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PubMed1985

Relationship between the microfilarial migration and the changes of sleep stage with special reference to REM sleep.

Eleven subjects with filariasis were investigated for the relationship between the microfilarial migration and the changes of sleep stage with special reference to REM sleep. Tests on ten patients except one case revealed that the sleep of each case showed a highly consistent pattern from the viewpoint of the first night. Microfilariae were counted every hour and at each REM stage. From these data, the characteristic findings were observed as follows: 1) Microfilarial migration reached the maximum peak around midnight, showing a Poisson type distribution, even though, one case slept only 47 minutes throughout the night, having no REM sleep. 2) Suppression of microfilarial migration during REM sleep was noted in 72%, which was independent of the slow wave sleep. Finally, suppression of microfilarial migration during REM sleep is discussed from the point of view of Hawking's pendulum model and physiological phenomena of REM sleep.

Adolescent↗
PubMedDate not supplied

[Patients' sleep in intensive care units and sleep-modifying factors].

Patients admitted to intensive care units sleep poorly, generally because of the environmental conditions of these units. Sleep deprivation in critical patients has severe consequences and can contribute to deterioration of their condition. The quality of sleep of the patients in our unit was evaluated to identify factors that they considered disruptive of sleep. The study included 33 patients who were admitted between April 1998 and January 1999 and had remained conscious and oriented for at least 5 days before being included in the study. We asked them to evaluate how well they had slept during their stay in the unit and to score specific factors that could disrupt sleep (environment, admission to the unit, techniques and procedures) on a scale of 0 to 10. Most patients (63.6%) claimed that they "always" or "usually" slept well. The most disruptive environmental factor was the sound of alarms, pain bothered patients more than fear or anxiety, and endotracheal intubation and mechanical ventilation were the techniques that most interfered with sleep. The quality of sleep of patients in the unit was apparently uninfluenced by pre-admission sleep problems, the severity of the process, or the type of analgesia-sedation administered. The largest percentage of patients who slept poorly had been admitted to one of the wings of the unit, which should be studied specifically.

Attitude to Health↗
PubMed2004

Involuntary sleep during civil air operations: wrist activity and the prevention of sleep.

BACKGROUND: During air operations, aircrew may encounter sleepiness that can arise from the length of duty periods, working during the circadian low of alertness, and circadian dysrhythmia arising from time-zone change. A previous study investigated physiological and physical measures that could be used to identify sleep and provide the basis of an alertness alarm. Eye movements were sensitive indicators of sleepiness and sleep, and wrist inactivity identified sleep episodes lasting longer than 5 min. HYPOTHESIS: Wrist inactivity can provide the basis of a practical alertness device for use by aircrew. METHODS: The electrical activity of the brain (electroencephalogram, EEG), eye movements, and wrist activity were recorded continuously from the Captain and First Officer during six return flights between London and Chicago. The route comprised an outward daytime and overnight return flight, each lasting approximately 9 h. The EEG and eye movements were used to identify sleepiness and sleep, and these episodes were correlated with periods of wrist inactivity. A software simulation based on the data collected during the study was conducted in order to determine the number of errors generated by an alertness alarm based on wrist inactivity lasting 3, 4, or 5 min. RESULTS: Sleepiness or sleep was observed in 8 of the 12 subjects. All periods of sustained sleep in excess of 5 min were associated with at least 5 min of wrist inactivity. The simulated alertness alarm using a wrist inactivity setting of 5 min gave only one false alarm, and in this respect performed better than a device based on a shorter time interval (3 or 4 min). CONCLUSIONS: An alertness device based on wrist inactivity would prevent sustained periods of sleep lasting longer than 5 min. It would not, however, reliably detect sleepiness and brief episodes of sleep. The anticipated use of the device is in support of the management of alertness in aircrew, where it could be used to ensure that unintended or unauthorized napping does not occur or is detected in a timely manner.

Adult↗
PubMed1996

Effects of sleeping in a chemical protective mask on sleep quality and cognitive performance.

