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PubMed1991

Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI)

Subjective sleep quality deteriorates with aging, but the extent to which this is a product of age itself, as opposed to the medical or psychiatric problems associated with aging, has not been carefully studied. To investigate this issue, we examined the subjective sleep quality of 44 healthy subjects over 80 years of age (20 men, 24 women), and 35 healthy subjects [corrected] between the ages of 20 and 30 (23 men, 12 women) using the Pittsburgh Sleep Quality Index (PSQI). All subjects underwent rigorous medical and psychiatric evaluations to verify that they were in excellent physical and psychological health. Significant age effects were noted for the global PSQI score and several PSQI component scores, but overall sleep quality for the majority (68.1%) of 80-yr-olds fell within a categorically defined range for "good" sleepers. Measures of habitual sleep quality did not correlate strongly with most polysomnographic sleep measures, number of medications used or circadian measures in elderly subjects. These results show that subjective sleep quality does deteriorate in the healthy elderly, but not to the level seen in patients with sleep disorders. Extremely healthy elderly subjects appear to adapt in their perception of objectively disturbed sleep.

Aged↗
PubMed1986

Performance and sleepiness following moderate sleep disruption and slow wave sleep deprivation.

Recent studies have shown that periodically disrupted sleep resulted in significant daytime sleepiness and performance loss in normal young adults. One study suggested that the periodicity of disturbance rather than the total number of sleep disturbances was the primary factor in causing degraded function. However, in that study, increased performance levels could have been associated with increased levels of slow wave sleep. The present study was designed to determine whether the amount of SWS rather than the periodic disruption of sleep accounts for decreased performance of Ss with disrupted sleep. Twelve normal young adults spent two 4-night periods in the laboratory. During one 4-night series, Ss were briefly aroused either following each 10 min of sleep or whenever they entered stage 3 sleep (No SWS condition). During the second series of nights, Ss were briefly aroused after each 10 min of sleep (SWS condition). In the second series, additional arousals were performed after 5-min periods (but not when Ss were in SWS) to equalize the total number of arousals in the SWS conditions with those in the No SWS condition. Total experimental arousals were equal in the disruption conditions, and the experimental manipulation was successful in reducing total SWS to infrequent epochs of stage 3 in the No SWS condition while allowing significantly more SWS in the SWS condition. In terms of sleep stages, this difference was balanced by increased stage 2 in the No SWS condition. Despite the differential occurrence of SWS, no performance, mood, or nap latency measure was different in the SWS vs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1980

Distribution of REM sleep on a 90 minute sleep-wake schedule.

Ten young adult (ages 17-21) volunteers lived on a 90 min sleep-wake schedule for 86 (n = 5) or 96 (n = 5) consecutive 90 min periods. Subjects were permitted to sleep in 30 min episodes separated by 60 min of enforced wakefulness. These bedrest episodes were monitored by electroencephalogram, electro-oculogram, and electromyogram and were scored in 30 sec epochs using standard criteria. REM sleep episodes on this schedule occurred with a clear daily cycle; 74% of REM sleep time occurred during the rising phase of the body temperature cycle. REM showed a marked tendency to recur during alternate bedrest episodes. Finally, REM and slow wave sleep occurred together during only 27 of 910 bedrest episodes. The findings support a circadian influence on the temporal distribution of REM sleep. Neither the sleep-independent nor the sleep-dependent models of REM sleep were supported by findings on the 90 min schedule.

Adolescent↗
PubMed1996

Prolonged interval from body temperature nadir to sleep offset in patients with delayed sleep phase syndrome.

In order to clarify the relationship between sleep-wake and core body temperature rhythms in the delayed sleep phase syndrome (DSPS), we conducted simultaneous monitoring of these rhythms in seven patients with DSPS and nine healthy control subjects for 6-10 days during their conventional sleep-wake schedules. The sleep onset and offset times were determined visually from sleep logs, and the temperature data were fitted to 24-hour cosinor curves by the least squares method. The sleep onset and offset times and temperature nadir were delayed significantly in patients with DSPS compared with the control subjects (p = 0.01, 0.003 and 0.02, respectively). We also found that sleep length and the temperature nadir to sleep offset interval were significantly longer in the DSPS than the control group (p = 0.03 and 0.02, respectively). The latter finding suggests that the inability of the patients with DSPS to normally phase-advance their circadian rhythm may be a consequence of masking of the advance portion of their phase-response curve by the last hours of their prolonged sleep episodes.

