sleep than elderly men following 36-h sleep deprivation, as evidenced by higher sleep maintenance/efficiency and more slow wave sleep (particularly in the amount of stage 4 sleep). During recovery sleep, both groups showed REM latency reduction (two men and three women had seven sleep-onset REM periods out of a total of 40 recovery nights), decrease in percentage of early REM sleep and increase in whole-night REM sleep time. Total Mood Disturbance scores on the Profile of Mood States increased in both men and women following sleep deprivation (reflecting a decrease in vigor and increase in fatigue and tension). While the increase tended to be greater in women, in both groups self-ratings of mood returned to baseline after 1 night of recovery sleep. These observations underscore the importance of gender in determining late-life sleep structure and suggest that the ability of older women to achieve slow wave sleep and to have long uninterrupted sleep in greater than that of men.

Aged↗
PubMed2001

Sleep complaints in women of ages 40-64 years in relation to sleep in their parents.

Objective: To study the occurrence of sleep complaints in women in relation to such complaints in their parents.Background: Sleep complaints are common and may be affected by many somatic, mental, and life-style and environmental factors.Methods: A cross-sectional questionnaire survey was undertaken among 3669 randomly selected women of ages 40-64 years. The women were asked about their own health and sleep and their recollection of the sleep of their parents.Results: The frequency of poor sleep was low among women reporting that neither parent had sleep disturbances. Sleep disturbances in the father, mother and both parents implied a 2.5 (95% confidence interval, 2.0-3.2), 2.5 (2.1-3.0) and 4.8-fold (3.4-6.8) increase in sleep complaints in the investigated women, respectively. The frequencies of numerous awakenings, difficulty in falling asleep again and too little sleep increased similarly. A series of logistic regression analyses revealed that all sleep characteristics were evaluated more negatively in women who reported sleep disturbances in their parents and also reported themselves to be in poor health. All sleep variables deteriorated with age. Because data regarding parent sleep was based on subjects' recall of that sleep, the results should be interpreted with some caution.Conclusions: The frequency of sleep complaints in women aged from 40 to 64 years was increased if sleep disturbances were reported in their parents.

Journal Article↗
PubMed2006

Nasal dilator strip therapy for chronic sleep-maintenance insomnia and symptoms of sleep-disordered breathing: a randomized controlled trial.

To test the impact of nasal dilator strips (NDSs) on insomnia severity, sleep-disordered breathing (SDB) symptoms, sleep quality, and quality of life. Randomized, controlled trial of 4 weeks' duration. Community sample of nonobese, adults with a primary sleep complaint of chronic sleep-maintenance insomnia and mild to moderate SDB symptoms (treatment, n=42; control, n=38). Primary outcomes were four validated scales: Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Functional Outcomes of Sleep Questionnaire (FOSQ), and Quality of Life Enjoyment and Satisfaction Questionnaire (QLESQ). Secondary outcomes were sleep indices, nonrestorative sleep ratings, and SDB symptoms, assessed retrospectively and prospectively. Both groups received nonspecific education about sleep disorders. Treatment group also received a brief SDB education and nasal strip instructions. At 4 weeks' follow-up, the treatment group demonstrated significant (p=.0001), large improvements in ISI and PSQI (mean Cohen's d=1.18) and significant (p<.02), medium-sized improvements in FOSQ and QLESQ (mean d=0.51) compared to small, nonsignificant changes in control group (Cohen's d range=0.36-0.09). Treatment group change scores among all four primary variables were significantly correlated (mean r=0.50, p=0.01). Secondary prospective and retrospective outcomes showed medium to large improvements in treatment compared to controls for sleep indices (mean d=0.52 vs 0.28), nonrestorative sleep ratings (mean d=0.69 vs 0.11), and sleep breathing symptoms (mean d=0.47 vs 0.09). Significance was obtained for prospective sleep indices (p=0.01), retrospective, and prospective nonrestorative sleep ratings (p=0.003, <0.05), and retrospective sleep breathing symptoms (p=0.03). SDB education and NDSs demonstrated therapeutic efficacy in a select sample of insomnia patients with SDB symptoms. Replication of results requires placebo controls and objectively confirmed SDB cases.

Chronic Disease↗
PubMed1990

Sleep and EEG spectra in the rabbit under baseline conditions and following sleep deprivation.

The 24-hr sleep-wake distribution and power spectra of the electroencephalogram were determined in rabbits that had been implanted with cortical and hippocampal electrodes. A diurnal preference for sleep was observed. The spectral power density in nonrapid eye movement sleep (NREM sleep) of the cortex showed a decreasing trend in most frequencies within the 12-hr light period. In the 12-hr dim period no clear trend was present. Most hippocampal EEG frequencies decreased in NREM sleep in the first two hours of the light period, and thereafter stayed on a constant level. Sleep deprivation elicited the following changes: a prolonged increase of NREM sleep and a short increase of REM sleep; in the cortex, an increase of slow-wave activity (SWA; power density in the 0.25-2.0 Hz frequency band) in NREM sleep, which declined in the course of recovery; an enhancement of slow-wave (1.25-3 Hz) and theta (6.25-7 Hz) activity in REM sleep. The hippocampus showed an increase in NREM sleep power density in almost all frequencies. In REM sleep the hippocampus exhibited an increase in power density in the 6.25-7 Hz and 12.25-13 Hz bands, whereas in the 7.25-8 Hz band the values were below baseline. The results show that SWA in NREM sleep and theta activity in REM sleep are enhanced by sleep deprivation, as has been observed in other mammalian species. The EEG changes in the hippocampus resembled those in the cortex.

