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PubMedDate not supplied

Monitoring for sleep-related threat: a pilot study of the Sleep Associated Monitoring Index (SAMI).

OBJECTIVE: The aims of this pilot study were: 1) to establish the reliability and validity of a new self-report instrument designed to index monitoring for sleep-related threat; 2) to determine the presence of ten monitoring types proposed in a recent cognitive model of insomnia and to examine the relationship between monitoring for sleep-related threat and severity of sleep disturbance; and 3) to explore the association between monitoring and the established constructs of amplification and self-focus. METHODS: Participants (N = 400) completed the Sleep Associated Monitoring Index (SAMI) and the Pittsburgh Sleep Quality Index (PSQI) (1). Based on the PSQI score, the sample was split into two groups to compare normal sleepers (NS) and individuals with a clinically significant sleep disturbance (CSSD). A subset of the sample completed the SAMI and a battery of questionnaires to examine convergent validity between monitoring, amplification, and self-focus. RESULTS: Individuals in the CSSD group had higher SAMI scores than the NS group and the SAMI correlated positively with severity of sleep disturbance as indexed by the PSQI. A principal components analysis extracted 8 components accounting for 69% of the variance. The 30-item SAMI demonstrated high validity, consistency, and reliability. Scores on the SAMI were moderately positively correlated with scores on measures of amplification and self-focus. CONCLUSIONS: Preliminary evidence suggests that the SAMI offers a valid and reliable instrument to index monitoring before and after treatment for sleep disturbance. The implications for the presence of monitoring for sleep-related threat in chronic insomnia are discussed.

Adult↗
PubMed1996

The value of sleep nasendoscopy in the evaluation of patients with suspected sleep-related breathing disorders.

Fifty patients with sleep-related breathing disorders were tested with nocturnal polysomnography and with nasendoscopic diurnal polysomnography after diazepam administration, and various indices of breathing disorders were examined, and the results obtained in the two sleep studies compared. There were no significant differences between the two sleep studies in either the type of apnoea or the indices of breathing disorder except for the longest duration of apnoea. There was a significant difference in the duration of REM sleep between the two sleep studies, but no significant difference in the duration of each stage of non-REM sleep. We speculate that nasendoscopic diurnal polysomnography with diazepam can be used as a substitute for nocturnal polysomnography in the clinical study of non-REM sleep stage but it is not sufficient in evaluating REM sleep stage, in patients with sleep-related breathing disorders without pathological obesity or abnormal respiratory function.

Diazepam↗
PubMed1982

Correlations of some physical variables with REM sleep and slow wave sleep in man.

Polysomnographic recordings were taken on 11 healthy male students aged 19-23 years. The correlations were examined between the various physical variables and the appearance rates of REM sleep and slow wave sleep (SWS). The height showed a significant inverse correlation with %st.4 sleep and with %SWS and the plantar length with %SWS. The body weight and chest circumference showed a significant inverse correlation with %REM sleep. The weight/height ratio tended toward an inverse correlation with %REM sleep. Both the body surface area and basal metabolic rate showed a significant inverse correlation with %st.4 and %REM sleep. There was no significant correlation between the total sleep time and each physical variable. From these results the roles of REM sleep and slow wave sleep in man were discussed.

Adult↗
PubMed1988

Sleep apnea and sleep-related periodic leg movements in community resident seniors.

The elderly have a high incidence of sleep complaints. A high incidence of sleep apnea (SA) and sleep-related periodic leg movements (PLMs) is also suspected. The relationship between the incidence and severity of SA and PLMs and sleep complaints has not, however, been determined in terms of symptomatology and physiologic abnormality. In a group of 46 community resident seniors (60 to 95 years old), the incidence of SA and PLMs was correlated with subjective sleep-wake complaints. Sixty-one percent of subjects had SA and/or PLMs. Apneas/hypopneas were associated with an average oxygen desaturation of less than 5% and an average change in heart rate of less than 10 beats per minute. While subjects with SA or PLMs had clear evidence of objective sleep disturbance, only one quarter of them admitted to any subjective sleep complaints or daytime sleepiness. Furthermore, severity of SA or PLMs failed to predict sleep-wake complaints, and vice versa. This study confirms that typically mild SA and PLMs are widespread in the elderly but tend not to be manifested in sleep-wake complaints and probably go untreated as a result. Further research is needed to determine any long-term medical significance.

