Electroencephalographic slow waves prior to sleepwalking episodes.

PubMed

Perrault, Rosemarie; Carrier, Julie; Desautels, Alex; Montplaisir, Jacques; Zadra, Antonio

2014-12-01

Recent studies have suggested that the onset of sleepwalking episodes may be preceded by fluctuations in slow-wave sleep electroencephalographic characteristics. However, whether or not such fluctuations are specific to sleepwalking episodes or generalized to all sleep-wake transitions in sleepwalkers remains unknown. The goal of this study was to compare spectral power for delta (1-4 Hz) and slow delta (0.5-1 Hz) as well as slow oscillation density before the onset of somnambulistic episodes versus non-behavioral awakenings recorded from the same group of sleepwalkers. A secondary aim was to describe the time course of observed changes in slow-wave activity and slow oscillations during the 3 min immediately preceding the occurrence of somnambulistic episodes. Twelve adult sleepwalkers were investigated polysomnographically during the course of one night. Slow-wave activity and slow oscillation density were significantly greater prior to patients' somnambulistic episodes as compared with non-behavioral awakenings. However, there was no evidence for a gradual increase over the 3 min preceding the episodes. Increased slow-wave activity and slow oscillation density appear to be specific to sleepwalking episodes rather than generalized to all sleep-wake transitions in sleepwalkers. Copyright © 2014 Elsevier B.V. All rights reserved.

Psychopathologic correlates of adult sleepwalking.

PubMed

Labelle, Marc-Antoine; Desautels, Alex; Montplaisir, Jacques; Zadra, Antonio

2013-12-01

Sleepwalking (SW) often has been associated with psychopathology, but the nature and magnitude of this relation remains unclear. The aim of our study was to investigate the presence of psychopathology in a large cohort of sleepwalkers and to determine if levels of psychopathology showed differential relations to specific characteristics of the disorder, including clinical history. One-hundred and five sleepwalkers (39 men, 66 women; mean age, 32.4±9.5years) referred to our sleep disorders clinic for chronic SW underwent a comprehensive clinical investigation that included an overnight polysomnography (PSG) assessment in 90% of cases. All participants also completed a series of questionnaires, including the Beck Depression Inventory, Second Revision (BDI-II), the Beck Anxiety Inventory (BAI), and the Symptom Checklist 90-Revised (SCL-90-R). The proportion of sleepwalkers who scored above the minimal clinical threshold on the BDI-II, BAI, and SCL-90-R was 27%, 40%, and 28%, respectively. Only 15% of sleepwalkers showed moderate to severe symptoms on the BDI-II and 19% on the BAI. Taken as a whole, these profiles are similar to those observed in the general adult population. The presence of psychopathology in sleepwalkers was associated with a negative family history for SW, a higher frequency of nightmares, and with potentially injurious behaviors enacted during somnambulistic episodes. A majority of adult sleepwalkers consulting for the disorder do not report clinically significant levels of depression or anxiety. Overall, sleepwalkers with and without psychopathology appear more similar than dissimilar. Copyright © 2013 Elsevier B.V. All rights reserved.

Zolpidem-induced sleepwalking, sleep related eating disorder, and sleep-driving: fluorine-18-flourodeoxyglucose positron emission tomography analysis, and a literature review of other unexpected clinical effects of zolpidem.

PubMed

Hoque, Romy; Chesson, Andrew L

2009-10-15

Zolpidem is a hypnotic which acts at the GABAA receptor and is indicated for short-term insomnia. Sleep related disorders including somnambulism, sleep related eating and sleep-driving have been reported with zolpidem. A 51-year-old insomniac who used zolpidem 10 mg nightly starting at 44 years of age is described. A few weeks after starting zolpidem she began walking, eating, and had one episode of driving while asleep. Episodes of sleep related eating, sleepwalking, and sleeptalking occurred 3 nights per week, 1 to 2 h after sleep onset. After her evaluation, the patient's zolpidem was gradually discontinued, and all sleep related activities immediately ceased. An 18F-FDG-PET was obtained 2 months after discontinuation of zolpidem. The following day, FDG was administered 1 h after oral administration of 10 mg zolpidem, and then a second PET was performed. We report the results and a review of the literature regarding other unintended effects seen with zolpidem use.

The course and character of sleepwalking in adulthood: a clinical and polysomnographic study.

PubMed

Bušková, Jitka; Piško, Juraj; Pastorek, Lukáš; Šonka, Karel

2015-01-01

To describe characteristics of adult sleepwalking (potential triggers and correlates with polysomnography), 52 patients were interviewed regarding their sleepwalking episodes and underwent video-polysomnography on two consecutive nights. Sleepwalking history averaged 12 years and frequent episodes (more than once per week) occurred in 62%. Higher frequency was associated with earlier onset of sleepwalking (p < 0.005) and 53.8% reported dangerous sleepwalking behavior. The most common self-reported triggers were sleep deprivation and stressful events, while no specific trigger was reported in 37% of patients. More awakening from slow-wave sleep was associated with a higher frequency of sleepwalking episodes (p < 0.001). A longer history of sleepwalking was associated with more sleepwalking episodes, even without the presence of sleep comorbidities or other known precipitating factors.

Sleepiness in sleepwalking and sleep terrors: a higher sleep pressure?

PubMed

Carrillo-Solano, Marisol; Leu-Semenescu, Smaranda; Golmard, Jean-Louis; Groos, Elisabeth; Arnulf, Isabelle

2016-10-01

To identify the determinants of excessive daytime sleepiness in adults with sleepwalking or sleep terrors (SW/ST). We collected the charts of all consecutive adult patients admitted from 2012 to 2014 for SW/ST. They had completed the Paris Arousal Disorders Severity Scale and the Epworth Sleepiness Scale, and had undergone one (n = 34) or two consecutive (n = 124) nocturnal videopolysomnographies. The demographic, clinical, and sleep determinants of excessive daytime sleepiness (defined as an Epworth Sleepiness Scale score of greater than 10) were analyzed. Almost half (46.8%) of the 158 adult patients with SW/ST reported excessive daytime sleepiness. They had shorter sleep onset latencies (in night 1 and night 2), shorter REM sleep latencies, longer total sleep time, and higher REM sleep percentages in night 2, but no greater clinical severity of the parasomnia than patients without sleepiness. The level of sleepiness correlated with the same measures (sleep onset latency on both nights, REM sleep onset latency, and total sleep time in night 2), plus the latency to N3. In the regression model, higher sleepiness was determined by shorter sleep onset latency on night 1, lower number of awakenings in N3 on night 1, and higher total sleep time on night 2. Daytime sleepiness in patients with SW/ST is not the consequence of disturbed sleep but is associated with a specific polygraphic phenotype (rapid sleep onset, long sleep time, lower numbers of awakenings on N3) that is suggestive of a higher sleep pressure that may contribute to incomplete arousal from N3. Copyright © 2015 Elsevier B.V. All rights reserved.

Sleep-related automatism and the law.

PubMed

Ebrahim, Irshaad Osman; Fenwick, Peter

2008-04-01

Crimes carried out during or arising from sleep highlight many difficulties with our current law and forensic sleep medicine clinical practice. There is a need for clarity in the law and agreement between experts on a standardised form of assessment and diagnosis in these challenging cases. We suggest that the time has come for a standardised, internationally recognised diagnostic protocol to be set as a minimum standard in all cases of suspected sleep-related forensic cases. The protocol of a full medical history, sleep history, psychiatric history, neuropsychiatric and psychometric examination and electroencephalography (EEG), should be routine. It should now be mandatory to carry out routine polysomnography (PSG) to establish the presence of precipitating and modulating factors. Sleepwalking is classified as insane automatism in England and Wales and sudden arousal from sleep in a non-sleepwalker as sane automatism. The recent case in England of R v. Lowe (2005) highlights these anomalies. Moreover, the word insanity stigmatises sleepwalkers and should be dropped. The simplest solution to these problems would be for the law to be changed so that there is only one category of defence for all sleep-related offences--not guilty by reason of sleep disorder. This was rejected by the House of Lords for cases of automatism due to epilepsy, and is likely to be rejected for sleepwalkers. Removing the categories of automatism (sane or insane) would be the best solution. Risk assessment is already standard practice in the UK and follow up, subsequent to disposal, by approved specialists should become part of the sentencing process. This will provide support for the defendant and protection of the public.

Sleepwalking episodes are preceded by arousal-related activation in the cingulate motor area: EEG current density imaging.

PubMed

Januszko, Piotr; Niemcewicz, Szymon; Gajda, Tomasz; Wołyńczyk-Gmaj, Dorota; Piotrowska, Anna Justyna; Gmaj, Bartłomiej; Piotrowski, Tadeusz; Szelenberger, Waldemar

2016-01-01

To investigate local arousal fluctuations in adults who received ICSD-2 diagnosis of somnambulism. EEG neuroimaging (eLORETA) was utilized to compare current density distribution for 4s epochs immediately preceding sleepwalking episode (from -4.0 s to 0 s) to the distribution during earlier 4s epochs (from -8.0 s to -4.0 s) in 20 EEG segments from 15 patients. Comparisons between eLORETA images revealed significant (t>4.52; p<0.05) brain activations before onset of sleepwalking, with greater current density within beta 3 frequency range (24-30 Hz) in Brodmann areas 33 and 24. Sleepwalking motor events are associated with arousal-related activation of cingulate motor area. These results support the notion of blurred boundaries between wakefulness and NREM sleep in sleepwalking. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Is there a dissociative process in sleepwalking and night terrors?

PubMed Central

Hartman, D; Crisp, A; Sedgwick, P; Borrow, S

2001-01-01

The enduring and contentious hypothesis that sleepwalking and night terrors are symptomatic of a protective dissociative mechanism is examined. This is mobilised when intolerable impulses, feelings and memories escape, within sleep, the diminished control of mental defence mechanisms. They then erupt but in a limited motoric or affective form with restricted awareness and subsequent amnesia for the event. It has also been suggested that such processes are more likely when the patient has a history of major psychological trauma. In a group of 22 adult patients, referred to a tertiary sleep disorders service with possible sleepwalking/night terrors, diagnosis was confirmed both clinically and polysomnographically, and only six patients had a history of such trauma. More commonly these described sleepwalking/night terrors are associated with vivid dream-like experiences or behaviour related to flight from attack. Two such cases, suggestive of a dissociative process, are described in more detail.
The results of this study are presented largely on account of the negative findings. Scores on the dissociation questionnaire (DIS-Q) were normal, although generally higher in the small "trauma" subgroup. These were similar to scores characterising individuals with post-traumatic stress disorder. This "trauma" group also scored particularly highly on the anxiety, phobic, and depression scales of the Crown-Crisp experiential index. In contrast the "no trauma" group scored more specifically highly on the anxiety scale, along with major trends to high depression and hysteria scale scores. Two cases are presented which illustrate exceptional occurrence of later onset of sleepwalking/night terrors with accompanying post-traumatic symptoms during wakefulness. It is concluded that a history of major psychological trauma exists in only a minority of adult patients presenting with sleepwalking/night terror syndrome. In this subgroup trauma appears to dictate the subsequent content

Sexsomnia: A case of sleep masturbation documented by video-polysomnography in a young adult male with sleepwalking.

PubMed

Yeh, Shih-Bin; Schenck, Carlos H

2016-01-01

The first case of video-polysomnography (vPSG) documented sleep masturbation in a male is reported, and the second reported case of shift work induced sexsomnia. A 20 y.o. soldier with childhood sleepwalking (SW) developed sleep masturbation and SW triggered by military shift work. vPSG documented two episodes of sleep masturbation from N2 sleep in the fourth sleep cycle and from N3 sleep during the fifth sleep cycle. There was no sleep-disordered breathing nor periodic limb movements. vPSG thus confirmed confusional arousals from NREM sleep as the cause of the masturbation. Bedtime clonazepam therapy controlled the SW but not the masturbation.

Fight or flight? Dream content during sleepwalking/sleep terrors vs. rapid eye movement sleep behavior disorder.

PubMed

Uguccioni, Ginevra; Golmard, Jean-Louis; de Fontréaux, Alix Noël; Leu-Semenescu, Smaranda; Brion, Agnès; Arnulf, Isabelle

2013-05-01

Dreams enacted during sleepwalking or sleep terrors (SW/ST) may differ from those enacted during rapid eye movement sleep behavior disorder (RBD). Subjects completed aggression, depression, and anxiety questionnaires. The mentations associated with SW/ST and RBD behaviors were collected over their lifetime and on the morning after video polysomnography (PSG). The reports were analyzed for complexity, length, content, setting, bizarreness, and threat. Ninety-one percent of 32 subjects with SW/ST and 87.5% of 24 subjects with RBD remembered an enacted dream (121 dreams in a lifetime and 41 dreams recalled on the morning). These dreams were more complex and less bizarre, with a higher level of aggression in the RBD than in SW/ST subjects. In contrast, we found low aggression, anxiety, and depression scores during the daytime in both groups. As many as 70% of enacted dreams in SW/ST and 60% in RBD involved a threat, but there were more misfortunes and disasters in the SW/ST dreams and more human and animal aggressions in the RBD dreams. The response to these threats differed, as the sleepwalkers mostly fled from a disaster (and 25% fought back when attacked), while 75% of RBD subjects counterattacked when assaulted. The dreams setting included their bedrooms in 42% SW/ST dreams, though this finding was exceptional in the RBD dreams. Different threat simulations and modes of defense seem to play a role during dream-enacted behaviors (e.g., fleeing a disaster during SW/ST, counterattacking a human or animal assault during RBD), paralleling and exacerbating the differences observed between normal dreaming in nonrapid eye movement (NREM) vs rapid eye movement (REM) sleep. Copyright © 2013 Elsevier B.V. All rights reserved.

Somnambulism (sleepwalking).

PubMed

Remulla, Agnes; Guilleminault, Christian

2004-10-01

Somnambulism is an arousal parasomnia consisting of a series of complex behaviours that result in large movements in bed or walking during sleep. It occurs in 2-14% of children and 1.6-2.4% of adults. Occasional benign episodes are managed conservatively. However, recurrent sleepwalking with a risk of injury to self or others mandates immediate treatment with pharmacotherapy while awaiting work-up. The most commonly used medications are benzodiazepines, particularly clonazepam, with tricyclic antidepressants and serotonin selective re-uptake inhibitors also administered. Treatment of underlying causes such as obstructive sleep apnoea, upper airway resistance syndrome, restless legs syndrome and periodic limb movements, is currently the best approach and usually eliminates somnambulism in children and adults.

Sleep Deprivation Reveals Altered Brain Perfusion Patterns in Somnambulism.

PubMed

Dang-Vu, Thien Thanh; Zadra, Antonio; Labelle, Marc-Antoine; Petit, Dominique; Soucy, Jean-Paul; Montplaisir, Jacques

2015-01-01

Despite its high prevalence, relatively little is known about the pathophysiology of somnambulism. Increasing evidence indicates that somnambulism is associated with functional abnormalities during wakefulness and that sleep deprivation constitutes an important drive that facilitates sleepwalking in predisposed patients. Here, we studied the neural mechanisms associated with somnambulism using Single Photon Emission Computed Tomography (SPECT) with 99mTc-Ethylene Cysteinate Dimer (ECD), during wakefulness and after sleep deprivation. Ten adult sleepwalkers and twelve controls with normal sleep were scanned using 99mTc-ECD SPECT in morning wakefulness after a full night of sleep. Eight of the sleepwalkers and nine of the controls were also scanned during wakefulness after a night of total sleep deprivation. Between-group comparisons of regional cerebral blood flow (rCBF) were performed to characterize brain activity patterns during wakefulness in sleepwalkers. During wakefulness following a night of total sleep deprivation, rCBF was decreased bilaterally in the inferior temporal gyrus in sleepwalkers compared to controls. Functional neural abnormalities can be observed during wakefulness in somnambulism, particularly after sleep deprivation and in the inferior temporal cortex. Sleep deprivation thus not only facilitates the occurrence of sleepwalking episodes, but also uncovers patterns of neural dysfunction that characterize sleepwalkers during wakefulness.

Sleep Deprivation Reveals Altered Brain Perfusion Patterns in Somnambulism

PubMed Central

Dang-Vu, Thien Thanh; Zadra, Antonio; Labelle, Marc-Antoine; Petit, Dominique; Soucy, Jean-Paul; Montplaisir, Jacques

2015-01-01

Background Despite its high prevalence, relatively little is known about the pathophysiology of somnambulism. Increasing evidence indicates that somnambulism is associated with functional abnormalities during wakefulness and that sleep deprivation constitutes an important drive that facilitates sleepwalking in predisposed patients. Here, we studied the neural mechanisms associated with somnambulism using Single Photon Emission Computed Tomography (SPECT) with 99mTc-Ethylene Cysteinate Dimer (ECD), during wakefulness and after sleep deprivation. Methods Ten adult sleepwalkers and twelve controls with normal sleep were scanned using 99mTc-ECD SPECT in morning wakefulness after a full night of sleep. Eight of the sleepwalkers and nine of the controls were also scanned during wakefulness after a night of total sleep deprivation. Between-group comparisons of regional cerebral blood flow (rCBF) were performed to characterize brain activity patterns during wakefulness in sleepwalkers. Results During wakefulness following a night of total sleep deprivation, rCBF was decreased bilaterally in the inferior temporal gyrus in sleepwalkers compared to controls. Conclusions Functional neural abnormalities can be observed during wakefulness in somnambulism, particularly after sleep deprivation and in the inferior temporal cortex. Sleep deprivation thus not only facilitates the occurrence of sleepwalking episodes, but also uncovers patterns of neural dysfunction that characterize sleepwalkers during wakefulness. PMID:26241047

Quetiapine-induced sleep-related eating disorder-like behavior: a case series.

PubMed

Tamanna, Sadeka; Ullah, M Iftekhar; Pope, Chelle R; Holloman, Garland; Koch, Christian A

2012-11-06

Somnambulism or sleepwalking is a disorder of arousal from non-rapid eye movement sleep. The prevalence of sleep-related eating disorder has been found to be approximately between 1% and 5% among adults. Many cases of medication-related somnambulism and sleep-related eating disorder-like behavior have been reported in the literature. Quetiapine, an atypical antipsychotic medication, has been associated with somnambulism but has not yet been reported to be associated with sleep-related eating disorder. Case 1 is a 51-year-old obese African American male veteran with a body mass index of 34.11kg/m2 and severe sleep apnea who has taken 150mg of quetiapine at bedtime for more than one year for depression. He developed sleepwalking three to four nights per week which resolved after stopping quetiapine while being compliant with bi-level positive pressure ventilation therapy. At one year follow-up, his body mass index was 32.57kg/m2.Case 2 is a 50-year-old African American female veteran with a body mass index of 30.5kg/m2 and mild sleep apnea who has taken 200mg of quetiapine daily for more than one year for depression. She was witnessed to sleepwalk three nights per week which resolved after discontinuing quetiapine while being treated with continuous positive airway pressure. At three months follow-up, her body mass index was 29.1kg/m2. These cases illustrate that quetiapine may precipitate complex motor behavior including sleep-related eating disorder and somnambulism in susceptible patients. Atypical antipsychotics are commonly used in psychiatric and primary care practice, which means the population at risk of developing parasomnia may often go unrecognized. It is important to recognize this potential adverse effect of quetiapine and, to prevent injury and worsening obesity, discuss this with the patients who are prescribed these medications.

A review of sleepwalking (somnambulism): the enigma of neurophysiology and polysomnography with differential diagnosis of complex partial seizures.

PubMed

Hughes, John R

2007-12-01

The goal of this report is to review all aspects of sleepwalking (SW), also known as somnambulism. Various factors seem to initiate SW, especially drugs, stress, and sleep deprivation. As an etiology, heredity is important, but other conditions include thyrotoxicosis, stress, and herpes simplex encephalitis. Psychological characteristics of sleepwalkers often include aggression, anxiety, panic disorder, and hysteria. Polysomnographic characteristics emphasize abnormal deep sleep associated with arousal and slow wave sleep fragmentation. In the differential diagnosis, the EEG is important to properly identify a seizure disorder, rather than SW. Associated disorders are Tourette's syndrome, sleep-disordered breathing, and migraine. Various kinds of treatment are discussed, as are legal considerations, especially murder during sleepwalking.

Scalp and Source Power Topography in Sleepwalking and Sleep Terrors: A High-Density EEG Study

PubMed Central

Castelnovo, Anna; Riedner, Brady A.; Smith, Richard F.; Tononi, Giulio; Boly, Melanie; Benca, Ruth M.

2016-01-01

Study Objectives: To examine scalp and source power topography in sleep arousals disorders (SADs) using high-density EEG (hdEEG). Methods: Fifteen adult subjects with sleep arousal disorders (SADs) and 15 age- and gender-matched good sleeping healthy controls were recorded in a sleep laboratory setting using a 256 channel EEG system. Results: Scalp EEG analysis of all night NREM sleep revealed a localized decrease in slow wave activity (SWA) power (1–4 Hz) over centro-parietal regions relative to the rest of the brain in SADs compared to good sleeping healthy controls. Source modelling analysis of 5-minute segments taken from N3 during the first half of the night revealed that the local decrease in SWA power was prominent at the level of the cingulate, motor, and sensori-motor associative cortices. Similar patterns were also evident during REM sleep and wake. These differences in local sleep were present in the absence of any detectable clinical or electrophysiological sign of arousal. Conclusions: Overall, results suggest the presence of local sleep differences in the brain of SADs patients during nights without clinical episodes. The persistence of similar topographical changes in local EEG power during REM sleep and wakefulness points to trait-like functional changes that cross the boundaries of NREM sleep. The regions identified by source imaging are consistent with the current neurophysiological understanding of SADs as a disorder caused by local arousals in motor and cingulate cortices. Persistent localized changes in neuronal excitability may predispose affected subjects to clinical episodes. Citation: Castelnovo A, Riedner BA, Smith RF, Tononi G, Boly M, Benca RM. Scalp and source power topography in sleepwalking and sleep terrors: a high-density EEG study. SLEEP 2016;39(10):1815–1825. PMID:27568805

Quetiapine-induced sleep-related eating disorder-like behavior: a case series

PubMed Central

2012-01-01

Introduction Somnambulism or sleepwalking is a disorder of arousal from non-rapid eye movement sleep. The prevalence of sleep-related eating disorder has been found to be approximately between 1% and 5% among adults. Many cases of medication-related somnambulism and sleep-related eating disorder-like behavior have been reported in the literature. Quetiapine, an atypical antipsychotic medication, has been associated with somnambulism but has not yet been reported to be associated with sleep-related eating disorder. Case presentation Case 1 is a 51-year-old obese African American male veteran with a body mass index of 34.11kg/m2 and severe sleep apnea who has taken 150mg of quetiapine at bedtime for more than one year for depression. He developed sleepwalking three to four nights per week which resolved after stopping quetiapine while being compliant with bi-level positive pressure ventilation therapy. At one year follow-up, his body mass index was 32.57kg/m2. Case 2 is a 50-year-old African American female veteran with a body mass index of 30.5kg/m2 and mild sleep apnea who has taken 200mg of quetiapine daily for more than one year for depression. She was witnessed to sleepwalk three nights per week which resolved after discontinuing quetiapine while being treated with continuous positive airway pressure. At three months follow-up, her body mass index was 29.1kg/m2. Conclusion These cases illustrate that quetiapine may precipitate complex motor behavior including sleep-related eating disorder and somnambulism in susceptible patients. Atypical antipsychotics are commonly used in psychiatric and primary care practice, which means the population at risk of developing parasomnia may often go unrecognized. It is important to recognize this potential adverse effect of quetiapine and, to prevent injury and worsening obesity, discuss this with the patients who are prescribed these medications. PMID:23130910

Precipitating factors of somnambulism: impact of sleep deprivation and forced arousals.

PubMed

Pilon, Mathieu; Montplaisir, Jacques; Zadra, Antonio

2008-06-10

Experimental attempts to induce sleepwalking with forced arousals during slow-wave sleep (SWS) have yielded mixed results in children and have not been investigated in adult patients. We hypothesized that the combination of sleep deprivation and external stimulation would increase the probability of inducing somnambulistic episodes in sleepwalkers recorded in the sleep laboratory. The main goal of this study was to assess the effects of forced arousals from auditory stimuli (AS) in adult sleepwalkers and control subjects during normal sleep and following post-sleep deprivation recovery sleep. Ten sleepwalkers and 10 controls were investigated. After a baseline night, participants were presented with AS at predetermined sleep stages either during normal sleep or recovery sleep following 25 hours of sleep deprivation. One week later, the conditions with AS were reversed. No somnambulistic episodes were induced in controls. When compared to the effects of AS during sleepwalkers' normal sleep, the presentation of AS during sleepwalkers' recovery sleep significantly increased their efficacy in experimentally inducing somnambulistic events and a significantly greater proportion of sleepwalkers (100%) experienced at least one induced episode during recovery SWS as compared to normal SWS (30%). There was no significant difference between the mean intensity of AS that induced episodes during sleepwalkers' SWS and the mean intensity of AS that awakened sleepwalkers and controls from SWS. Sleep deprivation and forced arousals during slow-wave sleep can induce somnambulistic episodes in predisposed adults. The results highlight the potential value of this protocol in establishing a video-polysomnographically based diagnosis for sleepwalking.

[Life-threatening sleepwalking (Elpenor's syndrome) in a 10-year-old child].

PubMed

Madigand-Tordjman, M-A; Egler, P-J; Bertran, F; Jokic, M; Guénolé, F

2017-06-01

Though benign in the majority of cases, sleepwalking sometimes causes injuries due, among other causes, to falls. Such accidents can be life-threatening - a situation that has been termed Elpenor syndrome (in reference to an accident experienced by a character in Homer's epic The Odyssey) - in particular when entailing defenestration. This syndrome has been described in adults and adolescents; we report here a case in a child. This 10-year-old girl was admitted at night to our hospital after a 3-m fall at home. She was alert (Glasgow score, 15) at admission; a frontal wound and a deformation of the right wrist were noted. Brain CT scans showed a frontal skull fracture and frontal lobe contusion, wrist x-rays showed a displaced right fracture. The patient underwent urgent neurosurgery (wound excision and suture after reduction of skull fracture) and closed reduction and immobilization of the wrist fracture, both under general anesthesia. She underwent a psychiatric assessment in the intensive care unit 3 days after her fall. She was alert, well-oriented in time and space, and spoke fluently. She had no memory of her fall, only remembering going to bed in the evening before the accident and waking up in the ambulance on the way to the hospital. She displayed no sign of a concurrent mental illness and no suicidal ideas. Her parents reported that the evening of the accident she and her two brothers had all fallen asleep about 11:00 pm while watching TV, in the double bed of the guest room, placed just beside its window. At approximately 1:00 am, her father, who was going to bed and had just made noise in the hall, heard a cry from the guest room. He entered the room immediately and saw the opened window and his daughter lying on the outside ground; the brothers only awakened after the fall. The family had returned 2 days before from a 6-month stay in the United States, with jet-lag, sleep deprivation, and a disorganized sleep/wake rhythm in the patient. There was

Complex dream-enacting behavior in sleepwalking.

PubMed

Pillmann, Frank

2009-02-01

Currently, dream-enacting behaviors are viewed as occurring typically in association with a REM-sleep behavior disorder. In some cases, dream-like mentation is found also in non-REM parasomnia. We report a case of complex and dramatic sleepwalking behavior in a 26-year-old adult male who tied his 4-month-old daughter to the clothesline in the attic of his house. The explanation of this seemingly senseless behavior, which was related to psychosocial stressors, was found in a detailed dream-like mentation that was reported by the patient. At the same time, an organic factor, namely, a worsening of the patient's asthma, was identified as the cause of an increased fragmentation of sleep. In some cases of non-REM parasomnia, detailed dream-like mentation may act as a bridge between psychosocial stressors and the specific parasomnic behavior.

Not Only Sleepwalking But NREM Parasomnia Irrespective of the Type Is Associated with HLA DQB1*05:01.

PubMed

Heidbreder, Anna; Frauscher, Birgit; Mitterling, Thomas; Boentert, Matthias; Schirmacher, Anja; Hörtnagl, Paul; Schennach, Harald; Massoth, Christina; Happe, Svenja; Mayer, Geert; Young, Peter; Högl, Birgit

2016-04-15

Despite the high prevalence and clinical relevance of NREM parasomnias, data on supportive genetic markers are scarce, and mainly refer to sleepwalking only. We retrospectively analyzed clinical, polysomnographic, and HLA findings of 74 adults (37 men) with NREM parasomnia gathered from four neurological sleep centers. Parasomniac events were classified according to ICSD-2 criteria. HLA DQB1 genotyping was compared to regional-matched reference allele-frequencies. Fifty-six patients had more than 2 different parasomnia type: 11 sleepwalking, 4 sleep terrors, 3 confusional arousals only. Parasomniac events were documented during video-polysomnography (V-PSG) in 70% (49/70) of subjects (71.4% confusional arousals, 8.2% sleep terrors, 4.1% sleepwalking, 16.3% ≥ 2 NREM parasomnia types). Violent behavior during V-PSG occurred in 8.5% (6/71). NREM parasomnia onset was reported after the age of 30 years in 6.8% (5/74). The HLA DQB1*05:01 allele was present in 41% (29/71) compared to 24.2% in the regional-matched reference allele group (p < 0.05). This haplotype prevalence did not differ within the NREM parasomnia type. Epworth Sleepiness Score was 10 or higher in 28.6%. This is a large polysomnography-based case series of patients with NREM parasomnia. In patients with suspected sleepwalking or sleep terrors, polysomnography is highly useful in detecting arousals from NREM sleep as a marker of NREM parasomnia. We confirmed previous findings by demonstrating a high prevalence of the HLA DQB1*05:01 genotype for different types of NREM parasomnias. Our findings therefore support a common genetic background, and corroborate the importance of video-polysomnography in the work-up of parasomnia. © 2016 American Academy of Sleep Medicine.

Sleep Talking (Somniloquy)

MedlinePlus

... Overview & Facts Symptoms & Risk Factors Diagnosis & Treatment Sleep Terrors Overview & Facts Symptoms & Risk Factors Diagnosis & Treatment Sleep ... radius: Email Print Parasomnias Confusional Arousals Sleepwalking Sleep Terrors Sleep Eating Disorder REM Sleep Behavior Disorder Sleep ...

Sleep Disorders

MedlinePlus

... Narcolepsy - daytime "sleep attacks" Nightmares, night terrors, sleepwalking, sleep talking, head banging, wetting the bed and grinding your teeth are kinds of sleep problems called parasomnias. There are treatments for most ...

A biopsychosocial model of violence when sleepwalking: review and reconceptualisation

PubMed Central

Bari, Andrea

2017-01-01

Summary Violence towards others during sleepwalking is relatively uncommon, but can result in serious injury or even death. Much of the research in this field has focused on the forensic consequences of violence during sleepwalking without sufficient attention to an understanding of the risk factors for violence during sleepwalking and the development of prevention and interventions based on these risk factors. This paper reviews the characteristics of impulsive violence in general and reconceptualises violence during sleepwalking as an extension of this prior vulnerability. We propose a biopsychosocial model of the risk for violence during sleepwalking that is supported through a review of empirical literature both within sleepwalking and violent behaviour more generally. Biological, psychological and social risk factors are hypothesised to mediate the relationship between sleepwalking and violence. Implications for prevention and treatment of this potentially fatal problem are discussed. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:28446961

Somnambulism: Emergency Department Admissions Due to Sleepwalking-Related Trauma.

