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At least 721 records · Page 40Linked to original sources
PubMed2001

An algorithm to stratify sleep apnea risk in a sleep disorders clinic population.

Obstructive sleep apnea may lead to complications if not identified and treated. Polysomnography is the diagnostic standard, but is often inaccessible due to bed shortages. A system that facilitates prioritization of patients requiring sleep studies would thus be useful. We retrospectively compared the accuracy of a two-stage risk-stratification algorithm for sleep apnea using questionnaire plus nocturnal pulse oximetry against using polysomnography to identify patients without apnea (Objective 1) and those with severe apnea (Objective 2). Patients were those referred to a university-based sleep disorders clinic due to suspicion of sleep apnea. Subjects completed a sleep apnea symptom questionnaire, and underwent oximetry and two-night polysomnography. We used bootstrap methodology to maximize sensitivity of our model for Objective 1 and specificity for Objective 2. We calculated sensitivity, specificity, positive and negative predictive values, and rate of misclassification error of the two-stage risk-stratification algorithm for each of our two objectives. The model identified cases of sleep apnea with 95% sensitivity and severe apnea with 97% specificity. It excluded only 8% of patients from sleep studies, but prioritized up to 23% of subjects to receive in-laboratory studies. Among sleep disorders clinic referrals, a two-stage risk-stratification algorithm using questionnaire and nocturnal pulse oximetry excluded few patients from sleep studies, but identified a larger proportion of patients who should receive early testing because of their likelihood of having severe disease.

Aged↗
PubMed2002

Home sleep studies in the assessment of sleep apnea/hypopnea syndrome.

OBJECTIVE: To determine the clinical utility of a limited sleep-recording device used unsupervised in the patient's home, compared with in-laboratory, fully supervised polysomnography for the diagnosis of sleep apnea/hypopnea syndrome (SAHS), and to assess its impact on costs. DESIGN: Prospective case study. SETTING: The sleep-disorders unit of a tertiary referral university hospital. PATIENTS: Fifty-five patients suspected of having SAHS and living within 30 km of our laboratory. METHODS: Patients were studied first in their homes with the limited sleep-recording device. Polysomnography was performed within 30 days of the first study. Both studies were read by independent investigators blinded to the results of the other study. Diagnoses and therapeutic decisions regarding the use of continuous positive airway pressure obtained from the home and laboratory studies were compared. Agreement between the home and laboratory study recordings was also assessed using receiver operating characteristic (ROC) curves and Bland-Altman analysis. One half of the home studies were randomly assigned to be performed with a sleep technician's set up of the equipment in the patient's home (group 1), and the other half with the patient's own setup of the sleep-recording device (group 2), after an instruction period in the hospital. An economic analysis was performed, considering the cost of repeating studies in cases with faulty or inconclusive home studies (these patients should undergo polysomnography as a second step). RESULTS: Seven percent of the home studies in group 1, and 33% in group 2 produced no interpretable data because of artifacts (p < 0.05). Sixteen percent of the home study findings were inconclusive. The diagnosis obtained from the limited sleep-recording device and polysomnography agreed in 75% of the interpretable home studies (89%, if inconclusive home studies were excluded). The area under the ROC curve for the home study-derived parameters was between 0.84 and 0.89, compared with polysomnography. There was no bias between home and polysomnography studies in the Bland-Altman plot. The cost per study of home study recordings was less expensive than that of polysomnography (143.86 euros), either with (93.08 euros) or without (129.97 euros) intervention of the technician in the patient's home. CONCLUSION: Home sleep studies are a viable form of diagnosing SAHS, and are less expensive than polysomnography. Intervention of a sleep technician in the patient's home was the least expensive strategy, because of the high percentages of faulty studies with the patient's own setup of the equipment, when using the limited sleep-recording device.

Adult↗
PubMed2000

Infant sleep position policies in licensed child care centers after back to sleep campaign.