PURPOSE: We wanted to determine whether sleep is disrupted when soldiers sleep in a new chemical protective mask, the M40. Sleep quantity and quality, extent of protection provided by the mask during sleep, and next day performance were assessed. METHOD: After several days of training, 9 male soldiers slept with and without the M40 mask on four occasions. RESULTS: Soldiers were able to tolerate the mask for most or all of the night. However, sleep, as assessed by wrist-worn activity monitors, was significantly disturbed. Minutes (mean +/- SEM) of waking significantly increased, from 25 +/- 2.1 to 86 +/- 8.5 per night (p < 0.001), and number of awakenings rose from 8 +/- 0.6 to 20 +/- 0.9 (p < 0.0001). Soldiers reported that it took longer and was more difficult to fall asleep when wearing the mask. Errors on a choice reaction time task increased significantly and subjects reported greater fatigue and sleepiness the day after sleeping in the mask. Protection provided by the masks varied substantially among subjects and declined over the course of the study. Some soldiers were protected throughout the night but others were only protected intermittently. CONCLUSION: We conclude that sleeping in the chemical protective mask should only be done when necessary, given the adverse effects on sleep and daytime function, as well as the variability of protection, of the mask.

Adult↗
PubMed1998

Delta sleep deficits in schizophrenia: evidence from automated analyses of sleep data.

BACKGROUND: Several, though not all, polysomnographic studies that use conventional visual scoring techniques show delta sleep deficits in schizophrenia. Delta sleep (in particular, > or = 1- to 2-Hz frequency range), mediated by thalamocortical circuits, is postulated to be abnormal in schizophrenia. We investigated whether deficits in delta sleep occur in schizophrenia and whether these are primarily related to the illness or are epiphenomena of previous medication use or illness chronicity. METHODS: We compared 30 unmedicated schizophrenic patients and 30 age- and sex-matched controls for sleep data evaluated by visual scoring as well as automated period amplitude analyses and power spectral analyses. RESULTS: Schizophrenic patients had reduced visually scored delta sleep. Period amplitude analyses showed significant reductions in delta wave counts but not rapid eye movement counts; power spectral analyses showed reductions in delta as well as theta power. Delta spectral power was also reduced in the subset of 19 neuroleptic-naive, first-episode schizophrenic patients compared with matched controls. Delta deficits were more pronounced in the greater than 1- to 2-Hz frequency range. CONCLUSIONS: Delta sleep deficits that occur in schizophrenia may be related to the primary pathophysiological characteristics of the illness and may not be secondary to previous neuroleptic use. Automated sleep quantification by means of period amplitude and power spectral analyses can complement the use of conventional visual scoring for understanding electrophysiological abnormalities in psychiatric disorders.

Adult↗
PubMed1979

Influence of diffuse brain stimulation (DBS) on human sleep. I. Sleep pattern changes.

A 20 min period of diffuse brain stimulation (DBS), administered just before sleep onset in 16 human subjects, appeared to alter significantly the first sleep cycle of the succeeding sleep. The length of the first sleep cycle and the amount of REM sleep increased, whereas a shift from deep to more superficial NREM sleep occurred. This effect of DBS on sleep is discussed with respect to data from the literature on the effect of narcotic DBS and on that of local brain stimulation in animals.

Adult↗
PubMed1986

Enhanced slow sleep in extended sleep.

The slow wave sleep (0.5-2.5 Hz) of 42 subjects who slept in a laboratory for more than 8 h was examined. Although the amount of slow wave sleep diminished exponentially across the first 11 h of sleep, there is evidence of an increase in amount of slow wave sleep in more extended sleep. This finding complicates the concepts of slow wave sleep as an index of sleep need due to prior wakefulness or an index of a restoration process.

Adult↗
PubMed1990

The effect of 3-h and 6-h sleep deprivation on sleep and EEG spectra of the rat.

Vigilance states and EEG power density of the rat were determined after a 3- or 6-h sleep deprivation (SD) in the beginning of the 12-h light period. In comparison to baseline, non-rapid eye movement (REM) sleep showed a delayed and transitory increase after 3 h SD, and an immediate and persistent increase after 6 h SD. REM sleep was not affected. In non-REM sleep, EEG power density in the low-frequency range (0.75-6.0 Hz) was markedly enhanced after 6 h SD, but not significantly increased after 3 h SD. In REM sleep EEG activity in the 5-6 Hz band was increased after 6 h SD. We conclude that in the early part of the light period, 3 h waking prolongs non-REM sleep, whereas 6 h waking also enhances non-REM sleep intensity.

Animals↗
PubMed2005

Tiagabine enhances slow wave sleep and sleep maintenance in primary insomnia.