PubMed

Sauter, Thomas C; Veerakatty, Sajitha; Haider, Dominik G; Geiser, Thomas; Ricklin, Meret E; Exadaktylos, Aristomenis K

2016-11-01

Somnambulism is a state of dissociated consciousness, in which the affected person is partially asleep and partially awake. There is pervasive public opinion that sleepwalkers are protected from hurting themselves. There have been few scientific reports of trauma associated with somnambulism and no published investigations on the epidemiology or trauma patterns associated with somnambulism. We included all emergency department (ED) admissions to University Hospital Inselspital, Berne, Switzerland, from January 1, 2000, until August 11, 2015, when the patient had suffered a trauma associated with somnambulism. Demographic data (age, gender, nationality) and medical data (mechanism of injury, final diagnosis, hospital admission, mortality and medication on admission) were included. Of 620,000 screened ED admissions, 11 were associated with trauma and sleepwalking. Two patients (18.2%) had a history of known non-rapid eye movement parasomnias. The leading cause of admission was falls. Four patients required hospital admission for orthopedic injuries needing further diagnostic testing and treatment (36.4%). These included two patients with multiple injuries (18.2%). None of the admitted patients died. Although sleepwalking seems benign in the majority of cases and most of the few injured patients did not require hospitalization, major injuries are possible. When patients present with falls of unknown origin, the possibility should be evaluated that they were caused by somnambulism.

Prevalence of Sleepwalking: A Systematic Review and Meta-Analysis.

PubMed

Stallman, Helen M; Kohler, Mark

2016-01-01

Sleepwalking is thought to be a common arousal disorder; however, the epidemiology of this disorder has not yet been systematically examined. A systematic search of MEDLINE, CINAHL, EMBASE, PsycINFO, PubMed, and ScienceDirect was conducted for 'sleepwalking' OR 'somnambulism' in any field, to identify studies that reported the epidemiology of sleepwalking or sleepwalking disorders. Fifty-one studies assessed the prevalence rates of sleepwalking in a total sample of 100 490. The meta-analysis showed the estimated lifetime prevalence of sleepwalking was 6.9% (95% CI 4.6%-10.3%). The current prevalence rate of sleepwalking-within the last 12 months-was significantly higher in children 5.0% (95% CI 3.8%-6.5%) than adults 1.5% (95% CI 1.0%-2.3%). There was no evidence of developmental trends in sleepwalking across childhood. The significant risk of bias across all studies suggests these results should be used cautiously. Further epidemiological research that addresses methodological problems found in studies of sleepwalking to date is needed.

Somnambulism: Emergency Department Admissions Due to Sleepwalking-Related Trauma

PubMed Central

Sauter, Thomas C.; Veerakatty, Sajitha; Haider, Dominik G.; Geiser, Thomas; Ricklin, Meret E.; Exadaktylos, Aristomenis K.

2016-01-01

Introduction Somnambulism is a state of dissociated consciousness, in which the affected person is partially asleep and partially awake. There is pervasive public opinion that sleepwalkers are protected from hurting themselves. There have been few scientific reports of trauma associated with somnambulism and no published investigations on the epidemiology or trauma patterns associated with somnambulism. Methods We included all emergency department (ED) admissions to University Hospital Inselspital, Berne, Switzerland, from January 1, 2000, until August 11, 2015, when the patient had suffered a trauma associated with somnambulism. Demographic data (age, gender, nationality) and medical data (mechanism of injury, final diagnosis, hospital admission, mortality and medication on admission) were included. Results Of 620,000 screened ED admissions, 11 were associated with trauma and sleepwalking. Two patients (18.2%) had a history of known non-rapid eye movement parasomnias. The leading cause of admission was falls. Four patients required hospital admission for orthopedic injuries needing further diagnostic testing and treatment (36.4%). These included two patients with multiple injuries (18.2%). None of the admitted patients died. Conclusion Although sleepwalking seems benign in the majority of cases and most of the few injured patients did not require hospitalization, major injuries are possible. When patients present with falls of unknown origin, the possibility should be evaluated that they were caused by somnambulism. PMID:27833677

Self-reported sleepwalking in Australian senior secondary school students.

PubMed

Stallman, H M; Kohler, M; Wilson, A; Biggs, S; Dollman, J; Martin, J; Kennedy, D; Lushington, K

2016-09-01

Few studies have examined self-reported sleepwalking in older adolescents. The aim of this study was to examine the prevalence rates of sleepwalking in a one-month self-report period in Australian adolescents. Participants were 532 Australian adolescents in their final two years of secondary school. The prevalence of sleepwalking in the one-month self-report period was 2.9% (95% confidence interval (CI) 1.47-4.33) in this sample-1% reported sleepwalking at least once a week in the previous month. A significant proportion (17.5%) of the participants was unsure if they had sleepwalked. The results provide data on the self-reported prevalence rate of sleepwalking in older adolescents. Compared with the population data, this rate falls within the confidence intervals of child and adult prevalence rates of sleepwalking and is consistent with a decline in sleepwalking from childhood and adulthood. Further research is needed to explore how adolescents know they sleepwalk to understand the reliability of self-report measures. Copyright © 2016 Elsevier B.V. All rights reserved.

Hypersynchronous delta waves and somnambulism: brain topography and effect of sleep deprivation.

PubMed

Pilon, Mathieu; Zadra, Antonio; Joncas, Steve; Montplaisir, Jacques

2006-01-01

Hypersynchronous delta activity (HSD) is usually described as several continuous high-voltage delta waves (> or = 150 microV) in the sleep electroencephalogram of somnambulistic patients. However, studies have yielded varied and contradictory results. The goal of the present study was to evaluate HSD over different electroencephalographic derivations during the non-rapid eye movement (NREM) sleep of somnambulistic patients and controls during normal sleep and following 38 hours of sleep deprivation, as well as prior to sleepwalking episodes. N/A. Sleep disorders clinic. Ten adult sleepwalkers and 10 sex- and age-matched control subjects were investigated polysomnographically during a baseline night and following 38 hours of sleep deprivation. N/A. During normal sleep, sleepwalkers had a significantly higher ratio of HSD over the time spent in stage 2, 3 and 4 on frontal and central derivations when compared with controls. Sleep deprivation resulted in a significant increase in the ratio of the time in HSD over the time in stage 4 on the frontal lead in both groups and on the central lead in controls. There was no evidence for a temporal accumulation of HSD prior to the episodes. HSD shows a clear frontocentral gradient across all subjects during both baseline and recovery sleep and has relatively low specificity for the diagnosis of NREM parasomnias. Increases in HSD after sleep deprivation may reflect an enhancement of the homeostatic process underlying sleep regulation.

Sleep and Sex: What Can Go Wrong? A Review of the Literature on Sleep Related Disorders and Abnormal Sexual Behaviors and Experiences

PubMed Central

Schenck, Carlos H.; Arnulf, Isabelle; Mahowald, Mark W.

2007-01-01

Study Objectives: To formulate the first classification of sleep related disorders and abnormal sexual behaviors and experiences. Design: A computerized literature search was conducted, and other sources, such as textbooks, were searched. Results: Many categories of sleep related disorders were represented in the classification: parasomnias (confusional arousals/sleepwalking, with or without obstructive sleep apnea; REM sleep behavior disorder); sleep related seizures; Kleine-Levin syndrome (KLS); severe chronic insomnia; restless legs syndrome; narcolepsy; sleep exacerbation of persistent sexual arousal syndrome; sleep related painful erections; sleep related dissociative disorders; nocturnal psychotic disorders; miscellaneous states. Kleine-Levin syndrome (78 cases) and parasomnias (31 cases) were most frequently reported. Parasomnias and sleep related seizures had overlapping and divergent clinical features. Thirty-one cases of parasomnias (25 males; mean age, 32 years) and 7 cases of sleep related seizures (4 males; mean age, 38 years) were identified. A full range of sleep related sexual behaviors with self and/or bed partners or others were reported, including masturbation, sexual vocalizations, fondling, sexual intercourse with climax, sexual assault/rape, ictal sexual hyperarousal, ictal orgasm, and ictal automatism. Adverse physical and/or psychosocial effects from the sleepsex were present in all parasomnia and sleep related seizure cases, but pleasurable effects were reported by 5 bed partners and by 3 patients with sleep related seizures. Forensic consequences were common, occurring in 35.5% (11/31) of parasomnia cases, with most (9/11) involving minors. All parasomnias cases reported amnesia for the sleepsex, in contrast to 28.6% (2/7) of sleep related seizure cases. Polysomnography (without penile tumescence monitoring), performed in 26 of 31 parasomnia cases, documented sexual moaning from slow wave sleep in 3 cases and sexual intercourse during

Sleep and wakefulness in somnambulism: a spectral analysis study.

PubMed

Guilleminault, C; Poyares, D; Aftab, F A; Palombini, L; Abat, F

2001-08-01

The sleep structure and the dynamics of EEG slow-wave activity (SWA) were investigated in 12 young adults and age- and gender-matched controls. Polysomnography was performed in subjects with well-documented chronic sleepwalking and in matched controls. Blinded visual scoring was performed using the international criteria from the Rechtschaffen and Kales atlas [A manual of standardized technology, techniques and scoring systems for sleep stages of human subjects. Los Angeles: UCLA Brain Information Service, Brain Research Institute, 1968.] and by determining the presence of microarousals as defined in the American Sleep Disorders Association (ASDA) atlas [Sleep 15 (1992) 173.]. An evaluation of SWA overnight was performed on total nocturnal sleep to determine if a difference existed between groups of subjects, since sleepwalking usually originates with slow-wave sleep. Investigation of the delta power in successive nonoverlapping 4-second windows in the 32 seconds just prior to EMG activity associated with a confusional arousal was also conducted. One central EEG lead was used for all analyses. Somnambulistic individuals experienced more disturbed sleep than controls during the first NREM-REM sleep cycle. They had a higher number of ASDA arousals and presented lower peak of SWA during the first cycle that led to a lower SWA decline overnight. When the investigation focused on the short segment immediately preceding a confusional arousal, they presented an important increase in the relative power of low delta (0.75-2 Hz) just prior to the confusional arousal. Sleepwalkers undergo disturbed nocturnal sleep at the beginning of the night. The increased power of low delta just prior to the confusional arousal experienced may not be related to Stages 3-4 NREM sleep. We hypothesize that it may be translated as a cortical reaction to brain activation.

Prevalence of Sleepwalking: A Systematic Review and Meta-Analysis

PubMed Central

Kohler, Mark

2016-01-01

Sleepwalking is thought to be a common arousal disorder; however, the epidemiology of this disorder has not yet been systematically examined. A systematic search of MEDLINE, CINAHL, EMBASE, PsycINFO, PubMed, and ScienceDirect was conducted for ‘sleepwalking’ OR ‘somnambulism’ in any field, to identify studies that reported the epidemiology of sleepwalking or sleepwalking disorders. Fifty-one studies assessed the prevalence rates of sleepwalking in a total sample of 100 490. The meta-analysis showed the estimated lifetime prevalence of sleepwalking was 6.9% (95% CI 4.6%–10.3%). The current prevalence rate of sleepwalking—within the last 12 months—was significantly higher in children 5.0% (95% CI 3.8%–6.5%) than adults 1.5% (95% CI 1.0%–2.3%). There was no evidence of developmental trends in sleepwalking across childhood. The significant risk of bias across all studies suggests these results should be used cautiously. Further epidemiological research that addresses methodological problems found in studies of sleepwalking to date is needed. PMID:27832078

[Sleep deprivation in somnambulism. Effect of arousal, deep sleep and sleep stage changes].

PubMed

Mayer, G; Neissner, V; Schwarzmayr, P; Meier-Ewert, K

1998-06-01

Diagnosis of parasomnias in the sleep laboratory is difficult since the nocturnal behavior reported by the patients often does not show up in the laboratory. To test the efficacy of sleep deprivation as a tool to provoke somnambulism we investigated ten patients (three women and seven men, mean age 27 +/- 3.4) with somnambulism. Their standard polysomnographies and videomonitored nocturnal behavior was compared to that of sex- and age-matched controls and to polysomnography and behavior after sleep deprivation. Patients with parasomnias and controls did not show significant differences in sleep parameters with the exception of longer arousal duration in controls, which was nonsignificant. In magnetic resonance tomography, patients with parasomnias did not reveal abnormality of the brain that might explain release of nocturnal behavior. Sleep deprivation led to significantly reduced number of arousals, reduced arousal index, significantly prolonged arousal duration and more stage shifts from all sleep stages (nonsignificant). Complex behavior during sleep increased under sleep deprivation, whereas sleepwalking did not increase. The majority of complex behavior during sleep is triggered by stage shifts and not by arousal in the sense of the arousal definition of the American Sleep Disorder Society. Complex behavior in sleep is stereotypical and nonviolent. Its complexity seems to depend on the duration and intensity of arousals. Sleep deprivation can be recommended as an efficacious method of increasing complex behavior in sleep, which is a preliminary stage of sleepwalking. Concerning the underlying pathology it seems to be important to register the quality and duration of stimuli that trigger arousals instead of focusing the number of arousals alone.

Factors that predispose, prime and precipitate NREM parasomnias in adults: clinical and forensic implications.

PubMed

Pressman, Mark R

2007-02-01

Sleepwalking and related disorders are the result of factors that predispose, prime and precipitate episodes. In the absence of one or more of these factors sleepwalking is unlikely to occur. Predisposition to sleepwalking is based on genetic susceptibility and has a familial pattern. Priming factors include conditions and substances that increase slow wave sleep (SWS) or make arousal from sleep more difficult. These factors include sleep deprivation, alcohol, medications, situational stress and fever among others. The patient with a genetic predisposition to sleepwalking and with priming factors still requires a precipitating factor or trigger to set the sleepwalking episode in motion. Classical theories of sleepwalking were based primarily on case reports. Recently some of these theories have been tested in the sleep laboratory. Experimental sleep deprivation studies of sleepwalkers generally report an increase in complex behaviors during SWS, although one prominent study reported the opposite effect. However, the generally accepted theory that alcohol and medications can induce sleepwalking episodes remains entirely based on clinical and forensic case reports. Alleged cases of alcohol related sleepwalking often involve individuals lacking the generally accepted characteristics of sleepwalkers but with very high blood alcohol levels that could in and of itself account for complex behaviors noted without the presence of sleepwalking. Further, the effects of high levels of alcohol dramatically decrease SWS, a finding inconsistent with sleepwalking. Case reports of medication-related induction of apparent sleepwalking most often present a complex medical and psychiatric history associated with multiple medications. These patients often lack the clinical history and other criteria currently required for the diagnosis of sleepwalking. The medication-related behaviors may instead represent some other condition in an awake, but impaired patient. Sleep laboratory

Defending sleepwalkers with science and an illustrative case.

PubMed

Cartwright, Rosalind D; Guilleminault, Christian

2013-07-15

To test whether laboratory-based research differentiating sleepwalkers (SW) from controls (C) can be applied in an uncontrolled forensic case as evidence the alleged crime was committed during an arousal from sleep in which the mind is not fully conscious due to a SW disorder. A PSG study recorded 8 months after the defendant was charged was analyzed independently by spectral analysis. Slow wave activity (SWA) and cyclic alternating pattern (CAP) rates were computed. Clinical interviews and police records were reviewed for data re: the defendant's sleep prior to the event and use of drugs, alcohol, and stimulants. The SWA distribution was abnormally low and flat, significantly lower than published controls; in the first NREM cycle, CAP rate 55 was above normal. Two weeks of prior sleep deprivation was confirmed from interviews and defendant's observed daytime sleepiness. Caffeine intake the day before the event was calculated at 826 mg over 14 hours. Snoring and a mild breathing disorder were present in the PSG. Testimony based on spectral analysis of PSG recorded following an alleged criminal event supported a SW explanation for the non-rational behaviors charged. The defendant was acquitted of all charges and has been successfully treated.

Disorders of Arousal From Sleep and Violent Behavior: The Role of Physical Contact and Proximity

PubMed Central

Pressman, Mark R.

2007-01-01

Study Objectives: To review medical and legal case reports to determine how many appear to support the belief that violence against other individuals that occurs during Disorders of Arousal - sleepwalking, confusional arousal, and sleep terrors – is triggered by direct physical contact or close proximity to that individual and does not occur randomly or spontaneously. Design: Historical review of case reports in the medical and legal literature. Measurements and Results: A total of 32 cases drawn from medical and legal literature were reviewed. Each case contained a record of violence associated with Disorders of Arousal; in each, details of the violent behavior were available. Violent behaviors associated with provocations and/or close proximity were found to be present in 100% of confusional arousal patients and 81% of sleep terror patients. Violent behaviors were associated with provocation or close proximity in 40%–90% of sleepwalking cases, depending on whether the legal verdict and other factors were taken into account. Often the provocation was quite minor and the response greatly exaggerated. The specific manner in which the violence was triggered differed among sleepwalking, confusional arousals, and sleep terrors. Conclusions: In the cases reviewed, violent behavior directed against other individuals associated with Disorders of Arousal most frequently appeared to follow direct provocation by, or close proximity to, another individual. Sleepwalkers most often did not seek out victims, but rather the victims sought out or encountered the sleepwalker. These conclusions are tempered by several limitations: the selection of cases was not random and may not represent an accurate sample of violent behaviors associated with Disorders of Arousal. Also, final verdicts by juries in reported legal cases should not be confused with scientific proof of the presence or absence of sleepwalking. The pathophysiology of Disorders of Arousal with and without violent

Disorders of arousal from sleep and violent behavior: the role of physical contact and proximity.

PubMed

Pressman, Mark R

2007-08-01

To review medical and legal case reports to determine how many appear to support the belief that violence against other individuals that occurs during Disorders of Arousal - sleepwalking, confusional arousal, and sleep terrors - is triggered by direct physical contact or close proximity to that individual and does not occur randomly or spontaneously. Historical review of case reports in the medical and legal literature. A total of 32 cases drawn from medical and legal literature were reviewed. Each case contained a record of violence associated with Disorders of Arousal; in each, details of the violent behavior were available. Violent behaviors associated with provocations and/or close proximity were found to be present in 100% of confusional arousal patients and 81% of sleep terror patients. Violent behaviors were associated with provocation or close proximity in 40%-90% of sleepwalking cases, depending on whether the legal verdict and other factors were taken into account. Often the provocation was quite minor and the response greatly exaggerated. The specific manner in which the violence was triggered differed among sleepwalking, confusional arousals, and sleep terrors. In the cases reviewed, violent behavior directed against other individuals associated with Disorders of Arousal most frequently appeared to follow direct provocation by, or close proximity to, another individual. Sleepwalkers most often did not seek out victims, but rather the victims sought out or encountered the sleepwalker. These conclusions are tempered by several limitations: the selection of cases was not random and may not represent an accurate sample of violent behaviors associated with Disorders of Arousal. Also, final verdicts by juries in reported legal cases should not be confused with scientific proof of the presence or absence of sleepwalking. The pathophysiology of Disorders of Arousal with and without violent behavior could be associated with normally occurring deactivation of the

Sleep-Related Violence and Sexual Behavior in Sleep: A Systematic Review of Medical-Legal Case Reports

PubMed Central

Ingravallo, Francesca; Poli, Francesca; Gilmore, Emma V.; Pizza, Fabio; Vignatelli, Luca; Schenck, Carlos H.; Plazzi, Giuseppe

2014-01-01

Objective: To review systematically medical-legal cases of sleep-related violence (SRV) and sexual behavior in sleep (SBS). Search Methods: We searched Pubmed and PsychINFO (from 1980 to 2012) with pre-specified terms. We also searched reference lists of relevant articles. Selection Criteria: Case reports in which a sleep disorder was purported as the defense during a criminal trial and in which information about the forensic evaluation of the defendant was provided. Data Extraction and Analysis: Information about legal issues, defendant and victim characteristics, circumstantial factors, and forensic evaluation was extracted from each case. A qualitative-comparative assessment of cases was performed. Results: Eighteen cases (9 SRV and 9 SBS) were included. The charge was murder or attempted murder in all SRV cases, while in SBS cases the charge ranged from sexual touching to rape. The defense was based on sleepwalking in 11 of 18 cases. The trial outcome was in favor of the defendant in 14 of 18 cases. Defendants were relatively young males in all cases. Victims were usually adult relatives of the defendants in SRV cases and unrelated young girls or adolescents in SBS cases. In most cases the criminal events occurred 1-2 hours after the defendant's sleep onset, and both proximity and other potential triggering factors were reported. The forensic evaluations widely differed from case to case. Conclusion: SRV and SBS medical-legal cases did not show apparent differences, except for the severity of the charges and the victim characteristics. An international multidisciplinary consensus for the forensic evaluation of SRV and SBS should be developed as an urgent priority. Citation: Ingravallo F, Poli F, Gilmore EV, Pizza F, Vignatelli L, Schenck CH, Plazzi G. Sleep-related violence and sexual behavior in sleep: a systematic review of medical-legal case reports. J Clin Sleep Med 2014;10(8):927-935. PMID:25126042

Sleep violence--forensic science implications: polygraphic and video documentation.

PubMed

Mahowald, M W; Bundlie, S R; Hurwitz, T D; Schenck, C H

1990-03-01

During the past century, infrequent, anecdotal reports of sleep-related violence with forensic science implications have appeared. Recent rapid developments in the field of sleep-disorders medicine have resulted in greater understanding of a variety of sleep-related behaviors, and formal sleep-behavior monitoring techniques have permitted their documentation and classification. Sleep-related violence can be associated with a number of diagnosable and treatable sleep disorders, including (1) night terrors/sleepwalking, (2) nocturnal seizures, (3) rapid eye movement (REM) sleep-behavior disorder, (4) sleep drunkenness, and (5) psychogenic dissociative states occurring during the sleep period. Potentially violent automatized behavior, without consciousness, can and does occur during sleep. The violence resulting from these disorders may be misinterpreted as purposeful suicide, assault, or even homicide. Sleep-related violence must be added to the list of automatisms. A classification system of both waking and sleep-related automatic behavior is proposed, with recommendations for assessment of such behavior.

[Sleep psychiatry].

PubMed

Chiba, Shigeru

2013-01-01

Sleep disorders are serious issues in modern society. There has been marked scientific interest in sleep for a century, with the discoveries of the electrical activity of the brain (EEG), sleep-wake system, rapid eye movement (REM) sleep, and circadian rhythm system. Additionally, the advent of video-polysomnography in clinical research has revealed some of the consequences of disrupted sleep and sleep deprivation in psychiatric disorders. Decades of clinical research have demonstrated that sleep disorders are intimately tied to not only physical disease (e. g., lifestyle-related disease) but psychiatric illness. According to The International Classification of Sleep Disorders (2005), sleep disorders are classified into 8 major categories: 1) insomnia, 2) sleep-related breathing disorders, 3) hypersomnias of central origin, 4) circadian rhythm sleep disorders, 5) parasomnias, 6) sleep-related movement disorders, 7) isolated symptoms, and 8) other sleep disorders. Several sleep disorders, including obstructive sleep apnea syndrome, restless legs syndrome, periodic limb movement disorder, sleepwalking, REM sleep behavior disorder, and narcolepsy, may be comorbid or possibly mimic numerous psychiatric disorders, and can even occur due to psychiatric pharmacotherapy. Moreover, sleep disorders may exacerbate underlying psychiatric disorders when left untreated. Therefore, psychiatrists should pay attention to the intimate relationship between sleep disorders and psychiatric symptoms. Sleep psychiatry is an academic field focusing on interrelations between sleep medicine and psychiatry. This mini-review summarizes recent findings in sleep psychiatry. Future research on the bidirectional relation between sleep disturbance and psychiatric symptoms will shed light on the pathophysiological view of psychiatric disorders and sleep disorders.

Sleep-related violence and sexual behavior in sleep: a systematic review of medical-legal case reports.

PubMed

Ingravallo, Francesca; Poli, Francesca; Gilmore, Emma V; Pizza, Fabio; Vignatelli, Luca; Schenck, Carlos H; Plazzi, Giuseppe

2014-08-15

To review systematically medical-legal cases of sleep-related violence (SRV) and sexual behavior in sleep (SBS). We searched Pubmed and PsychINFO (from 1980 to 2012) with pre-specified terms. We also searched reference lists of relevant articles. Case reports in which a sleep disorder was purported as the defense during a criminal trial and in which information about the forensic evaluation of the defendant was provided. Information about legal issues, defendant and victim characteristics, circumstantial factors, and forensic evaluation was extracted from each case. A qualitative-comparative assessment of cases was performed. Eighteen cases (9 SRV and 9 SBS) were included. The charge was murder or attempted murder in all SRV cases, while in SBS cases the charge ranged from sexual touching to rape. The defense was based on sleepwalking in 11 of 18 cases. The trial outcome was in favor of the defendant in 14 of 18 cases. Defendants were relatively young males in all cases. Victims were usually adult relatives of the defendants in SRV cases and unrelated young girls or adolescents in SBS cases. In most cases the criminal events occurred 1-2 hours after the defendant's sleep onset, and both proximity and other potential triggering factors were reported. The forensic evaluations widely differed from case to case. SRV and SBS medical-legal cases did not show apparent differences, except for the severity of the charges and the victim characteristics. An international multidisciplinary consensus for the forensic evaluation of SRV and SBS should be developed as an urgent priority.

Sleep problems in children and adolescents at pediatric clinics

PubMed Central

Kim, Dong Soon; Lee, Cho Long

2017-01-01

Purpose To investigate the frequency of childhood sleep problems at pediatric clinics in Seoul and Gyeonggi provinces. Methods Children (n=936) and their parents who visited 5 primary and 1 secondary pediatric outpatient clinics were invited to complete a Pediatric Sleep Questionnaire. Results Among patients, 901 (96.3%) answered questionnaires in sufficient detail for evaluation. The participant's mean age was 4.35±3.02 years (range, 0–18 years). The male to female ratio was 1:0.93 (466 boys, 435 girls). Habitual snoring (>3 day/week) was reported in 16.9% of the participants. The prevalence of habitual snoring in children <2 years and those between 2–5 years was 9% and 18%, respectively. Sleep disordered breathing was found in 15.1% (106 of 700) of children >2 years. Insomnia was reported in 13.2% of children. The prevalence of sleepwalking, night terrors, and bruxism, is 1.6%, 19%, and 21.1%, respectively. Snoring was associated with increased incidence of sleepwalking, night terrors, and bruxism. Age was associated with insomnia and habitual snoring (P<0.05). Insomnia was more prevalent in younger (21%) than in older children (6%). Snoring was more frequent in both preschool (34%) and school-aged children (33%). The frequency of sleep disordered breathing and insomnia did not vary significantly with gender. However, snoring was more prevalent in boys. Conclusion Sleep problems are frequent among children in Korea. Children with snoring have an increased risk of sleepwalking, night terror, and bruxism. Primary clinicians should consider children's sleep habits to improve their health. PMID:28592979

Sleep disorders in kidney disease.

PubMed

De Santo, R M; Perna, A; Di Iorio, B R; Cirillo, M

2010-03-01

Sleep disorders are common in patients with end stage renal disease receiving hemodialysis or peritoneal dialysis. However also a well functioning renal graft does not cure the poor sleep pattern which now emerges as a problem even in early chronic kidney disease (CKD). When patients are made aware for the first time of a disease such as CKD, which may brink to dialysis or at the best to a renal transplant patients begin to experience a disordered sleep. Sleeping disorders include insomnia (I), sleep apnoea (SAS), restless legs syndrome (RLS), periodic limb movement disorder (PLMD), excessive daily sleeping (EDS), sleepwalking, nightmares, and narcolepsy. Disordered sleep did not meet the clinical and scientific interest it deserves, in addition and we do not have a well defined solution for sleeping complaints. However, awareness that a poor sleep is associated with poor quality of life and carries an increase in mortality risk has recently stimulated interest in the field. There are many putative causes for a disordered sleep in chronic kidney disease and in end-stage renal disease. For a unifying hypothesis demographic factors, lifestyles, disease related factors, psychological factors, treatment related factors, and social factor must be taken into consideration.

Sleep self-intoxication and sleep driving as rare zolpidem-induced complex behaviour.

PubMed

Paulke, Alexander; Wunder, Cora; Toennes, Stefan W

2015-01-01

The GABA(A) receptor agonist zolpidem has been used for treatment of insomnia since years, but special side effects have been reported. These side effects were called zolpidem-induced sleep-related complex behaviour. Such complex behaviour is associated with somnambulism and includes sleepwalking, sleep eating, sleep conversation and sleep driving. Two cases of zolpidem-induced sleep-related complex behaviour following self-intoxication, sleep driving and amnesia are presented. In both cases, the subjects reported the voluntary intake of only one zolpidem tablet of 10 mg and amnesia for the time afterwards. Shortly after the onset of the drug's action, both individuals drifted into a somnambulism-like state and toxicological blood analysis suggested the intake of the remaining zolpidem tablets which might be called "sleep intoxication". Later, the subjects were arrested by police after driving under drug influence and not realizing the situation. Retrospectively, both subjects suffered from psychiatric disorders and in case 2, the subject was treated for depression with doxepin. Consequently, these co-factors may have increased the risk for the occurrence of the sleep-related complex behaviour. Involuntary self-intoxication should be taken into account in addition to the known pattern of zolpidem-induced complex behaviour. In legal cases, the forensic expert has to assess the blood concentration of zolpidem in evaluating this strange behaviour. Amnesia and incoherence of speech, disorganization of behaviour, inability to realize the situation and mood changes may indicate a zolpidem-induced somnambulism-like state with sleep-related complex behaviour.

Sleepwalking through history: medicine, arts, and courts of law.

PubMed

Umanath, Sharda; Sarezky, Daniel; Finger, Stanley

2011-10-01

Somnambulism, or sleepwalking, has always been of interest to theologians, writers, philosophers, physicians, and others fascinated by unusual behaviors. This parasomnia, which was defined less precisely in the past than it is today, has long been featured in medical dissertations and books of medicine. Further, Shakespeare, Bellini, and Brown, among others, incorporated it into their plays, operas, and novels. Because some somnambulists turned violent and committed other acts detrimental to society, sleepwalking also demanded attention from legal systems, and guidelines were set for whether somnambulists could be held responsible for their actions. This historical review focuses on these developments pertaining to somnambulism through the seventeenth, eighteenth, and nineteenth centuries.

The Development of Sleep Medicine: A Historical Sketch

PubMed Central

Schulz, Hartmut; Salzarulo, Piero

2016-01-01

For centuries the scope of sleep disorders in medical writings was limited to those disturbances which were either perceived by the sleeper him- or herself as troublesome, such as insomnia, or which were recognized by an observer as strange behavioral acts during sleep, such as sleepwalking or sleep terrors. Awareness of other sleep disorders, which are caused by malfunction of a physiological system during sleep, such as sleep-related respiratory disorders, were widely unknown or ignored before sleep monitoring techniques became available, mainly in the second half of the 20th century. Finally, circadian sleep-wake disorders were recognized as a group of disturbances by its own only when chronobiology and sleep research began to interact extensively in the last two decades of the 20th century. Sleep medicine as a medical specialty with its own diagnostic procedures and therapeutic strategies could be established only when key findings in neurophysiology and basic sleep research allowed a breakthrough in the understanding of the sleeping brain, mainly since the second half of the last century. Citation: Schulz H, Salzarulo P. The development of sleep medicine: a historical sketch. J Clin Sleep Med 2016;12(7):1041–1052. PMID:27250813

REM sleep behavior disorder and other sleep disturbances in Disney animated films.

PubMed

Iranzo, Alex; Schenck, Carlos H; Fonte, Jorge

2007-08-01

During a viewing of Disney's animated film Cinderella (1950), one author (AI) noticed a dog having nightmares with dream-enactment that strongly resembled RBD. This prompted a study in which all Disney classic full-length animated films and shorts were analyzed for other examples of RBD. Three additional dogs were found with presumed RBD in the classic films Lady and the Tramp (1955) and The Fox and the Hound (1981), and in the short Pluto's Judgment Day (1935). These dogs were elderly males who would pant, whine, snuffle, howl, laugh, paddle, kick, and propel themselves while dreaming that they were chasing someone or running away. In Lady and the Tramp the dog was also losing both his sense of smell and his memory, two associated features of human RBD. These four films were released before RBD was first formally described in humans and dogs. In addition, systematic viewing of the Disney films identified a broad range of sleep disorders, including nightmares, sleepwalking, sleep related seizures, disruptive snoring, excessive daytime sleepiness, insomnia and circadian rhythm sleep disorder. These sleep disorders were inserted as comic elements. The inclusion of a broad range of accurately depicted sleep disorders in these films indicates that the Disney screenwriters were astute observers of sleep and its disorders.