BACKGROUND: Since the Back to Sleep (BTS) campaign was initiated in 1994, the rate of prone sleeping has decreased to approximately 20%. However, child care centers may have an increased rate of prone sleeping in infants. In 1996, a study of licensed child care centers demonstrated that 43% were unaware of the association between sudden infant death syndrome (SIDS) and prone sleeping and that 49% positioned infants prone. OBJECTIVE: To determine effectiveness of a mailing from the BTS campaign to licensed child care centers by assessing the following: 1) child care center awareness of the recommendations of the American Academy of Pediatrics regarding infant sleep position and 2) implementation of the recommendations of the American Academy of Pediatrics in child care center practice. DESIGN: A descriptive, cross-sectional survey of licensed child care centers in the metropolitan Washington, DC, region. All licensed child care centers caring for infants <6 months old in Washington, DC, and Montgomery, Prince Georges, Howard, Anne Arundel, Frederick, and Charles Counties in Maryland were recruited for the study. RESULTS: Out of 236 eligible centers, 172 completed the survey. Seventy-five percent (129) of the centers were aware of recommendations regarding infant sleep position. Infants were placed prone in 27.9% of centers, although only 2.9% placed infants exclusively in the prone position. The most common reasons for avoiding prone position entirely were SIDS risk reduction and licensing regulations. Half of the centers had a written policy regarding sleep position. Twenty centers who were aware of the dangers of prone sleeping continued to placed infants prone at least some of the time, largely because of parental request. Only 56.9% of centers had heard of the BTS campaign despite the mass mailing. The mailing resulted in policy change for 14 centers. CONCLUSIONS: Since 1996, the percentage of licensed child care centers in the greater Washington, DC, area that are aware of the association between SIDS and infant sleep position has increased from 57% to 75%. In addition, the rate of placing infants prone in these centers has declined from 49% in 1996 to 27.9% in this study. When child care centers are aware of the risk of prone sleeping, the most likely reason for continued prone placement is parental request. Although media and mailings have been largely effective in communicating BTS information to many child care centers, nonprone positioning is not universal among child care providers. Additional educational efforts toward child care providers and parents remain necessary.

Child Day Care Centers↗
PubMed1999

The use of ENT-prescribed home sleep studies for patients with suspected obstructive sleep apnea.

Sleep disordered breathing, including obstructive sleep apnea, is a common and morbid health problem. Traditionally, sleep disordered breathing is diagnosed by complex sleep studies. However, newer, easy-to-use, highly sensitive, and highly specific home sleep study equipment is now available. The present study was undertaken to determine whether an otolaryngologist could easily and effectively dispense home sleep equipment from the office. We used a portable AutoSet home sleep machine. Our experience with the first 100 consecutively presenting patients was recorded and analyzed under institutional review board approval. Ninety-nine of the 100 tests were completed successfully on the first attempt; the one failure was successful on the second attempt. Our results were consistent with those reported from in-house polysomnogram sleep studies; 71% of our patients had an apnea-hypopnea index (AHI) of 15 or higher, and 93% had an AHI at least 5. We conclude that an otolaryngologist, using state-of-the-art home sleep testing equipment, can accurately and cost-effectively prescribe home sleep studies.

Equipment Design↗
PubMed2001

Effect of jaw muscle pain and soreness evoked by capsaicin before sleep on orofacial motor activity during sleep.

AIMS: Sleep bruxism, which is a form of orofacial motor activity (OMA), and jaw muscle pain and soreness have for a long time been thought to be mutually linked. The aim of this study was to investigate the effect of clinical and experimental jaw muscle pain and soreness on sleep OMA. METHODS: Twelve healthy subjects aged 21 to 31 years old participated in this study. All of them were aware of signs or symptoms of sleep OMA and were subdivided into a group with clinical pain complaints (n = 5) and a group without pain (n = 7). All subjects slept in the laboratory for 3 consecutive nights, including a habituation night, a baseline night, and an experimental night. Electroencephalographic (EEG) activity and electromyographic (EMG) activity from the masseter muscles were recorded during sleep. On the experimental night, before sleep, all subjects received an injection of capsaicin (0.1 mL, 100 micrograms/mL) into the masseter muscle that had demonstrated the most EMG activity during the previous recordings. The OMA events and episodes were quantified and were compared between the baseline night and the experimental night. Every evening and morning during the study period, pain intensity, unpleasantness, and soreness were scored by the subjects on a visual analog scale (VAS), and pain detection thresholds (PDTs) in the masseter muscles and maximal voluntary occlusal force (MVOF) were also measured. RESULTS: Pre-sleep injection of capsaicin did not cause significant differences between groups in peak pain intensity on the VAS. The PDT and MVOF did not show any significant differences between groups, injection and non-injection sides, or baseline and experimental nights and mornings. The number of EMG episodes/hour sleep, the number of bursts/hour sleep, and total area of all bursts and episodes during the baseline night were significantly higher in the subjects without pain than in the subjects with pain. However, the capsaicin injection did not cause any significant changes in these parameters. CONCLUSION: This study suggests that an acute pre-sleep painful stimulus does not have any effect on OMA during sleep, but the study extends previous findings that clinical jaw muscle pain and soreness are associated with less EMG activity in the masticatory muscles.

