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At least 109 records · Page 6Linked to original sources
PubMed1993

Sleep in nondepressed patients with panic disorder: I. Systematic assessment of subjective sleep quality and sleep disturbance.

To systematically assess sleep complaints in panic disorder (PD), the Pittsburgh Sleep Quality Index (PSQI) was administered to 34 untreated patients with DSM-III-R PD and 34 age-matched healthy controls (HC). PD patients reported significantly more impaired sleep than HC as indicated by higher global index scores on the PSQI (6.9 +/- 2.9 versus 3.1 +/- 2.0; p < 0.0001) and on four of seven of its subscales; sleep was worst among those PD patients with a prior history of major depression. Sixty-eight percent of patients with PD reported moderately or severely impaired sleep compared to only 15% of HC (chi 2 = 17.5, p < 0.0005). Twenty-six percent of PD patients--but none of the HC--complained of frequent awakenings in the preceding month because they "could not breathe comfortably" (Fisher's exact test, p < 0.00625). One-month prevalence of sleep panic in the patients was 18%; lifetime prevalence was 68%. Whereas these findings confirm previous reports of frequent sleep complaints in patients with PD, they also raise the possibility that some of the findings might be trait phenomena attributable to a history of mood disorder.

Adult↗
PubMed1999

Circadian and homeostatic influences on sleep in the squirrel monkey: sleep after sleep deprivation.

A series of sleep deprivation (SD) experiments were performed to examine the relative influence of circadian and homeostatic factors on the timing of sleep in squirrel monkeys free-running in constant illumination. All SDs started at the beginning of subjective night and lasted 0, 1/4, 1/2, 1, 1 1/4, or 1 1/2 circadian cycles. These six lengths represented three pairs: (0.1), (1/4, 1 1/4), (1/2, 1 1/2). Within each pair, SD ended at the same circadian phase but differed by one circadian cycle in duration. Both before and after SD, consolidated sleep (CS) episodes occurred predominantly during subjective night, even after long SDs ending at the beginning of subjective day. CS duration was strongly influenced by circadian phase but had no overall correlation with prior wake duration. Sleep loss incurred during SDs longer than 1/4 cycle was only partially recovered over the next two circadian cycles, though total sleep duration was closer to baseline levels after the second circadian cycle after SD. There was a trend toward a positive correlation between prior wake duration and the amount of NREM and delta activity measures during subjective day. Delta activity was not increased in the first 2 hours of CS after the SD. Relatively high levels of delta activity occurred immediately after the SD ended and again at the time of baseline CS onset. These data indicate that the amount of sleep and delta activity after SD in squirrel monkeys is weakly dependent on prior wake duration. Circadian factors appear to dominate homeostatic processes in determining the timing, duration and content of sleep in these diurnal primates.

Animals↗
PubMed1993

[Screening of sleep apnea syndrome using daytime polysomnography--its usefulness and the characteristics of daytime sleep in the patients with sleep apnea syndrome].

Some attempts have been made to screen sleep apnea syndrome (SAS). In this study, we performed daytime polysomnography (DPSG) as a means of screening SAS. 33 patients (28 males and 5 females, a mean age of 50.7 years) who were seen with the complaints of sleep-wake disorders, snoring and breathing disturbance in their nocturnal sleep were subjects for the screening. EEG, EMG, and EOG according to standard polysomnographic technique were recorded from 3:30 (p.m.) for 60 minutes, as additional indicators, oro-nasal airflow and abdominal movement were monitored simultaneously to confirm cessation of breathing. After the screening, we performed conventional polysomnography (PSG) to make a diagnosis of SAS, and compared the diagnosis with the appearance of apnea in the screening. We studied on the characteristics of daytime sleep in SAS and NonSAS by the comparison of EEG variables obtained from DPSG. Sleep apnea was detected in 20 cases with DPSG, 18 cases of these 20 were diagnosed as SAS. However, there were 6 patients who were diagnosed as SAS without the appearance of apnea in the screening. Dominant type of apnea in the screening were corresponded to ones confirmed with PSG, 16 cases showed obstructive type and 4 cases indicated central type. Some statistical differences of EEG variables between SAS and NonSAS were recognized. Number of stage shifts and percentage of stage W to total sleep time were significantly increased in SAS, on the contrary, percentage of stage 2 to total sleep time tended to be lower in SAS.(ABSTRACT TRUNCATED AT 250 WORDS)

Electroencephalography↗
PubMed2000

Altered phase relation between sleep timing and core body temperature rhythm in delayed sleep phase syndrome and non-24-hour sleep-wake syndrome in humans.