Animals↗
PubMed1994

Firing of neurons in the preoptic/anterior hypothalamic areas in rat: its possible involvement in slow wave sleep and paradoxical sleep.

The basal forebrain including the preoptic area and anterior hypothalamus plays an important role in regulation of slow wave sleep. To examine whether this area is concerned also in a neural mechanism of paradoxical sleep, single neuronal activity in and around the preoptic area along with cortical EEG and neck EMG was recorded in undrugged, 12-h sleep-deprived rats whose head was fixed painlessly. The neurons whose activity was recorded during all states of sleep and wakefulness (n = 98) were classified into following 5 groups according to their firing behavior in relation to sleep-waking states. (1) Neurons most active during paradoxical sleep (n = 26). (2) Those most inactive during paradoxical sleep, some of which were inactive also during slow wave sleep (n = 16). (3) Those specifically active during slow wave sleep (n = 14). (4) Those less active during slow wave sleep than during wakefulness and paradoxical sleep (n = 9). (5) Those whose activity showed no clear correlation with the sleep-waking states (n = 33). About one third of neurons in each of groups (1) to (4) began to increase their sleep-related activity in advance of the shift of sleep/wakefulness state recognized in EEG. These results suggest that the preoptic and anterior hypothalamic areas are involved, at least in rats, in regulation of not only slow wave sleep but also paradoxical sleep.

Animals↗
PubMed2004

Heart rate activation during spontaneous arousals from sleep: effect of sleep deprivation.

OBJECTIVE: Arousal (AR) from sleep is associated with an autonomic reflex activation raising blood pressure and heart rate (HR). Recent studies indicate that sleep deprivation may affect the autonomic system, contributing to high vascular risk. Since in sleep disorders a sleep fragmentation and a partial sleep deprivation occurs, it could be suggested that the cardiovascular effects observed at AR from sleep might be physiologically affected when associated with sleep deprivation. The aim of the study was to examine the effect of sleep deprivation on cardiac arousal response in healthy subjects. METHODS: Seven healthy male subjects participated in a 64 h sleep deprivation protocol. Arousals were classified into four groups, i.e. >3<6 s, >6<10 s, >10<15 s and >15 s, according to their duration. Pre-AR HR values were measured during 10 beats preceding the AR onset, and the event-related HR fluctuations were calculated during the 20 beats following AR onset. As an index of cardiac activation, the ratio of highest HR in the post-AR period over the lowest recorded before AR (HR ratio) was calculated. RESULTS: For AR lasting less than 10 s, the occurrence of AR induces typical HR oscillations in a bimodal pattern, tachycardia followed by bradycardia. For AR lasting more than 10 s, i.e. awakenings, the pattern was unimodal with a more marked and sustained HR rise. The HR response was consistently similar across nights, during NREM and REM sleep, without difference between conditions. CONCLUSIONS: Overall, total sleep deprivation appeared to have no substantial effect on cardiac response to spontaneous arousals and awakenings from sleep in healthy subjects. Further studies are needed to clarify the role of chronic sleep deprivation on cardiovascular risk in patients with sleep disorders. SIGNIFICANCE: In healthy subjects acute prolonged sleep deprivation does not affect the cardiac response to arousal.

Adult↗
PubMed2005

Sleep, sleep-dependent procedural learning and vigilance in chronic cocaine users: Evidence for occult insomnia.

Sleep disturbance has been implicated in cocaine use; however, the nature of the disturbance and its potential effects on cognition and learning are largely unknown. Twelve chronic cocaine users completed a 23-day inpatient study that included randomized, placebo-controlled, cocaine self-administration sessions. Six subjects received cocaine on each of days 4-6 and placebo on days 18-20, the other six received cocaine on each of days 18-20 and placebo on days 4-6. Sleep was measured by polysomnography, the Nightcap sleep monitor, and self-reported measures. Simple and vigilance reaction times were measured daily; a motor-sequence test of procedural learning was administered four times. Electrophysiological measures of sleep showed a different pattern than self-reported sleep across cocaine administration and abstinence: total sleep time and sleep latency were at their worst by 14-17 days of abstinence while self-reported sleep was at its best. Vigilance correlated positively with electrophysiologically measured sleep and negatively with self-reported measures. Similarly, sleep-dependent procedural learning correlated with total sleep time and was impaired at 17 days abstinence relative to 2- and 3-days abstinence. Slow-wave activity was lowest at days 4-9 of abstinence and highest during use and days 10-17 of abstinence. With sustained abstinence, chronic cocaine users exhibit decreased sleep, impaired vigilance and sleep-dependent procedural learning, and spectral activity suggestive of chronic insomnia. However, they report subjectively improving sleep, indicating they are unaware of this "occult" insomnia. These results suggest the possibility of homeostatic sleep drive dysregulation in chronic cocaine users.

Adult↗