Adult↗
PubMedDate not supplied

The effect of topical nasal fluticasone on objective sleep testing and the symptoms of rhinitis, sleep, and daytime somnolence in perennial allergic rhinitis.

Recent data suggested that daytime somnolence in patients with allergic rhinitis was secondary to disrupted sleep caused by nasal congestion. Medications, which decreased congestion, would be expected to improve sleep and daytime somnolence. Previously, we showed that nasal steroids improved all three symptoms. Presently, we have not performed objective sleep testing to determine if there is a correlation between subjective improvement of congestion, sleep, and daytime somnolence. The objective of this 8-week, double-blind, placebo-controlled study was to determine if topical nasal fluticasone is effective at decreasing subjective congestion and daytime somnolence and improving sleep and if this improvement correlated with a change in overnight sleep testing (polysomnography). We recruited 32 subjects with perennial allergic rhinitis and randomized them in a double-blinded, cross-over fashion, to receive placebo or fluticasone (50 micrograms a spray), 2 sprays each side everyday, using Balaam's design. Questionnaires, quality of life instruments, daily diary, Epworth Sleepiness Scale, and an overnight sleep test with polysomnograms were used as tools. The last 2 weeks of each 4-week treatment period were summarized, scored, and compared by PROC MIXED in SAS. Correlations between arousals on sleep tests and subjective tests were performed. Fluticasone improved subjective sleep when compared with placebo (p = 0.04); however, there was no difference in the apnea/hypopnea index in those that were treated. Daytime sleepiness and fatigue were decreased by > 10% in the treated group; however, this was not statistically significant. However, fluticasone used at approved doses improves subjective sleep in patients with perennial allergic rhinitis without a change in the apnea/hypopnea index.

Administration, Topical↗
PubMed2003

[Diagnosis of sleep disorders and medical sleep-related diseases--a review].

A person's well-being and health are greatly affected by disorders of sleep and wakefulness. It is of the utmost importance to diagnose and treat such conditions, since the associated daytime sleepiness is a major risk factor for accidents. Early establishment of the correct diagnosis paves the way to achieving an excellent therapeutic outcome. Health-economic requirements of appropriateness and necessity mandate the specific use of cost- and time-intensive examinations in the sleep laboratory. In accordance with the guidelines for "non-restorative sleep", severe and chronic sleep disorders can be diagnosed outside the sleep lab if the underlying cause can already be identified on the basis of the patient's history. Such is usually the case in sleep disorders caused by external influences, disturbed circadian rhythm or pre-existing neurological, psychiatric or internal disorders. Standardized questionnaires are used to record and evaluate the patient's complaints, and vigilance testing to assess impaired sustained attention during the day. Excessive daytime sleepiness is quantified by the multiple sleep latency test (MSLT). In the case of some disorders such as apnoea, or periodic leg movements, simplified ambulatory methods have been developed to enable their detection at an early stage. The gold standard for the diagnosis of sleep disorders in the sleep lab is cardiorespiratory polysomnography. The relevant biosignals for the assessment of sleep, respiration, heart function, the cardiovascular system and movement are well established. Some of the sensors employed need further improvement. Numerous methods for signal analysis are still undergoing development, and currently available automatic evaluation systems are not yet reliable enough to obviate the need for manual interpretation.

Ambulatory Care↗
PubMed1992

[A case of obstructive sleep apnea syndrome with increased lung water content during sleep].

A 57-year-old man was admitted complaining of sleep disturbance. All night polysomnography showed a pattern of obstructive sleep apnea. We performed 201Tl scintigraphy to evaluate hemodynamic change and degree of stress on the right ventricle during sleep, and compared it with a 201Tl scintigram during wakefulness. We recognized 201Tl uptake by the lung in the 201Tl scintigram during sleep, but not during wakefulness. To determine the mechanism of 201Tl uptake by the lung during sleep, we measured lung water content during sleep by double indicator dilution method (Nihon Koden, NTV-1100). We recognized an increase of lung water content during sleep. We consider that the increase of lung water content during sleep is caused by sleep apnea, probably by hemodynamic change due to negative pleural pressure swings during sleep apnea.