Aged↗
PubMed1996

An interleukin-1 receptor fragment inhibits spontaneous sleep and muramyl dipeptide-induced sleep in rabbits.

Interleukin-1 (IL-1) is hypothesized to be involved in physiological sleep regulation and in sleep responses occurring during infectious disease. If this hypothesis is correct, then inhibition of endogenous IL-1 should reduce both normal sleep and N-acetylmuramyl-L-alanyl-D-isoglutamine (MDP)-induced sleep. MDP is a somnogenic substance derived from bacterial cell walls. We report here the effects of a synthetic IL-1 receptor fragment corresponding to amino acid residues 86-95 of the human type I IL-1 receptor (IL-1RF) on spontaneous sleep and IL-1 beta- and MDP-induced sleep and fever in rabbits. Two doses of the IL-1RF (25 and 50 micrograms) were injected into normal rabbits intracerebroventricularly (icv). Both doses significantly decreased spontaneous non-rapid eye movement sleep (NREMS) across a 22-h recording period. Pretreatment of rabbits with 25 micrograms of IL-1RF blocked the somnogenic actions of 10 ng icv IL-1. Similarly, central pretreatment of animals with 25 micrograms IL-1RF significantly attenuated the NREMS-promoting and REMS-suppressive actions of 150 pmol MDP injected centrally. The increase in NREMS and decrease in REMS induced by systemic injection of 12.5 micrograms/kg MDP were also significantly suppressed by central administration of 50 micrograms IL-1RF. In contrast, the febrile response induced by either intracerebroventricularly or intravenously injected MDP were not significantly affected by IL-1RF. These results support the hypothesis that endogenous, brain-derived IL-1 contributes to the maintenance of normal sleep and may mediate sleep responses to systemic as well as central bacterial infections.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed2005

Recovery after prolonged sleep deprivation: residual effects of slow-release caffeine on recovery sleep, sleepiness and cognitive functions.

A long work schedule often results in sleep deprivation, sleepiness, impaired performance and fatigue. We investigated the residual effects of slow-release caffeine (SRC) on sleep, sleepiness and cognitive performance during a 42-hour recovery period following a 64-hour continuous wakefulness period in 16 healthy males, according to a double-blind, randomised, placebo-controlled, crossover study. Three hundred milligrams of SRC or placebo was given twice a day at 21:00 and 9:00 during the first 48 h of wakefulness. Recovery sleep was analysed with electroencephalography (EEG) and wrist actigraphy, daytime sleepiness with continuous EEG, sleep latency tests and actigraphy and cognitive functions with computerized tests from the NATO AGARD STRES battery. Both drug groups exhibited almost the same sleep architecture with a rebound of slow-wave sleep during both recovery nights and of REM sleep during the second night. Wakefulness level and cognitive functions were similarly impaired in both groups on the first day of recovery and partially returned to baseline on the second. To conclude, SRC appears to have no unwanted side-effects on recovery sleep, wakefulness and cognitive performance after a long period of sleep deprivation and might therefore be a useful choice over other psychostimulants for a long work schedule.

Adult↗
PubMed1983

The alpha-sleep pattern. Differentiation from other sleep patterns and effect of hypnotics.

We observed the alpha-sleep pattern in 6 out of 44 subjects who offered neither somatic nor psychological complaints. All of the 6 subjects demonstrated the pattern consistently over a period of several years. 14 of the polygraphic sleep EEGs were recorded when free of any drugs, 10 after administration of benzodiazepine hypnotics. The alpha-sleep pattern is superimposed on all the regular patterns during any of the different sleep stages, and shows a cyclic representation with an increase correlating to the delta-sleep stages 3 and 4. It can be differentiated from other activities due to its localization, frequency characteristics, occurrence in relation to different sleep stages, and modification under the influence of benzodiazepine hypnotics. In contrast to the sigma-spindle activity, the alpha-sleep pattern is reduced with these drugs. Regarding the functional significance of the alpha-sleep pattern one might consider the possibility that it indicates a partially heightened level of sleep depth.

Adult↗
PubMed1999

Patient perception of sleep quality and etiology of sleep disruption in the intensive care unit.