Adult↗
PubMed1996

[Quality of sleep and periodic breathing during sleep in healthy persons at a height of 3200 meters].

In order to investigate quality of sleep and sleep-related breathing disorders (SRBD) at high altitude we performed full polysomnography in 9 young healthy volunteers at lowland (760 m above see level) and on the 1st and 6th night after the ascent to the altitude of 3200 m. The subjects were non-smoking males aged 20.3 +/- 3.5 years with normal spirometry and arterial blood gas measurements performed at low altitude. We found no statistical difference in sleep quality between low and both nights at high altitude as considered by % of stages 1, 2, 3 + 4 non-REM, and REM sleep, total sleep time, sleep efficiency, and number of awakenings+arousals. There was no periodic breathing (PB) during sleep but some central events of SRBD at low altitude. PB appeared at high altitude mostly during non-REM sleep and remained stable throughout the study period. There were also some obstructive SRBD found during high altitude nights. Mean SaO2 was lower during both nights at high altitude when compared to low altitude (p < 0.00001). It was higher during the 6th than during the 1st night at altitude (p < 0.0001). Minimum SaO2 was comparable during low altitude and 6th night at altitude and was lower during the 1st altitude night (p < 0.02). We conclude that sleep quality at the altitude of 3200 m remains unchanged when compared to lowland. There is high individual variability in PB at altitude and its intensity is negligible.

Adult↗
PubMed1997

[Actigraphy: methodological limits for evaluation of sleep stages and sleep structure of healthy probands].

UNLABELLED: Purpose of the investigation was to evaluate the differences of movement density during the sleep stages and waking. 22 diurnally active, healthy, male volunteers of mean age 30.7 (+/-Standard deviation +/- 3.3) years and a Body-Mass-Index 23.6 +/- 3.3 kg/m2 participated in the study. All subjects were recorded in the sleep lab via cardiorespiratory polysomnography and wrist actigraphy (Ambulatory Monitoring, Ardsley, USA) worn on the non-dominant hand, for two consecutive nights. The activity data, consisting of the number of zero crossings (NZC) were recorded in 1-minute periods. Sleep stages were scored visually according to standard criteria. EEG- and actigraphy data were converted to the same data format (European Feature Files). Attaching the actimetry data to the sleep stages was calculated mean NZC for every sleep stage and Wake. In spite of high differences in total individual NZC we observed that most NZC occurred during Wake. NREM 1 movement density was significantly higher in 19 recordings (86%) than in any other sleep stage. In 18 cases (82%) lowest movement density was found in NREM 3/4 with significant difference to all other sleep stages. Within 50% of the recordings were found decreasing activity in the following sequence of stages: Wake > NREM 1 > REM > NREM 2 > NREM 3/4 However, in all other cases there was a varying pattern of activity. CONCLUSION: Although there is some correlation between motor activity and sleep stages, the predictive value of actimetry data analysis in the assessment of sleep structure appeared to be limited mainly by individual movement density, especially during REM and NREM 2.

Adult↗
PubMed1981

The influence of synthetic DSIP (delta-sleep-inducing-peptide) on disturbed human sleep.

The effects of acute intravenous administration of synthetic DSIP, 25 nmoles/kg b.wt, on disturbed human sleep were tested in 6 middle-aged chronic insomniacs. The results were: longer sleep duration and a higher quality of sleep with fewer interruptions; slightly more REM-sleep, but no day-time sedation or other side effects though the sleep enhancing capacity was seen for up to 6 h of night sleep. Sleep-promoting effects occurred only in the second hour after injection, in the first hour a slight arousing effect was indicated. The study corroborates the findings of previous investigations in healthy subjects and shows that DSIP has a normalizing influence on human sleep regulation.

Adult↗
PubMed1976

Recovery sleep following different visual conditions during total sleep deprivation in man.