Extravascular Lung Water↗
PubMed2004

Sleep position in Israeli Jewish infants following the "back to sleep" campaign.

BACKGROUND: Prone sleeping has been recognized as a risk factor for sudden infant death syndrome. Ten years ago, non-prone sleeping was recommended in many countries around the world including Israel. The rate of infants sleeping prone and the rate of parents' adherence with the recommendations have not been studied. OBJECTIVES: To study infants' sleep position and parents' adherence to recommendations, and to identify risk factors for prone sleeping following the campaign to prevent prone sleeping in the Israeli population. METHODS: We conducted a longitudinal telephone survey with the parents of 608 randomly selected 2 month old infants, repeated at 4 and 6 months. RESULTS: Non-prone sleeping decreased from 75% to 67% and 63% at 2, 4 and 6 months respectively. There was a significant relationship between prone positioning and the use of a home apnea monitor at 2 months (P = 0.038, odds ratio 1.37, 95% confidence interval 0.94-2.15). Other risk factors for prone sleeping were the level of religious practice, with ultra-Orthodox Jews having the highest prevalence (2 months: OR 2.78, 95% CI 1.75-4.55) and higher parity - especially in families with more than five children (P = 0.041). CONCLUSIONS: The prone sleeping position is relatively high in Israel. Groups at high risk were closely associated with the level of religiousness and parity. Efforts to promote supine sleeping should be directed towards identifiable groups.

Female↗
PubMed2006

Sleep and aggression in substance-abusing adolescents: results from an integrative behavioral sleep-treatment pilot program.

STUDY OBJECTIVE: To examine whether change in total sleep time during an integrative, behavioral sleep intervention is associated with aggression. Specifically, we tested whether adolescents who reported experiencing aggressive thoughts or actions after treatment had worse treatment trajectories (e.g., less total sleep time across treatment) than adolescents with no aggressive thoughts or actions after treatment. DESIGN: Nonpharmacologic open trial with 9 weeks of weekly assessment. SETTING: University of Arizona Sleep Research Laboratory PATIENTS OR PARTICIPANTS: Twenty-three adolescents recently treated for substance abuse in outpatient community centers. INTERVENTIONS: Six-week integrative, behavioral sleep intervention. MEASUREMENTS AND RESULTS: Weekly sleep-summary indexes were calculated from daily sleep diaries and entered as dependent variables in a series of growth-curve analyses. Statistically significant Session x Post-treatment Aggressive Ideation interactions emerged when predicting changes in total sleep time, gamma13 = 9.76 (SE = 4.12), p < .05, and time spent in bed, gamma13 = 10.08, (SE = 4.33), p < .05, even after controlling for aggressive ideation and the frequency of substance use, as assessed at baseline. A similar pattern of results was seen for self-reported aggressive actions occurring during conflicts. CONCLUSIONS: These pilot data suggest that inadequate sleep in substance-abusing adolescents may contribute to the experiencing of aggressive thoughts and actions. Limitations include a small sample size and a restricted assessment of aggression. Nonetheless, these findings lend preliminary support to the breadth of therapeutic effectiveness of an integrative, behavioral sleep-therapy program for adolescents with a history of substance abuse and related behaviors.

Adolescent↗
PubMedDate not supplied

[Sleep disturbances in patients with generalized anxiety: a clinical and EEG sleep study].

All night EEG sleep recordings and clinical evaluations of sleep were performed in order to compare patients with generalized anxiety and normal controls. Patients were selected according to DSM III-R criteria and went through a two weeks phase treatment with placebo before the sleep evaluation. As compared to normals, anxious patients showed a fragmented and superficial sleep with no changes of REM sleep features. Further to disturbances of sleep continuity and duration, they had a higher percentage of wake and stage 2, as well as a reduction of slow wave sleep (SWS) mainly due to a diminished percentage of stage 4. Several EEG sleep measures--related both with the amounts of SWS and sleep duration and continuity--are significantly correlated with symptoms severity. The pathogenic significance of sleep disturbances in generalized anxiety is discussed.

Adult↗
PubMed1993

Sleep patterns of children sleeping in residential care, in kibbutz dormitories and at home--a comparative study.