The sleepwalking/night terrors syndrome in adults.

PubMed Central

Crisp, A. H.

1996-01-01

A third of a million adults in the UK sleepwalk while a million suffer from night terrors. In both conditions the individual is unaware of the fullness of their surroundings and is totally focussed in their concern or activity. Doctors are only likely to become involved if the individual comes to harm or seeks help or if other people are inconvenienced or threatened. The constitutional basis of the disorder is beyond doubt, although the actual expression may be related to stressful life-events resulting from an individual's personality, relationships and circumstances. Treatment may include the provision of a secure environment, counselling, and the use of benzodiazepines and serotonin re-uptake inhibitors. PMID:8977941

Scalp and Source Power Topography in Sleepwalking and Sleep Terrors: A High-Density EEG Study.

PubMed

Castelnovo, Anna; Riedner, Brady A; Smith, Richard F; Tononi, Giulio; Boly, Melanie; Benca, Ruth M

2016-10-01

To examine scalp and source power topography in sleep arousals disorders (SADs) using high-density EEG (hdEEG). Fifteen adult subjects with sleep arousal disorders (SADs) and 15 age- and gender-matched good sleeping healthy controls were recorded in a sleep laboratory setting using a 256 channel EEG system. Scalp EEG analysis of all night NREM sleep revealed a localized decrease in slow wave activity (SWA) power (1-4 Hz) over centro-parietal regions relative to the rest of the brain in SADs compared to good sleeping healthy controls. Source modelling analysis of 5-minute segments taken from N3 during the first half of the night revealed that the local decrease in SWA power was prominent at the level of the cingulate, motor, and sensori-motor associative cortices. Similar patterns were also evident during REM sleep and wake. These differences in local sleep were present in the absence of any detectable clinical or electrophysiological sign of arousal. Overall, results suggest the presence of local sleep differences in the brain of SADs patients during nights without clinical episodes. The persistence of similar topographical changes in local EEG power during REM sleep and wakefulness points to trait-like functional changes that cross the boundaries of NREM sleep. The regions identified by source imaging are consistent with the current neurophysiological understanding of SADs as a disorder caused by local arousals in motor and cingulate cortices. Persistent localized changes in neuronal excitability may predispose affected subjects to clinical episodes. © 2016 Associated Professional Sleep Societies, LLC.

Comorbid sleep disorders and suicide risk among children and adolescents with bipolar disorder.

PubMed

Stanley, Ian H; Hom, Melanie A; Luby, Joan L; Joshi, Paramjit T; Wagner, Karen D; Emslie, Graham J; Walkup, John T; Axelson, David A; Joiner, Thomas E

2017-12-01

Children and adolescents with bipolar disorder are at increased risk for suicide. Sleep disturbances are common among youth with bipolar disorder and are also independently implicated in suicide risk; thus, comorbid sleep disorders may amplify suicide risk in this clinical population. This study examined the effects of comorbid sleep disorders on suicide risk among youth with bipolar disorder. We conducted secondary analyses of baseline data from the Treatment of Early Age Mania (TEAM) study, a randomized controlled trial of individuals aged 6-15 years (mean ± SD = 10.2 ± 2.7 years) with DSM-IV bipolar I disorder (N = 379). Sleep disorders (i.e., nightmare, sleep terror, and sleepwalking disorders) and suicide risk were assessed via the WASH-U-KSADS and the CDRS-R, respectively. We constructed uncontrolled logistic regression models as well as models controlling for trauma history, a generalized anxiety disorder (GAD) diagnosis, and depression symptoms. Participants with a current comorbid nightmare disorder versus those without were nearly twice as likely to screen positive for suicide risk in an uncontrolled model and models controlling for trauma history, a GAD diagnosis, and depression symptoms. Neither a current comorbid sleep terror disorder nor a sleepwalking disorder was significantly associated with suicide risk. This pattern of findings remained consistent for both current and lifetime sleep disorder diagnoses. Youth with bipolar I disorder and a comorbid nightmare disorder appear to be at heightened suicide risk. Implications for assessment and treatment are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Parasomnias and isolated sleep symptoms in Parkinson's disease: a questionnaire study on 661 patients.

PubMed

Ylikoski, Ari; Martikainen, Kirsti; Partinen, Markku

2014-11-15

Sleep disorders are among the most common non-motor symptoms in Parkinson's disease. The prevalence of parasomnias and their association with other symptoms were studied in a questionnaire study among 1447 randomly selected Parkinson patients, aged 43 to 89 years. The response rate was 59.0% and of these 77% had answered to all questions that were used in the analyses (N = 661). The prevalence of REM sleep behavior disorder (RBD) evaluated by the RBDSQ ≥ 6 was 39.0%. The occurrences of other parasomnias (≥ 1/week) in patients with PD were: nightmares 17.2%, night terrors 3.9%, sleepwalking 1.8%, enuresis 21.0%, and hallucinations 15.3%. Occurrences (≥ 1/week) of the isolated sleep symptoms were: nocturnal sweating 28.8%, bruxism 4.7%, and sleep talking 21.7%. Association of RBD with sleepwalking (parasomnia overlap disorder) was found in 1.7% of all PD patients. Adjusted logistic regression analysis showed that weekly nightmares (OR 12.5; 95% CI 5.3 to 29.7), hallucinations (OR 5.1; 2.1 to 12.4), sleep talking (OR 11.6; 5.9 to 22.8), male gender (OR 1.9; 1.1 to 3.1), and restless legs syndrome (OR 4.7; 1.7 to 13.2) associated with the presence of RBD. Parkinson patients with RBD have often also other parasomnias and/or isolated sleep symptoms. Copyright © 2014 Elsevier B.V. All rights reserved.

Child temperament, parenting discipline style, and daytime behavior in childhood sleep disorders.

PubMed

Owens-Stively, J; Frank, N; Smith, A; Hagino, O; Spirito, A; Arrigan, M; Alario, A J

1997-10-01

Fifty-two children without significant sleep disturbance seen at a primary care clinic for well-child care were compared on measures of temperament, parenting style, daytime behavior, and overall sleep disturbance to three diagnostic subgroups identified in a pediatric sleep clinic: children with obstructive sleep apnea (n = 33), parasomnias (night terrors, sleepwalking, etc.) (n = 16), and behavioral sleep disorders (limit-setting disorder, etc.) (n = 31). The mean age of the entire sample was 5.7 years. Temperamental emotionality in the behavioral sleep disorders group was associated with a higher level of sleep disturbance (p < .001); parenting laxness was associated with sleep disturbance in the general pediatric population (p < .01); and intense and negative temperament characteristics seemed to be associated with clinically significant behavioral sleep disturbances. Ineffective parenting styles and daytime disruptive behaviors were more likely to be associated with the milder sleep disturbances found in children in a primary care setting.

Somnambulism: clinical aspects and pathophysiological hypotheses.

PubMed

Zadra, Antonio; Desautels, Alex; Petit, Dominique; Montplaisir, Jacques

2013-03-01

Somnambulism, or sleepwalking, can give rise to a wide range of adverse consequences and is one of the leading causes of sleep-related injury. Accurate diagnosis is crucial for proper management and imperative in an ever-increasing number of medicolegal cases implicating sleep-related violence. Unfortunately, several widely held views of sleepwalking are characterised by key misconceptions, and some established diagnostic criteria are inconsistent with research findings. The traditional idea of somnambulism as a disorder of arousal might be too restrictive and a comprehensive view should include the idea of simultaneous interplay between states of sleep and wakefulness. Abnormal sleep physiology, state dissociation, and genetic factors might explain the pathophysiology of the disorder. Copyright © 2013 Elsevier Ltd. All rights reserved.

Sleep-related movement disorders.

PubMed

Merlino, Giovanni; Gigli, Gian Luigi

2012-06-01

Several movement disorders may occur during nocturnal rest disrupting sleep. A part of these complaints is characterized by relatively simple, non-purposeful and usually stereotyped movements. The last version of the International Classification of Sleep Disorders includes these clinical conditions (i.e. restless legs syndrome, periodic limb movement disorder, sleep-related leg cramps, sleep-related bruxism and sleep-related rhythmic movement disorder) under the category entitled sleep-related movement disorders. Moreover, apparently physiological movements (e.g. alternating leg muscle activation and excessive hypnic fragmentary myoclonus) can show a high frequency and severity impairing sleep quality. Clinical and, in specific cases, neurophysiological assessments are required to detect the presence of nocturnal movement complaints. Patients reporting poor sleep due to these abnormal movements should undergo non-pharmacological or pharmacological treatments.

Stability of sleep disorders from preschool to first grade and their bidirectional relationship with psychiatric symptoms.

PubMed

Steinsbekk, Silje; Wichstrøm, Lars

2015-05-01

To examine the prevalence and stability of DSM-4-defined sleep disorders from preschool to first grade and to explore the bidirectional relationship between sleep disorders and symptoms of psychiatric disorders. All children born in 2003 or 2004 in Trondheim, Norway, who attended regular community health checkups for 4-year-olds, were invited to participate (97.2% attendance; 82.0% consent rate, n = 2475) in this study. The authors recruited a screen-stratified subsample of 1250 children and interviewed 994 parents (79.6%) using a structured diagnostic interview (the Preschool Age Psychiatric Assessment). Two years later, 795 of the parents completed the interview. There was stability in insomnia (adjusted odds ratio [OR] = 4.03, confidence interval [CI] = 2.83-5.75) and sleepwalking (adjusted OR = 19.28, CI = 4.53-82.10), whereas none of the children with hypersomnia or nightmare disorder at age 4 had the same disorder 2 years later. Insomnia increased the risk for developing symptoms of conduct disorder, major depressive disorder (MDD), and social phobia when the initial levels of insomnia were adjusted for. Symptoms of attention-deficit hyperactivity disorder, oppositional defiant disorder, and MDD at age 4 were statistically linked to insomnia at age 6. Sleepwalking predicted later separation anxiety disorder, whereas hypersomnia was unrelated to symptoms of psychiatric disorders. Insomnia is a prevalent and stable disorder in children and is bidirectionally related to psychiatric symptoms.

Familial recurrent hypersomnia: two siblings with Kleine-Levin syndrome and menstrual-related hypersomnia.

PubMed

Rocamora, Rodrigo; Gil-Nagel, Antonio; Franch, Oriol; Vela-Bueno, Antonio

2010-11-01

Kleine-Levin syndrome and menstrual-related hypersomnia are rare idiopathic sleep disorders occurring primarily in adolescence. They are characterized by intermittent periods of excessive sleepiness, cognitive disturbances, and behavioral abnormalities. In both, the etiology remains unknown but autoinmune, hormonal, infectious, and inflammatory mechanisms have been proposed. The authors describe, for the first time, the association of Kleine-Levin syndrome and menstrual-related hypersomnia in 2 adolescent siblings who shared the human leukocyte antigen (HLA) loci DQB1*0501. The same haplotype has been associated with sleepwalking and with rapid eye movement (REM) sleep behavior disorder. This gender differences in the manifestation of a probably genetic influenced sleep disorder suggests that hormonal mechanisms could be implicated in the phenotypical expression of this sleep disorder. The male sibling with Kleine-Levin syndrome was easily controlled with carbamazepine in low doses, but his sister could be only efficaciously treated with oral contraceptives.

Sexsomnia: A Specialized Non-REM Parasomnia?

PubMed

Dubessy, Anne-Laure; Leu-Semenescu, Smaranda; Attali, Valérie; Maranci, Jean-Baptiste; Arnulf, Isabelle

2017-02-01

To describe patients with sexsomnia and to contrast their clinical and sleep measures with those of healthy controls and sleepwalkers. Subjects referred for sexsomnia and for sleepwalking/night terror were interviewed, completed the Paris Arousal Disorder Severity Scale (PADSS), and were monitored 1-2 nights with video-polysomnography. Seventeen patients (70.6% male, aged 17-76 years) had sexsomnia, with amnestic fondling of the bed partner (n = 11), complete sexual intercourse (n = 8), masturbation (n = 8), and spontaneous orgasm (n = 1). The sexual behaviors were more direct during sleep than during wakefulness (n = 12), leading to 6 sexual assaults, including intra-conjugal rape (n = 3), assault of a family member (n = 2), rape of a friend (n = 1), and forensic consequences (n = 2). In 47% of sexsomnia patients, there was a history or current occurrences of sleepwalking/night terrors. Patients with sexsomnia had more N3 awakenings than healthy matched controls and the same amount as regular sleepwalkers. Half of them presented evidence of cortico-cortical dissociation, including concomitant slow (mostly frontal) and rapid (mostly temporal and occipital) electroencephalography (EEG) rhythms, with concomitant N3 penile erection in 1 case. Of 89 sleepwalkers, 10% had previous episodes of amnestic sexual behaviors, with a higher PADSS-A score and a trend of a higher total PADSS score than the 80 sleepwalkers without sexsomnia. In this single-center series, we confirmed the male predominance of sexsomnias and its potential for severe clinical and forensic consequences. The results suggest a continuum of regular sleepwalking, sleepwalking with occasional sexsomnia, and quasi-exclusive sexsomnia. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Information processing during sleep and stress-related sleep vulnerability.

PubMed

Lin, Yen-Hsuan; Jen, Chun-Hui; Yang, Chien-Ming

2015-02-01

Previous studies showed enhanced attention and decreased inhibitory processes during early non-rapid eye movement sleep in primary insomnia patients, as measured by event-related potentials. The current study aims to examine information processing during sleep in non-insomniac individuals with high vulnerability (HV) to stress-related sleep disturbances. Twenty-seven non-insomniac individuals were recruited, 14 with low vulnerability and 13 with HV. After passing a screening interview and polysomnographic recording, subjects came to the sleep laboratory for 2 nights (a baseline night and a stress-inducing night) for event-related potentials recordings. The HV group demonstrated shorter P2 latency during the first 5 min of stage 2 sleep and higher P900 amplitudes under the stress condition during slow-wave sleep, which indicates an increased level of inhibitory processes. In addition, they had shorter N1 latencies during slow-wave sleep that could indicate an elevated level of attention processing during deep sleep. Unlike patients with chronic insomnia, individuals with high sleep vulnerability to stress show a compensatory process that may prevent external stimulation from interfering with their sleep. This may be one of the factors preventing their acute sleep disturbances from becoming chronic problems. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

Medicolegal aspects of complex behaviours arising from the sleep period: a review and guide for the practising sleep physician.

PubMed

Morrison, Ian; Rumbold, John M M; Riha, Renata L

2014-06-01

This review is aimed at summarizing the current state of knowledge regarding parasomnias, which have been implicated in medicolegal cases as well as providing guidance to those working within common-law jurisdictions regarding the technical aspects of the law. Sleepwalking and sexsomnia as a defence are being raised more frequently in criminal cases and there has been public debate on their validity. Unfortunately, expert evidence on forensic sleep disorders continues to be heavily opinion-based with the potential for miscarriages of justice seen in recent highly publicized cases. There is an apparent inertia in research into violent sleep disorders. We review the current state of forensic sleep science in the United Kingdom (UK) and abroad and discuss the need to formulate guidelines based on available evidence. We also highlight the pressing necessity for more research in this area as well as the need to reform the law, which is the subject of a recent Criminal Law Commission report in the United Kingdom. In time, this will facilitate the efficient, proportionate, and just disposal of violence arising from sleep, thus benefitting both society and the individual sufferer. Copyright © 2013 Elsevier Ltd. All rights reserved.

Prevalence of Sleep Disorders Among Primary School Children.

PubMed

Gupta, Ravi; Goel, Deepak; Kandpal, S D; Mittal, Nidhi; Dhyani, Mohan; Mittal, Manish

2016-11-01

To screen symptoms of sleep disorders among primary school children. Four schools from urban area and four rural schools were included in this study. Symptoms of sleep disorders were assessed using the validated Hindi version of Childhood Sleep Habit Questionnaire in 8-13 y old children. Comparison was made between urban and rural group and between boys and girls. Descriptive statistics was calculated. Mean age of the subjects included in this study was 8.9 ± 1.5 y. Boys and girls were equally distributed, however, rural sample was smaller. More than one awakening each night was found in 12.2 % children. In the whole group, prevalence of bed-wetting was 8.7 %, sleep-talking 20.9 %, sleep-walking 3.2 %, teeth grinding 15.4 % and night terrors 8.4 %. Daytime sleepiness was reported by 25.5 % and napping by 56.4 %. 17.3 % used to fall asleep in unusual circumstances and the teacher or the friend in 6.9 % students noticed it. Snoring was reported by 11.4 % children, and 6.3 % reportedly struggled to breathe during sleep. Domicile and gender did not affect prevalence of parasomnia, however, symptoms of sleep apnea were more frequent among rural children. Daytime sleepiness was more common among rural children as compared to urban. Symptoms of sleep disorders are prevalent among primary school children. Common disorders are parasomnia, sleep apnea and daytime sleepiness.

What Does the Sleeping Brain Say? Syntax and Semantics of Sleep Talking in Healthy Subjects and in Parasomnia Patients.

PubMed

Arnulf, Isabelle; Uguccioni, Ginevra; Gay, Frederick; Baldayrou, Etienne; Golmard, Jean-Louis; Gayraud, Frederique; Devevey, Alain

2017-11-01

Speech is a complex function in humans, but the linguistic characteristics of sleep talking are unknown. We analyzed sleep-associated speech in adults, mostly (92%) during parasomnias. The utterances recorded during night-time video-polysomnography were analyzed for number of words, propositions and speech episodes, frequency, gaps and pauses (denoting turn-taking in the conversation), lemmatization, verbosity, negative/imperative/interrogative tone, first/second person, politeness, and abuse. Two hundred thirty-two subjects (aged 49.5 ± 20 years old; 41% women; 129 with rapid eye movement [REM] sleep behavior disorder and 87 with sleepwalking/sleep terrors, 15 healthy subjects, and 1 patient with sleep apnea speaking in non-REM sleep) uttered 883 speech episodes, containing 59% nonverbal utterance (mumbles, shouts, whispers, and laughs) and 3349 understandable words. The most frequent word was "No": negations represented 21.4% of clauses (more in non-REM sleep). Interrogations were found in 26% of speech episodes (more in non-REM sleep), and subordinate clauses were found in 12.9% of speech episodes. As many as 9.7% of clauses contained profanities (more in non-REM sleep). Verbal abuse lasted longer in REM sleep and was mostly directed toward insulting or condemning someone, whereas swearing predominated in non-REM sleep. Men sleep-talked more than women and used a higher proportion of profanities. Apparent turn-taking in the conversation respected the usual language gaps. Sleep talking parallels awake talking for syntax, semantics, and turn-taking in conversation, suggesting that the sleeping brain can function at a high level. Language during sleep is mostly a familiar, tensed conversation with inaudible others, suggestive of conflicts. © Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society]. All rights reserved. For permissions, please email: journals.permissions@oup.com

Topiramate-induced somnambulism in a migraineur: a probable idiosyncratic adverse effect.

PubMed

Mathew, Thomas; Sarma, G R K; Nadig, Raghunandan; Varghese, Raji

2012-04-15

Somnambulism (sleepwalking) is a disorder of arousal that falls under "parasomnia" group and is more common in children. These phenomena occur as primary sleep events or secondary to systemic disease or can be drug induced. Medications that can cause sleepwalking include neuroleptics, hypnotics, lithium, amitriptyline, and β-blockers. This report presents an unusual adverse effect of topiramate on sleep in a patient with migraine.

Respiratory pathophysiology: sleep-related breathing disorders

PubMed Central

Schäfer, Thorsten

2006-01-01

A widespread network of respiratory-related neurons within the brainstem controls the regular respiratory cycle, which is dependent upon unspecific and specific drives like hypoxia or hypercapnia. This respiratory network and its respiratory drives are subjects to typical changes during the transition from wakefulness to sleep and within the various sleep states, which favor a destabilization of breathing during sleep. There is also a respiratory-related innervation of the dilating and stiffening pharyngeal muscles as well as a local reflex control of the basic tone of upper airway muscles, both of which are influenced by the different states of wakefulness and sleep. These sleep-related changes cause an increase in upper airway resistance during sleep. In healthy subjects, however, these features during sleep are almost completely compensated and the gas exchange is hardly hindered. However, in the case of illness, severe disordered breathing, disturbed gas exchange and interrupted sleep may occur. The central hypoventilation syndrome, central apnea-hypopnea syndromes, as well as the obstructive sleep apnea syndrome belong to these diseases. Because of the intense research, we have a detailed picture of the pathophysiological mechanisms of the origin and the maintenance of sleep-related breathing disorders. PMID:22073070

Hypnotherapy for sleep disorders.

PubMed

Ng, Beng-Yeong; Lee, Tih Shih

2008-08-01

Hypnosis can be defined as a procedure during which changes in sensations, perceptions, thoughts, feelings or behaviour are suggested. Hypnosis can be used to amplify whatever it is about therapy that makes it therapeutic. It permits a wide range of choices regarding where and how to intervene in the patient's problems. In this paper, we set out to examine the rationale of using hypnotherapy to manage various types of sleep disorders, and to explore the techniques, strategies and hypnotic scripts employed by various hypnotherapists. We also examine the research data available on the efficacy of hypnosis in the treatment of sleep disorders. Acute and chronic insomnia often respond to relaxation and hypnotherapy approaches, along with sleep hygiene instructions. Hypnotherapy has also helped with nightmares and sleep terrors. There are several reports of successful use of hypnotherapy for parasomnias, specifically for head and body rocking, bedwetting and sleepwalking. Hypnosis is a specialised technique, not a therapy itself, and should be used as an adjunctive intervention within a complete psychological and medical treatment package. Most of the literature is limited to case reports or studies with such a small sample that at times it is very difficult to interpret the results. There is a major placebo effect, so uncontrolled trials are of limited value. It is hard to perform a randomised, double-blind, controlled trial to evaluate hypnotherapy given that cooperation and rapport between patient and therapist is needed to achieve a receptive trance state.

Parasomnias

MedlinePlus

... Overview & Facts Symptoms & Risk Factors Diagnosis & Treatment Sleep Terrors Overview & Facts Symptoms & Risk Factors Diagnosis & Treatment Sleep ... the night. Parasomnias include: Sleepwalking Confusional Arousals Sleep Terrors Sleep Eating Disorder REM Sleep Behavior Disorder Nightmare ...

Sleep patterns and sleep-related complaints of Brazilian interstate bus drivers.

PubMed

Mello, M T; Santana, M G; Souza, L M; Oliveira, P C; Ventura, M L; Stampi, C; Tufik, S

2000-01-01

Sleep-related complaints have become a highlight for physicians as well as public health administrators. Studies of sleep patterns and sleep-related complaints of shift workers have been useful in minimizing reduction in the quality of life due to the warping of the sleep-wake cycle. The objective of the present study was to assess patterns of sleep, sleep-related complaints as well as physical activity and scoring rates for depression and anxiety in interstate bus drivers. Data were obtained with a sleep questionnaire, with the Beck inventory for depression, and the State-Trait Anxiety Inventory (STAI). A total of 400 interstate bus drivers from the northern, southern, central-western and south-eastern regions of Brazil were interviewed. Sixty percent of the subjects interviewed presented at least one sleep-related complaint, 16% admitted to have dozed at the wheel while on duty, and 41% stated that they exercised on a regular basis. Other sleep disturbance complaints reported were: sleep latency 29'17"; physical fatigue, 59.8%; mental fatigue, 45.4%; sleepiness, 25.8%; irritability, 20.6%; insomnia, 37.5%, respiratory disturbances, 19. 25% and snoring, 20.75%. Scores for anxiety and depression were not in the pathological range. The present data reinforce the view that bus drivers are generally discontent with shift work and its effects on sleep. Consequently, it is very important to establish an appropriate work schedule for drivers, besides implementing photo-therapy and physical activities in order to minimize sleepiness when driving.

The relation between polysomnography and subjective sleep and its dependence on age - poor sleep may become good sleep.

PubMed

Åkerstedt, Torbjörn; Schwarz, Johanna; Gruber, Georg; Lindberg, Eva; Theorell-Haglöw, Jenny

2016-10-01

Women complain more about sleep than men, but polysomnography (PSG) seems to suggest worse sleep in men. This raises the question of how women (or men) perceive objective (PSG) sleep. The present study sought to investigate the relation between morning subjective sleep quality and PSG variables in older and younger women. A representative sample of 251 women was analysed in age groups above and below 51.5 years (median). PSG was recorded at home during one night. Perceived poor sleep was related to short total sleep time (TST), long wake within total sleep time (WTSP), low sleep efficiency and a high number of awakenings. The older women showed lower TST and sleep efficiency and higher WTSP for a rating of good sleep than did the younger women. For these PSG variables the values for good sleep in the older group were similar to the values for poor sleep in the young group. It was concluded that women perceive different levels of sleep duration, sleep efficiency and wake after sleep onset relatively well, but that older women adjust their objective criteria for good sleep downwards. It was also concluded that age is an important factor in the relation between subjective and objective sleep. © 2016 European Sleep Research Society.

Sleep-Related Rhythmic Movement Disorder and Obstructive Sleep Apnea in Five Adult Patients

PubMed Central

Chiaro, Giacomo; Maestri, Michelangelo; Riccardi, Silvia; Haba-Rubio, José; Miano, Silvia; Bassetti, Claudio L.; Heinzer, Raphaël C.; Manconi, Mauro

2017-01-01

Sleep-related rhythmic movements (SRRMs) are typical in infancy and childhood, where they usually occur at the wake-to-sleep transition. However, they have rarely been observed in adults, where they can be idiopathic or associated with other sleep disorders including sleep apnea. We report a case series of 5 adults with sleep-related rhythmic movement disorder, 4 of whom had a previous history of SRRMs in childhood. SRRMs mostly occurred in consolidated sleep, in association with pathological respiratory events, predominantly longer ones, especially during stage R sleep, and recovered in 1 patient with continuous positive airway pressure therapy. We hypothesize that sleep apneas may act as a trigger of rhythmic motor events through a respiratory-related arousal mechanism in genetically predisposed subjects. Citation: Chiaro G, Maestri M, Riccardi S, Haba-Rubio J, Miano S, Bassetti CL, Heinzer RC, Manconi M. Sleep-related rhythmic movement disorder and obstructive sleep apnea in five adult patients. J Clin Sleep Med. 2017;13(10):1213–1217. PMID:28859719

Menopause related sleep disorders.

PubMed

Eichling, Philip S; Sahni, Jyotsna

2005-07-15

Sleep difficulty is one of the hallmarks of menopause. Following recent studies showing no cardiac benefit and increased breast cancer, the question of indications for hormonal therapy has become even more pertinent. Three sets of sleep disorders are associated with menopause: insomnia/depression, sleep disordered breathing and fibromyalgia. The primary predictor of disturbed sleep architecture is the presence of vasomotor symptoms. This subset of women has lower sleep efficiency and more sleep complaints. The same group is at higher risk of insomnia and depression. The "domino theory" of sleep disruption leading to insomnia followed by depression has the most scientific support. Estrogen itself may also have an antidepressant as well as a direct sleep effect. Treatment of insomnia in responsive individuals may be a major remaining indication for hormone therapy. Sleep disordered breathing (SDB) increases markedly at menopause for reasons that include both weight gain and unclear hormonal mechanisms. Due to the general under-recognition of SDB, health care providers should not assume sleep complaints are due to vasomotor related insomnia/depression without considering SDB. Fibromyalgia has gender, age and probably hormonal associations. Sleep complaints are almost universal in FM. There are associated polysomnogram (PSG) findings. FM patients have increased central nervous system levels of the nociceptive neuropeptide substance P (SP) and lower serotonin levels resulting in a lower pain threshold to normal stimuli. High SP and low serotonin have significant potential to affect sleep and mood. Treatment of sleep itself seems to improve, if not resolve FM. Menopausal sleep disruption can exacerbate other pre-existing sleep disorders including RLS and circadian disorders.

Sleep-related problems in common medical conditions.

PubMed

Parish, James M

2009-02-01

Common medical problems are often associated with abnormalities of sleep. Patients with chronic medical disorders often have fewer hours of sleep and less restorative sleep compared to healthy individuals, and this poor sleep may worsen the subjective symptoms of the disorder. Individuals with lung disease often have disturbed sleep related to oxygen desaturations, coughing, or dyspnea. Both obstructive lung disease and restrictive lung diseases are associated with poor quality sleep. Awakenings from sleep are common in untreated or undertreated asthma, and cause sleep disruption. Gastroesophageal reflux is a major cause of disrupted sleep due to awakenings from heartburn, dyspepsia, acid brash, coughing, or choking. Patients with chronic renal disease commonly have sleep complaints often due to insomnia, insufficient sleep, sleep apnea, or restless legs syndrome. Complaints related to sleep are very common in patients with fibromyalgia and other causes of chronic pain. Sleep disruption increases the sensation of pain and decreases quality of life. Patients with infectious diseases, including acute viral illnesses, HIV-related disease, and Lyme disease, may have significant problems with insomnia and hypersomnolence. Women with menopause have from insomnia, sleep-disordered breathing, restless legs syndrome, or fibromyalgia. Patients with cancer or receiving cancer therapy are often bothered by insomnia or other sleep disturbances that affect quality of life and daytime energy. The objective of this article is to review frequently encountered medical conditions and examine their impact on sleep, and to review frequent sleep-related problems associated with these common medical conditions.

[Guidelines in Practice: The New S3 Guideline "Sleeping Disorders - Sleep-Related Abnormal Breathing"].

PubMed

Gerlach, Martin; Sanner, Bernd

2017-10-01

Sleep related breathing disorders include central sleep apnea (CSA), obstructive sleep apnea (OSA), sleep-related hypoventilation, and sleep-related hypoxia. These disorders are frequent and growing in clinical relevance. The related chapter of the S3 guideline "Non-restorative sleep/Sleep disorders", published by the German Sleep Society (DGSM), has recently been updated in November 2016. Epidemiology, diagnostics, therapeutic procedures, and classification of sleep related disorders have been revised. Concerning epidemiology, a considerably higher mortality rate among pregnant women with OSA has been emphasized. With regards to diagnostics, the authors point out that respiratory polygraphy may be sufficient in diagnosing OSA, if a typical clinical condition is given. For CSA, recommendations were changed to diagnose CSA with low apnea rates present. Significant changes for treating CSA in patients with left ventricular dysfunction have been introduced. In addition, there is now to be differentiated between sleep-related hypoventilation and sleep-related hypoxaemia. Obesity hypoventilation syndrome is discussed in more detail. This article sums up and comments on the published changes. Georg Thieme Verlag KG Stuttgart · New York.

[Guidelines in Practice: The New S3 Guideline "Sleeping Disorders - Sleep-Related Abnormal Breathing"].

PubMed

Gerlach, M; Sanner, B

2017-08-01

Sleep related breathing disorders include central sleep apnea (CSA), obstructive sleep apnea (OSA), sleep-related hypoventilation, and sleep-related hypoxia. These disorders are frequent and growing in clinical relevance. The related chapter of the S3 guideline "Non-restorative sleep/Sleep disorders", published by the German Sleep Society (DGSM), has recently been updated in November 2016. Epidemiology, diagnostics, therapeutic procedures, and classification of sleep related disorders have been revised. Concerning epidemiology, a considerably higher mortality rate among pregnant women with OSA has been emphasized. With regards to diagnostics, the authors point out that respiratory polygraphy may be sufficient in diagnosing OSA, if a typical clinical condition is given. For CSA, recommendations were changed to diagnose CSA with low apnea rates present. Significant changes for treating CSA in patients with left ventricular dysfunction have been introduced. In addition, there is now to be differentiated between sleep-related hypoventilation and sleep-related hypoxaemia. Obesity hypoventilation syndrome is discussed in more detail. This article sums up and comments on the published changes. © Georg Thieme Verlag KG Stuttgart · New York.

Sleep problems and internet addiction among children and adolescents: a longitudinal study.