Changes in the phase relation between sleep timing and the circadian pacemaker are suspected to have an etiological significance in circadian rhythm sleep disorders. Simultaneous recordings of rest-activity and rectal temperature in seven sighted delayed sleep phase syndrome (DSPS) patients, seven sighted non-24-h sleep-wake syndrome (non-24) patients, and 14 healthy controls were made for 10-14 days continuously in the subjects' homes. We found that sleep length and the interval from the body temperature (BT) trough to sleep offset were significantly longer in both non-24 and DSPS patients than in the controls, and that the interval between sleep onset and the BT trough was significantly less in the non-24 patients than in the DSPS patients and the controls. We postulate these alterations in phase relation to be associated with phase changes of the circadian pacemaker via different illumination timings.

Adult↗
PubMed2001

The association of sleep-disordered breathing and sleep symptoms with quality of life in the Sleep Heart Health Study.

This study assessed the extent to which sleep-disordered breathing (SDB), difficulty initiating and maintaining sleep (DIMS), and excessive daytime sleepiness (EDS) were associated with impairment of quality of life (QoL) using the SF-36. Participants (n=5,816; mean age=63 years; 52.5% women) were enrolled in the nation-wide population-based Sleep Heart Health Study (SHHS) implemented to investigate sleep-disordered breathing as a risk factor in the development of cardiovascular disease. Each transformed SF-36 scale was analyzed independently using multiple logistic regression analysis with sleep and other potential confounding variables (e.g., age, ethnicity) included as independent variables. Men (11.6%) were significantly more likely to have SDB compared to women (5.6%), while women (42.4%) were significantly more likely to report DIMS than men (32.5%). Vitality was the sole SF-36 scale to have a linear association with the clinical categories of SDB (mild, moderate, severe SDB). However, individuals with severe SDB indicated significantly poorer QoL on several SF-36 scales. Both DIMS and EDS were strongly associated with reduced QoL even after adjusting for confounding variables for both sexes. Findings suggest 1) mild to moderate SDB is associated with reduced vitality, while severe SDB is more broadly associated with poorer QoL, 2) subjective sleep symptoms are comprehensively associated with poorer QoL, and 3) SF-36 mean score profiles for SDB and sleep symptoms are equivalent to other chronic diseases in the U.S. general population.

Adult↗
PubMed1982

Quipazine has a biphasic effect on slow wave sleep and reduces REM sleep rebound in REM sleep deprived rats.

Rats implanted with electrodes for polygraphic recording were deprived of REM sleep for 24 hr. Following REM sleep deprivation animals were injected with quipazine maleate (7.5 mg/kg IP) and were polygraphically recorded for 48 hr. The results show that quipazine reduces REM sleep rebound and that it has a biphasic effect on slow-wave sleep: initial 6 hr suppression is followed by a delayed increase in the second 24 hr recording period. The initial suppression of slow-wave sleep we attribute to the stimulation of central serotonergic receptors while the effect on REM sleep rebound may result from quipazine's action on central catecholamines.

Animals↗
PubMed1981

[Intra-sleep awakenings in relation to habitual sleep length and modifications of the sleep-wake rhythms (author's transl)].

The number of episodes of intervening wakefulness, their duration and their sleep stage occurrence were analyzed in the sleep recordings of 19 young (19-23 years), good sleepers. There were 5 long sleepers (LS), 5 short sleepers (SS) and 9 regular sleepers (RS). The experimental protocol included 2 reference nights, a night sleep recovery (after 36 h of wakefulness) and a day sleep recovery (after 24 h). The night following the day sleep recovery was also recorded. The duration of waking episodes was very stable and was independent both of type of sleeper and of situation. The histogram of these durations seemed to follow an exponential law. The number of awakenings varied according to the individual, the habitual sleep length (SS had very few) and the situation (such as length of prior wakefulness or circadian factors).