BACKGROUND AND PURPOSE: To evaluate the effect of tiagabine on sleep and next-morning alertness and performance in adult patients with primary insomnia. PATIENTS AND METHODS: Patients with primary insomnia, as defined by Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition (DSM-IV), received tiagabine 4, 8, 12, 16 mg, and placebo in a randomized, double-blind, five-period, Latin square, crossover study. Efficacy was assessed using polysomnographic and self-report techniques; residual effects were evaluated using the Digit Symbol Substitution Test (DSST) and the Rey Auditory Verbal Learning Test (RAVLT). RESULTS: Fifty-eight patients (40f, 18m; mean age 46.6+/-8.0 years) were randomized. Results showed a significant dose-dependent increase in slow wave sleep percentage with all tiagabine doses, a trend toward a dose-dependent increase in total sleep time, and no effect on latency to persistent sleep. Wake after sleep onset also decreased in a dose-dependent manner, with the 16-mg dose differing significantly from placebo. The tolerability profiles of tiagabine 4 and 8 mg were similar to placebo. The most common adverse events reported following tiagabine 12 and 16 mg were dizziness and nausea. Residual effects were only apparent at 12- and 16-mg doses. CONCLUSIONS: Tiagabine increased slow wave sleep and reduced wake after sleep onset in a dose-dependent manner. Tiagabine dosages up to 8 mg did not compromise next-morning alertness and psychomotor performance in adult patients with primary insomnia. Further investigation of tiagabine doses up to 8 mg is warranted.

Adult↗
PubMedDate not supplied

Galanin has REM-sleep deprivation-like effects on the sleep EEG in healthy young men.

Rapid eye movement (REM) sleep deprivation leads to an induction of galanin gene expression in the rat brain, especially in the hypothalamus. Galanin affects neuroendocrine systems that are involved in sleep regulation, i.e. the growth hormone-releasing hormone-dependent system of the hypothalamus and the locus coeruleus. In the study reported here we investigated the effects of 4 x 50 microg galanin (n = 10) and of 4 x 150 microg galanin (n = 8) administered hourly between 22.00 and 01.00 h as intravenous boluses on the sleep EEG and nocturnal hormone secretion in healthy young men. Galanin administration significantly increased REM sleep in the third sleep cycle with no difference between the two doses. Spectral analysis revealed a significant increase in the EEG power in the delta and theta frequency range for the total night after the lower dose of galanin, but not after the higher dose. The secretion of growth hormone, cortisol and prolactin remained unchanged during sleep in both cases. Our data are consistent with the assumption of a functional resemblance between the effect of galanin and that of REM sleep deprivation, which is known to have antidepressive efficacy.

Adult↗
PubMed2006

Patients' and sleeping partners' experience of treatment for sleep-related breathing disorders with a mandibular repositioning splint.

AIM: To determine in detail the complications associated with the use of mandibular repositioning splints (MRS) to treat sleep-related breathing disorders. METHOD: This prospective cross-sectional cohort study audits the management with mandibular repositioning splints of 121 patients suffering from sleep-related breathing disorders. Investigation of patients' and sleeping partners' perspectives on treatment was undertaken with the use of a questionnaire based study. RESULTS: Sixty-eight per cent of respondents reported that they were compliant with treatment; various side effects were reported of which excess salivation was the most common. Investigation of sleeping partners' perspectives revealed that 70% felt that their partners' snoring was improved and 47% felt that their partner's breathing pauses during sleep were reduced. Sixty-four per cent of the sleeping partners also reported that their own sleep pattern had improved since their partner's treatment. CONCLUSION: Mandibular repositioning splints used in the manner described by this paper are demonstrated to have a good compliance rate, provide successful treatment and exhibit only minor, reversible side effects.

Adult↗
PubMed2004

Neurobehavioral functioning in obstructive sleep apnea: differential effects of sleep quality, hypoxemia and subjective sleepiness.

This study evaluated the relationship between neuropsychological and affective functioning, subjective sleepiness and sleep-disordered breathing in 100 patients with obstructive sleep apnea (OSA). Using principal components analysis, three indices of sleep-disordered breathing were identified from polysomnography: sleep disturbance, extent of nocturnal hypoxemia, and sleep quality. Poorer sleep quality was related to slower processing speed, somatic symptomatology and tension-anxiety levels. Nocturnal hypoxemia was related to visuconstructional abilities, processing speed and mental flexibility. Patients who had high levels of subjective sleepiness had poorer performances on a complex task of executive functioning and higher levels of tension-anxiety. These results imply a differential effect of sleep-disordered breathing on domains of neuropsychological functioning. Additionally, they suggest that a patient's subjective level of sleepiness is a good predictor of certain aspects of neurobehavioral functioning.