The findings of visual impairment during total sleep deprivation were used as a basis for a possible link between vision and sleep. It was proposed that the level of visual load imposed during sleep deprivation was an important variable, and would have a substantial effect upon recovery sleep. Six young male subjects underwent two conditions of 64 h of sleep deprivation on separate occasions. One condition incorporated a high visual load, and the other a low load. Exercise and sound were balanced. All night sleep EEGs were taken for two baseline nights, and also for two recovery nights following each condition. There was a significant increase of stage 4 on all recovery nights and a REM rebound on the second recovery night. SWS, particularly stage 4, TST and REM density, were significantly greater following the high load. Implications of these findings for sleep theories and for sleep deprivation research are discussed.

Adult↗
PubMed1985

Reduced sleep in cats after intraperitoneal injection of delta-sleep-inducing peptide (DSIP).

The effect of intraperitoneally injected delta-sleep-inducing peptide (DSIP) on sleep-wakefulness in cats was studied using EEG, EMG and EOG recording for 10 h following 30 nmol/kg DSIP or control saline i.p. injections. DSIP reduced the amount of sleep, specifically light slow-wave sleep and REM sleep, and REM sleep latency was increased. The results suggest that in cats with redundancy sleep DSIP increases wakefulness at the cost of light slow-wave sleep, and in addition it has a specific REM-reducing effect.

Animals↗
PubMed2000

Does obstructive sleep apnea confound sleep architecture findings in subjects with depressive symptoms?

BACKGROUND: Compared with normal subjects, depressed patients have shorter rapid eye movement sleep latency (REML), increased REM and decreased slow wave sleep as a percentage of total sleep time (REM%, SWS%), and longer sleep latency (SL). Obstructive sleep apnea (OSA) patients experience longer REML, decreased REM% and SWS%, and shorter SL. We examined the interplay of depressive symptoms, OSA, and sleep architecture. METHODS: Subjects (n = 106) were studied with polysomnography. OSA was defined as a Respiratory Disturbance Index > or = 15. Subjects were divided into Hi/Lo groups using a Center for Epidemiological Studies-Depression (CES-D) score of 16. RESULTS: OSA patients had shorter SL than non-OSA patients (14.5 vs. 26.8 min, p <.001); Hi CES-D subjects showed a trend toward longer SL than Lo CES-D subjects (23.7 vs. 17.5 min, p =.079). Significant OSA x CES-D interactions emerged, however, for REM% (p =.040) and SL (p =.002): OSA/Hi CES-D subjects had higher REM% than OSA/Lo CES-D subjects (19.3% vs. 14.3%, p =.021); non-OSA/Hi CES-D subjects had SL (35.3 min) 2-3 times as long as other subjects (p =.002-.012). CONCLUSIONS: Because of the high prevalence of OSA and depression, findings suggest that OSA must be considered in studies of mood and sleep architecture. Conversely, depressive symptoms must be considered in studies of OSA and sleep architecture.

Adult↗
PubMed1994

Decreased delta-sleep and plasma delta-sleep-inducing peptide in patients with Cushing syndrome.

To evaluate the sleep disturbances of patients with Cushing syndrome and to examine the relationship between the sleep disturbances and plasma levels of delta-sleep-inducing peptide-like immunoreactivity (DSIP-LI), we performed three polysomnographic/endocrinological studies in patients with Cushing syndrome. In study 1, polysomnography was studied in 12 patients and 12 matched normal volunteers. In addition, DSIP-LI was measured every 30 min for 24 h in 9 patients with Cushing syndrome and 12 normal volunteers. The percentage of time spent in delta sleep (stages 3 and 4) was significantly reduced in patients with Cushing syndrome (5.8 +/- 1.4%; mean +/- SEM) compared to normal volunteers (14.0 +/- 2.5%) (p < 0.01). REM sleep indices, however, were not significantly different between the two groups. There was a significant negative correlation between amount of delta sleep and 08.00 h DSIP-LI (r = -0.43, p < 0.05), which is against the notion of a causal relationship between DSIP-LI and delta sleep. The circadian rhythm of plasma DSIP-LI was found to be similar in Cushing patients and normal volunteers. In study 2, we measured plasma levels of delta-sleep-inducing peptide-like immunoreactivity (DSIP-LI) at 08.00 h in 65 patients with Cushing syndrome and 49 normal volunteers. The 08.00 h DSIP-LI concentrations of 797 +/- 57 pmol/l (mean +/- SEM) in the patients with Cushing syndrome were significantly reduced compared to the level of 1,062 +/- 99 pmol/l found in the normal volunteers (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenocorticotropic Hormone↗
PubMed1980

Effects of restricted sleep with different exercise loads upon subsequent sleep.