Adult↗
PubMed2006

[Sleep-related breathing disorders--a second edition of the International Classification of Sleep Disorders (ICSD-2) of the American Academy of Sleep Medicine (AASM)].

In 2005 the American Academy of Sleep Medicine (AASM) published a revised form of the International Classification of Sleep Disorders (ICSD-2). Goals of the ICSD-2 are: A) To describe all currently recognized sleep and arousal disorders, and to base the descriptions on scientific and clinical evidence. B) To present the sleep and arousal disorders in an overall structure that is rational and scientifically valid. C) To render the sleep and arousal disorders as compatible with ICD-9 and ICD-10 as possible. In this article, sleep-disordered breathing disorders, as classified in the ICSD-2 are presented.

Humans↗
PubMed2000

Sleep onset REM periods during multiple sleep latency tests in patients evaluated for sleep apnea.

Although 2 or more sleep onset rapid eye movement (REM) periods (2omSOREMPs) on a Multiple Sleep Latency Test (MSLT) raise the possibility of narcolepsy, patients with obstructive sleep apnea (OSA) also can have 2omSOREMPs, which may then cause diagnostic uncertainty. To explore what features among OSA patients predict 2omSOREMPs on an MSLT that follows nocturnal polysomnography, we reviewed data from 1,145 consecutively studied patients suspected or confirmed to have OSA rather than narcolepsy. Overall, 4.7% of the subjects had 2omSOREMPs. Variables that were independently predictive of 2omSOREMPs in logistic regression models included male gender (OR = 4.4, 95% CI = 1.9 to 12.7), a 5-min decrease in the MSLT-derived mean sleep latency (OR = 1.9, 95% CI = 1.3 to 2.8), a 90-min decrease in nocturnal latency to REM sleep (OR = 1.6, 95% CI = 1.1 to 2.5), and a 15-unit decrease in minimal recorded oxygen saturation (OR = 1.6, 95% CI = 1.3 to 2.0). We conclude that among patients suspected or confirmed to have OSA, one or more of these four variables-male sex, sleepiness, nocturnal REM sleep latency, and extent of oxygen desaturation-could reflect neurophysiological mechanisms responsible for 2omSOREMPs. Consideration of these variables, and especially gender, may be useful in clinical practice when 2omSOREMPs are found unexpectedly.

Adolescent↗
PubMed1998

[Sleep deprivation and subsequent sleep phase advance stabilizes the positive effect of sleep deprivation in depressive episodes].

Approximately 60% of patients with major depression disorder show a beneficial response to total sleep deprivation (TSD), but the positive effect of TSD is short, and naps or the following night's sleep destroy it. Various methods have been tried to stabilize the positive sleep-deprivation effect. A consecutive 1-week advance in the sleep phase stabilized mood in more than 50% of the sleep-deprivation responders. We examined 40 male patients with major depression who in addition to medical treatment took part in a phase advance study to prove possible synergistic effects. About 60% of the patients showed positive mood stabilization after 1-week of treatment when the patients were sleep-deprivation responders. These results support data from other groups.

Adult↗
PubMed2004

Long-term continuous positive airway pressure (CPAP) outcomes from a sleep service using limited sleep studies and daycase CPAP titration in the management of obstructive sleep apnoea/hypopnoea syndrome.

BACKGROUND: Detailed polysomnography (PSG) and overnight continuous positive airway pressure (CPAP) titration as the basis for investigation and treatment of obstructive sleep apnoea/hypopnoea syndrome (OSAHS) incurs high costs from inpatient stays and technician attendance, even when split night studies are employed. Responding to rapidly increasing demand, from 1996 the sleep service at Glasgow Royal Infirmary adopted limited sleep studies and daycase CPAP titration as first line management. Here we describe the outcomes of this service between 1996 and 1999. METHODS: Data were collected from prospective records made at follow up by sleep technicians and by casenote review. RESULTS: Results were available for 158 subjects (97.5%) of 162 commenced on CPAP during this period. One hundred and forty-eight (91%) were diagnosed by limited sleep studies and 80 (50%) were diagnosed at home. The median follow up was 23 months (interquartile range (IQR), 13-35). Median use of CPAP in those continuing therapy was 5.3 hours/night (IQR, 3.1 to 6.5) and 77% were still using CPAP at three years. Only initial low CPAP compliance (< 2 hours/night) significantly predicted early CPAP cessation. In those still on CPAP in 1999, the mean drop in Epworth Sleepiness Scale score was 4.6 points (95% confidence intervals, 3.2 to 6.0). CONCLUSION: These data from the CPAP population at Glasgow Royal Infirmary provide information on longterm outcomes using a diagnostic protocol based on limited sleep studies and daycase CPAP titration.