Adult↗
PubMed1992

Delta sleep-inducing-peptide-like immunoreactivity (DSIP-LI) and delta sleep in schizophrenic volunteers.

Delta sleep-inducing-peptide (DSIP) has been reported to increase sleep in subjects with insomnia. The authors studied cerebrospinal fluid (CSF) DSIP-like immunoreactivity (DSIP-LI) in 15 drug-free male subjects with a DSM-IIIR diagnosis of schizophrenia. The subjects underwent a lumbar puncture and three nights of polysomnography. CSF DSIP-LI was significantly correlated with polysomnography the night before the LP: with stage 3 sleep (p = 0.05), stage 3 and delta (stages 3 + 4) sleep during the first nonrapid eye movement NREM period (p = 0.02 and p = 0.05, respectively) and the ratio of the first and second NREM period (p < 0.05), and negatively with stage 2% sleep (p < 0.05). Whether this first report of a potential relationship between CSF DSIP-LI and slow-wave sleep in man might be generalized to sleep in nonpsychiatric subjects awaits further study.

Adult↗
PubMed2002

Factors related to the occurrence of isolated sleep paralysis elicited during a multi-phasic sleep-wake schedule.

STUDY OBJECTIVES: To further investigate mechanisms of isolated sleep paralysis (ISP) in normal individuals, we experimentally elicited ISPs by facilitating sleep onset REM periods (SOREMP), a prerequisite of ISPs, and examined behavioral and psychological measurements relating to ISP appearances. DESIGN: The multi-phasic sleep/wake schedule (MPS) began at approximately midnight and ended when net sleep reached 7.5 hours. Participants were awakened after every 5 min of REM sleep to obtain a maximum number of SOREMPs. Upon each awakening, mentation reports and subjective measurements were collected. Performance tests were then assigned. SETTING: Sleep lab, Tokyo Metropolitan Institute for Neurosciences, Japan. PARTICIPANTS: Thirteen healthy Japanese students (10 males) with high self-reported frequencies of ISPs but no other narcolepsy-related symptoms. INTERVENTIONS MEASUREMENTS AND RESULTS: From 184 sleep interruptions, 8 ISP episodes were obtained. In within participant comparisons between episodes with and without ISPs, the vigilance task (VT) reaction times were elevated before SOREMPs with ISPs. In between analyses (ISP vs non-ISP), the ISP group showed poorer performance, more complaints of physical, mental, and neurotic symptoms, increased subjective fatigue and increased stage 1 throughout the entire schedule. VT hit rates remained constant in the non-ISP group, but dropped in the later part of schedule in the ISP group. Subjective sleepiness dropped over time in the non-ISP group while it slightly increased in the ISP group. CONCLUSIONS: ISP is likely to appear as a phenotype of REM dissociation during SOREMP when participants with low tolerance for disrupted sleep-wake rhythms are placed in this type of schedule.

Adult↗
PubMed2004

Children with obstructive sleep-disordered breathing generate high-frequency inspiratory sounds during sleep.

STUDY OBJECTIVES: We observed that some children with adenotonsillar hypertrophy and obstructive sleep-disordered breathing (SDB) make high-frequency inspiratory sounds (HFIS) during sleep. Our objective was to determine whether HFIS occur in most children with obstructive SDB and adenotonsillar hypertrophy and whether adenotonsillectomy reduces HFIS. DESIGN: Prospective consecutive-entry trial. SETTING: Sleep laboratory. PARTICIPANTS: Twenty-six children between 6 and 12 years of age with adenotonsillar hypertrophy suspected of having obstructive SDB. MEASUREMENTS AND RESULTS: We performed polysomnography and measured sounds during sleep with a microphone suspended above the bed. Sounds were recorded on a computer at 44 kHz, analyzed with fast Fourier transformation for frequency content. HFIS were sounds occurring during an inspiration with frequencies greater than 2 kHz. HFIS were different from the low-frequency (< 2 kHz) sounds described in snoring adults. HFIS usually occurred in consecutive breaths, occasionally exceeding 100. We counted the number of HFIS that occurred per hour of sleep. Children who made more HFIS had more obstructive SDB than did those who did not make the HFIS, and there was a significant positive correlation between the number of HFIS and the obstructive apnea-hypopnea index. Children with more than 3 apneas and hypopneas per hour of sleep all made at least 10 HFIS per hour, and all children who had more than 10 HFIS per hour had obstructive apnea-hypopnea index values greater than 1. Children with adenotonsillar hypertrophy made more HFIS than did those children whose tonsils and adenoids had been removed. CONCLUSIONS: HFIS may be a marker of disturbed breathing during sleep in children with adenotonsillar hypertrophy.