PubMed

Chen, Yi-Lung; Gau, Susan Shur-Fen

2016-08-01

Although the literature has documented associations between sleep problems and internet addiction, the temporal direction of these relationships has not been established. The purpose of this study is to evaluate the bidirectional relationships between sleep problems and internet addiction among children and adolescents longitudinally. A four-wave longitudinal study was conducted with 1253 children and adolescents in grades 3, 5 and 8 from March 2013 to January 2014. The sleep problems of the student participants were measured by parental reports on the Sleep Habit Questionnaire, which catalogues early insomnia, middle insomnia, disturbed circadian rhythm, periodic leg movements, sleep terrors, sleepwalking, sleep talking, nightmares, bruxism, snoring and sleep apnoea. The severity of internet addiction was measured by students' self-reports on the Chen Internet Addiction Scale. Based on the results of time-lag models, dyssomnias (odds ratio = 1.31), especially early and middle insomnias (odds ratio = 1.74 and 2.24), sequentially predicted internet addiction, and internet addiction sequentially predicted disturbed circadian rhythm (odds ratio = 2.40), regardless of adjustment for gender and age. This is the first study to demonstrate the temporal relationship of early and middle insomnia predicting internet addiction, which subsequently predicts disturbed circadian rhythm. These findings imply that treatment strategies for sleep problems and internet addiction should vary according to the order of their occurrence. © 2016 European Sleep Research Society.

Sleep architecture and sleep-related mentation in securely and insecurely attached people

PubMed Central

McNamara, Patrick; Pace-Schott, Edward F.; Johnson, Patricia; Harris, Erica; Auerbach, Sanford

2011-01-01

Based on REM sleep’s brain activation patterns and its participation in consolidation of emotional memories, we tested the hypothesis that measures of REM sleep architecture and REM sleep-related mentation would be associated with attachment orientation. After a habituation night in a sleep lab, a convenience sample of 64 healthy volunteers were awakened 10 minutes into a REM sleep episode and 10 minutes into a control NREM sleep episode in counterbalanced order, then asked to report a dream and to rate themselves and a significant other on a list of trait adjectives. Relative to participants classified as having secure attachment orientations, participants classified as anxious took less time to enter REM sleep and had a higher frequency of REM dreams with aggression and self-denigrating themes. There were no significant differences across attachment groups in other measures of sleep architecture or in post REM-sleep awakening ratings on PANAS subscales reflecting mood and alertness. Selected aspects of REM sleep architecture and mentation appeared to be associated with attachment orientation. We suggest that REM sleep plays a role in processing experiences and emotions related to attachment, and that certain features of sleep and dreaming reflect attachment orientations. PMID:21390907

Sleep-related laryngospasm.

PubMed

Thurnheer, R; Henz, S; Knoblauch, A

1997-09-01

The term "sleep-related laryngospasm" refers to episodic, abrupt interruption of sleep accompanied by feelings of acute suffocation followed by stridor. The condition is included in the diagnostic and coding manual of the American Sleep Disorders Association (ASDA), but there are few references in the peer-reviewed literature. Our description of the distinct clinical picture associated with this condition is based on an analysis of the histories of a series of 10 patients. The patients and their families gave precise, uniform accounts of the dramatic attacks. Diagnostic work-up included pulmonary and gastroenterological assessment. All patients reported sudden awakening from sleep due to feelings of acute suffocation, accompanied by intense fear. Apnoea lasting 5-45 s was followed by stridor. Breathing returned to normal within minutes. Patients were left exhausted by the attacks. Nine of our 10 patients had evidence of gastro-oesophageal reflux and six responded to antireflux therapy. We conclude that the nocturnal choking attacks (and the occasional daytime attacks experienced by some of the patients) are caused by laryngospasm. The pathogenesis of the apparent underlying laryngeal irritability is unknown. The condition may be related to a gastro-oesophageal reflux.

Bidirectional relations between work-related stress, sleep quality and perseverative cognition.

PubMed

Van Laethem, Michelle; Beckers, Debby G J; Kompier, Michiel A J; Kecklund, Göran; van den Bossche, Seth N J; Geurts, Sabine A E

2015-11-01

In this longitudinal two-wave study, bidirectional relations between work-related stress and sleep quality were examined. Moreover, it was investigated whether perseverative cognition is a potential underlying mechanism in this association, related to both work-related stress and sleep quality. A randomly selected sample of Dutch employees received an online survey in 2012 and 2013. Of all invited employees, 877 participated in both waves. Structural equation modeling was performed to analyze the data. We found evidence for reversed relations between work-related stress and sleep quality. Specifically, when controlling for perseverative cognition, work-related stress was not directly related to subsequent sleep quality, but low sleep quality was associated with an increase in work-related stress over time. Moreover, negative bidirectional associations over time were found between perseverative cognition and sleep quality, and positive bidirectional associations were found between work-related stress and perseverative cognition. Lastly, a mediation analysis showed that perseverative cognition fully mediated the relationship between work-related stress and sleep quality. The study findings suggest that perseverative cognition could be an important underlying mechanism in the association between work-related stress and sleep quality. The bidirectionality of the studied relationships could be an indication of a vicious cycle, in which work-related stress, perseverative cognition, and sleep quality mutually influence each other over time. Copyright © 2015 Elsevier Inc. All rights reserved.

Varenicline and Abnormal Sleep Related Events

PubMed Central

Savage, Ruth L.; Zekarias, Alem; Caduff-Janosa, Pia

2015-01-01

Study Objectives: To assess adverse drug reaction reports of “abnormal sleep related events” associated with varenicline, a partial agonist to the α4β2 subtype of nicotinic acetylcholine receptors on neurones, indicated for smoking cessation. Design: Twenty-seven reports of “abnormal sleep related events” often associated with abnormal dreams, nightmares, or somnambulism, which are known to be associated with varenicline use, were identified in the World Health Organisation (WHO) Global Individual Case Safety Reports Database. Original anonymous reports were obtained from the four national pharmacovigilance centers that submitted these reports and assessed for reaction description and causality. Measurements and Results: These 27 reports include 10 of aggressive activity occurring during sleep and seven of other sleep related harmful or potentially harmful activities, such as apparently deliberate self-harm, moving a child or a car, or lighting a stove or a cigarette. Assessment of these 17 reports of aggression or other actual or potential harm showed that nine patients recovered or were recovering on varenicline withdrawal and there were no consistent alternative explanations. Thirteen patients experienced single events, and two had multiple events. Frequency was not stated for the remaining two patients. Conclusions: The descriptions of the reports of aggression during sleep with violent dreaming are similar to those of rapid eye movement sleep behavior disorder and also nonrapid eye movement (NREM) sleep parasomnias in some adults. Patients who experience somnambulism or dreams of a violent nature while taking varenicline should be advised to consult their health providers. Consideration should be given to clarifying the term sleep disorders in varenicline product information and including sleep related harmful and potentially harmful events. Citation: Savage RL, Zekarias A, Caduff-Janosa P. Varenicline and abnormal sleep related events. SLEEP 2015

Sleep and dream habits in a sample of French college students who report no sleep disorders.

PubMed

Vallat, Raphael; Eskinazi, Mickael; Nicolas, Alain; Ruby, Perrine

2018-02-06

There is a lack of up-to-date data on sleep and dream habits of college students. To fill in this gap, we used an online questionnaire sent to the student mailing lists of two major universities of Lyon (Lyon 1 and Lyon 2) for the recruitment of an functional magnetic resonance imaging study with sleep disorders as exclusion criteria. In the sample (1,137 French college students, 411 males, mean age = 22.2 ± 2.4 years, body mass index = 22.0 ± 3.2 kg m -2 ), on average, the participants reported spending about 8 hr in bed during weekdays, 9 hr during the weekends, and 90.9% of them reported no difficulty falling asleep. Less than 0.4% of students reported to have sleep-walking episodes regularly, but nearly 7% reported regular sleep-talking episodes. The average dream recall frequency was about 3 mornings per week with a dream in mind. Dream recall frequency was positively correlated with the clarity of dream content and the frequency of lucid dreaming, and was negatively correlated with age. Fourteen percent of the students reported frequent lucid dreams, and 6% reported frequent recurrent dreams. We found a gender effect for several sleep and dream parameters, including dream recall frequency and time in bed, both of which were higher in women than in men. We have also observed differences between academic disciplines, namely humanities students (Lyon 2) reported spending more time in bed than sciences students (Lyon 1). These results confirm a gender difference for several sleep and dream parameters, and suggest a link between academic disciplines and sleep duration. © 2018 European Sleep Research Society.

Association between sleep behavior and sleep-related factors among university students in Hong Kong.

PubMed

Suen, Lorna K P; Hon, K L Ellis; Tam, Wilson W S

2008-09-01

Sleep problems among university students are common; however, the association between many sleep-related factors and sleep behaviors is still unclear. The purpose of this study is to examine different sleep behaviors and sleep-related factors influencing such behaviors in university students. A descriptive survey was conducted on 400 university students in Hong Kong. The instruments for data collection consisted of the Pittsburgh Sleep Quality Index (PSQI), a sleep hygiene practice questionnaire, demographic data, and other sleep-related factors. The results reveal that 57.5% of the 400 university students are poor sleepers. Sex, year of study, sleep hygiene practice, and perceived adequate sleep in the past month all demonstrate significant associations with poor sleepers. A high prevalence of sleep-related problems among college students is confirmed and associated factors are identified. Students should be encouraged to follow sleep hygiene practice, adequate time management for academic and social activities, and suitable stress-relieving measures.

Objective daytime sleepiness in patients with somnambulism or sleep terrors.

PubMed

Lopez, Régis; Jaussent, Isabelle; Dauvilliers, Yves

2014-11-25

To objectively measure daytime sleepiness and to assess for clinical and polysomnographic determinants of mean sleep latency in adult patients with somnambulism (sleepwalking [SW]) or sleep terrors (ST) compared with controls. Thirty drug-free adult patients with primary SW or ST, and age-, sex-, and body mass index-matched healthy controls underwent a standardized clinical interview, completed questionnaires including the Epworth Sleepiness Scale, and underwent one night of video polysomnography followed by the Multiple Sleep Latency Test (MSLT). Excessive daytime sleepiness defined as Epworth Sleepiness Scale score >10 was reported in 66.7% of patients and 6.7% of controls. The temporal pattern of sleep latencies in individual MSLT trials differed between patients and controls, with progressive increased sleep latency in patients across the trials in contrast to a "U curve" for controls. We did not find between-group differences regarding the mean sleep latency on the 5 MSLT trials, but did observe reduced sleep latencies in patients for the first 2 trials. Despite increased slow-wave sleep disruptions found in patients (i.e, more micro-arousals and hypersynchronous high-voltage delta waves arousals), we did not find polysomnographic characteristic differences when comparing sleepy patients for either subjective or objective daytime sleepiness on the MSLT compared with alert patients. Excessive daytime sleepiness is a common complaint in subjects with SW or ST and shorter sleep latencies in the early morning hours. Despite an increased slow-wave sleep fragmentation found in these patients, we did not identify any association with the level of daytime sleepiness. © 2014 American Academy of Neurology.

Murdering while Asleep: Clinical and Forensic Issues.

ERIC Educational Resources Information Center

Gilmore, John Vaughn

On the basis of the relevant research literature, this article discusses adult sleepwalking disorders, and focuses particularly on the documented cases of violence occurring during sleepwalking. Important diagnostic elements are reviewed, including family history, age of onset, gender, stages of sleep, impairments in memory and judgment, automatic…

Varenicline and abnormal sleep related events.

PubMed

Savage, Ruth L; Zekarias, Alem; Caduff-Janosa, Pia

2015-05-01

To assess adverse drug reaction reports of "abnormal sleep related events" associated with varenicline, a partial agonist to the α4β2 subtype of nicotinic acetylcholine receptors on neurones, indicated for smoking cessation. Twenty-seven reports of "abnormal sleep related events" often associated with abnormal dreams, nightmares, or somnambulism, which are known to be associated with varenicline use, were identified in the World Health Organisation (WHO) Global Individual Case Safety Reports Database. Original anonymous reports were obtained from the four national pharmacovigilance centers that submitted these reports and assessed for reaction description and causality. These 27 reports include 10 of aggressive activity occurring during sleep and seven of other sleep related harmful or potentially harmful activities, such as apparently deliberate self-harm, moving a child or a car, or lighting a stove or a cigarette. Assessment of these 17 reports of aggression or other actual or potential harm showed that nine patients recovered or were recovering on varenicline withdrawal and there were no consistent alternative explanations. Thirteen patients experienced single events, and two had multiple events. Frequency was not stated for the remaining two patients. The descriptions of the reports of aggression during sleep with violent dreaming are similar to those of rapid eye movement sleep behavior disorder and also nonrapid eye movement (NREM) sleep parasomnias in some adults. Patients who experience somnambulism or dreams of a violent nature while taking varenicline should be advised to consult their health providers. Consideration should be given to clarifying the term sleep disorders in varenicline product information and including sleep related harmful and potentially harmful events. © 2015 Associated Professional Sleep Societies, LLC.

Topiramate-Induced Somnambulism in a Migraineur: A Probable Idiosyncratic Adverse Effect

PubMed Central

Mathew, Thomas; Sarma, G. R. K.; Nadig, Raghunandan; Varghese, Raji

2012-01-01

Somnambulism (sleepwalking) is a disorder of arousal that falls under “parasomnia” group and is more common in children. These phenomena occur as primary sleep events or secondary to systemic disease or can be drug induced. Medications that can cause sleepwalking include neuroleptics, hypnotics, lithium, amitriptyline, and β-blockers.1 This report presents an unusual adverse effect of topiramate on sleep in a patient with migraine. Citation: Mathew T; Sarma GRK; Nadig R; Varghese R. Topiramate-induced somnambulism in a migraineur: a probable idiosyncratic adverse effect. J Clin Sleep Med 2012;8(2):197-198. PMID:22505867

Low dose quetiapine in the treatment of an adolescent with somnambulism: a case report.

PubMed

Gill, Jesjeet Singh; Pillai, Subash Kumar; Koh, Ong Hui; Jambunathan, Stephen Thevanathan

2011-06-01

Somnambulism or sleepwalking is a sleep disorder of arousal. Compared to in adults, pediatric and adolescent sleep disorders is still under-researched and poorly described. We report the successful use of low dose quietiapine, an atypical antipsychotic, in the treatment of a 15-year-old Indian male who presented with significant somnambulism. To the best of our knowledge, this is the first report on the use of quetiapine for the treatment of somnambulism in the literature. The presence of high voltage delta waves in sleepwalkers has been offered as a possible explanation for the patho-physiology of sleepwalking Quetiapine has been reported to decrease brain delta activity, and we postulate that this may be the mechanism on how it was beneficial for our patient.

Pain-related diseases and sleep disorders

PubMed Central

Roizenblatt, M.; Rosa Neto, N.S.; Tufik, S.; Roizenblatt, S.

2012-01-01

Pain and sleep share mutual relations under the influence of cognitive and neuroendocrine changes. Sleep is an important homeostatic feature and, when impaired, contributes to the development or worsening of pain-related diseases. The aim of the present review is to provide a panoramic view for the generalist physician on sleep disorders that occur in pain-related diseases within the field of Internal Medicine, such as rheumatic diseases, acute coronary syndrome, digestive diseases, cancer, and headache. PMID:22760852

Age-Related Reduction in Daytime Sleep Propensity and Nocturnal Slow Wave Sleep

PubMed Central

Dijk, Derk-Jan; Groeger, John A.; Stanley, Neil; Deacon, Stephen

2010-01-01

Objective: To investigate whether age-related and experimental reductions in SWS and sleep continuity are associated with increased daytime sleep propensity. Methods: Assessment of daytime sleep propensity under baseline conditions and following experimental disruption of SWS. Healthy young (20-30 y, n = 44), middle-aged (40-55 y, n = 35) and older (66-83 y, n = 31) men and women, completed a 2-way parallel group study. After an 8-h baseline sleep episode, subjects were randomized to 2 nights with selective SWS disruption by acoustic stimuli, or without disruption, followed by 1 recovery night. Objective and subjective sleep propensity were assessed using the Multiple Sleep Latency Test (MSLT) and the Karolinska Sleepiness Scale (KSS). Findings: During baseline sleep, SWS decreased (P < 0.001) and the number of awakenings increased (P < 0.001) across the 3 age groups. During the baseline day, MSLT values increased across the three age groups (P < 0.0001) with mean values of 8.7min (SD: 4.5), 11.7 (5.1) and 14.2 (4.1) in the young, middle-aged, and older adults, respectively. KSS values were 3.7 (1.0), 3.2 (0.9), and 3.4 (0.6) (age-group: P = 0.031). Two nights of SWS disruption led to a reduction in MSLT and increase in KSS in all 3 age groups (SWS disruption vs. control: P < 0.05 in all cases). Conclusions: Healthy aging is associated with a reduction in daytime sleep propensity, sleep continuity, and SWS. In contrast, experimental disruption of SWS leads to an increase in daytime sleep propensity. The age-related decline in SWS and reduction in daytime sleep propensity may reflect a lessening in homeostatic sleep requirement. Healthy older adults without sleep disorders can expect to be less sleepy during the daytime than young adults. Citation: Dijk DJ; Groeger JA; Stanley N; Deacon S. Age-related reduction in daytime sleep propensity and nocturnal slow wave sleep. SLEEP 2010;33(2):211-223. PMID:20175405

[Non-Pharmacological Interventions for Pregnancy-Related Sleep Disturbances].

PubMed

Hung, Hsuan-Man; Chiang, Hsiao-Ching

2017-02-01

Most women experience the worse sleep quality of their life during pregnancy and the early postpartum period. Although pregnancy typically accounts for a relatively short part of a woman's life, the related sleep disturbances may have a significant and negative impact on her long-term health. Approximately 78-80% of pregnant women experience sleep disturbances, including interruptions in deep sleep, decreased total sleep time, poor subjective sleep quality, frequent night waking, and reduced sleep efficacy. Sleep disturbances during pregnancy start during the first trimester and become prevalent during the third trimester. Related factors include physiological and psychosocial changes and an unhealthy lifestyle. As non-pharmacological interventions have the potential to improve sleep quality in 70% to 80% of patients with insomnia, this is the main approached that is currently used to treat pregnancy-related sleep disturbances. Examples of these non-pharmacological interventions include music therapy, aerobic exercise, massage, progressive muscle relaxation, multi-modal interventions, and the use of a maternity support belt. The efficacy and safety of other related non-pharmacological interventions such as auricular acupressure, cognitive therapy, tai chi, and aromatherapy remain uncertain, with more empirical research required. Additionally, non-pharmacological interventions do not effectively treat sleep disturbances in all pregnant women.

[Parasomnias].

PubMed

Bjorvatn, Bjørn; Grønli, Janne; Pallesen, Ståle

2009-09-24

Parasomnias are undesirable experiences or motoric phenomena that occur in association with sleep. We have described characteristics of parasomnia subtypes. This review is based on the authors' research and clinical experience, and articles identified by non-systematic searches of Pubmed. Parasomnias are categorized into disorders of arousal (non-REM sleep parasomnias), e.g. sleepwalking, sleep terrors and confusional arousals, parasomnias associated with REM sleep, e.g. nightmare disorder, REM sleep behaviour disorder and recurrent isolated sleep paralysis, and other parasomnias, e.g. sleep-related groaning, exploding head syndrome, sleep-related hallucinations and sleep-related eating disorder. Prevalences for the subtypes vary. Most parasomnias are especially common in children. Drug treatment is seldom necessary, but may be indicated in severe cases.

Development and Validation of the PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment Item Banks.

PubMed

Forrest, Christopher B; Meltzer, Lisa J; Marcus, Carole L; de la Motte, Anna; Kratchman, Amy; Buysse, Daniel J; Pilkonis, Paul A; Becker, Brandon D; Bevans, Katherine B

2018-03-13

To develop and evaluate the measurement properties of child-report and parent-proxy versions of the PROMIS ® Pediatric Sleep Disturbance and Sleep-Related Impairment item banks. A national sample of 1,104 children (8-17 years-old) and 1,477 parents of children 5-17 years-old was recruited from an internet panel to evaluate the psychometric properties of 43 sleep health items. A convenience sample of children and parents recruited from a pediatric sleep clinic was obtained to provide evidence of the measures' validity; polysomnography data were collected from a subgroup of these children. Factor analyses suggested two dimensions: sleep disturbance and daytime sleep-related impairment. The final item banks included 15 items for Sleep Disturbance and 13 for Sleep-Related Impairment. Items were calibrated using the graded response model from item response theory. Of the 28 items, 16 are included in the parallel PROMIS adult sleep health measures. Reliability of the measures exceeded 0.90. Validity was supported by correlations with existing measures of pediatric sleep health and higher sleep disturbance and sleep-related impairment scores for children with sleep problems and those with chronic and neurodevelopmental disorders. The sleep health measures were not correlated with results from polysomnography. The PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment item banks provide subjective assessments of a child's difficulties falling and staying asleep as well as daytime sleepiness and its impact on functioning. They may prove useful in the future for clinical research and practice. Future research should evaluate their responsiveness to clinical change in diverse patient populations.

Insufficient sleep: Enhanced risk-seeking relates to low local sleep intensity.

PubMed

Maric, Angelina; Montvai, Eszter; Werth, Esther; Storz, Matthias; Leemann, Janina; Weissengruber, Sebastian; Ruff, Christian C; Huber, Reto; Poryazova, Rositsa; Baumann, Christian R

2017-09-01

Chronic sleep restriction is highly prevalent in modern society and is, in its clinical form, insufficient sleep syndrome, one of the most prevalent diagnoses in clinical sleep laboratories, with substantial negative impact on health and community burden. It reflects every-day sleep loss better than acute sleep deprivation, but its effects and particularly the underlying mechanisms remain largely unknown for a variety of critical cognitive domains, as, for example, risky decision making. We assessed financial risk-taking behavior after 7 consecutive nights of sleep restriction and after 1 night of acute sleep deprivation compared to a regular sleep condition in a within-subject design. We further investigated potential underlying mechanisms of sleep-loss-induced changes in behavior by high-density electroencephalography recordings during restricted sleep. We show that chronic sleep restriction increases risk-seeking, whereas this was not observed after acute sleep deprivation. This increase was subjectively not noticed and was related to locally lower values of slow-wave energy during preceding sleep, an electrophysiological marker of sleep intensity and restoration, in electrodes over the right prefrontal cortex. This study provides, for the first time, evidence that insufficient sleep restoration over circumscribed cortical areas leads to aberrant behavior. In chronically sleep restricted subjects, low slow-wave sleep intensity over the right prefrontal cortex-which has been shown to be linked to risk behavior-may lead to increased and subjectively unnoticed risk-seeking. Ann Neurol 2017;82:409-418. © 2017 American Neurological Association.

The Impact of Sleep-Related Attentional Bias on Polysomnographically Measured Sleep in Primary Insomnia

PubMed Central

Spiegelhalder, Kai; Kyle, Simon D.; Feige, Bernd; Prem, Martin; Nissen, Christoph; Espie, Colin A.; Riemann, Dieter

2010-01-01

Study Objectives: Although sleep-related attentional bias has been shown to be evident in primary insomnia, the association with objectively measured sleep has not been investigated. In the present study, we used polysomnography (PSG) to fill this void. Design: Patients with primary insomnia and healthy controls were studied using a visual dot probe task (VDP) and an emotional Stroop task (EST). Additionally, polysomnography was carried out in a sub-sample (n = 22) of patients in the subsequent night. Setting: Department of Psychiatry and Psychotherapy of the University of Freiburg Medical Center. Participants: Thirty patients with primary insomnia and 30 matched healthy controls. Interventions: N/A Measurements and Results: Patients with primary insomnia demonstrated a significant sleep-related attentional bias compared to controls in the EST but no significant group effects were found for the VDP. VDP attentional bias scores were positively correlated with measures of sleep pressure, including total sleep time, sleep efficiency, and the amount of slow wave sleep. EST attentional bias scores were not correlated with subsequent PSG parameters, and we did not observe a correlation between attentional bias scores on the two tasks. Conclusions: The unexpected relationship between increased attentional bias, in the VDP task, and improved markers of sleep duration and continuity, may be indicative of a homeostatic craving for sleep in those with high attentional bias. This awaits further testing in multiple night studies, to shed light on the mechanisms and implications of sleep-related attentional bias. Citation: Spiegelhalder K; Kyle SD; Feige B; Prem M; Nissen C; Espie CA; Riemann D. The impact of sleep-related attentional bias on polysomnographically measured sleep in primary insomnia. SLEEP 2010;33(1):107-112. PMID:20120627

Analysis of slow-wave activity and slow-wave oscillations prior to somnambulism.

PubMed

Jaar, Olivier; Pilon, Mathieu; Carrier, Julie; Montplaisir, Jacques; Zadra, Antonio

2010-11-01

STUDY OBJECTIVIES: several studies have investigated slow wave sleep EEG parameters, including slow-wave activity (SWA) in relation to somnambulism, but results have been both inconsistent and contradictory. The first goal of the present study was to conduct a quantitative analysis of sleepwalkers' sleep EEG by studying fluctuations in spectral power for delta (1-4 Hz) and slow delta (0.5-1 Hz) before the onset of somnambulistic episodes. A secondary aim was to detect slow-wave oscillations to examine changes in their amplitude and density prior to behavioral episodes. twenty-two adult sleepwalkers were investigated polysomnographically following 25 h of sleep deprivation. analysis of patients' sleep EEG over the 200 sec prior to the episodes' onset revealed that the episodes were not preceded by a gradual increase in spectral power for either delta or slow delta over frontal, central, or parietal leads. However, time course comparisons revealed significant changes in the density of slow-wave oscillations as well as in very slow oscillations with significant increases occurring during the final 20 sec immediately preceding episode onset. the specificity of these sleep EEG parameters for the occurrence and diagnosis of NREM parasomnias remains to be determined.

Actigraphy for Measurement of Sleep and Sleep-Wake Rhythms in Relation to Surgery

PubMed Central

Madsen, Michael T.; Rosenberg, Jacob; Gögenur, Ismail

2013-01-01

Study Objectives: Patients undergoing surgery have severe sleep and sleep-wake rhythm disturbances resulting in increased morbidity. Actigraphy is a tool that can be used to quantify these disturbances. The aim of this manuscript was to present the literature where actigraphy has been used to measure sleep and sleep-wake rhythms in relation to surgery. Methods: A systematic review was performed in 3 databases (Medline, Embase, and Psycinfo), including all literature until July 2012. Results: Thirty-two studies were included in the review. Actigraphy could demonstrate that total sleep time and sleep efficiency was reduced after surgery and number of awakenings was increased in patients undergoing major surgery. Disturbances were less severe in patients undergoing minor surgery. Actigraphy could be used to differentiate between delirious and non-delirious patients after major surgery. Actigraphy measurements could determine a differential effect of surgery based on the patient's age. The effect of pharmacological interventions (chronobiotics and hypnotics) in surgical patients could also be demonstrated by actigraphy. Conclusion: Actigraphy can be used to measure sleep and sleep-wake rhythms in patients undergoing surgery. Citation: Madsen MT; Rosenberg J; Gögenur I. Actigraphy for measurement of sleep and sleep-wake rhythms in relation to surgery. J Clin Sleep Med 2013;9(4):387-394. PMID:23585756

Sleep disorders in combat-related PTSD.

PubMed

Williams, Scott G; Collen, Jacob; Orr, Nicholas; Holley, Aaron B; Lettieri, Christopher J

2015-03-01

We sought to assess the rate of sleep complaints and sleep disorders among active duty soldiers with deployment-related PTSD and to determine whether any clinical features differentiated those with sleep disorders. Retrospective review of consecutive soldiers diagnosed with PTSD. We recorded subjective measures of sleep and polysomnographic data. We compared clinical and demographic variables including psychoactive medication use, psychiatric comorbidity, and combat-related traumatic injury with the presence of sleep disorders. One hundred thirty patients were included (91.5 % male, mean age of 35.1 ± 10.6 years, mean body mass index (BMI) 28.9 ± 4.4 Kg/m(2)). About 88.5 % had comorbid depression, with the majority (96.2 %) taking psychoactive medications (mean 3.4 ± 1.6 medications per patient). Over half of the cohort suffered combat-related traumatic physical injuries (54.6 %). The obstructive sleep apnea syndrome (OSAS) was diagnosed in 67.3 % (80 % of the cohort underwent polysomnography), with a mean apnea hypopnea index of 24.1 ± 22.8 events/hour and a mean oxygen saturation nadir of 84.2 ± 5.7 %. OSAS was significantly more common in the non-injured soldiers (72.9 vs. 38.0 %, p < 0.001). In multivariate analysis, absence of physical injury showed a trend towards predicting OSAS. Sleep complaints are common among soldiers with PTSD. We observed significantly higher rates of OSAS among those without physical injuries, raising the possibility that underlying sleep-disordered breathing is a risk factor for the development of PTSD. This potential association requires further validation.

Variations in sleep characteristics and sleep-related impairment in at-risk college drinkers: a latent profile analysis.

PubMed

DeMartini, Kelly S; Fucito, Lisa M

2014-10-01

Sleep disturbance and heavy drinking increase risk of negative consequences in college students. Limited research exists on how they act synergistically, and the overall nature of sleep and sleep-related impairment in college student drinkers is poorly understood. A latent profile analysis was conducted on the sleep characteristics and daytime sleep-related consequences of college student drinkers who were at-risk based on Alcohol Use Disorders Identification Test-Consumption scores. Participants (N = 312, mean age = 18.90 (0.97) years) consumed a mean (SD) of 20.93 (13.04) drinks per week. Scores on the 10 items of the Sleep/Wake Behavior Problems Scale (SWPS) were the class indicators. Four classes best described the sleep and sleep-related consequences of at-risk college drinkers. Classes represented different gradients and types of sleep patterns and sleep-related impairment; nearly half the sample reported late bedtimes and daytime consequences of insufficient sleep. Subsequent validation analyses indicated that these classes were directly correspondent with severity of alcohol consumption, alcohol-related consequences illicit substance use, and perceived health. These findings indicate the presence of significant heterogeneity in college drinkers' sleep patterns and experiences of sleep-related impairment. Class differences significantly impact the level of alcohol and drug use and the consequences members experience. Greater alcohol use and sleep/wake problems are associated with increased risk for negative consequences for certain classes. These results suggest that college drinking interventions could benefit from the incorporation of sleep-related content and the value in adding brief alcohol assessments and interventions to other college health treatments.

A preliminary survey on prevalence and knowledge about different aspects of somnambulism in Buner District of Khyber Pakhtunkhwa, Pakistan.

PubMed

Wajiha; Hasan, Zaigham; Afridi, Rabia; Rahman, Lubna; Qureshi, Naveeda Akhtar; Saeed, Kausar; Afridi, Humera

2018-01-20

Present study was aimed to investigate the prevalence and knowledge about different aspects of somnambulism in general population of Buner District, KP, Pakistan, during December 2015-November 2016. Data was collected through convenient sampling technique which was comprised of structured and detailed questionnaire. Collected data regarding different actions performed by sleepwalkers were adjusted through a weighted variable to generalize results. Univariate and multivariate logistic regression was used to evaluate association between variables related to somnambulism. Their odds ratios (ORs) were reported with their corresponding 95% CIs. In total, 11,881 individuals were surveyed, of which 448 (4%) suffered with sleep disorder. Females 256/448 (57%) were more prevalent as compared to males 192/448 (43%). Prevalence of somnambulism among children was 38% whereas 94% sufferers reported no effect on their growth. Majority of respondents reported that main cause of sleepwalking is stress and tension. Somnambulism was taken normal and mostly amusing disorder by sufferers and their families. Sleepwalking is not age specific and serious disorder. Sleepwalkers need special care during their episode due to unconsciousness.

Hypoglycaemia and somnambulism: a case report.