Adult↗
PubMed2004

Long sleepers sleep more and short sleepers sleep less: a comparison of older adults who sleep well.

To determine some of the risks and benefits of being a long or short sleeper, psychological adjustment, lifestyle, and sleep parameters were investigated in 239 older adults. Responses of people who slept well and who were either long or short sleepers were studied on 48 variables investigating sleep parameters and sleep-related affect and beliefs; daytime fatigue and sleepiness; demographic factors, including age, sex, and income satisfaction; sleep lifestyle factors, including naps, bedtimes, arising times, and the regularity of these; general lifestyle factors, including regularity of mealtimes, overall daytime pleasantness, perceived busyness, diversity and valence of daily activities, and potentially stressful major life events. In addition, 14 variables evaluated aspects of psychological adjustment, including cognitive and somatic arousal, nocturnal tension, anxious, negative, unpleasant and worrying self-talk, depression, anxiety, overall psychopathology, neuroticism, and life satisfaction. Overall, the results indicate that short sleepers get up earlier, spend less time in bed, and have lower sleep efficiencies than their long sleeper counterparts. They eat breakfast earlier, and of course, they sleep less. Only one of the 14 psychological adjustment variables was significant. In view of the many differences between short and long sleepers described in prior research, the lack of differences observed between long and short sleepers is noteworthy.

Aged↗
PubMed1997

Sleep in detoxified alcoholics: impairment of most standard sleep parameters and increased risk for sleep apnea, but not for myoclonias--a controlled study.

OBJECTIVE: To assess recently alcohol-abstinent chronic alcoholic patients for selected parameters indicative of sleep quality. METHOD: Patients (n = 24, 14 male), abstinent 3-6 weeks, and healthy controls (n = 20) were admitted to a clinical sleep unit. Measurements included sleep respiratory events and periodic limb movements, using strict methodology. RESULTS: Clear signs of sleep deterioration and a high prevalence of apneic/hypopneic episodes were observed. Apneas were found at the same frequency for men and women; this has not been described before. No periodic limb movement was found. CONCLUSIONS: Considering the high degree of morbidity and mortality observed in sleep apneic syndrome, systematic screening for sleep apneas is recommended for alcoholics seeking help.

Adult↗
PubMed2000

Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study.

CONTEXT: Sleep-disordered breathing (SDB) and sleep apnea have been linked to hypertension in previous studies, but most of these studies used surrogate information to define SDB (eg, snoring) and were based on small clinic populations, or both. OBJECTIVE: To assess the association between SDB and hypertension in a large cohort of middle-aged and older persons. DESIGN AND SETTING: Cross-sectional analyses of participants in the Sleep Heart Health Study, a community-based multicenter study conducted between November 1995 and January 1998. PARTICIPANTS: A total of 6132 subjects recruited from ongoing population-based studies (aged > or = 40 years; 52.8% female). MAIN OUTCOME MEASURES: Apnea-hypopnea index (AHI, the average number of apneas plus hypopneas per hour of sleep, with apnea defined as a cessation of airflow and hypopnea defined as a > or = 30% reduction in airflow or thoracoabdominal excursion both of which are accompanied by a > or = 4% drop in oxyhemoglobin saturation) [corrected], obtained by unattended home polysomnography. Other measures include arousal index; percentage of sleep time below 90% oxygen saturation; history of snoring; and presence of hypertension, defined as resting blood pressure of at least 140/90 mm Hg or use of antihypertensive medication. RESULTS: Mean systolic and diastolic blood pressure and prevalence of hypertension increased significantly with increasing SDB measures, although some of this association was explained by body mass index (BMI). After adjusting for demographics and anthropometric variables (including BMI, neck circumference, and waist-to-hip ratio), as well as for alcohol intake and smoking, the odds ratio for hypertension, comparing the highest category of AHI (> or = 30 per hour) with the lowest category (< 1.5 per hour), was 1.37 (95% confidence interval [CI], 1.03-1.83; P for trend = .005). The corresponding estimate comparing the highest and lowest categories of percentage of sleep time below 90% oxygen saturation (> or = 12% vs < 0.05%) was 1.46 (95% CI, 1.12-1.88; P for trend <.001). In stratified analyses, associations of hypertension with either measure of SDB were seen in both sexes, older and younger ages, all ethnic groups, and among normal-weight and overweight individuals. Weaker and nonsignificant associations were observed for the arousal index or self-reported history of habitual snoring. CONCLUSION: Our findings from the largest cross-sectional study to date indicate that SDB is associated with systemic hypertension in middle-aged and older individuals of different sexes and ethnic backgrounds.