The present study compares sleep patterns of two groups of children sleeping away from their families, in residential care (n = 31, age 3.7 +/- 1.7 years) and kibbutz (n = 29, age 3.7 +/- 1.8 years) dormitories, with age-matched children sleeping at home (n = 21, age 3.7 +/- 1.8 years). Sleep was monitored by wrist-worn actigraphs for three consecutive nights and assessed by sleep questionnaires, which were completed by parents of the kibbutz children and caretakers at residential care. Children in the residential care settled to sleep significantly earlier and slept longer than those children living in a kibbutz or at home. The longest period of uninterrupted sleep was more extended for children sleeping at home, compared to those sleeping in communal dormitories. Correlation analysis between various assessments of sleep and waking behaviors revealed a different pattern for kibbutz and residential care children. For the kibbutz children, there were significant correlations between difficulties falling asleep and various attributes of daytime tiredness. Conversely, in the residential care, difficulties falling asleep were significantly and positively correlated with parameters associated with daytime alertness. This pattern of correlations and the actigraphic data indicate that difficulties in falling asleep for children in residential care are probably a consequence of being put to bed too early and according to a rigid schedule, and not the result of emotional factors.

Child Behavior↗
PubMed1992

Effects of biperiden on sleep at baseline and after 72 h of REM sleep deprivation in the cat.

We examined the effects of the muscarinic M1 antagonist biperiden in cats. In the first experiment a dose-response analysis was performed with intraventricular injection (IV ventricle) of biperiden. In the second experiment after REM sleep deprivation cats were injected with either biperiden (0.1 mg/kg) or saline. Biperiden produced a reduction in REM sleep percentage and an increase in REM sleep latency with these high doses. The 0.1 mg/kg biperiden dose, which did not suppress REM sleep at baseline, did reduce the REM sleep rebound. The present study suggests a modulatory role of biperiden on REM sleep regulatory processes. The fact that an effect of biperiden is noted only at the high doses suggests that at these doses the drug is influencing non-M1 receptors. Changes in the sensitivity of these receptors as a result of REM sleep deprivation might explain why a dose of biperiden will reduce REM sleep rebound, while being ineffective in suppressing REM sleep at baseline.

Animals↗
PubMed2007

Autonomic function in sleep apnea patients: increased heart rate variability except during REM sleep in obese patients.

The objective of this study was to examine heart rate variability (HRV) among sleep stages in obstructive sleep apnea (OSA) patients. The study was retrospective within subjects and examined the sleep stages and HRV in relation to OSA, age, body mass index (BMI), and sex. Data collected during diagnostic polysomnograms were used in this study. There were 105 clinical patients undergoing polysomnography for suspected OSA. We sampled the electrocardiogram (ECG) from wakefulness, stage 2, and REM sleep and analyzed for frequency domain HRV. Sampled epochs were free of apnea and arousals. Heart rate variability decreased with age. Total frequency variability (TF) and low frequency variability (LF) in wakefulness and REM sleep increased as apnea severity increased. Measures of TF, LF, and the LF/HF ratio were greatest in REM sleep. There was less LF and TF in Stage REM sleep in patients with higher BMI. In conclusion, the decrease in HRV with aging is a robust finding that occurs even in a clinical sleep apnea population. However, apnea does not mimic aging effects on the heart because HRV increased as apnea severity increased. The decrease in HRV during REM sleep in the obese apnea patients suggests the possibility of an autonomic dysfunction in this subgroup.

Adult↗
PubMed2003

Low sleep quality and daytime sleepiness in obese patients without obstructive sleep apnoea syndrome.