PubMed

Cebrián, S; Gimeno, O; Orozco, D; Pertusa, S

2012-12-01

Sleepwalking (somnambulism) is a sleep disorder classified as a parasomnia. Sleepwalkers develop motor activities that may be simple or complex: they can get out of bed, walk, urinate and even leave the house while remaining unconscious and unable to communicate. It is difficult to wake a sleepwalker, but it is not dangerous - as many people think. Sleepwalking cases have been caused by jet lag, the consumption of narcotics, sedatives and alcohol, cardiac problems such as arrhythmias, and other medical conditions, including epilepsy, asthma and apnoea. In a quick search of the literature, only one case due to hypoglycaemia has been reported, describing a patient with type 1 diabetes whose sleepwalking was triggered by nocturnal hypoglycaemia. Our present case was similar, and our report also describes how it occurred and how the condition was remedied. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Reconceptualising Sleep: Relational Principles inside and outside the Pram

ERIC Educational Resources Information Center

Ulla, Bente

2017-01-01

This article explores sleep among kindergarten infants and toddlers. Although the collective order of sleep in kindergarten makes it a relational issue, the search here is for relations that extend beyond human actors and beyond the idea of the pram as a sleep container used by a sleeping subject. Here, sleep is seen as entangled with bodies and…

Sleep staging with movement-related signals.

PubMed

Jansen, B H; Shankar, K

1993-05-01

Body movement related signals (i.e., activity due to postural changes and the ballistocardiac effort) were recorded from six normal volunteers using the static-charge-sensitive bed (SCSB). Visual sleep staging was performed on the basis of simultaneously recorded EEG, EMG and EOG signals. A statistical classification technique was used to determine if reliable sleep staging could be performed using only the SCSB signal. A classification rate of between 52% and 75% was obtained for sleep staging in the five conventional sleep stages and the awake state. These rates improved from 78% to 89% for classification between awake, REM and non-REM sleep and from 86% to 98% for awake versus asleep classification.

Methscopolamine Inhibition of Sleep-Related Growth Hormone Secretion

PubMed Central

Mendelson, Wallace B.; Sitaram, Natarajan; Wyatt, Richard Jed; Gillin, J. Christian; Jacobs, Laurence S.

1978-01-01

We have examined the effects of cholinergic blockade with 0.5 mg methscopolamine bromide, intramuscularly, on sleep-related and insulin-induced growth hormone (GH) secretion. 17 normal young men were studied; 8 had sleep studies, and 12 (including 3 who also had sleep studies) had insulin tolerance tests (ITT) with 0.1 U/kg of regular insulin. After an adjustment night in the sleep laboratory, saline control night and methscopolamine night studies were done in random sequence; study procedures included electroencephalographic, electromyographic, and electrooculographic recordings, and blood sampling every 20 min for hormone radioimmunoassays. Prolactin levels were also measured during sleep. For methscopolamine night studies, the mean overall control GH level of 2.89±0.44 ng/ml and the mean peak control GH level of 11.09±3.11 ng/ml were dramatically reduced to 0.75±0.01 and 1.04±0.25 ng/ml, respectively (P<0.0001 and <0.001). Despite virtual absence of GH secretion during the night in every study subject, no measured sleep characteristic was affected by methscopolamine, including total slow-wave sleep (12.1±2.6% control vs. 10.3±2.5% drug, P>0.2). Sleep prolactin levels were not changed by methscopolamine. In contrast to the abolition of sleep-related GH secretion, administration of methscopolamine had only a marginal effect on the GH response to insulin hypoglycemia. None of nine time points differed significantly, as was also the case with peak levels, mean increments, and areas under the curves (P>0.2). Analysis of variance did, however, indicate that the lower GH concentrations achieved during ITT after methscopolamine (average 31.7% below control) were significantly different than control concentrations. We conclude that the burst of GH secretion which normally occurs after sleep onset is primed by a cholinergic mechanism which does not influence slow-wave sleep. Cholinergic mechanisms do not appear to play an important role in sleep-related prolactin

PROMIS Sleep Disturbance and Sleep-Related Impairment in Adolescents: Examining Psychometrics Using Self-Report and Actigraphy.

PubMed

Hanish, Alyson E; Lin-Dyken, Deborah C; Han, Joan C

The National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) has self-reported health measures available for both pediatric and adult populations, but no pediatric measures are available currently in the sleep domains. The purpose of this observational study was to perform preliminary validation studies on age-appropriate, self-reported sleep measures in healthy adolescents. This study examined 25 healthy adolescents' self-reported daytime sleepiness, sleep disturbance, sleep-related impairment, and sleep patterns. Healthy adolescents completed a physical exam at the National Institutes of Health Clinical Center (Bethesda, MD), had no chronic medical conditions, and were not taking any chronic medications. The Cleveland Adolescent Sleepiness Questionnaire (CASQ), PROMIS Sleep Disturbance (v. 1.0; 8a), and PROMIS Sleep-Related Impairment (v. 1.0; 8b) questionnaires were completed, and sleep patterns were assessed using actigraphy. Total scores on the three sleep questionnaires were correlated (all Spearman's r > .70, p < .001). Total sleep time determined by actigraphy was negatively correlated with the CASQ (p = .01), PROMIS Sleep Disturbance (p = .02), and PROMIS Sleep-Related Impairment (p = .02). The field of pediatric sleep is rapidly expanding, and researchers and clinicians will benefit from well-designed, psychometrically sound sleep questionnaires. Findings suggest the potential research and clinical utility of adult versions of PROMIS sleep measures in adolescents. Future studies should include larger, more diverse samples and explore additional psychometric properties of PROMIS sleep measures to provide age-appropriate, validated, and reliable measures of sleep in adolescents.

Sleep-related declarative memory consolidation and verbal replay during sleep talking in patients with REM sleep behavior disorder.

PubMed

Uguccioni, Ginevra; Pallanca, Olivier; Golmard, Jean-Louis; Dodet, Pauline; Herlin, Bastien; Leu-Semenescu, Smaranda; Arnulf, Isabelle

2013-01-01

To determine if sleep talkers with REM sleep behavior disorder (RBD) would utter during REM sleep sentences learned before sleep, and to evaluate their verbal memory consolidation during sleep. Eighteen patients with RBD and 10 controls performed two verbal memory tasks (16 words from the Free and Cued Selective Reminding Test and a 220-263 word long modified Story Recall Test) in the evening, followed by nocturnal video-polysomnography and morning recall (night-time consolidation). In 9 patients with RBD, daytime consolidation (morning learning/recall, evening recall) was also evaluated with the modified Story Recall Test in a cross-over order. Two RBD patients with dementia were studied separately. Sleep talking was recorded using video-polysomnography, and the utterances were compared to the studied texts by two external judges. Sleep-related verbal memory consolidation was maintained in patients with RBD (+24±36% words) as in controls (+9±18%, p=0.3). The two demented patients with RBD also exhibited excellent nighttime consolidation. The post-sleep performance was unrelated to the sleep measures (including continuity, stages, fragmentation and apnea-hypopnea index). Daytime consolidation (-9±19%) was worse than night-time consolidation (+29±45%, p=0.03) in the subgroup of 9 patients with RBD. Eleven patients with RBD spoke during REM sleep and pronounced a median of 20 words, which represented 0.0003% of sleep with spoken language. A single patient uttered a sentence that was judged to be semantically (but not literally) related to the text learned before sleep. Verbal declarative memory normally consolidates during sleep in patients with RBD. The incorporation of learned material within REM sleep-associated sleep talking in one patient (unbeknownst to himself) at the semantic level suggests a replay at a highly cognitive creative level.

Sleep-Related Declarative Memory Consolidation and Verbal Replay during Sleep Talking in Patients with REM Sleep Behavior Disorder

PubMed Central

Uguccioni, Ginevra; Pallanca, Olivier; Golmard, Jean-Louis; Dodet, Pauline; Herlin, Bastien; Leu-Semenescu, Smaranda; Arnulf, Isabelle

2013-01-01

Objective To determine if sleep talkers with REM sleep behavior disorder (RBD) would utter during REM sleep sentences learned before sleep, and to evaluate their verbal memory consolidation during sleep. Methods Eighteen patients with RBD and 10 controls performed two verbal memory tasks (16 words from the Free and Cued Selective Reminding Test and a 220-263 word long modified Story Recall Test) in the evening, followed by nocturnal video-polysomnography and morning recall (night-time consolidation). In 9 patients with RBD, daytime consolidation (morning learning/recall, evening recall) was also evaluated with the modified Story Recall Test in a cross-over order. Two RBD patients with dementia were studied separately. Sleep talking was recorded using video-polysomnography, and the utterances were compared to the studied texts by two external judges. Results Sleep-related verbal memory consolidation was maintained in patients with RBD (+24±36% words) as in controls (+9±18%, p=0.3). The two demented patients with RBD also exhibited excellent nighttime consolidation. The post-sleep performance was unrelated to the sleep measures (including continuity, stages, fragmentation and apnea-hypopnea index). Daytime consolidation (-9±19%) was worse than night-time consolidation (+29±45%, p=0.03) in the subgroup of 9 patients with RBD. Eleven patients with RBD spoke during REM sleep and pronounced a median of 20 words, which represented 0.0003% of sleep with spoken language. A single patient uttered a sentence that was judged to be semantically (but not literally) related to the text learned before sleep. Conclusion Verbal declarative memory normally consolidates during sleep in patients with RBD. The incorporation of learned material within REM sleep-associated sleep talking in one patient (unbeknownst to himself) at the semantic level suggests a replay at a highly cognitive creative level. PMID:24349492

Childhood abuse is associated with stress-related sleep disturbance and poor sleep quality in pregnancy

PubMed Central

Gelaye, Bizu; Kajeepeta, Sandhya; Zhong, Qiu-Yue; Borba, Christina P.C.; Rondon, Marta B.; Sánchez, Sixto E.; Henderson, David C.; Williams, Michelle A.

2015-01-01

Objectives Childhood abuse is associated with increased risks of adult psychiatric disorders and physical health conditions. Accumulating evidence documents associations of childhood abuse with sleep disturbances in adulthood. However, to date, no study has evaluated associations of childhood abuse and sleep disturbances among pregnant women. Methods This cross-sectional study included 634 pregnant Peruvian women. In-person interviews were conducted in early pregnancy to collect information regarding socio-demographic characteristics, history of childhood abuse, and complaints of sleep disturbances. Spanish language version of the Ford Insomnia Response to Stress Test (FIRST-S) and the Pittsburgh Sleep Quality Index (PSQI-S) were used to assess stress-related sleep disturbance and sleep quality, respectively. Logistic regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CIs). Results Women who experienced any childhood abuse had a 1.65-fold increased odds of stress-related sleep disturbance (aOR=1.65; 95% CI: 1.15–2.38) and 2.11-fold increased odds of poor sleep quality during early pregnancy (aOR=2.11; 95% CI: 1.35–3.30) as compared with women who reported no abuse. Compared with women who reported no childhood abuse, those who reported both physical and sexual abuse during childhood were more than twice as likely to suffer from stress-related sleep disturbance (aOR=2.26; 95% CI:1.44–3.53) and poor sleep quality (aOR=2.43; 95% CI:1.45–4.09). Conclusions A history of childhood abuse is associated with increased odds of stress-related sleep disturbance and poor sleep quality during pregnancy. These findings, if replicated, should be used to inform the development of trauma-informed care for such sleep disturbances induced by childhood trauma. PMID:26429757

Clinical identification of the simple sleep-related movement disorders.

PubMed

Walters, Arthur S

2007-04-01

Simple sleep-related movement disorders must be distinguished from daytime movement disorders that persist during sleep, sleep-related epilepsy, and parasomnias, which are generally characterized by activity that appears to be simultaneously complex, goal-directed, and purposeful but is outside the conscious awareness of the patient and, therefore, inappropriate. Once it is determined that the patient has a simple sleep-related movement disorder, the part of the body affected by the movement and the age of the patient give clues as to which sleep-related movement disorder is present. In some cases, all-night polysomnography with accompanying video may be necessary to make the diagnosis. Hypnic jerks (ie, sleep starts), bruxism, rhythmic movement disorder (ie, head banging/body rocking), and nocturnal leg cramps are discussed in addition to less well-appreciated disorders such as benign sleep myoclonus of infancy, excessive fragmentary myoclonus, and hypnagogic foot tremor/alternating leg muscle activation.

Lateralised sleep spindles relate to false memory generation.

PubMed

Shaw, John J; Monaghan, Padraic

2017-12-01

Sleep is known to enhance false memories: After presenting participants with lists of semantically related words, sleeping before recalling these words results in a greater acceptance of unseen "lure" words related in theme to previously seen words. Furthermore, the right hemisphere (RH) seems to be more prone to false memories than the left hemisphere (LH). In the current study, we investigated the sleep architecture associated with these false memory and lateralisation effects in a nap study. Participants viewed lists of related words, then stayed awake or slept for approximately 90min, and were then tested for recognition of previously seen-old, unseen-new, or unseen-lure words presented either to the LH or RH. Sleep increased acceptance of unseen-lure words as previously seen compared to the wake group, particularly for RH presentations of word lists. RH lateralised stage 2 sleep spindle density relative to the LH correlated with this increase in false memories, suggesting that RH sleep spindles enhanced false memories in the RH. Copyright © 2017 Elsevier Ltd. All rights reserved.

Plasticity-Related Gene Expression During Eszopiclone-Induced Sleep.

PubMed

Gerashchenko, Dmitry; Pasumarthi, Ravi K; Kilduff, Thomas S

2017-07-01

Experimental evidence suggests that restorative processes depend on synaptic plasticity changes in the brain during sleep. We used the expression of plasticity-related genes to assess synaptic plasticity changes during drug-induced sleep. We first characterized sleep induced by eszopiclone in mice during baseline conditions and during the recovery from sleep deprivation. We then compared the expression of 18 genes and two miRNAs critically involved in synaptic plasticity in these mice. Gene expression was assessed in the cerebral cortex and hippocampus by the TaqMan reverse transcription polymerase chain reaction and correlated with sleep parameters. Eszopiclone reduced the latency to nonrapid eye movement (NREM) sleep and increased NREM sleep amounts. Eszopiclone had no effect on slow wave activity (SWA) during baseline conditions but reduced the SWA increase during recovery sleep (RS) after sleep deprivation. Gene expression analyses revealed three distinct patterns: (1) four genes had higher expression either in the cortex or hippocampus in the group of mice with increased amounts of wakefulness; (2) a large proportion of plasticity-related genes (7 out of 18 genes) had higher expression during RS in the cortex but not in the hippocampus; and (3) six genes and the two miRNAs showed no significant changes across conditions. Even at a relatively high dose (20 mg/kg), eszopiclone did not reduce the expression of plasticity-related genes during RS period in the cortex. These results indicate that gene expression associated with synaptic plasticity occurs in the cortex in the presence of a hypnotic medication. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Hippocampal Sleep Features: Relations to Human Memory Function

PubMed Central

Ferrara, Michele; Moroni, Fabio; De Gennaro, Luigi; Nobili, Lino

2012-01-01

The recent spread of intracranial electroencephalographic (EEG) recording techniques for presurgical evaluation of drug-resistant epileptic patients is providing new information on the activity of different brain structures during both wakefulness and sleep. The interest has been mainly focused on the medial temporal lobe, and in particular the hippocampal formation, whose peculiar local sleep features have been recently described, providing support to the idea that sleep is not a spatially global phenomenon. The study of the hippocampal sleep electrophysiology is particularly interesting because of its central role in the declarative memory formation. Recent data indicate that sleep contributes to memory formation. Therefore, it is relevant to understand whether specific patterns of activity taking place during sleep are related to memory consolidation processes. Fascinating similarities between different states of consciousness (wakefulness, REM sleep, non-REM sleep) in some electrophysiological mechanisms underlying cognitive processes have been reported. For instance, large-scale synchrony in gamma activity is important for waking memory and perception processes, and its changes during sleep may be the neurophysiological substrate of sleep-related deficits of declarative memory. Hippocampal activity seems to specifically support memory consolidation during sleep, through specific coordinated neurophysiological events (slow waves, spindles, ripples) that would facilitate the integration of new information into the pre-existing cortical networks. A few studies indeed provided direct evidence that rhinal ripples as well as slow hippocampal oscillations are correlated with memory consolidation in humans. More detailed electrophysiological investigations assessing the specific relations between different types of memory consolidation and hippocampal EEG features are in order. These studies will add an important piece of knowledge to the elucidation of the ultimate

Treatments for somnambulism in adults: assessing the evidence.

PubMed

Harris, Melanie; Grunstein, Ronald R

2009-08-01

Somnambulism, or sleepwalking, is a parasomnia of non-rapid eye movement (NREM) sleep where movement behaviours usually confined to wakefulness are displayed during sleep. Generally, if sleepwalking is causing distress or danger in spite of safety measures, medical or psychological treatment is indicated. Clinicians will need to assess the evidence for treatment options. MEDLINE, EMBASE, PsycINFO and the Ovid Evidence-Based Medicine Reviews (EBM) multifile databases were searched. No properly powered rigorous controlled trials were found for treatment of sleepwalking in adults. Seven reports described small trials with some kind of control arm, or retrospective case series which included 30 or more patients. With no high quality evidence to underpin recommendations for treatments of somnambulism, full discussion with patients is advised. Adequately powered, well-designed clinical trials are now needed, and multi-centre collaborations may be required to obtain the sample sizes required.

Brain tumor presenting as somnambulism in an adolescent.

PubMed

Prashad, Priya S; Marcus, Carole L; Brown, Lawrence W; Dlugos, Dennis J; Feygin, Tamara; Harding, Brian N; Heuer, Gregory G; Mason, Thornton B Alexander

2013-09-01

Sleepwalking is typically a benign and self-limited non-rapid eye movement parasomnia of childhood. We describe an unusual 15-year-old boy referred to our sleep center for new-onset sleepwalking. An overnight polysomnogram was normal from a respiratory standpoint, but a concurrent extended electroencephalogram montage showed frequent epileptiform discharges from the right parietal-temporal region and two electroclinical seizures arising from the right-frontal-central-temporal region during sleep. Magnetic resonance imaging scan revealed a right parasagittal parietal region lesion consistent with a low-grade neoplasm, and surgical resection of the lesion demonstrated a right parietal dysembryoplastic neuroepithelial tumor. Complex partial seizures and sleepwalking remitted completely with anticonvulsant therapy following surgery. This patient highlights the differential diagnosis of nocturnal events appearing to be typical parasomnias, especially when they arise abruptly at an older age. Copyright © 2013 Elsevier Inc. All rights reserved.

Association Between Stress-Related Sleep Reactivity and Metacognitive Beliefs About Sleep in Insomnia Disorder: Preliminary Results.

PubMed

Palagini, Laura; Bruno, Rosa Maria; Paolo, Toti; Caccavale, Lisa; Gronchi, Alessia; Mauri, Mauro; Riemann, Dieter; Drake, Christopher L

2016-01-01

To evaluate the relation between stress-related sleep reactivity and metacognitive beliefs about sleep in subjects with insomnia disorder (93) and in a group of healthy controls (30) a set of variables, including Ford Insomnia Response to Stress Test (FIRST) and Metacognition Questionnaire-Insomnia (MCQ-I), have been used. Internal consistency of the Italian version of FIRST was studied. Univariate correlation, regression analysis, and principal component analysis were also performed. The Italian version of FIRST showed good internal consistency and discriminant validity. Sleep reactivity was higher in women (p < .05) and correlates positively in both genders with metacognitive beliefs about sleep (p < .01) in insomnia. In insomnia, metacognitive beliefs may play a key role in modulating sleep reactivity. Therapeutic strategies acting selectively on metacognition to reduce stress-related sleep reactivity in insomnia may be useful.

Heart Rate Variability in Sleep-Related Migraine without Aura

PubMed Central

Vollono, Catello; Gnoni, Valentina; Testani, Elisa; Dittoni, Serena; Losurdo, Anna; Colicchio, Salvatore; Di Blasi, Chiara; Mazza, Salvatore; Farina, Benedetto; Della Marca, Giacomo

2013-01-01

Objectives: This is an observational study aimed to investigate the activity of autonomic nervous system during sleep in patients with sleep-related migraine. Methods: Eight consecutive migraineurs without aura were enrolled (6 women and 2 men), aged 30 to 62 years (mean 48.1 ± 9.3 years). Inclusion criteria were: high frequency of attacks (> 5 per month) and occurrence of more than 75% of the attacks during sleep causing an awakening. Patients were compared with a control group of 55 healthy subjects (23 men and 32 women, mean age 54.2 ± 13.0 years), and with a further control group of 8 age- and gender-matched healthy controls. Patient and controls underwent polysomnography and heart rate variability analysis. Results: A significant reduction of the LF/HF ratio during N2 and N3 sleep stages was observed in migraineurs compared with controls. No differences in sleep macrostructure were observed; cyclic alternating pattern (CAP) time and CAP rate were lower in migraineurs than in controls. Conclusions: These findings indicate a peculiar modification of the autonomic balance during sleep in sleep-related migraine. The reduction of LF/HF ratio in NREM sleep was observed in controls, but it was quantitatively much more evident in migraineurs. Changes in LF/HF could be consequent to an autonomic unbalance which could manifest selectively (or alternatively become more evident) during sleep. These findings, together with the reduction in CAP rate, could be an expression of reduced arousability during sleep in patients with sleep-related migraine. The simultaneous involvement of the autonomic, arousal, and pain systems might suggest involvement of the hypothalamic pathways. Citation: Vollono C; Gnoni V; Testani E; Dittoni S; Losurdo A; Colicchio S; Di Blasi C; Mazza S; Farina B; Della Marca G. Heart rate variability in sleep-related migraine without aura. J Clin Sleep Med 2013;9(7):707-714. PMID:23853566

Analysis of Slow-Wave Activity and Slow-Wave Oscillations Prior to Somnambulism

PubMed Central

Jaar, Olivier; Pilon, Mathieu; Carrier, Julie; Montplaisir, Jacques; Zadra, Antonio

2010-01-01

Study Objectivies: Several studies have investigated slow wave sleep EEG parameters, including slow-wave activity (SWA) in relation to somnambulism, but results have been both inconsistent and contradictory. The first goal of the present study was to conduct a quantitative analysis of sleepwalkers' sleep EEG by studying fluctuations in spectral power for delta (1-4 Hz) and slow delta (0.5-1 Hz) before the onset of somnambulistic episodes. A secondary aim was to detect slow-wave oscillations to examine changes in their amplitude and density prior to behavioral episodes. Participants: Twenty-two adult sleepwalkers were investigated polysomnographically following 25 h of sleep deprivation. Results: Analysis of patients' sleep EEG over the 200 sec prior to the episodes' onset revealed that the episodes were not preceded by a gradual increase in spectral power for either delta or slow delta over frontal, central, or parietal leads. However, time course comparisons revealed significant changes in the density of slow-wave oscillations as well as in very slow oscillations with significant increases occurring during the final 20 sec immediately preceding episode onset. Conclusions: The specificity of these sleep EEG parameters for the occurrence and diagnosis of NREM parasomnias remains to be determined. Citation: Jaar O; Pilon M; Carrier J; Montplaisir J; Zadra A. Analysis of slow-wave activity and slow-wave oscillations prior to somnambulism. SLEEP 2010;33(11):1511-1516. PMID:21102993

Who gets the best sleep? Ethnic and socioeconomic factors related to sleep complaints.

PubMed

Grandner, Michael A; Patel, Nirav P; Gehrman, Philip R; Xie, Dawei; Sha, Daohang; Weaver, Terri; Gooneratne, Nalaka

2010-05-01

Lower socioeconomic status is associated with short or long sleep duration and sleep disturbance (e.g., sleep apnea), which are all related to increased mortality risk. General sleep complaints, however, which may better approximate symptoms as they are experienced, have not been examined in a large population sample. Sample consisted of n=159,856 participants from the Behavioral Risk Factor Surveillance System, representing 36 states/regions across the US. Sleep complaints were measured with a telephone survey item that assessed "trouble falling asleep," "staying asleep" or "sleeping too much." Data analysis utilized hierarchical logistic regression and Rao-Schott chi(2). Asian respondents reported the least complaints, and Hispanic/Latino and Black/African-American individuals reported fewer complaints than Whites. Lower income and educational attainment was associated with more sleep complaints. Employment was associated with less sleep complaints and unemployment with more. Married individuals reported the least sleep complaints. Significant interactions with race/ethnicity indicate that the relationship between sleep complaints and marital status, income and employment differs among groups for men, and the relationship with education differs among groups for women. Rates of sleep complaints in African-American, Hispanic/Latino and Asian/Other groups were similar to Whites. Lower socioeconomic status was associated with higher rates of sleep complaint. Copyright 2010 Elsevier B.V. All rights reserved.

Respiratory cycle-related electroencephalographic changes during sleep in healthy children and in children with sleep disordered breathing.

PubMed

Immanuel, Sarah A; Pamula, Yvonne; Kohler, Mark; Martin, James; Kennedy, Declan; Saint, David A; Baumert, Mathias

2014-08-01

To investigate respiratory cycle-related electroencephalographic changes (RCREC) in healthy children and in children with sleep disordered breathing (SDB) during scored event-free (SEF) breathing periods of sleep. Interventional case-control repeated measurements design. Paediatric sleep laboratory in a hospital setting. Forty children with SDB and 40 healthy, age- and sex-matched children. Adenotonsillectomy in children with SDB and no intervention in controls. Overnight polysomnography; electroencephalography (EEG) power variations within SEF respiratory cycles in the overall and frequency band-specific EEG within stage 2 nonrapid eye movement (NREM) sleep, slow wave sleep (SWS), and rapid eye movement (REM) sleep. Within both groups there was a decrease in EEG power during inspiration compared to expiration across all sleep stages. Compared to controls, RCREC in children with SDB in the overall EEG were significantly higher during REM and frequency band specific RCRECs were higher in the theta band of stage 2 and REM sleep, alpha band of SWS and REM sleep, and sigma band of REM sleep. This between-group difference was not significant postadenotonsillectomy. The presence of nonrandom respiratory cycle-related electroencephalographic changes (RCREC) in both healthy children and in children with sleep disordered breathing (SDB) during NREM and REM sleep has been demonstrated. The RCREC values were higher in children with SDB, predominantly in REM sleep and this difference reduced after adenotonsillectomy. Immanuel SA, Pamula Y, Kohler M, Martin J, Kennedy D, Saint DA, Baumert M. Respiratory cycle-related electroencephalographic changes during sleep in healthy children and in children with sleep disordered breathing.

SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment.

PubMed

Moon, Rachel Y

2011-11-01

Despite a major decrease in the incidence of sudden infant death syndrome (SIDS) since the American Academy of Pediatrics (AAP) released its recommendation in 1992 that infants be placed for sleep in a nonprone position, this decline has plateaued in recent years. Concurrently, other causes of sudden unexpected infant death that occur during sleep (sleep-related deaths), including suffocation, asphyxia, and entrapment, and ill-defined or unspecified causes of death have increased in incidence, particularly since the AAP published its last statement on SIDS in 2005. It has become increasingly important to address these other causes of sleep-related infant death. Many of the modifiable and nonmodifiable risk factors for SIDS and suffocation are strikingly similar. The AAP, therefore, is expanding its recommendations from focusing only on SIDS to focusing on a safe sleep environment that can reduce the risk of all sleep-related infant deaths, including SIDS. The recommendations described in this policy statement include supine positioning, use of a firm sleep surface, breastfeeding, room-sharing without bed-sharing, routine immunizations, consideration of using a pacifier, and avoidance of soft bedding, overheating, and exposure to tobacco smoke, alcohol, and illicit drugs. The rationale for these recommendations is discussed in detail in the accompanying "Technical Report--SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment," which is included in this issue of Pediatrics (www.pediatrics.org/cgi/content/full/128/5/e1341).

SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment.

PubMed

Moon, Rachel Y

2011-11-01

Despite a major decrease in the incidence of sudden infant death syndrome (SIDS) since the American Academy of Pediatrics (AAP) released its recommendation in 1992 that infants be placed for sleep in a nonprone position, this decline has plateaued in recent years. Concurrently, other causes of sudden unexpected infant death occurring during sleep (sleep-related deaths), including suffocation, asphyxia, and entrapment, and ill-defined or unspecified causes of death have increased in incidence, particularly since the AAP published its last statement on SIDS in 2005. It has become increasingly important to address these other causes of sleep-related infant death. Many of the modifiable and nonmodifiable risk factors for SIDS and suffocation are strikingly similar. The AAP, therefore, is expanding its recommendations from being only SIDS-focused to focusing on a safe sleep environment that can reduce the risk of all sleep-related infant deaths including SIDS. The recommendations described in this report include supine positioning, use of a firm sleep surface, breastfeeding, room-sharing without bed-sharing, routine immunization, consideration of a pacifier, and avoidance of soft bedding, overheating, and exposure to tobacco smoke, alcohol, and illicit drugs. The rationale for these recommendations is discussed in detail in this technical report. The recommendations are published in the accompanying "Policy Statement--Sudden Infant Death Syndrome and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment," which is included in this issue (www.pediatrics.org/cgi/doi/10.1542/peds.2011-2220).

Suicidal ideations and sleep-related problems in early adolescence.

PubMed

Franić, Tomislav; Kralj, Zana; Marčinko, Darko; Knez, Rajna; Kardum, Goran

2014-05-01

Suicidal ideation and sleep-related problems are associated with many common psychopathological entities in early adolescence. This study examined possible association between suicidal ideation and sleep-related problems. A cross-sectional study was performed in classroom settings at 840 early adolescents 11-13 years of age. Of those, 791 adolescents fully completed the data and thus represent an actual sample. Suicidal ideations were assessed with three dichotomous (yes/no) items: 'I often think about death'; 'I wish I was dead'; 'I often think about suicide.' A composite measure of perceived sleep-related problems was formed by combining items from the Junior Eysenck Personality Questionnaire (Do you find it hard to sleep at night because you are worrying about things?), Children Depression Inventory (It is hard for me to fall asleep at night), and two additional dichotomous questions (I often was not able to fall asleep because of worrying; At times I was not able to stay asleep because of worrying). This score mainly assessed difficulties in initiating or maintaining sleep. A total of 7.1% adolescents reported suicidal ideation and 86.7% of them had sleep problems. Sleep-related problems were associated with any suicidal ideation and each type of ideation separately. This study suggests association of sleep problems and suicidal ideations in early adolescence. Therefore, clinicians should evaluate this population for sleep disturbances, as they might be a marker of increased risk for suicidality. © 2013 Wiley Publishing Asia Pty Ltd.

Respiratory Cycle-Related Electroencephalographic Changes during Sleep in Healthy Children and in Children with Sleep Disordered Breathing

PubMed Central

Immanuel, Sarah A.; Pamula, Yvonne; Kohler, Mark; Martin, James; Kennedy, Declan; Saint, David A.; Baumert, Mathias

2014-01-01

Study Objective: To investigate respiratory cycle-related electroencephalographic changes (RCREC) in healthy children and in children with sleep disordered breathing (SDB) during scored event-free (SEF) breathing periods of sleep. Design: Interventional case-control repeated measurements design. Setting: Paediatric sleep laboratory in a hospital setting. Participants: Forty children with SDB and 40 healthy, age- and sex-matched children. Interventions: Adenotonsillectomy in children with SDB and no intervention in controls. Measurements and Results: Overnight polysomnography; electroencephalography (EEG) power variations within SEF respiratory cycles in the overall and frequency band-specific EEG within stage 2 nonrapid eye movement (NREM) sleep, slow wave sleep (SWS), and rapid eye movement (REM) sleep. Within both groups there was a decrease in EEG power during inspiration compared to expiration across all sleep stages. Compared to controls, RCREC in children with SDB in the overall EEG were significantly higher during REM and frequency band specific RCRECs were higher in the theta band of stage 2 and REM sleep, alpha band of SWS and REM sleep, and sigma band of REM sleep. This between-group difference was not significant postadenotonsillectomy. Conclusion: The presence of nonrandom respiratory cycle-related electroencephalographic changes (RCREC) in both healthy children and in children with sleep disordered breathing (SDB) during NREM and REM sleep has been demonstrated. The RCREC values were higher in children with SDB, predominantly in REM sleep and this difference reduced after adenotonsillectomy. Citation: Immanuel SA, Pamula Y, Kohler M, Martin J, Kennedy D, Saint DA, Baumert M. Respiratory cycle-related electroencephalographic changes during sleep in healthy children and in children with sleep disordered breathing. SLEEP 2014;37(8):1353-1361. PMID:25083016

Intimate Partner Violence Is Associated with Stress-Related Sleep Disturbance and Poor Sleep Quality during Early Pregnancy

PubMed Central

Sanchez, Sixto E.; Islam, Suhayla; Zhong, Qiu-Yue; Gelaye, Bizu; Williams, Michelle A.