Adult↗
PubMed1998

Sleep, sleeping sites, and sleep-related activities: awakening to their significance.

Since primates spend about half of their life at sleeping sites, knowledge of behavior in the vicinity of sleeping sites and analysis of factors influencing their use is important for understanding the diversity of primates' adaptations to their environment. The present paper reviews recent progress in the ethology and ecology of sleep in diurnal monkeys and apes. Emphasis is given to the following topics: safety from predators at sleeping sites, physical comfort, social behavior, and psychophysiology of sleep. In all cases, study at the group level and at the individual level can provide insights into behavioral adaptations. As well as increasing understanding of behavior in the wild, knowledge of sleep-related behavior can be applied with a view to improving the environment for captive primates.

Animals↗
PubMed2000

A complementary relationship between wake and REM sleep in the auditory system: a pre-sleep increase of middle-ear muscle activity (MEMA) causes a decrease of MEMA during sleep.

Since some evidence has supported a complementary relationship between waking and REM-sleep eye movement (variations in frequency, amplitude, or direction of waking saccades have been found to inversely affect the corresponding parameters of rapid eye movements), the present study assessed whether this relationship can also be shown for other phasic components of REM sleep, such as middle-ear muscle activity (MEMA), as a consequence of an increase of middle-ear reflex frequency during pre-sleep wake. Ten subjects were studied in three consecutive nights (one adaptation, one baseline, one experimental). In the experimental night, subjects underwent a 2-h pure-tone (1000 Hz, 90 dB SPL) auditory stimulation and MEMA was monitored every 15 min; noise exposure during daytime was also controlled. Results show that MEMA frequency during REM sleep significantly decreased during the experimental nights compared with baseline nights, while each sleep variable as well as mean daily auditory input did not present any significant difference between baseline and experimental nights. Results suggest that the complementary relationship between wake and REM sleep is not bounded to oculomotor activity, but it may also be extended at least to middle-ear muscle phasic activity.

Acoustic Stimulation↗
PubMed2004

Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey.

OBJECTIVE: To assess the association between sleep problems and chronic disease in older adults. METHODS: Self-reported standardized questionnaire data from 1506 community-dwelling men and women aged 55-84 years in the continental United States who completed a 20-min telephone interview when contacted from lists of randomly selected telephone numbers. RESULTS: A majority of the participants (83%) reported one or more of 11 medical conditions and nearly one in four elderly respondents (age 65-84 years) had major comorbidity (i.e. four or more conditions). Depression, heart disease, bodily pain and memory problems were associated with more prevalent symptoms of insomnia. Other conditions such as obesity, arthritis, diabetes, lung diseases, stroke and osteoporosis were associated with other sleep-related problems such as breathing pauses, snoring, daytime sleepiness, restless legs or insufficient sleep (<6 h nightly). CONCLUSIONS: Poll findings are consistent with epidemiological studies of sleep, aging and chronic disease. These results suggest that the sleep complaints common in older adults are often secondary to their comorbidities and not to aging per se. These types of studies may be useful in promoting sleep awareness among health professionals and among older adults, especially those with heart disease, depression, chronic bodily pain or major comorbidity.

Aged↗