The etiology of sleep disruption in patients in intensive care units (ICUs) is poorly understood, but is thought to be related to environmental stimuli, especially noise. We sampled 203 patients (121 males and 82 females) from different ICUs (cardiac [CCU], cardiac stepdown [CICU], medical [MICU], and surgical [SICU]) by questionnaire on the day of their discharge from the unit, to determine the perceived effect of environmental stimuli on sleep disturbances in the ICU. Perceived ICU sleep quality was significantly poorer than baseline sleep at home (p = 0.0001). Perceived sleep quality and daytime sleepiness did not change over the course of the patients' stays in the ICU, nor were there any significant differences (p > 0.05) in these parameters among respective units. Disruption from human interventions and diagnostic testing were perceived to be as disruptive to sleep as was environmental noise. In general, patients in the MICU appeared to be more susceptible to sleep disruptions from environmental factors than patients in the other ICUs. Our data show that: (1) poor sleep quality and daytime sleepiness are problems common to all types of ICUs, and affect a broad spectrum of patients; and (2) the environmental etiologies of sleep disruption in the ICU are multifactorial.

Adult↗
PubMed2004

Impact of sleep deprivation and subsequent recovery sleep on cortisol in unmedicated depressed patients.

OBJECTIVE: One night of sleep deprivation induces a transient improvement in about 60% of depressed patients. Since depression is associated with abnormalities of the hypothalamic-pituitary-adrenal (HPA) axis, the authors measured cortisol secretion before, during, and after therapeutic sleep deprivation for 1 night. METHOD: Fifteen unmedicated depressed inpatients participated in a combined polysomnographic and endocrine study. Blood was sampled at 30-minute intervals during 3 consecutive nights before, during, and after sleep deprivation. Saliva samples were collected at 30-minute intervals during the daytime before and after the sleep deprivation night. RESULTS: During the night of sleep deprivation, cortisol levels were significantly higher than at baseline. During the daytime, cortisol levels during the first half of the day were higher than at baseline in the patients who responded to sleep deprivation but not in the nonresponders. During recovery sleep, cortisol secretion returned to baseline values. CONCLUSIONS: This study demonstrated a significant stimulatory effect of 1 night of sleep deprivation on the HPA axis in unmedicated depressed patients. The results suggest that the short-term effects of antidepressant treatments on the HPA axis may differ from their long-term effects. A higher cortisol level after sleep deprivation might transiently improve negative feedback to the hypothalamus or interact with other neurotransmitter systems, thus mediating or contributing to the clinical response. The fast return to baseline values coincides with the short clinical effect.

Adult↗
PubMed2004

Wrist-actigraphic estimation of sleep time under nCPAP treatment in sleep apnoea patients.

The aim of this study was to correlate daily use of nasal continuous positive airway pressure (nCPAP) with total sleep time (TST) evaluated by home actigraphy. Actigraphy was validated by comparing TST determined by actigraphy (aTST) and polysomnography (pTST) in 24 untreated patients with suspected sleep apnoea. The % sleep time spent under nCPAP was estimated on 3 consecutive days in 28 patients receiving long-term nCPAP, by comparing machine-use periods with sleep periods identified by home actigraphy. The mean difference between pTST and aTST was 2.5 min. The correlation coefficient between aTST and pTST was 0.90. Daily use of nCPAP over the 3 study days was 388 +/- 114 min. nCPAP was used 41-100% (82 +/- 17% (mean +/- sD)) of sleep time detected by actigraphy. Some patients used nCPAP during nonsleep periods. In conclusion, comparison of nasal continuous positive airway pressure use with sleep time estimated by home actigraphy shows marked individual differences in the % sleep time under nasal continuous positive airway pressure. These results suggest that actigraphic estimation of sleep time under nasal continuous positive airway pressure could provide a better index than simple daily use of the device to evaluate the impact of treatment in sleep apnoea.

Female↗
PubMed2001

Sleep patterns and sleep disruptions in kindergarten children.

Assessed sleep patterns and sleep disruptions in kindergarten children and investigated the relation between sleep measures derived from objective and subjective evaluation methods. The sleep patterns of 59 normal kindergarten children (mean age = 5.5 years) were monitored for 4 to 5 consecutive nights by means of activity monitors (actigraph) and by means of parental daily sleep logs. The correlation between the actigraphic measures and the daily parental logs indicated that parents were accurate reporters of sleep schedule measures. However, parents were less accurate in assessing sleep quality measures, significantly underestimating the number of night-wakings and overestimating the quality of their children's sleep. Fragmented sleep was found, by means of activity monitoring, in 41% of the children.