2016-01-01

Objectives To examine the associations of Intimate partner violence (IPV) with stress-related sleep disturbance (measured using the Ford Insomnia Response to Stress Test [FIRST]) and poor sleep quality (measured using the Pittsburgh Sleep Quality Index [PSQI]) during early pregnancy. Methods This cross-sectional study included 634 pregnant Peruvian women. In-person interviews were conducted in early pregnancy to collect information regarding IPV history, and sleep traits. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CIs) were calculated using logistic regression procedures. Results Lifetime IPV was associated with a 1.54-fold increased odds of stress-related sleep disturbance (95% CI: 1.08–2.17) and a 1.93-fold increased odds of poor sleep quality (95% CI: 1.33–2.81). Compared with women experiencing no IPV during lifetime, the aOR (95% CI) for stress-related sleep disturbance associated with each type of IPV were: physical abuse only 1.24 (95% CI: 0.84–1.83), sexual abuse only 3.44 (95%CI: 1.07–11.05), and physical and sexual abuse 2.51 (95% CI: 1.27–4.96). The corresponding aORs (95% CI) for poor sleep quality were: 1.72 (95% CI: 1.13–2.61), 2.82 (95% CI: 0.99–8.03), and 2.50 (95% CI: 1.30–4.81), respectively. Women reporting any IPV in the year prior to pregnancy had increased odds of stress-related sleep disturbance (aOR = 2.07; 95% CI: 1.17–3.67) and poor sleep quality (aOR = 2.27; 95% CI: 1.30–3.97) during pregnancy. Conclusion Lifetime and prevalent IPV exposures are associated with stress-related sleep disturbance and poor sleep quality during pregnancy. Our findings suggest that sleep disturbances may be important mechanisms that underlie the lasting adverse effects of IPV on maternal and perinatal health. PMID:27023005

Sleeping sites, sleeping trees, and sleep-related behaviors of black crested gibbons (Nomascus concolor jingdongensis) at Mt. Wuliang, Central Yunnan, China.

PubMed

Fan, Peng-Fei; Jiang, Xue-Long

2008-02-01

Data on sleep-related behaviors were collected for a group of central Yunnan black crested gibbons (Nomascus concolor jingdongensis) at Mt. Wuliang, Yunnan, China from March 2005 to April 2006. Members of the group usually formed four sleeping units (adult male and juvenile, adult female with one semi-dependent black infant, adult female with one dependent yellow infant, and subadult male) spread over different sleeping trees. Individuals or units preferred specific areas to sleep; all sleeping sites were situated in primary forest, mostly (77%) between 2,200 and 2,400 m in elevation. They tended to sleep in the tallest and thickest trees with large crowns on steep slopes and near important food patches. Factors influencing sleeping site selection were (1) tree characteristics, (2) accessibility, and (3) easy escape. Few sleeping trees were used repeatedly by the same or other members of the group. The gibbons entered the sleeping trees on average 128 min before sunset and left the sleeping trees on average 33 min after sunrise. The lag between the first and last individual entering the trees was on average 17.8 min. We suggest that sleep-related behaviors are primarily adaptations to minimize the risk of being detected by predators. Sleeping trees may be chosen to make approach and attack difficult for the predator, and to provide an easy escape route in the dark. In response to cold temperatures in a higher habitat, gibbons usually sit and huddle together during the night, and in the cold season they tend to sleep on ferns and/or orchids. (c) 2007 Wiley-Liss, Inc.

Sleep-related memory consolidation in primary insomnia.

PubMed

Nissen, Christoph; Kloepfer, Corinna; Feige, Bernd; Piosczyk, Hannah; Spiegelhalder, Kai; Voderholzer, Ulrich; Riemann, Dieter

2011-03-01

It has been suggested that healthy sleep facilitates the consolidation of newly acquired memories and underlying brain plasticity. The authors tested the hypothesis that patients with primary insomnia (PI) would show deficits in sleep-related memory consolidation compared to good sleeper controls (GSC). The study used a four-group parallel design (n=86) to investigate the effects of 12 h of night-time, including polysomnographically monitored sleep ('sleep condition' in PI and GSC), versus 12 h of daytime wakefulness ('wake condition' in PI and GSC) on procedural (mirror tracing task) and declarative memory consolidation (visual and verbal learning task). Demographic characteristics and memory encoding did not differ between the groups at baseline. Polysomnography revealed a significantly disturbed sleep profile in PI compared to GSC in the sleep condition. Night-time periods including sleep in GSC were associated with (i) a significantly enhanced procedural and declarative verbal memory consolidation compared to equal periods of daytime wakefulness in GSC and (ii) a significantly enhanced procedural memory consolidation compared to equal periods of daytime wakefulness and night-time sleep in PI. Across retention intervals of daytime wakefulness, no differences between the experimental groups were observed. This pattern of results suggests that healthy sleep fosters the consolidation of new memories, and that this process is impaired for procedural memories in patients with PI. Future work is needed to investigate the impact of treatment on improving sleep and memory. © 2010 European Sleep Research Society.

Chronic obstructive pulmonary disease and sleep related disorders.

PubMed

Tsai, Sheila C

2017-03-01

Sleep related disorders are common and under-recognized in the chronic obstructive pulmonary disease (COPD) population. COPD symptoms can disrupt sleep. Similarly, sleep disorders can affect COPD. This review highlights the common sleep disorders seen in COPD patients, their impact, and potential management. Treatment of sleep disorders may improve quality of life in COPD patients. Optimizing inhaler therapy improves sleep quality. Increased inflammatory markers are noted in patients with the overlap syndrome of COPD and obstructive sleep apnea versus COPD alone. There are potential benefits of noninvasive positive pressure ventilation therapy for overlap syndrome patients with hypercapnia. Nocturnal supplemental oxygen may be beneficial in certain COPD subtypes. Nonbenzodiazepine hypnotic therapy for insomnia has shown benefit without associated respiratory failure or worsening respiratory symptoms. Melatonin may provide mild hypnotic and antioxidant benefits. This article discusses the impact of sleep disorders on COPD patients and the potential benefits of managing sleep disorders on respiratory disease control and quality of life.

Antimony and sleep-related disorders: NHANES 2005-2008.

PubMed

Scinicariello, Franco; Buser, Melanie C; Feroe, Aliya G; Attanasio, Roberta

2017-07-01

Antimony is used as a flame-retardant in textiles and plastics, in semiconductors, pewter, and as pigments in paints, lacquers, glass and pottery. Subacute or chronic antimony poisoning has been reported to cause sleeplessness. The prevalence of short sleep duration (<7h/night) has been reported to be 37.1% in the general US population, and obstructive sleep apnea (OSA) affects 12-28 million US adults. Insufficient sleep and OSA have been linked to the development of several chronic conditions including diabetes, cardiovascular disease, obesity and depression, conditions that pose serious public health threats. To investigate whether there is an association between antimony exposure and sleep-related disorders in the US adult population using the National Health and Nutrition Examination Survey (NHANES) 2005-2008. We performed multivariate logistic regression to analyze the association of urinary antimony with several sleep disorders, including insufficient sleep and OSA, in adult (ages 20 years and older) participants of NHANES 2005-2008 (n=2654). We found that participants with higher urinary antimony levels had higher odds to experience insufficient sleep (≤6h/night) (OR 1.73; 95%CI; 1.04, 2.91) as well as higher odds to have increased sleep onset latency (>30min/night). Furthermore, we found that higher urinary antimony levels in participants were associated with OSA (OR 1.57; 95%CI; 1.05, 2.34), sleep problems, and day-time sleepiness. In this study, we found that urinary antimony was associated with higher odds to have insufficient sleep and OSA. Because of the public health implications of sleep disorders, further studies, especially a prospective cohort study, are warranted to evaluate the association between antimony exposure and sleep-related disorders. Copyright © 2017. Published by Elsevier Inc.

Exploring the relationship between work-related rumination, sleep quality, and work-related fatigue.

PubMed

Querstret, Dawn; Cropley, Mark

2012-07-01

This study examined the association among three conceptualizations of work-related rumination (affective rumination, problem-solving pondering, and detachment) with sleep quality and work-related fatigue. It was hypothesized that affective rumination and poor sleep quality would be associated with increased fatigue and that problem-solving pondering and detachment would be associated with decreased fatigue. The mediating effect of sleep quality on the relationship between work-related rumination and fatigue was also tested. An online questionnaire was completed by a heterogeneous sample of 719 adult workers in diverse occupations. The following variables were entered as predictors in a regression model: affective rumination, problem-solving pondering, detachment, and sleep quality. The dependent variables were chronic work-related fatigue (CF) and acute work-related fatigue (AF). Affective rumination was the strongest predictor of increased CF and AF. Problem-solving pondering was a significant predictor of decreased CF and AF. Poor sleep quality was predictive of increased CF and AF. Detachment was significantly negatively predictive for AF. Sleep quality partially mediated the relationship between affective rumination and fatigue and between problem-solving pondering and fatigue. Work-related affective rumination appears more detrimental to an individual's ability to recover from work than problem-solving pondering. In the context of identifying mechanisms by which demands at work are translated into ill-health, this appears to be a key finding and suggests that it is the type of work-related rumination, not rumination per se, that is important.

Sleep variability and fatigue in adolescents: Associations with school-related features.

PubMed

Matos, M G; Gaspar, T; Tomé, G; Paiva, T

2016-10-01

This study aims to evaluate the influences of sleep duration and sleep variability (SleepV), upon adolescents' school-related situations. The Health Behaviour in School-Aged Children (HBSC) survey is based on a self-completed questionnaire. The participants were 3164 pupils (53.7% girls), attending the 8th and 10th grades, 14.9 years old, and were inquired about subjective sleep duration during the week and weekends, SleepV, fatigue, difficulties in sleep initiation, school achievement, feelings towards schools, pressure with school work and skipping classes. Multiple regression models used, as dependent variables: (a) school achievement, (b) disliking school, (c) pressure with school work and (d) skipping classes, using as independent variables, each of the remaining school-related variables, fatigue, total sleep duration and difficulties in sleep initiation. The average sleep duration in the week and during weekdays was lower than recommended for these age groups, and almost half of students had high SleepV between weekdays and weekends. A logistic model revealed that the absence of SleepV was associated with lower perception of school work pressure, less frequent skipping classes, more infrequent fatigue and more infrequent difficulties in sleep initiation. Poor sleep quality, SleepV and insufficient sleep duration affected negatively school-related variables. © 2015 International Union of Psychological Science.

Heart rate variability in sleep-related migraine without aura.

PubMed

Vollono, Catello; Gnoni, Valentina; Testani, Elisa; Dittoni, Serena; Losurdo, Anna; Colicchio, Salvatore; Di Blasi, Chiara; Mazza, Salvatore; Farina, Benedetto; Della Marca, Giacomo

2013-07-15

This is an observational study aimed to investigate the activity of autonomic nervous system during sleep in patients with sleep-related migraine. Eight consecutive migraineurs without aura were enrolled (6 women and 2 men), aged 30 to 62 years (mean 48.1 ± 9.3 years). Inclusion criteria were: high frequency of attacks (> 5 per month) and occurrence of more than 75% of the attacks during sleep causing an awakening. Patients were compared with a control group of 55 healthy subjects (23 men and 32 women, mean age 54.2 ± 13.0 years), and with a further control group of 8 age- and gender-matched healthy controls. Patient and controls underwent polysomnography and heart rate variability analysis. A significant reduction of the LF/HF ratio during N2 and N3 sleep stages was observed in migraineurs compared with controls. No differences in sleep macrostructure were observed; cyclic alternating pattern (CAP) time and CAP rate were lower in migraineurs than in controls. These findings indicate a peculiar modification of the autonomic balance during sleep in sleep-related migraine. The reduction of LF/HF ratio in NREM sleep was observed in controls, but it was quantitatively much more evident in migraineurs. Changes in LF/HF could be consequent to an autonomic unbalance which could manifest selectively (or alternatively become more evident) during sleep. These findings, together with the reduction in CAP rate, could be an expression of reduced arousability during sleep in patients with sleep-related migraine. The simultaneous involvement of the autonomic, arousal, and pain systems might suggest involvement of the hypothalamic pathways.

Dissociative Disorders

MedlinePlus

... use disorders Depression and anxiety disorders Post-traumatic stress disorder Personality disorders Sleep disorders, including nightmares, insomnia and sleepwalking Eating disorders Physical symptoms such as ...

Sleep-Related Painful Erections in a Patient With Obstructive Sleep Apnea Syndrome.

PubMed

Abouda, Maher; Jomni, Taieb; Yangui, Ferdaws; Charfi, Mohamed Ridha; Arnulf, Isabelle

2016-01-01

Sleep-related painful erection (SRPE) is a rare sleep disorder characterized by recurrent, painful penile erections occurring when awakening from rapid eye movement sleep, while erections are painless during wakefulness. Almost 35 cases have been reported worldwide, and only two of them had an associated obstructive sleep apnea syndrome (OSAS). We report a new case of a 61-year-old man suffering from SRPE associated with OSAS. The adequate treatment of respiratory events with continuous positive airway pressure did not alleviate the SRPE symptoms and excessive daytime sleepiness. The SRPE diagnosis was made by polysomnography coupled with video surveillance when the patient was referred to the sleep laboratory for residual excessive daytime sleepiness. The patient had 2-4 episodes of SRPE/night. Beta-blocker did not alleviate the SRPE, but a transient improvement was noted when the patient was treated with paroxetine. In contrast with the two previously published cases of SRPE plus OSAS, continuous positive airway treatment did not improve SRPE symptoms in our patient.

Pre-diagnostic Sleep Duration and Sleep Quality in Relation to Subsequent Cancer Survival

PubMed Central

Phipps, Amanda I.; Bhatti, Parveen; Neuhouser, Marian L.; Chen, Chu; Crane, Tracy E.; Kroenke, Candyce H.; Ochs-Balcom, Heather; Rissling, Michelle; Snively, Beverly M.; Stefanick, Marcia L.; Treggiari, Miriam M.; Watson, Nathaniel F.

2016-01-01

, Rissling M, Snively BM, Stefanick ML, Treggiari MM, Watson NF. Pre-diagnostic sleep duration and sleep quality in relation to subsequent cancer survival. J Clin Sleep Med 2016;12(4):495–503. PMID:26612513

SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment.

PubMed

2016-11-01

Approximately 3500 infants die annually in the United States from sleep-related infant deaths, including sudden infant death syndrome (SIDS; International Classification of Diseases, 10th Revision [ICD-10], R95), ill-defined deaths (ICD-10 R99), and accidental suffocation and strangulation in bed (ICD-10 W75). After an initial decrease in the 1990s, the overall death rate attributable to sleep-related infant deaths has not declined in more recent years. Many of the modifiable and nonmodifiable risk factors for SIDS and other sleep-related infant deaths are strikingly similar. The American Academy of Pediatrics recommends a safe sleep environment that can reduce the risk of all sleep-related infant deaths. Recommendations for a safe sleep environment include supine positioning, the use of a firm sleep surface, room-sharing without bed-sharing, and the avoidance of soft bedding and overheating. Additional recommendations for SIDS reduction include the avoidance of exposure to smoke, alcohol, and illicit drugs; breastfeeding; routine immunization; and use of a pacifier. New evidence is presented for skin-to-skin care for newborn infants, use of bedside and in-bed sleepers, sleeping on couches/armchairs and in sitting devices, and use of soft bedding after 4 months of age. The recommendations and strength of evidence for each recommendation are included in this policy statement. The rationale for these recommendations is discussed in detail in the accompanying technical report (www.pediatrics.org/cgi/doi/10.1542/peds.2016-2940). Copyright © 2016 by the American Academy of Pediatrics.

Circadian-Related Sleep Disorders and Sleep Medication Use in the New Zealand Blind Population: An Observational Prevalence Survey

PubMed Central

Warman, Guy R.; Pawley, Matthew D. M.; Bolton, Catherine; Cheeseman, James F.; Fernando, Antonio T.; Arendt, Josephine; Wirz-Justice, Anna

2011-01-01

Study Objectives To determine the prevalence of self-reported circadian-related sleep disorders, sleep medication and melatonin use in the New Zealand blind population. Design A telephone survey incorporating 62 questions on sleep habits and medication together with validated questionnaires on sleep quality, chronotype and seasonality. Participants Participants were grouped into: (i) 157 with reduced conscious perception of light (RLP); (ii) 156 visually impaired with no reduction in light perception (LP) matched for age, sex and socioeconomic status, and (iii) 156 matched fully-sighted controls (FS). Sleep Habits and Disturbances The incidence of sleep disorders, daytime somnolence, insomnia and sleep timing problems was significantly higher in RLP and LP compared to the FS controls (p<0.001). The RLP group had the highest incidence (55%) of sleep timing problems, and 26% showed drifting sleep patterns (vs. 4% FS). Odds ratios for unconventional sleep timing were 2.41 (RLP) and 1.63 (LP) compared to FS controls. For drifting sleep patterns, they were 7.3 (RLP) and 6.0 (LP). Medication Use Zopiclone was the most frequently prescribed sleep medication. Melatonin was used by only 4% in the RLP group and 2% in the LP group. Conclusions Extrapolations from the current study suggest that 3,000 blind and visually impaired New Zealanders may suffer from circadian-related sleep problems, and that of these, fewer than 15% have been prescribed melatonin. This may represent a therapeutic gap in the treatment of circadian-related sleep disorders in New Zealand, findings that may generalize to other countries. PMID:21789214

SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment.

PubMed

Moon, Rachel Y

2016-11-01

Approximately 3500 infants die annually in the United States from sleep-related infant deaths, including sudden infant death syndrome (SIDS), ill-defined deaths, and accidental suffocation and strangulation in bed. After an initial decrease in the 1990s, the overall sleep-related infant death rate has not declined in more recent years. Many of the modifiable and nonmodifiable risk factors for SIDS and other sleep-related infant deaths are strikingly similar. The American Academy of Pediatrics recommends a safe sleep environment that can reduce the risk of all sleep-related infant deaths. Recommendations for a safe sleep environment include supine positioning, use of a firm sleep surface, room-sharing without bed-sharing, and avoidance of soft bedding and overheating. Additional recommendations for SIDS risk reduction include avoidance of exposure to smoke, alcohol, and illicit drugs; breastfeeding; routine immunization; and use of a pacifier. New evidence and rationale for recommendations are presented for skin-to-skin care for newborn infants, bedside and in-bed sleepers, sleeping on couches/armchairs and in sitting devices, and use of soft bedding after 4 months of age. In addition, expanded recommendations for infant sleep location are included. The recommendations and strength of evidence for each recommendation are published in the accompanying policy statement, "SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment," which is included in this issue. Copyright © 2016 by the American Academy of Pediatrics.

Sleep-Related Electrophysiology and Behavior of Tinamous (Eudromia elegans): Tinamous Do Not Sleep Like Ostriches.

PubMed

Tisdale, Ryan K; Vyssotski, Alexei L; Lesku, John A; Rattenborg, Niels C

2017-01-01

The functions of slow wave sleep (SWS) and rapid eye movement (REM) sleep, distinct sleep substates present in both mammals and birds, remain unresolved. One approach to gaining insight into their function is to trace the evolution of these states through examining sleep in as many taxonomic groups as possible. The mammalian and avian clades are each composed of two extant groups, i.e., the monotremes (echidna and platypus) and therian (marsupial and eutherian [or placental]) mammals, and Palaeognaths (cassowaries, emus, kiwi, ostriches, rheas, and tinamous) and Neognaths (all other birds) among birds. Previous electrophysiological studies of monotremes and ostriches have identified a unique "mixed" sleep state combining features of SWS and REM sleep unlike the well-delineated sleep states observed in all therian mammals and Neognath birds. In the platypus this state is characterized by periods of REM sleep-related myoclonic twitching, relaxed skeletal musculature, and rapid eye movements, occurring in conjunction with SWS-related slow waves in the forebrain electroencephalogram (EEG). A similar mixed state was also observed in ostriches; although in addition to occurring during periods with EEG slow waves, reduced muscle tone and rapid eye movements also occurred in conjunction with EEG activation, a pattern typical of REM sleep in Neognath birds. Collectively, these studies suggested that REM sleep occurring exclusively as an integrated state with forebrain activation might have evolved independently in the therian and Neognath lineages. To test this hypothesis, we examined sleep in the elegant crested tinamou (Eudromia elegans), a small Palaeognath bird that more closely resembles Neognath birds in size and their ability to fly. A 24-h period was scored for sleep state based on electrophysiology and behavior. Unlike ostriches, but like all of the Neognath birds examined, all indicators of REM sleep usually occurred in conjunction with forebrain activation in

Sleeping on the motor engram: The multifaceted nature of sleep-related motor memory consolidation.

PubMed

King, Bradley R; Hoedlmoser, Kerstin; Hirschauer, Franziska; Dolfen, Nina; Albouy, Genevieve

2017-09-01

For the past two decades, it has generally been accepted that sleep benefits motor memory consolidation processes. This notion, however, has been challenged by recent studies and thus the sleep and motor memory story is equivocal. Currently, and in contrast to the declarative memory domain, a comprehensive overview and synthesis of the effects of post-learning sleep on the behavioral and neural correlates of motor memory consolidation is not available. We therefore provide an extensive review of the literature in order to highlight that sleep-dependent motor memory consolidation depends upon multiple boundary conditions, including particular features of the motor task, the recruitment of relevant neural substrates (and the hippocampus in particular), as well as the specific architecture of the intervening sleep period (specifically, sleep spindle and slow wave activity). For our field to continue to advance, future research must consider the multifaceted nature of sleep-related motor memory consolidation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessment of Sleep Quantity and Sleep Disturbances During Recovery From Sports-Related Concussion in Youth Athletes.

PubMed

Murdaugh, Donna L; Ono, Kim E; Reisner, Andrew; Burns, Thomas G

2018-05-01

To determine the relation between sleep quantity and sleep disturbances on symptoms and neurocognitive ability during the acute phase (<7d) and after sports-related concussion (SRC; >21d). Prospective inception cohort study. General community setting of regional middle and high schools. A sample (N=971) including youth athletes with SRC (n=528) and controls (n=443) (age, 10-18y). Not applicable. Athletes completed the Immediate Post-Concussion Assessment and Cognitive Testing battery. Partial correlation analyses and independent t tests were conducted to assess sleep quantity the night before testing. Multivariate analysis of covariance was used to assess sleep disturbances and their interaction with age. Less sleep quantity was correlated with greater report of cognitive (P=.001) and neuropsychological (P=.024) symptoms specific to prolonged recovery from SRC. Sleep disturbances significantly affect each migraine, cognitive, and neuropsychological symptoms (P<.001). A significant interaction was found between sleep disturbances and age (P=.04) at >21 days post-SRC. Findings emphasize that the continued presence of low sleep quantity and sleep disturbances in youth athletes with SRC should be a specific indicator to health professionals that these athletes are at an increased risk of protracted recovery. Further research should identify additional factors that may interact with sleep to increase the risk of protracted recovery. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Sleep-related factors and work-related injuries among farmers in Heilongjiang Province, People's Republic of China.

PubMed

Zhu, Huiping; Han, Yunfeng; Sun, Yaowu; Xie, Zhiping; Qian, Xueyan; Stallones, Lorann; Xiang, Huiyun; Wang, Limin

2014-09-11

The association between sleep and work-related injuries among Chinese farmers has not been well studied. This study examined the impact of lack of sleep on agricultural work-related injuries among farmers in China. Data were from a cross-sectional survey of farm-workers in northeastern China. Information was obtained on injuries that occurred in 12 months prior to the survey, on eight sleep-related variables, and on socio-demographic variables. Logistic regression analyses were conducted to test the hypothesis that lack of sleep significantly increased the risk of work-related injuries after controlling for other injury-related risk- factors. Farmers who slept less than six hours per night were 59% more likely to be injured than those who slept more than eight hours per night (OR = 1.59; 95% CI = 1.04, 2.41). The odds of a work-related injury was 2.46 (1.56-3.89) for farmers who reported going to sleep after midnight at least once a week compared with farmers who reported going to sleep after midnight once a month. Farmers who reported having difficulty falling asleep or waking frequently during the night, who often having nightmares, or who experienced daytime sleepiness were at higher injury risk compared with the reference group after controlling for age, gender and alcohol consumption. Reduced sleep hours and poor sleep quality significantly increased the risk of work-related injuries in Chinese farmers. Sleep hours and sleep quality should be considered when assessing occupational safety among farmers.

Sleep-related problems and minor psychiatric disorders among Brazilian shift workers.

PubMed

Olinto, Maria Teresa Anselmo; Garcez, Anderson; Henn, Ruth Liane; Macagnan, Jamile Block Araldi; Paniz, Vera Maria Vieira; Pattussi, Marcos Pascoal

2017-11-01

The aim of this study was to explore the association between sleep-related problems with the occurrence of minor psychiatric disorders in shift workers of southern Brazil. A cross-sectional study with 1202 workers (785 females) aged 18-50 years was carried out. Minor psychiatric disorders were assessed using the Self-Reporting Questionnaire (SRQ-20), and four sleep problems were collected and analyzed: sleep deprivation (≤ 5h), difficulty falling asleep, waking up during sleep, and sleep medication use. Results show that the overall prevalence of minor psychiatric disorders was 26.8%, but it was more prevalent among females than males (30.2% vs. 20.4%). Nightshift work was significantly associated with the occurrence of sleep-related problems. After adjusting for confounding factors, the number of sleep-related problems showed a positive linear trend with psychiatric disorders in both sexes. Having two or more sleep-related problems was associated with increased probability of psychiatric disorders approximately three-fold among males and two-fold among females, when compared with those without sleep problems. In conclusion, this study demonstrated that sleep-related problems have a strong and independent association with psychiatric disorders among shift workers. Furthermore, the prevalence of both conditions was higher among females than males; however, the strength of these associations was higher in males. Copyright © 2017 Elsevier B.V. All rights reserved.

Sleep-related Issues for Recovery and Performance in Athletes.

PubMed

Kölling, Sarah; Duffield, Rob; Erlacher, Daniel; Venter, Ranel; Halson, Shona L

2018-04-13

The body of research that reports the relevance of sleep in high-performance sports is growing steadily. While the identification of sleep cycles and diagnosis of sleep disorders is limited to lab-based assessment via polysomnography, the development of activity-based devices estimating sleep patterns provides greater insight into the sleep behaviour of athletes in ecological settings. Overall, small sleep quantity and/or poor quality appears to exist in many athletic populations, though this may be related to training and competition context. Typical sleep-affecting factors are the scheduling of training sessions and competitions as well as impaired sleep-onset as a result of increased arousal prior to competition or due to the use of electronic devices before bedtime. Further challenges are travel demands which may be accompanied by jet-lag symptoms and disruption of sleep habits. Promotion of sleep may be approached via behavioural strategies, such as sleep hygiene, extending night-time sleep or daytime napping. Pharmacological interventions should be limited to clinically-induced treatments as evidence among healthy and athletic populations is lacking. To optimise and manage sleep in athletes, it is recommended to implement routine sleep monitoring on an individual basis.

Timing and Variability of Postpartum Sleep in Relation to Daytime Performance

PubMed Central

McBean, Amanda L.; Montgomery-Downs, Hawley E.

2013-01-01

Postpartum women have highly disturbed sleep, also known as sleep fragmentation. Fragmentation extends their total sleep period, also disrupting sleep timing. A stable and earlier sleep period among non-postpartum populations are related to better performance, physical health, and mental health. However, sleep timing has not been examined among postpartum women who are also vulnerable to daytime impairment. The study objective was to examine how the timing and regularity of sleep during the early postpartum period are related to daytime functioning across postpartum weeks 2-13. In this field-based study, 71 primiparous women wore an actigraph, a small wrist-worn device that monitors sleep and sleep timing, for the 12-week study period. Mothers self-administered a 5-minute psychomotor vigilance test (PVT) each morning to evaluate the number of >500ms response lapses. They also completed a Morningness-Eveningness scale at the beginning of the study to identify chronotype. After controlling for maternal age, earlier sleep timing was associated with significantly fewer PVT lapses at postpartum weeks 9,12; a more stable sleep midpoint was associated with significantly fewer PVT lapses at postpartum weeks 2,5-13. Earlier sleep midpoints were related to more stable sleep midpoints at postpartum week 2 and a morning-type chronotype. An earlier sleep midpoint was also associated with a reduced slope of worsening PVT lapses across weeks. Across the first 12 postpartum weeks, women with earlier or more stable sleep periods had less daytime impairment than women with later or more variable sleep midpoints. Postpartum women with earlier sleep midpoints also showed less severe decrements in performance across time, which has been attributed to cumulative impacts of sleep disturbance. These data suggest the sleep period, in addition to sleep duration and fragmentation, should be more closely examined, particularly among vulnerable women, as it may affect the neurobehavioral

The Relative Contributions of the Homeostatic and Circadian Processes to Sleep Regulation under Conditions of Severe Sleep Restriction

PubMed Central

Paech, Gemma M.; Ferguson, Sally A.; Sargent, Charli; Kennaway, David J.; Roach, Gregory D.

2012-01-01

Study Objectives: To investigate the relative contributions of the homeostatic and circadian processes on sleep regulation under conditions of severe sleep restriction. Design: The 13-day laboratory based study consisted of 3 × 24-h baseline days (8 h sleep opportunity, 16 h wake) followed by 7 × 28-h forced desynchrony days (4.7 h sleep opportunity, 23.3 h wake). Setting: The study was conducted in a time isolation unit at the Centre for Sleep Research, University of South Australia. Participants: Fourteen healthy, nonsmoking males, aged 21.8 ± 3.8 (mean ± SD) years participated in the study. Interventions: N/A Measurements: Sleep was measured using standard polysomnography. Core body temperature (CBT) was recorded continuously using a rectal thermistor. Each epoch of sleep was assigned a circadian phase based on the CBT data (6 × 60-degree bins) and an elapsed time into sleep episode (2 × 140-min intervals). Results: The percentage of SWS decreased with elapsed time into the sleep episode. However, no change in the percentage of REM sleep was observed with sleep progression. Whilst there was a circadian modulation of REM sleep, the amplitude of the circadian variation was smaller than expected. Sleep efficiency remained high throughout the sleep episode and across all circadian phases. Conclusions: Previous forced desynchrony studies have demonstrated a strong circadian influence on sleep, in the absence of sleep restriction. The current study suggests that in the presence of high homeostatic pressure, the circadian modulation of sleep, in particular sleep efficiency and to a lesser extent, REM sleep, are reduced. Citation: Paech GM; Ferguson SA; Sargent C; Kennaway DJ; Roach GD. The relative contributions of the homeostatic and circadian processes to sleep regulation under conditions of severe sleep restriction. SLEEP 2012;35(7):941-948. PMID:22754040

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

PubMed

Bates, C J; McDonald, J P

2006-01-28

To determine in detail the complications associated with the use of mandibular repositioning splints (MRS) to treat sleep-related breathing disorders. 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. 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. 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.

Are disease severity, sleep-related problems, and anxiety associated with work functioning in patients with obstructive sleep apnoea?