Seven male cats were adapted to different schedules of restricted sleep. The cat was permitted to go to sleep either 2, 4 or 8 hours per day with the balance to 24-h periode spent in wakefulness enforced by means of a treadmill. Two experiments were run and the same cats served in both runs. The experiments and schedules were separated by at least two weeks during which time cats were maintained under ordinary laboratory conditions. Our experiment used treadmill speed of 2.6 m/min which was easily tolerated and effective in eliminating sleep. Another experiment used treadmill speed of 4.6 m/min which produced more physical exercise. As available sleep time become progressively shorter, REM sleep increased while SWS decreased. If restriction in sleep time was associated with more physical exercise then the composition of the subsequent sleep was different : SWS increased while REM sleep decreased. The functional significance of these opposite effects are presumably different. The immediate SWS response to the prior muscular exercise is suggestive of its recovery function.

Animals↗
PubMed1975

Dreaming sleep attacks and desynchronized sleep enhancement. Report of a case of brain stem signs.

When central neurologic signs were localized to the vestibular region of the brain stem and cerebellum, a 54-year-old man experienced frequent awakenings from nocturnal sleep and daytime sleep attacks with hallucinosis. Sleep attacks were characterized by lid fluttering and closure, upward turning of the eyes, rapid eye movements, myoclonic twitching of all extremities, and loss of consciousness, lasting one or two minutes and aborted by strong sensory stimulation. At their termination, reports of hallucinoid imagery were given. In a sleep record of 6.5 hours, there were 2.2 hours awake (34%), 4.3 hours desynchronized sleep (66%), and a complete absence of synchronized sleep. Reports of hallucinoid imagery were given after awakenings from desynchronized sleep. The findings support the hypotheses that desynchronized sleep is normally under brain stem control and that some types of narcolepsy may be pathophysiologically related to desynchronized sleep.

Brain Diseases↗
PubMed1979

Short and long sleep and sleeping pills. Is increased mortality associated?

Prospective epidemiologic data of the American Cancer Society disclosed that reported usual sleep durations among groups who complained of insomnia and sleeping pill use "often" overlapped with those of groups who had no complaints. Reports of insomnia were not consistently associated with increased mortality when several factors were controlled; however, men who reported usually sleeping less than four hours were 2.80 times as likely to have died within six years as men who reported 7.0 to 7.9 hours of sleep. The ratio for women was 1.48. Men and women who reported sleeping ten hours or more had about 1.8 times the mortality of those who reported 7.0 to 7.9 hours of sleep. Those who reported using sleeping pills "often" had 1.5 times the mortality of those who "never" used sleeping pills. These results do not prove that mortality could be reduced by altering sleep durations or by reducing hypnotic prescribing. Rather, studies are needed to determine the causes of these mortality risk factors.

Adult↗
PubMed2005

Effects of periodic leg movements during sleep in middle-aged subjects without sleep complaints.

Recent reports have called into question the relevance of periodic leg movements during sleep disorder (PLMSD) as a specific clinical entity. Because periodic leg movement in sleep index (PLMSI) increases with age, it has become an important exclusion criterion in research on aging. However, it is unknown if PLMSI is related to sleep quality in middle-aged subjects without sleep complaints. The sleep of 70 healthy, middle-aged subjects (age 40 to 60 years) without sleep complaints was evaluated. Subjects were divided into two groups according to their PLMSI severity: (1) 43 subjects (28 women, 15 men) were in the low PLMSI group (<5) and (2) 22 subjects (9 women, 13 men) were in the high PLMSI group (>10). A significantly higher proportion of men than women showed PLMSI greater than 5. There was no significant effect of PLMSI severity group for polysomnographic sleep parameters. PLMSI exerted a small but significant effect on subjective sleep quality, especially in middle-aged men. These results raise questions about the relevance of PLMSI as a pathological index for middle-aged subjects without sleep complaints and support the notion that an increase in PLMSI may be part of the normal process of aging associated with the loss of dopaminergic function.

Adult↗
PubMed1981

Raphe unit activity during REM sleep in normal cats and in pontine lesioned cats displaying REM sleep without atonia.