Child↗
PubMed2001

Sleep duration, subjective sleep disturbances and associated factors among university students in Korea.

Objective of this study was to look into sleep patterns of university students in association with their lifestyle, specifically to examine mean sleep duration, prevalence of sleep disturbances and their correlates. This study also aimed to examine a possible association of sleep patterns of young adults with new media like computers and videos, which were supposed to have a great influence on their lifestyle. Self-reported sleep data were derived from questionnaires administered to a total of 1,414 students of one university located in Chullabuk-do, Korea. Statistical methods such as t-test, analyses of variance, chi-square test and multivariate logistic regression were used for analysis. The mean sleep duration of the respondents was 6.7+/-1.3 hr. Of the respondents, 30.2% reported having insufficient sleep. About one third of them pointed to visual media including computers as the primary reason. The proportion of those having some types of sleep disturbances was 36.2%. The risk of subjective sleep disturbances was significantly lower among those perceiving themselves healthy than among those perceiving themselves unhealthy (OR=0.44; 95% CI: 0.34-0.57).

Adult↗
PubMed2001

Sleep and sleep disorders in pregnancy.

Sleep problems are common in pregnant women. This review examines sleep in normal pregnancy; discusses the physiologic bases for alterations in sleep, including hormonal and mechanical factors; and correlates these factors with changes in sleep of pregnant women, as determined subjectively by surveys and objectively by polysomnographic studies. The changes in respiratory physiology during pregnancy, the possible predisposition of the pregnant woman to sleep-disordered breathing because of these changes, and results of published studies of sleep-disordered breathing in pregnancy are discussed. Finally, the effect of pregnancy on other sleep disorders and the management of these sleep disorders during pregnancy are outlined, including changes in management necessitated by this state. The paucity of available data and the need for further studies of incidence and outcomes of sleep disorders in the pregnant woman are emphasized.

Central Nervous System↗
PubMed2001

[Sleep and intellectual functioning in the elderly: the role of sleep quality and apnea--literature survey].

In both relatively healthy and in demented elderly people mental abilities and sleep quality decrease in becoming older and nocturnal respiratory disturbance increases. Perhaps there is an association between sleep and cognition. The hypothesis that specific sleep phenomena are necessary to assure an adequate level of cognitive functioning is called the sleep cognition hypothesis. In this article the findings of research in older people are reviewed. 23 research reports were found in which sleep was measured with polysomnography. The findings in relatively healthy older people do not suggest a strong association between sleep and cognition nor a causal effect between a specific cognitive dysfunction and a specific sleep variable. The findings in demented older people concerning sleep and cognition are inconsistent. In relatively healthy older people a significant correlation between nocturnal respiratory disturbance and cognitive functioning was seldom found, whereas in demented older people a clear association was shown. Therefore, in demented older people prudence is necessary in prescribing psychopharmaca because these can enhance the appearance of sleep apneas.

Aged↗
PubMed2002

Rapid Eye Movement (REM) sleep behavior disorder: a sleep disturbance affecting mainly older men.

Rapid Eye Movement (REM) sleep behavior disorder is characterized by the intermittent loss of REM-related muscle atonia and the appearance of elaborated motor behaviors (sometimes violent behavior) and vocalizations associated with dream mentation. Nine patients were diagnosed in our Sleep Disorders Unit with this syndrome during the period August 1997-April 2000. All were male, average age 67.9 +/- 6.9 years. The complaint of all our patients was the occurrence of violent or injurious sleep behavior mainly during the dream stage. Jumping or falling out of bed and slapping or beating their wives were more common. None had history or showed signs of dementia, Parkinson or other neurodegenerative diseases. A relative high amount of SWS (20.9%) was found. Seven showed an intermittent increase in chin EMG tonus while the other two had an almost continuous high chin EMG tonus during REM sleep. We did not observe any violent motor behavior during the polysomnographic recordings. Phasic activities during REM sleep were high but density quantification was not performed. Six patients had also Periodic Limb Movement (PLM) Disorders, four had also Obstructive Sleep Apnea (OSA) Syndrome. The treatment recommended to all patients was Clonazepam beginning with a 0.5-mg dose. Four patients reported a decrease or disappearance of sleep agitation and nightmares and were very happy with the treatment and without side effects. The others decided not to try Clonazepam or stopped after a few days of using it. RBD appears to be a sleep disturbance affecting mainly aged men. Its violent expression may frighten the patients and their bed-partners and may cause injury to both. In some cases this sleep disorder seems to be an early manifestation of a neurodegenerative disorder while in others it may represent only an idiopathic form. Clonazepam at lower doses is a good agent for the treatment of this condition.