PubMed

Timkova, Vladimira; Nagyova, Iveta; Reijneveld, Sijmen A; Tkacova, Ruzena; van Dijk, Jitse P; Bültmann, Ute

2018-04-17

To examine whether Obstructive Sleep Apnoea severity, sleep-related problems, and anxiety are associated with work functioning in Obstructive Sleep Apnoea patients, when controlled for age, gender and type of occupation. To investigate whether anxiety moderates the associations between sleep-related problems and work functioning. We included 105 Obstructive Sleep Apnoea patients (70% male; mean age 46.62 ± 9.79 years). All patients completed the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Beck Anxiety Inventory, and the Work Role Functioning Questionnaire-2.0. Obstructive Sleep Apnoea-severity, poor nighttime sleep quality, and anxiety were univariately associated with impaired work functioning. Multivariate analyzes revealed that poor perceived sleep quality was more strongly associated with work functioning than sleep efficiency and daily disturbances. Anxiety was strongly associated with impaired work functioning. After adding anxiety, the explained variance in work functioning increased from 20% to 25%. Anxiety moderated the association between low and medium levels of nighttime sleep quality problems and work functioning. Poor perceived sleep quality and anxiety were strongly associated with impaired work functioning in Obstructive Sleep Apnoea patients. These findings may help to optimize management, standard treatment, and work functioning in people with Obstructive Sleep Apnoea when confirmed in longitudinal studies. Implications for Rehabilitation Studies show an impairment of functional status, including work functioning, in obstructive sleep apnea patients. Aside from physical disorders, obstructive sleep apnea patients often experience mental problems, such as anxiety. As many people with obstructive sleep apnea are undiagnosed, our results demonstrate to employers and healthcare professionals the need to encourage patients for obstructive sleep apnea screening, especially in the situation of impaired work functioning

'Il Sonnambulo' by Michele Carafa: A Forgotten Romantic Opera with Sleepwalking.

PubMed

Riva, Michele Augusto; Mazzocchi, Caterina; Cesana, Giancarlo; Finger, Stanley

2016-01-01

Romantic operas provide a useful tool for historians to understand the perception of some medical disorders that existed during the nineteenth century. Somnambulism was still a mysterious condition during this time, since its pathogenesis was unknown. Hence, it comes as no surprise that somnambulism features in a number of operas, the best known of which are Verdi's 'Macbeth' and Bellini's 'La Sonnambula', both the subject of recent scholarship. Here we examine a more obscure opera in which sleepwalking is depicted. Dating from 1824, 'Il Sonnambulo' by the Italian composer Michele Carafa is based on a libretto by Felice Romani. Although it shares some features with the Verdi and Bellini operas, it also presents original elements. Our analysis of this forgotten opera supports the contention that studying operas can shed light on medical theories and practices, and on how ideas about mind and body disorders were transmitted to the laity in times past. © 2016 S. Karger AG, Basel.

Sleeping difficulties and health-related quality of life in Parkinson's disease.

PubMed

Ylikoski, A; Martikainen, K; Sieminski, M; Partinen, M

2017-04-01

Various sleep-related symptoms occur in Parkinson's disease (PD). Their occurrence with health-related quality of life (HRQL), comorbid sleep disorders, and other comorbidities was studied. Altogether, 1447 randomly selected patients with Parkinson's disease, aged 43-89 years, participated in a questionnaire study. A structured questionnaire with 207 items was based on the Basic Nordic Sleep Questionnaire. Questions on demographics, PD, sleep disorders, and comorbidities were included. The response rate was 59.0%, and of these, 80% had answered to all questions that were used in the analyses (N=684). Occurrence of long sleep was found in 26.2% of the subjects, short sleep in 32.5%, poor sleep in 21.2%, sleep deprivation in 33.8%, disrupted sleep in 47.4%, and difficulties to fall asleep in 12.2%, respectively. Poor self-rated health and poor quality of life occurred in 44.4% and in 43.3% of all participants. In the logistic regression, age and gender differentially predicted long sleep and sleep deprivation, such that older age and being male were positively associated with long sleep but negatively associated with the report of sleep deprivation. Depression, subjective negative stress, and fatigue occurred with long sleep. On the other hand, poor sleep and excessive daytime sleepiness occurred with short sleep and sleep deprivation. The sleep difficulties in PD are frequent. The long sleeping patients have depression, stress, and fatigue. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Housing influences among sleep-related infant injury deaths in the USA.

PubMed

Chu, Tracy; Hackett, Martine; Kaur, Navpreet

2016-06-01

This article examines the role of housing conditions in sleep-related infant injury death, a leading cause of infant mortality in the USA. The use of an unsafe sleep surface is a major risk factor for sleep-related infant injury. This exploratory study examined contextual circumstances, specifically those related to the physical environment, which may contribute to caregivers' decisions to place an infant on an unsafe sleep surface. It employed a retrospective review of 255 sleep-related infant injury death cases in a large urban area from 2004 to 2010 where an infant was found sleeping on an unsafe sleep surface, including 122 cases where a crib or bassinet was identified in the home. Quantitative findings indicated no differences in demographic or risk characteristics between infants with cribs or bassinets and those without them. Qualitative findings suggested the lack of crib or bassinet use may be related to environmental factors influenced by poverty, specifically crowded living space, room temperature and vermin infestation. This study suggests that infants may be at risk of sleep-related injury deaths even when a crib or bassinet is present in the home and supports the consideration of housing conditions in health promotion efforts to reduce infant mortality. Understanding environmental factors that may contribute to infants sleeping on an unsafe surface can help maternal child health and public health professionals develop more appropriate interventions that address deleterious living conditions. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Sleep disturbance relates to neuropsychological functioning in late-life depression.

PubMed

Naismith, Sharon L; Rogers, Naomi L; Lewis, Simon J G; Terpening, Zoë; Ip, Tony; Diamond, Keri; Norrie, Louisa; Hickie, Ian B

2011-07-01

Sleep-wake disturbance in older people is a risk factor for depression onset and recurrence. The aim of this study was to determine if objective sleep-wake disturbance in late-life depression relates to neuropsychological functioning. Forty-four older patients with a lifetime history of major depression and 22 control participants underwent psychiatric, medical and neuropsychological assessments. Participants completed self-report sleep measures, sleep diaries and wore wrist actigraphy for two weeks. Outcome measures included sleep latency, the number and duration of nocturnal awakenings and the overall sleep efficiency. Patients with depression had a greater duration of nocturnal awakenings and poorer sleep efficiency, in comparison to control participants. Sleep disturbance in patients was associated with greater depression severity and later ages of depression onset. It also related to poorer psychomotor speed, poorer verbal and visual learning, poorer semantic fluency as well as poorer performance on tests of executive functioning. These relationships largely remained significant after controlling for depression and estimated apnoea severity. This sample had only mild levels of depression severity and results require replication in patients with moderate to severe depression. The inclusion of polysomnography and circadian markers would be useful to delineate the specific features of sleep-wake disturbance that are critical to cognitive performance. Sleep-wake disturbance in older patients with depression is related to neuropsychological functioning and to later ages of illness onset. This study suggests that common neurobiological changes may underpin these disease features, which may, in turn, warrant early identification and management. Copyright © 2011 Elsevier B.V. All rights reserved.

[Prevalence of sleep-related breathing disorders of inpatients with psychiatric disorders].

PubMed

Behr, M; Acker, J; Cohrs, S; Deuschle, M; Danker-Hopfe, H; Göder, R; Norra, C; Richter, K; Riemann, D; Schilling, C; Weeß, H-G; Wetter, T C; Wollenburg, L M; Pollmächer, T

2018-06-06

Sleep-related breathing disorders seriously impair well-being and increase the risk for relevant somatic and psychiatric disorders. Moreover, risk factors for sleep-related breathing disorders are highly prevalent in psychiatric patients. The aim of this study was for the first time in Germany to study the prevalence of obstructive sleep apnea syndrome (OSAS) as the most common form of sleep-related breathing disorder in patients with psychiatric disorders. In 10 psychiatric hospitals in Germany and 1 hospital in Switzerland, a total of 249 inpatients underwent an 8‑channel sleep polygraphy to investigate the prevalence of sleep apnea in this group of patients. With a conspicuous screening result of 23.7% of the subjects, a high prevalence of sleep-related breathing disorders was found to occur among this group of patients. Male gender, higher age and high body mass index (BMI) were identified as positive risk factors for the detection of OSAS. The high prevalence indicates that sleep apnea is a common sleep disorder among psychiatric patients. Although OSAS can lead to substantial disorders of the mental state and when untreated is accompanied by serious somatic health problems, screening procedures are not part of the routine work-up in psychiatric hospitals; therefore, sleep apnea is presumably underdiagnosed in psychiatric patients. In view of the results of this and previous studies, this topic complex should be the subject of further research studies.

Trait- and pre-sleep-state-dependent arousal in insomnia disorders: what role may sleep reactivity and sleep-related metacognitions play? A pilot study.

PubMed

Palagini, Laura; Mauri, Mauro; Dell'Osso, Liliana; Riemann, Dieter; Drake, Christopher L

2016-09-01

Research into the cause of chronic insomnia has identified hyperarousal as a key factor, which is likely to have both trait and state components. Sleep-related cognition, metacognition, and sleep reactivity also play an important role in insomnia. Our aim was to investigate how these insomnia-related constructs are associated with trait predisposition and pre-sleep arousal in subjects with an insomnia disorder. Fifty-three individuals with insomnia disorder (according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (F = 33; 52 + 10)) and 30 healthy controls (F = 18; 51.8 + 12 years) were evaluated with a set of questionnaires, including the Ford Insomnia Response to Stress Test (FIRST), Metacognition Questionnaire - Insomnia (MCQI), Arousal Predisposition Scale (APS), and Pre-sleep Arousal Scale (PSAS). Statistical analyses included multiple regression to elucidate the independent determinants of APS and PSAS. Participants with insomnia presented higher FIRST, MCQI, APS, PSAS scores (p-values <0.001) than healthy controls. In insomnia, APS and cognitive PSAS were best determined by MCQI (respectively, B = 0.09, p = 0.001, B = 0.08, p = 0.02), somatic PSAS by cognitive arousal (PSAS B = 0.35, p = 0.004) CONCLUSIONS: This study suggests that in insomnia disorders, trait predisposition toward hyperarousal and pre-sleep-cognitive-state-dependent arousal may be closely related to sleep-related metacognitive processes. Sleep-related metacognitive processes may be associated with trait hyperarousal within the framework of a mutual relationship, and could, in turn, modulate cognitive pre-sleep-state arousal. A broad range of cognitive and metacognitive processes should be considered when dealing with subjects with insomnia. Copyright © 2016 Elsevier B.V. All rights reserved.

Immigration transition and sleep-related symptoms experienced during menopausal transition

PubMed Central

Im, Eun-Ok; Ko, Young; Chee, Eunice; Chee, Wonshik

2018-01-01

The transition due to immigration from one country to another country (referred to as immigration transition henceforth) is inherently stressful, placing an additional dimension of stress to midlife women in the menopausal transition. However, few studies have examined the association of immigration to sleep-related symptoms experienced by midlife women in the menopausal transition. The purpose of this study was to explore the associations of immigration to sleep-related symptoms among four major racial/ethnic groups of 1,054 midlife women in the U.S. This was a secondary analysis of data from two national surveys that were collected from 2005 to 2013. The instruments included questions on background characteristics, health and menopausal status, immigration transition and the Sleep Index for Midlife Women. The data were analyzed using t-tests, chi-square tests, correlation analyses, and hierarchical multiple regression analyses. Immigrants reported fewer total numbers of and lower total severity scores of sleep-related symptoms than non-immigrants (p < .01). Yet, when background characteristics and health and menopausal status were controlled, self-reported racial/ethnic identity was the only significant factor associated with sleep-related symptoms (Δ R2=0.02, p<0.01). Health care providers need to consider self-reported racial/ethnic identity as a factor significantly related to sleep-related symptoms during the menopausal transition. PMID:26881786

Immigration transition and sleep-related symptoms experienced during menopausal transition.

PubMed

Im, Eun-Ok; Ko, Young; Chee, Eunice; Chee, Wonshik

2017-01-01

The transition due to immigration from one country to another country (referred to as immigration transition henceforth) is inherently stressful, placing an additional dimension of stress to midlife women in the menopausal transition. However, few studies have examined the association of immigration to sleep-related symptoms experienced by midlife women in the menopausal transition. The authors' purpose for this study was to explore the associations of immigration to sleep-related symptoms among four major racial/ethnic groups of 1,054 midlife women in the United States. This was a secondary analysis of data from two national surveys that were collected from 2005 to 2013. The instruments included questions on background characteristics, health and menopausal status, immigration transition, and the Sleep Index for Midlife Women. The data were analyzed using t-tests, chi-square tests, correlation analyses, and hierarchical multiple regression analyses. Immigrants reported fewer total numbers of and lower total severity scores of sleep-related symptoms than non-immigrants (p < .01). Yet, when background characteristics and health and menopausal status were controlled, self-reported racial/ethnic identity was the only significant factor associated with sleep-related symptoms (ΔR 2  = 0.02, p < .01). Health-care providers need to consider self-reported racial/ethnic identity as a factor significantly related to sleep-related symptoms during the menopausal transition.

Ultradian rhythms in pituitary and adrenal hormones: their relations to sleep.

PubMed

Gronfier, C; Brandenberger, G

1998-02-01

Sleep and circadian rhythmicity both influence the 24-h profiles of the main pituitary and adrenal hormones. From studies using experimental strategies including complete and partial sleep deprivation, acute and chronic shifts in the sleep period, or complete sleep-wake reversal as occurs with transmeridian travel or shift-work, it appears that prolactin (PRL) and growth hormone (GH) profiles are mainly sleep related, while cortisol profile is mainly controlled by the circadian clock with a weak influence of sleep processes. Thyrotropin (TSH) profile is under the dual influence of sleep and circadian rhythmicity. Recent studies, in which we used spectral analysis of sleep electroencephalogram (EEG) rather than visual scoring of sleep stages, have evaluated the temporal associations between pulsatile hormonal release and the variations in sleep EEG activity. Pulses in PRL and in GH are positively linked to increases in delta wave activity, whereas TSH and cortisol pulses are related to decreases in delta wave activity. It is yet not clear whether sleep influences endocrine secretion, or conversely, whether hormone secretion affects sleep structure. These well-defined relationships raise the question of their physiological significance and of their clinical implications.

Sleep-Related Behaviors and Beliefs Associated With Race/Ethnicity in Women

PubMed Central

Grandner, Michael A.; Patel, Nirav P.; Jean-Louis, Girardin; Jackson, Nicholas; Gehrman, Philip R.; Perlis, Michael L.; Gooneratne, Nalaka S.

2013-01-01

Explore how social factors influence sleep, especially sleep-related beliefs and behaviors. Sleep complaints, sleep hygiene behaviors, and beliefs about sleep were studied in 65 black/African American and white/European American women. Differences were found for snoring and discrepancy between sleep duration and need. Sleep behaviors differed across groups for napping, methods for coping with sleep difficulties, and nonsleep behaviors in bed. Beliefs also distinguished groups, with differences in motivation for sleep and beliefs about sleep being important for health and functioning. These findings have important public health implications in terms of developing effective sleep education interventions that include consideration of cultural aspects. PMID:23862291

Nighttime Parenting Strategies and Sleep-Related Risks to Infants

PubMed Central

Volpe, Lane E.; Ball, Helen L.; McKenna, James J.

2012-01-01

A large social science and public health literature addresses infant sleep safety, with implications for infant mortality in the context of accidental deaths and Sudden Infant Death Syndrome (SIDS). As part of risk reduction campaigns in the USA, parents are encouraged to place infants supine and to alter infant bedding and elements of the sleep environment, and are discouraged from allowing infants to sleep unsupervised, from bed-sharing either at all or under specific circumstances, or from sofa-sharing. These recommendations are based on findings from large-scale epidemiological studies that generate odds ratios or relative risk statistics for various practices; however, detailed behavioural data on nighttime parenting and infant sleep environments are limited. To address this issue, this paper presents and discusses the implications of four case studies based on overnight observations conducted with first-time mothers and their four-month old infants. These case studies were collected at the Mother-Baby Behavioral Sleep Lab at the University of Notre Dame USA between September 2002 and June 2004.Each case study provides a detailed description based on video analysis of sleep-related risks observed while mother-infant dyads spent the night in a sleep lab. The case studies provide examples of mothers engaged in the strategic management of nighttime parenting for whom sleep-related risks to infants arose as a result of these strategies. Although risk reduction guidelines focus on eliminating potentially risky infant sleep practices as if the probability of death from each were equal, the majority of instances in which these occur are unlikely to result in infant mortality. Therefore, we hypothesise that mothers assess potential costs and benefits within margins of risk which are not acknowledged by risk-reduction campaigns. Exploring why mothers might choose to manage sleep and nighttime parenting in ways that appear to increase potential risks to infants may help

Nighttime parenting strategies and sleep-related risks to infants.

PubMed

Volpe, Lane E; Ball, Helen L; McKenna, James J

2013-02-01

A large social science and public health literature addresses infant sleep safety, with implications for infant mortality in the context of accidental deaths and Sudden Infant Death Syndrome (SIDS). As part of risk reduction campaigns in the USA, parents are encouraged to place infants supine and to alter infant bedding and elements of the sleep environment, and are discouraged from allowing infants to sleep unsupervised, from bed-sharing either at all or under specific circumstances, or from sofa-sharing. These recommendations are based on findings from large-scale epidemiological studies that generate odds ratios or relative risk statistics for various practices; however, detailed behavioural data on nighttime parenting and infant sleep environments are limited. To address this issue, this paper presents and discusses the implications of four case studies based on overnight observations conducted with first-time mothers and their four-month old infants. These case studies were collected at the Mother-Baby Behavioral Sleep Lab at the University of Notre Dame USA between September 2002 and June 2004. Each case study provides a detailed description based on video analysis of sleep-related risks observed while mother-infant dyads spent the night in a sleep lab. The case studies provide examples of mothers engaged in the strategic management of nighttime parenting for whom sleep-related risks to infants arose as a result of these strategies. Although risk reduction guidelines focus on eliminating potentially risky infant sleep practices as if the probability of death from each were equal, the majority of instances in which these occur are unlikely to result in infant mortality. Therefore, we hypothesise that mothers assess potential costs and benefits within margins of risk which are not acknowledged by risk-reduction campaigns. Exploring why mothers might choose to manage sleep and nighttime parenting in ways that appear to increase potential risks to infants may

Aripiprazole-induced sleep-related eating disorder: a case report.

PubMed

Kobayashi, Nobuyuki; Takano, Masahiro

2018-04-05

Sleep-related eating disorder is characterized by parasomnia with recurrent episodes of nocturnal eating or drinking during the main sleep period. Several drugs, including atypical antipsychotics, induce sleep-related eating disorder. However, aripiprazole has not previously been associated with sleep-related eating disorder. A 41-year-old Japanese man visited our clinic complaining of depression. The patient was treated with sertraline, which was titrated up to 100 mg for 4 weeks. A sleep inducer and an anxiolytic were coadministered. His depressive mood slightly improved, but it continued for an additional 4 months. Subsequently, aripiprazole (3 mg) was added as an adjunctive therapy. After 3 weeks, the patient's mother found that the patient woke up and ate food at night. The next morning, the patient was amnesic for this event, felt full, and wondered why the bags of food were empty. This episode lasted for 2 days. The patient gained 5 kg during these 3 weeks. After the aripiprazole dose was reduced to 1.5 mg, the patient's nocturnal eating episodes rapidly and completely disappeared. To the best of our knowledge, this is first report of sleep-related eating disorder induced by aripiprazole, and it indicates that this disorder should be considered a possible side effect of aripiprazole. Although aripiprazole is used mainly in patients with schizophrenia, its recently documented use as an adjunctive therapy in patients with depression might induce hitherto unknown side effects.

[Complex injuries associated with somnambulism].

PubMed

Sillesen, Nanna Hylleholt; Nielsen, Lisa Toft; Bonde, Christian

2010-12-13

Up to 3% of adults walk in their sleep and some perform complex behaviours. Treatment recommendations for sleepwalking are inconsistent. This case report describes a 64-year-old man who climbed out of a 2nd floor toilet window during somnambulism. He fell 6-8 meters and fractured the tibia, fibula, cervical columna, lumbal columna, calcaneus, costae and suffered a pneumothorax. Evidence to support sleepwalking treatment is lacking and besides benzodiazepines, prevention is the preferred treatment choice according to the literature.

The influence of personality and dysfunctional sleep-related cognitions on the severity of insomnia.

PubMed

Park, Jang Ho; An, Hoyoung; Jang, Eun Sook; Chung, Seockhoon

2012-05-30

Previous findings suggest that personality traits and dysfunctional sleep-related cognitions may perpetuate insomnia, but findings concerning this have been scarce. Thus, we hypothesized that personality and sleep-related cognitions influence the severity of insomnia, and investigated the association personality and sleep-related cognitions had with various sleep-related parameters, including severity of insomnia. Forty-four patients with psychophysiological insomnia were assessed using The Temperament and Character Inventory, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Dysfunctional Belief and Attitudes toward Sleep Scale, the Pre-Sleep Arousal Scale and the Hospital Anxiety and Depression Scale. Insomnia severity was significantly and positively correlated with harm avoidance, self-transcendence and sleep-related cognitions, and negatively correlated with novelty seeking, reward dependence, and cooperativeness. Dysfunctional sleep-related cognitions were positively correlated with insomnia severity and sleep quality. Stepwise multiple regression analysis showed that sleep-related cognitions, depression and reward dependence scores were significant determinants of insomnia severity, and that sleep-related cognitions and self-transcendence were significant positive determinants of sleep quality. Reward dependence, depression and sleep-related cognitions were associated with insomnia severity, and comparison with previous findings implied that 'internalizing behavior' and depression may be more plausible candidates for the link between personality and insomnia than anxiety. Considering the major role of cognitive-behavioral treatment (CBT) in the treatment of insomnia, assessment of these factors and management of sleep-related cognitions may help alleviate symptoms in patients with insomnia. Copyright © 2011 Elsevier Ltd. All rights reserved.

Sleep-obesity relation: underlying mechanisms and consequences for treatment.

PubMed

St-Onge, M-P

2017-02-01

Short sleep duration has been associated with obesity in numerous epidemiological studies. However, such association studies cannot establish evidence of causality. Clinical intervention studies, on the other hand, can provide information on a causal effect of sleep duration on markers of weight gain: energy intake and energy expenditure. Herein is an overview of the science related to the impact of sleep restriction, in the context of clinical intervention studies, on energy intake, energy expenditure and body weight. Additionally, studies that evaluate the impact of sleep restriction on weight loss and the impact of sleep extension on appetite are discussed. Information to date suggests that weight management is hindered when attempted in the context of sleep restriction, and the public should be made aware of the negative consequences of sleep restriction for weight regulation. © 2017 World Obesity Federation.

Sleep duration and sleep quality in relation to 12-year cardiovascular disease incidence: the MORGEN study.

PubMed

Hoevenaar-Blom, Marieke P; Spijkerman, Annemieke M W; Kromhout, Daan; van den Berg, Julia F; Verschuren, W M Monique

2011-11-01

We studied sleep duration and sleep quality in relation to cardiovascular disease (CVD) incidence. Dutch population-based cohort study. 20,432 men and women aged 20-65 and with no history of CVD. N/A. Sleep duration and sleep quality were assessed by a self-administered questionnaire. Morbidity data, vital status, and causes of death were obtained through linkage with several national registries. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using Cox proportional hazards models. During 10-15 years of follow-up, 1,486 CVD and 1,148 coronary heart disease (CHD) events occurred. Short sleepers (≤ 6 h) had a 15% higher risk of total CVD (HR: 1.15; 95%CI: 1.00-1.32) and a 23% higher risk of CHD (HR: 1.23 [1.04-1.45]) compared to normal sleepers (7 h) after adjustment for all confounders. Additional adjustment for intermediate biological risk factors attenuated these relative risks to 1.11 (0.97-1.27) for total CVD and to 1.19 (1.00-1.40) for CHD. Short sleepers with poor sleep quality had a 63% higher risk of CVD (HR: 1.63 [1.21-2.19]) and a 79% higher risk of CHD incidence (HR: 1.79 [1.24-2.58]) compared to normal sleepers with good sleep quality, after adjustments for all confounders. We observed no associations between long sleep duration (≥ 9 h) and CVD or CHD incidence. Short sleepers, especially those with poor sleep quality, have an increased risk of total CVD and CHD incidence. Future investigations should not only focus on sleep duration, but should also take sleep quality into account.

Stress-related sleep vulnerability and maladaptive sleep beliefs predict insomnia at long-term follow-up.

PubMed

Yang, Chien-Ming; Hung, Chih-Ying; Lee, Hsin-Chien

2014-09-15

Vulnerability to stress-related sleep disturbances and maladaptive sleep beliefs has been proposed to be predisposing factors for insomnia. Yet previous studies addressing these factors have been cross-sectional in nature and could not be used to infer the time sequences of the association. The current study used a six-year follow-up to examine the predisposing roles of these two factors and their interactions with major life stressors in the development of insomnia. One hundred seventeen college students recruited for a survey in 2006 participated in this follow-up survey in 2012. In 2006, they completed a packet of questionnaires including the Dysfunctional Beliefs and Attitudes about Sleep Questionnaire, 10-item version (DBAS-10), the Ford Insomnia Response to Stress Test (FIRST), and the Pittsburgh Sleep Quality Index (PSQI); in 2012 they completed the Insomnia Severity Index (ISI) and the modified Life Experiences Survey (LES). Fourteen of the participants were found to suffer from insomnia as measured by the ISI. Logistic regression showed that scores on both DBAS-10 and FIRST could predict insomnia at follow-up. When the interaction of DBAS-10 and LES and that of FIRST and LES were added, both DBAS-10 and FIRST remained significant predictors, while the interaction of FIRST and LES showed a near-significant trend in predicting insomnia. The results showed that both vulnerability to stress-related sleep disturbances and maladaptive sleep beliefs are predisposing factors for insomnia. The hypothesized interaction effect between sleep vulnerability and major life stressors was found to be marginal. The maladaptive sleep beliefs, on the other hand, showed a predisposing effect independent from the influences of negative life events. © 2014 American Academy of Sleep Medicine.

[Relations between problems on sleeping and suicidal behaviors in middle school students].

PubMed

Chen, Jing; Wan, Yuhui; Sun, Ying; Tao, Fangbiao

2014-02-01

To understand the epidemiological characteristics and possible associations between sleeping problems and suicidal behaviors among middle school students. A total of 13 817 middle school students were selected in Shenyang,Xinxiang, Chongqing and Guangzhou cities and cluster sampling method was used. Questionnaires would include information on demographics, quality of sleep, psychopathological status and suicidal behaviors. Pittsburgh Sleep Quality index (PSQI) and Adolescent Multidimensional Sub-health Questionnaire (MSQA) were used to assess the quality of sleep and psychosomatic symptoms, respectively. Rates on sleeping problems and suicidal behaviors were compared in students with specific characteristics. Effects related to sleeping problems and suicidal behaviors were analyzed, using the multivariate logistic regression model. The overall prevalence of problems related to sleeping among middle school students was 26.5%. 28.2% of the girls and 35.2% of senior students reported as having more sleeping problems. Rates on suicide related ideation, planning and attempts were 16.6%, 9.6% and 4.7% , respectively. Girls reported more suicide ideation than boys. However, no gender differences were found in suicide planning or attempted suicide. It also suggested that the incidence of the suicidal behavior among students with sleeping problems was significantly higher than students without sleeping problems. Data from Multivariable logistic regression analysis showed that sleeping problems appeared as independent risk factors on suicidal behavior. Higher PSQI scores seemed coincide with the increased risk of suicidal behaviors. Students having sleeping time less than 5 hours per day showed higher risk of suicidal behaviors. Problems on sleeping seemed a strong risk factor for suicidal behaviors among middle school students. Improvement on the quality of sleep and reasonable arrangement of sleeping time could help prevent related suicidal behaviors among middle school

Maternal Sleep-Related Cognitions and Infant Sleep: A Longitudinal Study from Pregnancy through the 1st Year

ERIC Educational Resources Information Center

Tikotzky, Liat; Sadeh, Avi

2009-01-01

Infant sleep is a major source of concern for many parents. The aims of this longitudinal study were to assess: (a) the development of sleep patterns among infants, (b) the development of maternal cognitions regarding infant sleep, and (c) the relations between these domains during the 1st year of life. Eighty-five mothers were recruited during…

Presence and persistence of sleep-related symptoms and suicidal ideation in psychiatric inpatients.

PubMed

Nadorff, Michael R; Ellis, Thomas E; Allen, Jon G; Winer, E Samuel; Herrera, Steve

2014-01-01

Although sleep is an important risk factor for suicidal behavior, research has yet to examine the association between sleep problems and suicidality across the course of inpatient treatment. This study examined the relationship among sleep-related symptoms and suicidal ideation across inpatient treatment. To examine whether poor sleep at admission longitudinally predicts less improvement in suicidal ideation over the course of treatment. Further, to examine whether suicidal ideation is reduced in patients whose sleep does not improve. The study utilized the Beck Depression Inventory (BDI)-II, which contains items measuring depressive symptoms, sleep-related symptoms, and suicidal ideation. The study sample consisted of 1,529 adult psychiatric inpatients. Patients were assessed at admission, biweekly, and at treatment termination. Admission fatigue, loss of energy, and change in sleep pattern were associated with higher levels of suicidal ideation at admission and discharge. Fatigue at admission predicted suicidal ideation at termination independent of admission depression and suicidal ideation. Individuals whose sleep did not improve over the course of treatment had significantly higher suicidal ideation scores at termination relative to those whose sleep symptoms improved, after controlling for sleep, depression, and suicidal ideation scores at admission. These findings suggest that persistence of sleep-related symptoms warrants clinical attention in the treatment of suicidal patients.

Longitudinal Relations Between Constructive and Destructive Conflict and Couples’ Sleep

PubMed Central

El-Sheikh, Mona; Koss, Kalsea J.; Kelly, Ryan J.; Rauer, Amy J.

2016-01-01

We examined longitudinal relations between interpartner constructive (negotiation) and destructive (psychological and physical aggression) conflict strategies and couples’ sleep over 1 year. Toward explicating processes of effects, we assessed the intervening role of internalizing symptoms in associations between conflict tactics and couples’ sleep. Participants were 135 cohabiting couples (M age = 37 years for women and 39 years for men). The sample included a large representation of couples exposed to economic adversity. Further, 68% were European American and the remainder were primarily African American. At Time 1 (T1), couples reported on their conflict and their mental health (depression, anxiety). At T1 and Time 2, sleep was examined objectively with actigraphs for 7 nights. Three sleep parameters were derived: efficiency, minutes, and latency. Actor–partner interdependence models indicated that husbands’ use of constructive conflict forecasted increases in their own sleep efficiency as well as their own and their wives’ sleep duration over time. Actor and partner effects emerged, and husbands’ and wives’ use of destructive conflict strategies generally predicted worsening of some sleep parameters over time. Several mediation and intervening effects were observed for destructive conflict strategies. Some of these relations reveal that destructive conflict is associated with internalizing symptoms, which in turn are associated with some sleep parameters longitudinally. These findings build on a small, albeit growing, literature linking sleep with marital functioning, and illustrate that consideration of relationship processes including constructive conflict holds promise for gaining a better understanding of factors that influence the sleep of men and women. PMID:25915089

Longitudinal relations between constructive and destructive conflict and couples' sleep.

PubMed

El-Sheikh, Mona; Kelly, Ryan J; Koss, Kalsea J; Rauer, Amy J

2015-06-01

We examined longitudinal relations between interpartner constructive (negotiation) and destructive (psychological and physical aggression) conflict strategies and couples' sleep over 1 year. Toward explicating processes of effects, we assessed the intervening role of internalizing symptoms in associations between conflict tactics and couples' sleep. Participants were 135 cohabiting couples (M age = 37 years for women and 39 years for men). The sample included a large representation of couples exposed to economic adversity. Further, 68% were European American and the remainder were primarily African American. At Time 1 (T1), couples reported on their conflict and their mental health (depression, anxiety). At T1 and Time 2, sleep was examined objectively with actigraphs for 7 nights. Three sleep parameters were derived: efficiency, minutes, and latency. Actor-partner interdependence models indicated that husbands' use of constructive conflict forecasted increases in their own sleep efficiency as well as their own and their wives' sleep duration over time. Actor and partner effects emerged, and husbands' and wives' use of destructive conflict strategies generally predicted worsening of some sleep parameters over time. Several mediation and intervening effects were observed for destructive conflict strategies. Some of these relations reveal that destructive conflict is associated with internalizing symptoms, which in turn are associated with some sleep parameters longitudinally. These findings build on a small, albeit growing, literature linking sleep with marital functioning, and illustrate that consideration of relationship processes including constructive conflict holds promise for gaining a better understanding of factors that influence the sleep of men and women. (c) 2015 APA, all rights reserved).