Adenoidectomy↗
PubMedDate not supplied

Sleep studies in benign epilepsy of childhood with rolandic spikes. I. Sleep pathology.

Polygraphic all-night sleep records of 11 children with typical benign epilepsy of childhood with rolandic spikes (BERS) and those of eight nonepileptic controls were investigated with regard to sleep pathology. Basic properties of sleep organization and electromorphology were preserved in both groups. Seventeen quantitative sleep parameters were measured. Except for more waking in the BERS group, no sleep parameter showed significant differences between the BERS and the control group, but differences existed in comparison to normative values. We interpret our results as showing that in BERS epileptic neuronal malfunctioning does not affect sleep organization in a characteristic manner. The lack of detrimental interactions between epileptic neuronal behavior and pathological sleep alterations may be an additional cause of the benign course of BERS.

Adolescent↗
PubMed2005

Challenging the sleep homeostat does not influence the thermoregulatory system in men: evidence from a nap vs. sleep-deprivation study.

The purpose of our study was to understand the relationship between the components of the three-process model of sleepiness regulation (homeostatic, circadian, and sleep inertia) and the thermoregulatory system. This was achieved by comparing the impact of a 40-h sleep deprivation vs. a 40-h multiple nap paradigm (10 cycles with 150/75 min wakefulness/sleep episodes) on distal and proximal skin temperatures, core body temperature (CBT), melatonin secretion, subjective sleepiness, and nocturnal sleep EEG slow-wave activity in eight healthy young men in a "controlled posture" protocol. The main finding of the study was that accumulation of sleep pressure increased subjective sleepiness and slow-wave activity during the succeeding recovery night but did not influence the thermoregulatory system as measured by distal, proximal, and CBT. The circadian rhythm of sleepiness (and proximal temperature) was significantly correlated and phase locked with CBT, whereas distal temperature and melatonin secretion were phase advanced (by 113 +/- 28 and 130 +/- 30 min, respectively; both P < 0.005). This provides evidence for a primary role of distal vasodilatation in the circadian regulation of CBT and its relationship with sleepiness. Specific thermoregulatory changes occur at lights off and on. After lights off, skin temperatures increased and were most pronounced for distal; after lights on, the converse occurred. The decay in distal temperature (vasoconstriction) was significantly correlated with the disappearance of sleep inertia. These effects showed minor and nonsignificant circadian modulation. In summary, the thermoregulatory system seems to be independent of the sleep homeostat, but the circadian modulation of sleepiness and sleep inertia is clearly associated with thermoregulatory changes.

Body Temperature↗
PubMed1998

Sleep fragmentation indices as predictors of daytime sleepiness and nCPAP response in obstructive sleep apnea.

Sleep fragmentation and respiratory disturbance measures are used in the assessment of obstructive sleep apnea (OSA) but have proved to be disappointingly poor correlates of daytime sleepiness. This study investigates the ability of electroencephalograph (EEG) and non-EEG sleep fragmentation indices to predict both presenting sleepiness and the improvement in sleepiness with subsequent nasal continuous positive airway pressure (nCPAP) therapy (nCPAP responsive sleepiness). Forty-one patients (36 men, 5 women), ranging from nonsnorers to severe OSA (> 4% O2 dip rate, median 11.1, range 0.4 to 76.5), had polysomnography with microarousal scoring, computerized EEG analysis, autonomic arousal detection, and body movement analysis. All patients received a trial of nCPAP regardless of sleep study outcome. Spearman's correlation analysis showed significant and similar associations between all sleep fragmentation indices with both pretreatment and nCPAP responsive sleepiness. There was no deterioration in sleepiness on nCPAP in the nonsnorers. Using stepwise multiple regression analysis, the best predictor of nCPAP responsive subjective and objective sleepiness was body movement index, explaining 38% and 43% of the variance, respectively. Variability in EEG sleep depth, quantified from computerized EEG analysis, was the only other index to contribute to these models. Together these indices explained 44% and 51% of the subjective and objective response to nCPAP, respectively. These results suggest that sleep fragmentation indices are useful for identifying OSA patients with sleepiness likely to respond to nCPAP.

Adult↗