Adult↗
PubMed2002

Sleep disorders. Obstructive sleep apnea syndrome, restless legs syndrome, and insomnia in geriatric patients.

Sleep disorders may affect one out of two older Americans and may present as insomnia, excessive daytime sleepiness, or both. Age-related changes seem to cause a decreased need for sleep. The average 70-year-old sleeps only 6 hours a night, but may obtain an additional hour or even 2 during daytime naps. Older adults also experience an increase in the number of sleep disruptions and an increased incidence of chronic diseases, which can contribute to poorer sleep in this group. The two most common geriatric sleep disorders are obstructive sleep apnea syndrome and restless legs syndrome. Detailed diagnostic workup and treatment are usually referred to a center for sleep medicine where polysomnographic studies are performed. Left untreated, sleep disorders may present a serious threat to the patient's health and lead to increased morbidity and mortality.

Age Factors↗
PubMed2005

[Changes in sleep architecture by resumption of CPAP in patients with sleep apnea syndrome].

It is known that application of continuous positive airway pressure (CPAP) improves sleep architecture in patients with sleep apnea syndrome (SAS). In contrast, there have been only a few studies which deal with deterioration of sleep architecture by discontinuation of CPAP. In the present study we analyzed changes of sleep architecture by temporary removal of CPAP. The subjects were 41 patients who underwent polysomnography (PSG) for diagnosis of SAS. The patients chose either a 1-night study in which only PSG was done, or a 2-night study in which, after treatment with CPAP for one month, PSGs with and without CPAP at night were done. The mean ages, heights, and weights between the 1-night group and the 2-night group were not statistically different The mean AHI of the 1-night group (38.9 +/- 5.0/hr; mean +/- SE) and that of the 2-night group (45.7 +/- 5.4/hr) were not significantly different. The mean AHI profoundly decreased (4.4 +/- 0.9) by CPAP therapy on the second night. Percents of each sleep stage in the 1-night group were as follows; stage 1, 31.8%; stage 2, 50.0%; stage (3 + 4), 2.8%: REM, 15.7%. In the 2-night group, stage 1 was 43.6%, significantly higher than that in the 1-night group, while stage 2 was 39.9%, which was significantly smaller. There were no significant difference in stage (3 + 4) and REM. When CPAP was again applied to the 2-night patients, stage 1 significantly decreased to 15.5%, while stage 2 (55.6%), stage (3 + 4) 6.7%, and REM (22.3%) increased significantly. Therefore, cessation of CPAP shifts the sleep stage from stage 2 to stage 1. Since stages 1 and 2 occupy approximately 80% of total sleep duration, the shift may have some physiological significance. Resumation of CPAP may have improved quality of life and day-time sleepiness by decreasing stage 1 sleep and increasing stages of deeper sleep and REM.

Continuous Positive Airway Pressure↗
PubMed1991

Biperiden administration in normal sleep and after rapid eye movement sleep deprivation in healthy volunteers.

Twenty-six healthy volunteers were randomly assigned to one of four groups. Groups Bip-4 and Bip-6, each with six subjects, received 4 and 6 mg of biperiden, respectively, and were studied on acclimatization, baseline, biperiden, and follow-up nights. Group REM-P (n = 7) and Group REM-Bip (n = 7) were studied on acclimatization, baseline, six nights of REM sleep deprivation, and one recovery (treatment) night with either placebo (group REM-P) or biperiden (group REM-Bip), and one follow-up night. Biperiden 4 and 6 mg increased REM sleep latency and biperiden 6 mg reduced REM sleep time. On the recovery night following REM sleep deprivation Group REM-P and REM-Bip showed an increase in sleep continuity. REM sleep time in the REM-P group was increased during the recovery (treatment) night (REM sleep recovery), while the REM-Bip group did not show a significant REM sleep increase during recovery (treatment) night. It was not until the follow-up night that REM sleep increased in the REM-Bip group.

Adult↗