OBJECTIVES: To evaluate sleep quality, sleep-related symptoms, and degree of excessive daytime sleepiness (EDS) in severe obesity, independently of obstructive sleep apnoea syndrome (OSAS). DESIGN: A cross-sectional study. SETTING: Primary-care setting. SUBJECTS, MAIN OUTCOME MEASURES: Anthropometric parameters, respiratory function data and sleep related symptoms were evaluated in 78 severely obese patients (aged 16-75 years) without OSAS and in 40 healthy sex- and age-matched normal weight subjects, who underwent a full-night polysomnography. RESULTS: Obese patients and control subjects had similar sleep latency and rapid eye movement (REM) latency, but they showed lower percentage of REM (P < 0.01) and sleep efficiency (P < 0.05) than controls. All sleep-related symptoms (observed or reported apnoea, awakenings, choking and unrefreshing sleep) were significantly more frequent in obese patients than in control subjects. Loud snoring was present in 46.7% of the obese patients and in 8.1% of the control individuals (P < 0.01). Excess daytime sleepiness was reported by 34.7% of the obese patients and by 2.7% of the normal weight subjects (P < 0.01). The Epworth Sleepiness Scale (ESS) was higher in the obese group than in the control group (P < 0.01), whereas arousals were not different between the two groups. CONCLUSIONS: This study clearly shows that severe obesity, even in the absence of OSAS, is associated with sleep-related disorders and EDS. All these alterations may be partly responsible for a lower quality of life, a higher prevalence of medical complications, an increased risk of occupational injury, and both social and family problems characterizing obese patients, independently of the presence of OSAS.

Adolescent↗
PubMed2000

Peculiar respiratory response observed during sleep-onset REM sleep of an infant with Ondine's curse.

We treated an infant with congenital central hypoventilation syndrome ("Ondine's curse"). She was cyanotic and given ventilatory support at the first hour after birth. An investigation of sleep state and respiration performed at the age of 3 months led to this diagnosis. Hypoventilation persisted in all sleep stages, with the most severely reduced tidal volumes occurring during delta-wave sleep (stages 3 and 4). In addition, severe secondary reduction in tidal volumes occurred in sleep-onset REM sleep. This phenomenon was absent in non sleep-onset REM sleep. At 4 months of age, her respiratory treatment was successfully converted to positive-pressure ventilation via a nasal mask, thus avoiding tracheotomy. This transition to noninvasive ventilatory support dramatically improved her quality of life during wakefulness. This report may be a clue to discuss the function of sleep-onset REM sleep seen in the early stage of life and suggests that nasal mask ventilation is a viable option in selected cases with congenital central hypoventilation syndrome (CCHS).

Female↗
PubMed1992

Sleep-disordered breathing in elderly people and subjective sleep-wake disturbance.

Sleep-disordered breathing and subjective reports of sleep-wake disturbances are both common in elderly people but previous studies investigating the relationship between the two have produced uncertain results. We hypothesized that there is no relationship between sleep-disordered breathing and subjective reports of sleep-wake disturbance. Ninety-three random-sampled retirement-village residents, mean age 77.6 years, were monitored overnight with a portable microprocessor-based system. The respiratory disturbance index (RDI) was used as a measure of sleep-disordered breathing. Subjects were interviewed regarding sleep-wake patterns and snoring history and the Mini Mental State Examination, Geriatric Depression Scale and Nelson Adult Reading Test were administered. The sleep-wake responses were entered into a principal components analysis. Two components, reflecting night-time and daytime disturbance, accounted for 34% of the variance. Multiple regression analyses were performed using RDI as a continuous dependent variable, and three predictor variables, night-time, and daytime disturbance and history of snoring. Together, these variables accounted for only 2% of the variance. We conclude there is no relationship between mild and moderate sleep-disordered breathing and subjective sleep-wake disturbance in this population.

Aged↗
PubMed2002

Regional differences of the human sleep electroencephalogram in response to selective slow-wave sleep deprivation.

The purpose of this study was to assess the topographic changes in sleep recuperative processes in response to selective slow-wave sleep (SWS) deprivation. SWS was suppressed on two consecutive nights by means of acoustic stimulation. The electroencephalogram (EEG) power of baseline, deprivation and recovery nights was analysed in 1 Hz bins. During the SWS deprivation nights, large decreases of EEG power were found at frontopolar, central and parietal derivations encompassing the delta, theta and alpha range, while only slow delta (0.5-2 Hz) was affected at the frontal derivation. Recovery sleep was characterized by a generalized increase of power during non-REM sleep encompassing the delta, theta and alpha bands, with a clear antero-posterior gradient. The coherent behaviour of different EEG bands with traditionally different electrophysiological meanings during non-REM sleep suggests that, in light of the recent advances in sleep neurophysiology, a re-examination of the functional role of EEG rhythms during sleep is needed. The 'resistance' to selective SWS deprivation of the frontal area, together with its larger increase of EEG power during recovery, may be interpreted as a sign of a greater sleep need of the frontal cortical areas, confirming that some aspects of the regulatory processes of human sleep are local in nature and may show use-dependent characteristics.

Adult↗