Previous studies have shown that the activity of serotonin-containing raphe neurons in cats is almost completely suppressed during rapid eye movement (REM) sleep. However, since raphe unit activity is known to be grossly correlated with the level of behavioral arousal or tonic motor activity, this decrease in activity during REM sleep may be simply due to the fact that tonic EMG activity or motoric output is at a minimum. On the other hand, raphe unit activity may be related to the state (i.e. REM sleep) of the organism. To test these competing hypotheses, in the present study we compared raphe unit activity in normal cats with that in cats that display REM sleep without atonia (produced by bilateral lesions of the pontine tegmentum). These lesioned cats manifest episodes which, by all criteria, appear to be REM sleep except that they display overt behavior, presumably because the mechanism normally responsible for producing atonia has been disrupted. Although the activity of raphe neurons in lesioned cats during REM sleep without atonia was significantly below that seen in these cats during waking, the level of activity was often impressive. This is especially true when those animals that displayed the greatest degree of tonic motor activity during REM sleep (group IV animals) are considered separately. In these cats, the depression was only 40.5% below their quiet waking level, whereas in lesioned cats displaying less tonic motor activity (Group II animals), raphe discharge rate was 65.6% below their quiet waking level. The discharge rate of raphe neurons during REM sleep in lesioned cats was more than 6-fold greater than that seen in normal animals. These data, in conjunction with other recent results from our laboratory, suggest that the decrease in raphe unit activity during REM sleep is largely a concomitant of the atonia which characterizes that state. These data are discussed within the general context of the relationship between raphe unit discharge and the activity of central motor systems.

Animals↗
PubMed1990

Periodicity analysis of sleep EEG in the second and minute ranges--example of application in different alpha activities in sleep.

To investigate the temporal organization of EEG sleep activity in the second and minute ranges we developed a method which, based on Fourier transformation, allows the presentation of periodic oscillations of spectral power and coherence. The application of this method is demonstrated in 3 subjects with different types of alpha activity during sleep: (a) alpha-sleep pattern (a physiological variant of NREM sleep activity); (b) abnormally increased arousal alpha activity. The results show that differences in the temporal organization of these alpha activities can be determined with the following parameters: period length, duration of sequences with periodic activity, number and rate of these sequences, and proportion of periodicities generated simultaneously in the left and right hemispheres. The physiologically modulated periodicities of the alpha-sleep pattern are contrary to a stereotyped 40-60 sec periodicity of abnormal arousal alpha activity. Such abnormal periodicity corresponds to periodicities occurring in association with other sleep disturbances, such as sleep apnea or periodic movements in sleep. Periodicity analysis gives additional criteria for a more refined evaluation of normal as well as abnormal sleep structure.

Adult↗
PubMed2004

Sleep inertia: performance changes after sleep, rest and active waking.

Napping benefits and sustains subsequent performance. Prophylactic naps have been recommended as a means to maintain performance during extended wakefulness, as required during shiftwork. However, napping may cause short-term performance impairments, because awakening from sleep is followed by sleep inertia, a period of hypovigilance and impaired cognitive and behavioral performance. We investigated sleep inertia after an afternoon nap. Healthy 18-28 year-olds (n=50, not sleep deprived) were assigned to sleep, active wake or rest groups for a 2-h experimental phase with polysomnography starting either at 14:00 or 16:00 for half of each group. Before (baseline, 12:30 or 14:30) and in five sessions during the hour after the experimental phase (16:00-17:00 or 18:00-19:00), subjects completed an addition task, an auditory reaction time task, and the Stanford Sleepiness Scale. In session one, addition speed in the sleep group was reduced compared with baseline and with active wake controls, whereas calculation accuracy did not change. Addition speed in the sleep and rest groups increased substantially from session one to session two and reached a level similar to that of the active wake group by the fifth session. In the first session, auditory reaction speed of the sleep group was reduced compared with baseline and with rest controls but did not differ from the active wake group. The slowest reaction times showed significant recovery after 20 min. The groups reported similar increases in subjective sleepiness after the experimental period. These findings provide evidence for performance slowing and recovery during the hour following a 2-h nap opportunity. They highlight the importance of employing multiple control groups and various objective and subjective measures to assess sleep inertia.

Acoustic Stimulation↗