The relationship between complaints of night-time heartburn and sleep-related gastroesophageal reflux.

PubMed

Orr, W C; Goodrich, S; Estep, M E; Shepherd, K

2014-01-01

This study investigated whether the complaint of night-time heartburn (NHB) as opposed to daytime heartburn (DHB) is a reliable reflection of actual sleep-related reflux events. Three groups of individuals were studied: individuals with complaints of NHB at least twice per week (n = 24), individuals with complaints of DHB (n = 23), and normal participants without any complaints of regular heartburn during the day or night (n = 25). All three groups were studied on one occasion with combined pH monitoring and polysomnography, and subjective questionnaires about sleep disturbance and sleep quality were given to all participants. The NHB group had significantly more sleep-related reflux events compared with both DHB and control groups (P < 0.01). DHB subjects had significantly (P < 0.05) more sleep-related reflux events than normal controls. Total acid contact time (ACT) was significantly (P < 0.05) elevated in the NHB group compared with both the DHB and control group. Sleep-related ACT was also significantly (P < 0.05) elevated in the NHB group compared with the other two groups, while upright (daytime) ACT was not significantly different. The NHB group was significantly (P < 0.05) worse regarding measures of both objective and subjective sleep quality. Subjects with exclusively DHB do have sleep-related reflux that is greater than normal controls. Subjects with NHB have significantly more sleep-related reflux, and both objective and subjective sleep abnormalities compared with normal controls. Complaints of NHB reflect sleep-related reflux events and may be indicative of a more clinically significant condition. © 2013 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

Lowered Insulin Signalling Ameliorates Age-Related Sleep Fragmentation in Drosophila

PubMed Central

Hendrich, Oliver; Hinze, Yvonne; Birras, Ulrike; Partridge, Linda

2014-01-01

Sleep fragmentation, particularly reduced and interrupted night sleep, impairs the quality of life of older people. Strikingly similar declines in sleep quality are seen during ageing in laboratory animals, including the fruit fly Drosophila. We investigated whether reduced activity of the nutrient- and stress-sensing insulin/insulin-like growth factor (IIS)/TOR signalling network, which ameliorates ageing in diverse organisms, could rescue the sleep fragmentation of ageing Drosophila. Lowered IIS/TOR network activity improved sleep quality, with increased night sleep and day activity and reduced sleep fragmentation. Reduced TOR activity, even when started for the first time late in life, improved sleep quality. The effects of reduced IIS/TOR network activity on day and night phenotypes were mediated through distinct mechanisms: Day activity was induced by adipokinetic hormone, dFOXO, and enhanced octopaminergic signalling. In contrast, night sleep duration and consolidation were dependent on reduced S6K and dopaminergic signalling. Our findings highlight the importance of different IIS/TOR components as potential therapeutic targets for pharmacological treatment of age-related sleep fragmentation in humans. PMID:24690889

Anxiety Sensitivity and Sleep-Related Problems in Anxious Youth

PubMed Central

Weiner, Courtney L.; Elkins, Meredith; Pincus, Donna; Comer, Jonathan

2015-01-01

Anxiety disorders constitute the most common mental health disturbance experienced by youth. Sleep-related problems (SRPs) are highly prevalent among anxious youth and encompass a variety of problems including nighttime fears, insomnia, and refusal to sleep alone. Given that chronic sleep disturbance is associated with a range of behavioral and physical problems in youth and predicts future psychopathology, it is important to elucidate the nature of SRPs in anxious youth. The present study investigated the relationship between sleep problems and anxiety sensitivity in a sample of 101 anxious youth, ages 6–17. Heightened anxiety sensitivity significantly predicted prolonged sleep onset latency across the sample, even after accounting for severity of anxiety, depression, and age. Results support previous research indicating that SRPs are common among anxious youth and suggest that anxiety sensitivity may play a particularly important role in sleep onset latency. PMID:25863826

Sleep Duration and Age-Related Changes in Brain Structure and Cognitive Performance

PubMed Central

Lo, June C.; Loh, Kep Kee; Zheng, Hui; Sim, Sam K.Y.; Chee, Michael W.L.

2014-01-01

Study Objectives: To investigate the contribution of sleep duration and quality to age-related changes in brain structure and cognitive performance in relatively healthy older adults. Design: Community-based longitudinal brain and cognitive aging study using a convenience sample. Setting: Participants were studied in a research laboratory. Participants: Relatively healthy adults aged 55 y and older at study commencement. Interventions: N/A. Measurements and Results: Participants underwent magnetic resonance imaging and neuropsychological assessment every 2 y. Subjective assessments of sleep duration and quality and blood samples were obtained. Each hour of reduced sleep duration at baseline augmented the annual expansion rate of the ventricles by 0.59% (P = 0.007) and the annual decline rate in global cognitive performance by 0.67% (P = 0.050) in the subsequent 2 y after controlling for the effects of age, sex, education, and body mass index. In contrast, global sleep quality at baseline did not modulate either brain or cognitive aging. High-sensitivity C-reactive protein, a marker of systemic inflammation, showed no correlation with baseline sleep duration, brain structure, or cognitive performance. Conclusions: In healthy older adults, short sleep duration is associated with greater age-related brain atrophy and cognitive decline. These associations are not associated with elevated inflammatory responses among short sleepers. Citation: Lo JC, Loh KK, Zheng H, Sim SK, Chee MW. Sleep duration and age-related changes in brain structure and cognitive performance. SLEEP 2014;37(7):1171-1178. PMID:25061245

Sleep Spindles and Intellectual Ability: Epiphenomenon or Directly Related?

PubMed

Fang, Zhuo; Sergeeva, Valya; Ray, Laura B; Viczko, Jeremy; Owen, Adrian M; Fogel, Stuart M

2017-01-01

Sleep spindles-short, phasic, oscillatory bursts of activity that characterize non-rapid eye movement sleep-are one of the only electrophysiological oscillations identified as a biological marker of human intelligence (e.g., cognitive abilities commonly assessed using intelligence quotient tests). However, spindles are also important for sleep maintenance and are modulated by circadian factors. Thus, the possibility remains that the relationship between spindles and intelligence quotient may be an epiphenomenon of a putative relationship between good quality sleep and cognitive ability or perhaps modulated by circadian factors such as morningness-eveningness tendencies. We sought to ascertain whether spindles are directly or indirectly related to cognitive abilities using mediation analysis. Here, we show that fast (13.5-16 Hz) parietal but not slow (11-13.5 Hz) frontal spindles in both non-rapid eye movement stage 2 sleep and slow wave sleep are directly related to reasoning abilities (i.e., cognitive abilities that support "fluid intelligence," such as the capacity to identify complex patterns and relationships and the use of logic to solve novel problems) but not verbal abilities (i.e., cognitive abilities that support "crystalized intelligence"; accumulated knowledge and experience) or cognitive abilities that support STM (i.e., the capacity to briefly maintain information in an available state). The relationship between fast spindles and reasoning abilities is independent of the indicators of sleep maintenance and circadian chronotype, thus suggesting that spindles are indeed a biological marker of cognitive abilities and can serve as a window to further explore the physiological and biological substrates that give rise to human intelligence.

The influence of sleep duration and sleep-related symptoms on baseline neurocognitive performance among male and female high school athletes.

PubMed

Sufrinko, Alicia; Johnson, Eric W; Henry, Luke C

2016-05-01

Typically, the effects of sleep duration on cognition are examined in isolation. This study examined the effects of restricted sleep and related symptoms on neurocognitive performance. Baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and postconcussion symptom scale (PCSS) were administered to athletes (N = 7,150) ages 14-17 (M = 15.26, SD = 1.09) prior to sport participation. Three groups of athletes were derived from total sleep duration: sleep restriction (≤5 hours), typical sleep (5.5-8.5 hours), and optimal sleep (≥9 hours). A MANCOVA (age and sex as covariates) was conducted to examine differences across ImPACT/PCSS. Follow-up MANOVA compared ImPACT/PCSS performance among symptomatic (e.g., trouble falling asleep, sleeping less than usual) adolescents from the sleep restriction group (n = 78) with asymptomatic optimal sleepers (n = 99). A dose-response effect of sleep duration on ImPACT performance and PCSS was replicated (Wilk's λ = .98, F2,7145 = 17.25, p < .001, η2 = .01). The symptomatic sleep restricted adolescents (n = 78) had poorer neurocognitive performance: verbal memory, F = 11.60, p = .001, visual memory, F = 6.57, p = .01, visual motor speed, F = 6.19, p = .01, and reaction time (RT), F = 5.21, p = .02, compared to demographically matched controls (n = 99). Girls in the sleep problem group performed worse on RT (p = .024). Examining the combination of sleep-related symptoms and reduced sleep duration effectively identified adolescents at risk for poor neurocognitive performance than sleep duration alone. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Prevalence of Sleep Related Symptoms in Four Latin American Cities

PubMed Central

Bouscoulet, Luis Torre; Vázquez-García, Juan Carlos; Muiño, Adriana; Márquez, Maria; López, Maria Victorina; de Oca, Maria Montes; Talamo, Carlos; Valdivia, Gonzalo; Pertuze, Julio; Menezes, Ana Maria B.; Pérez-Padilla, Rogelio

2008-01-01

Study Objectives: to estimate the prevalence of the most common sleep related symptoms (SRS) in the metropolitan areas of Mexico City, Montevideo (Uruguay), Santiago (Chile), and Caracas (Venezuela). Methods: The study consisted of a multistage cluster sampling of adults aged ≥ 40 years living in metropolitan areas. All participants completed a questionnaire on sleep related symptoms. Simplified respiratory polygraphy during sleep was conducted on 188 subjects from Mexico City. Obstructive sleep apnea syndrome was defined as Epworth Sleepiness Scale score ≥ 11 and respiratory disturbance index (RDI) ≥ 15 events/h; a cut-off of 15 was chosen because of its high sensitivity and specificity in association with the portable monitor used in the study. Results: The study included 4,533 subjects (1,062 in Mexico City, 941 in Montevideo, 1,173 in Santiago, and 1,357 in Caracas). Snoring was reported by 60.2% (95% CI 58.8% to 61.6%), excessive daytime sleepiness by 16.4% (15.3% to 17.5%), observed apneas by 12.3% (11.4% to 13.3%), insomnia by 34.7% (33.3% to 36%), sedative use by 15.1% (14.1% to 16.2%), daytime napping by 29.2% (27.7% to 30.6%), and a combination of snoring, sleepiness, and observed apneas by 3.4% (2.9% to 4%). Men had a higher frequency of snoring and daytime napping, whereas women reported more insomnia and sedative use. Prevalence of OSAS varied from 2.9% among subjects who denied snoring, excessive daytime sleepiness, and observed apneas, to 23.5% among those reporting these 3 symptoms. Conclusions: A high prevalence of sleep related symptoms and undiagnosed obstructive sleep apnea in Latin America was observed. Citation: Bouscoulet LT; Vázquez-García JC; Muiño A; Márquez M; López MV; Montes de Oca M; Talamo C; Valdivia G; Pertuze J; Menezes AMB; Pérez-Padilla R. Prevalence of Sleep Related Symptoms in Four Latin American Cities. J Clin Sleep Med 2008;4(6):579-585. PMID:19110888

Preschooler Sleep Patterns Related to Cognitive and Adaptive Functioning

ERIC Educational Resources Information Center

Keefe-Cooperman, Kathleen; Brady-Amoon, Peggy

2014-01-01

Research Findings: Preschoolers' sleep patterns were examined related to cognitive and adaptive functioning. The sample consisted of 874 typically developing preschool children with a mean age of 40.01 months. Parent/caregiver reports of children's sleep pattern factors, Stanford-Binet 5 intelligence scale scores, and Behavior Assessment System…

How Do Sleep-Related Health Problems Affect Functional Status According to Sex?

PubMed Central

Boccabella, Allegra; Malouf, John

2017-01-01

Study Objectives: To measure differences in functional status between men and women presenting with sleep-related health problems. Methods: A retrospective clinical audit of 744 Australian patients across 7 private general practices between April 2013 and January 2015 was conducted. Patients completed an electronic survey as part of their routine consultation, which included the Epworth Sleepiness Scale (ESS), the Functional Outcomes of Sleep Questionnaire 10 (FOSQ-10), and other questions relating to the effect of their sleep problem. The proportion of males and females with ESS and FOSQ-10 scores associated with disorders of daytime sleepiness and burden of symptoms due to sleepiness, respectively, were compared, as well as reported differences between the sexes in memory, concentration, issues with relationships, feeling depressed, and trouble sleeping. Results: On presentation, females were more likely to have sleeping disorders associated with daytime sleepiness (median ESS score of 9 for females versus 8 for males, P = .038; proportion ESS > 9 was 49.0% for females versus 36.9% for males, P = .003). Women were also more likely to report an increased burden of symptoms due to sleepiness compared to men, as shown by lower FOSQ-10 scores (P < .001). Secondary outcome measures showed that females were more likely to feel excessively tired and depressed, have difficulties with memory and concentration, and have trouble sleeping at night. Snoring kept partners awake in roughly the same proportion of males and females, and a larger proportion of the partners of males were forced out of the room. Conclusions: Sleep-related health issues both manifest in and affect the lives of males and females differently. Sleep health professionals should recognize these differences on all levels of disease prevention and health promotion from patient education, to diagnosis and management to improve quality of life for those with sleep-related health problems. Citation: Boccabella

Perseverative Cognition as an Explanatory Mechanism in the Relation Between Job Demands and Sleep Quality.

PubMed

Van Laethem, Michelle; Beckers, Debby G J; Geurts, Sabine A E; Garefelt, Johanna; Magnusson Hanson, Linda L; Leineweber, Constanze

2018-04-01

The aim of this longitudinal three-wave study was to examine (i) reciprocal associations among job demands, work-related perseverative cognition (PC), and sleep quality; (ii) PC as a mediator in-between job demands and sleep quality; and (iii) continuous high job demands in relation to sleep quality and work-related PC over time. A representative sample of the Swedish working population was approached in 2010, 2012, and 2014, and 2316 respondents were included in this longitudinal full-panel survey study. Structural equation modelling was performed to analyse the temporal relations between job demands, work-related PC, and sleep quality. Additionally, a subsample (N = 1149) consisting of individuals who reported the same level of exposure to job demands during all three waves (i.e. stable high, stable moderate, or stable low job demands) was examined in relation to PC and sleep quality over time. Analyses showed that job demands, PC, and poor sleep quality were positively and reciprocally related. Work-related PC mediated the normal and reversed, direct across-wave relations between job demands and sleep quality. Individuals with continuous high job demands reported significantly lower sleep quality and higher work-related PC, compared to individuals with continuous moderate/low job demands. This study substantiated reciprocal relations between job demands, work-related PC, and sleep quality and supported work-related PC as an underlying mechanism of the reciprocal job demands-sleep relationship. Moreover, this study showed that chronically high job demands are a risk factor for low sleep quality.

Sleep duration and age-related changes in brain structure and cognitive performance.

PubMed

Lo, June C; Loh, Kep Kee; Zheng, Hui; Sim, Sam K Y; Chee, Michael W L

2014-07-01

To investigate the contribution of sleep duration and quality to age-related changes in brain structure and cognitive performance in relatively healthy older adults. Community-based longitudinal brain and cognitive aging study using a convenience sample. Participants were studied in a research laboratory. Relatively healthy adults aged 55 y and older at study commencement. N/A. Participants underwent magnetic resonance imaging and neuropsychological assessment every 2 y. Subjective assessments of sleep duration and quality and blood samples were obtained. Each hour of reduced sleep duration at baseline augmented the annual expansion rate of the ventricles by 0.59% (P = 0.007) and the annual decline rate in global cognitive performance by 0.67% (P = 0.050) in the subsequent 2 y after controlling for the effects of age, sex, education, and body mass index. In contrast, global sleep quality at baseline did not modulate either brain or cognitive aging. High-sensitivity C-reactive protein, a marker of systemic inflammation, showed no correlation with baseline sleep duration, brain structure, or cognitive performance. In healthy older adults, short sleep duration is associated with greater age-related brain atrophy and cognitive decline. These associations are not associated with elevated inflammatory responses among short sleepers. Lo JC, Loh KK, Zheng H, Sim SK, Chee MW. Sleep duration and age-related changes in brain structure and cognitive performance.

Sleep Related Breathing Disorders in Adults with Down Syndrome.

ERIC Educational Resources Information Center

Resta, Onofrio; Barbaro, Maria Pia Foschino; Giliberti, Tiziana; Caratozzolo, Gennaro; Cagnazzo, Maria Grazia; Scarpelli, Franco; Nocerino, Maria Cristina

2003-01-01

This study evaluated sleep-related breathing disorders in six adults with Down syndrome. Five were found to have respiratory events justifying the diagnosis of sleep apnea syndrome. Results suggest that the nocturnal respiratory pattern of adults with Down syndrome depends on several pathogenetic factors such as age, severity of upper airway…

Elementary Students' Sleep Habits and Teacher Observations of Sleep-Related Problems.

ERIC Educational Resources Information Center

Amschler, Denise H.; McKenzie, James F.

2005-01-01

Sleep affects the health and well-being of children and plays a key role in preventing disease and injury, stability of mood, and ability to learn. Unfortunately, children often do not get adequate sleep on a regular basis. This study surveyed 199 fifth-grade students regarding their sleep habits using the Sleep Self-Report (SSR) instrument…

Prevalence and correlates of sleep-related problems in adults receiving medical cannabis for chronic pain.

PubMed

Cranford, James A; Arnedt, J Todd; Conroy, Deirdre A; Bohnert, Kipling M; Bourque, Carrie; Blow, Frederic C; Ilgen, Mark

2017-11-01

To examine the prevalence and correlates of sleep problems in a sample of medical cannabis patients. Adults ages 21 and older (N=801,M age=45.8) who were seeking medical cannabis certification (either for the first time or as a renewal) for chronic pain at medical cannabis clinics in southern Michigan completed baseline measures of cannabis use, sleep, pain, and other related constructs. Over half of the sample (59%) met criteria for past 1-month sleep disturbance, defined as at least one sleep problem occurring on 15 or more nights in the past month. Most participants (86%) reported that sleep problems were due to their current pain. Approximately 80% of participants reported using cannabis in the past 6 months to improve sleep and, among these participants, cannabis was rated as helpful for improving sleep. Sleep-related cannabis side effects were rare (35%), but sleep-related cannabis withdrawal symptoms were relatively common (65%). Statistically significant correlates of past 1-month sleep disturbance included a) being female, b) being white, c) being on disability, d) not having a medical cannabis card, and e) frequency of using cannabis to help sleep. Sleep problems are highly prevalent and frequent in medical cannabis patients and are closely tied to pain. Sleep-related cannabis withdrawal symptoms are relatively common but their clinical relevance is unknown. The association between frequency of cannabis use to help sleep with higher odds of sleep problems will need to be clarified by longitudinal studies. Copyright © 2017 Elsevier B.V. All rights reserved.

Need for recovery from work and sleep-related complaints among nursing professionals.

PubMed

Silva-Costa, Aline; Griep, Rosane Harter; Fischer, Frida Marina; Rotenberg, Lúcia

2012-01-01

The concept of need for recovery from work (NFR) was deduced from the effort recuperation model. In this model work produces costs in terms of effort during the working day. When there is enough time and possibilities to recuperate, a worker will arrive at the next working day with no residual symptoms of previous effort. NFR evaluates work characteristics such as psychosocial demands, professional work hours or schedules. However, sleep may be an important part of the recovery process. The aim of the study was to test the association between sleep-related complaints and NFR. A cross-sectional study was carried out at three hospitals. All females nursing professionals engaged in assistance to patients were invited to participate (N = 1,307). Participants answered a questionnaire that included four sleep-related complaints (insomnia, unsatisfactory sleep, sleepiness during work hours and insufficient sleep), work characteristics and NRF scale. Binomial logistic regression analysis showed that all sleep-related complaints are associated with a high need for recovery from work. Those who reported insufficient sleep showed a greater chance of high need for recovery; OR=2.730 (CI 95% 2.074 - 3.593). These results corroborate the hypothesis that sleep is an important aspect of the recovery process and, therefore, should be thoroughly investigated.

The median preoptic nucleus reciprocally modulates activity of arousal-related and sleep-related neurons in the perifornical lateral hypothalamus.

PubMed

Suntsova, Natalia; Guzman-Marin, Ruben; Kumar, Sunil; Alam, Md Noor; Szymusiak, Ronald; McGinty, Dennis

2007-02-14

The perifornical-lateral hypothalamic area (PF/LH) contains neuronal groups playing an important role in control of waking and sleep. Among the brain regions that regulate behavioral states, one of the strongest sources of projections to the PF/LH is the median preoptic nucleus (MnPN) containing a sleep-active neuronal population. To evaluate the role of MnPN afferents in the control of PF/LH neuronal activity, we studied the responses of PF/LH cells to electrical stimulation or local chemical manipulation of the MnPN in freely moving rats. Single-pulse electrical stimulation evoked responses in 79% of recorded PF/LH neurons. No cells were activated antidromically. Direct and indirect transsynaptic effects depended on sleep-wake discharge pattern of PF/LH cells. The majority of arousal-related neurons, that is, cells discharging at maximal rates during active waking (AW) or during AW and rapid eye movement (REM) sleep, exhibited exclusively or initially inhibitory responses to stimulation. Sleep-related neurons, the cells with elevated discharge during non-REM and REM sleep or selectively active in REM sleep, exhibited exclusively or initially excitatory responses. Activation of the MnPN via microdialytic application of L-glutamate or bicuculline resulted in reduced discharge of arousal-related and in excitation of sleep-related PF/LH neurons. Deactivation of the MnPN with muscimol caused opposite effects. The results indicate that the MnPN contains subset(s) of neurons, which exert inhibitory control over arousal-related and excitatory control over sleep-related PF/LH neurons. We hypothesize that MnPN sleep-active neuronal group has both inhibitory and excitatory outputs that participate in the inhibitory control of arousal-promoting PF/LH mechanisms.

Variables Related to Sleep Problems in Children with Autism

ERIC Educational Resources Information Center

Mayes, Susan Dickerson; Calhoun, Susan L.

2009-01-01

Our study of 477 children with autism (1-15 years, IQs 9-146) showed that parent reported sleep problems are found in most children with autism and are not significantly related to age, IQ, gender, race, parent occupation, neuropsychological functioning, and learning ability. However, sleep problems increased with severity of autistic symptoms and…

How Do Sleep-Related Health Problems Affect Functional Status According to Sex?

PubMed

Boccabella, Allegra; Malouf, John

2017-05-15

To measure differences in functional status between men and women presenting with sleep-related health problems. A retrospective clinical audit of 744 Australian patients across 7 private general practices between April 2013 and January 2015 was conducted. Patients completed an electronic survey as part of their routine consultation, which included the Epworth Sleepiness Scale (ESS), the Functional Outcomes of Sleep Questionnaire 10 (FOSQ-10), and other questions relating to the effect of their sleep problem. The proportion of males and females with ESS and FOSQ-10 scores associated with disorders of daytime sleepiness and burden of symptoms due to sleepiness, respectively, were compared, as well as reported differences between the sexes in memory, concentration, issues with relationships, feeling depressed, and trouble sleeping. On presentation, females were more likely to have sleeping disorders associated with daytime sleepiness (median ESS score of 9 for females versus 8 for males, P = .038; proportion ESS > 9 was 49.0% for females versus 36.9% for males, P = .003). Women were also more likely to report an increased burden of symptoms due to sleepiness compared to men, as shown by lower FOSQ-10 scores ( P < .001). Secondary outcome measures showed that females were more likely to feel excessively tired and depressed, have difficulties with memory and concentration, and have trouble sleeping at night. Snoring kept partners awake in roughly the same proportion of males and females, and a larger proportion of the partners of males were forced out of the room. Sleep-related health issues both manifest in and affect the lives of males and females differently. Sleep health professionals should recognize these differences on all levels of disease prevention and health promotion from patient education, to diagnosis and management to improve quality of life for those with sleep-related health problems. © 2017 American Academy of Sleep Medicine

Prospective relationship between poor sleep and substance-related problems in a national sample of adolescents

PubMed Central

Wong, Maria M.; Roberson, Gail; Dyson, Rachel

2014-01-01

Background Previous studies showed that poor sleep prospectively predicted alcohol related problems and illicit drug use in adolescents and young adults (Wong et al., 2010, 2012). However, more works needs to be done to elucidate the nature of these problems. The purpose of this study was to examine whether sleep difficulties and hours of sleep prospectively predicted several serious substance related problems, e.g., binge drinking, driving under the influence of alcohol, risky sexual behavior. Methods Study participants were 6504 adolescents from the National Longitudinal Study of Adolescent Health (ADD HEALTH). Data were collected from interviews and questionnaires. The current study analyzed data from the first three waves of data (T1: 1994–95; T2: 1996; T3: 2001–02). In all analyses, we used sleep difficulties at a previous wave to predict substance-related problems at a subsequent wave, while controlling for substance-related problems at a previous wave. Results Holding T1 alcohol-related problems constant, sleep difficulties at T1 significantly predicted alcohol-related interpersonal problems, binge drinking, gotten drunk or very high on alcohol, driving under the influence of alcohol, getting into a sexual situation one later regretted due to drinking, ever using any illicit drugs and drugs-related problems at T2. T1 hours of sleep negatively predicted T2 alcohol-related interpersonal problems and binge drinking. The relationship between T2 sleep variables and T3 substance-related problems were consistent with previous waves, though the effect was weaker. Conclusions Sleep difficulties and hours of sleep are a significant predictor of a number of substance-related problems. It may be useful to educate adolescents about the importance of sleep, sleep hygiene and the potential consequences of poor sleep on drinking and related behaviors. PMID:25598438

Learning-related brain hemispheric dominance in sleeping songbirds.

PubMed

Moorman, Sanne; Gobes, Sharon M H; van de Kamp, Ferdinand C; Zandbergen, Matthijs A; Bolhuis, Johan J

2015-03-12

There are striking behavioural and neural parallels between the acquisition of speech in humans and song learning in songbirds. In humans, language-related brain activation is mostly lateralised to the left hemisphere. During language acquisition in humans, brain hemispheric lateralisation develops as language proficiency increases. Sleep is important for the formation of long-term memory, in humans as well as in other animals, including songbirds. Here, we measured neuronal activation (as the expression pattern of the immediate early gene ZENK) during sleep in juvenile zebra finch males that were still learning their songs from a tutor. We found that during sleep, there was learning-dependent lateralisation of spontaneous neuronal activation in the caudomedial nidopallium (NCM), a secondary auditory brain region that is involved in tutor song memory, while there was right hemisphere dominance of neuronal activation in HVC (used as a proper name), a premotor nucleus that is involved in song production and sensorimotor learning. Specifically, in the NCM, birds that imitated their tutors well were left dominant, while poor imitators were right dominant, similar to language-proficiency related lateralisation in humans. Given the avian-human parallels, lateralised neural activation during sleep may also be important for speech and language acquisition in human infants.

Learning-related brain hemispheric dominance in sleeping songbirds

PubMed Central

Moorman, Sanne; Gobes, Sharon M. H.; van de Kamp, Ferdinand C.; Zandbergen, Matthijs A.; Bolhuis, Johan J.

2015-01-01

There are striking behavioural and neural parallels between the acquisition of speech in humans and song learning in songbirds. In humans, language-related brain activation is mostly lateralised to the left hemisphere. During language acquisition in humans, brain hemispheric lateralisation develops as language proficiency increases. Sleep is important for the formation of long-term memory, in humans as well as in other animals, including songbirds. Here, we measured neuronal activation (as the expression pattern of the immediate early gene ZENK) during sleep in juvenile zebra finch males that were still learning their songs from a tutor. We found that during sleep, there was learning-dependent lateralisation of spontaneous neuronal activation in the caudomedial nidopallium (NCM), a secondary auditory brain region that is involved in tutor song memory, while there was right hemisphere dominance of neuronal activation in HVC (used as a proper name), a premotor nucleus that is involved in song production and sensorimotor learning. Specifically, in the NCM, birds that imitated their tutors well were left dominant, while poor imitators were right dominant, similar to language-proficiency related lateralisation in humans. Given the avian-human parallels, lateralised neural activation during sleep may also be important for speech and language acquisition in human infants. PMID:25761654

Polysomnographic measures of sleep in cocaine dependence and alcohol dependence: Implications for age‐related loss of slow wave, stage 3 sleep

PubMed Central

Bjurstrom, Martin F.; Olmstead, Richard

2016-01-01

Abstract Background and aims Sleep disturbance is a prominent complaint in cocaine and alcohol dependence. This controlled study evaluated differences of polysomnographic (PSG) sleep in cocaine‐ and alcohol‐dependent subjects, and examined whether substance dependence interacts with age to alter slow wave sleep and rapid eye movement (REM) sleep. Design Cross‐sectional comparison. Setting Los Angeles and San Diego, CA, USA. Participants Abstinent cocaine‐dependent subjects (n = 32), abstinent alcohol‐dependent subjects (n = 73) and controls (n = 108); mean age 40.3 years recruited 2005–12. Measurements PSG measures of sleep continuity and sleep architecture primary outcomes of Stage 3 sleep and REM sleep. Covariates included age, ethnicity, education, smoking, body mass index and depressive symptoms. Findings Compared with controls, both groups of substance dependent subjects showed loss of Stage 3 sleep (P < 0.001). A substance dependence × age interaction was found in which both cocaine‐ and alcohol‐dependent groups showed loss of Stage 3 sleep at an earlier age than controls (P < 0.05 for all), and cocaine‐dependent subjects showed loss of Stage 3 sleep at an earlier age than alcoholics (P < 0.05). Compared with controls, REM sleep was increased in both substance‐dependent groups (P < 0.001), and cocaine and alcohol dependence were associated with earlier age‐related increase in REM sleep (P < 0.05 for all). Conclusions Cocaine and alcohol dependence appear to be associated with marked disturbances of sleep architecture, including increased rapid eye movement sleep and accelerated age‐related loss of slow wave, Stage 3 sleep. PMID:26749502

Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnoea syndrome: a randomised, placebo-controlled trial on self-reported symptoms of common sleep disorders and sleep-related problems.

PubMed

Nikolopoulou, M; Byraki, A; Ahlberg, J; Heymans, M W; Hamburger, H L; De Lange, J; Lobbezoo, F; Aarab, G

2017-06-01

Obstructive sleep apnoea syndrome (OSAS) is associated with several sleep disorders and sleep-related problems. Therefore, the aim of this study was to compare the effects of a mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. In this randomised placebo-controlled trial, sixty-four OSAS patients (52·0 ± 9·6 years) were randomly assigned to an MAD, nCPAP or an intra-oral placebo appliance in a parallel design. All participants filled out the validated Dutch Sleep Disorders Questionnaire (SDQ) twice: one before treatment and one after six months of treatment. With 88 questions, thirteen scales were constructed, representing common sleep disorders and sleep-related problems. Linear mixed model analyses were performed to study differences between the groups for the different SDQ scales over time. The MAD group showed significant improvements over time in symptoms corresponding with 'insomnia', 'excessive daytime sleepiness', 'psychiatric sleep disorder', 'periodic limb movements', 'sleep apnoea', 'sleep paralysis', 'daytime dysfunction', 'hypnagogic hallucinations/dreaming', 'restless sleep', 'negative conditioning' and 'automatic behaviour' (range of P values: 0·000-0·014). These improvements in symptoms were, however, not significantly different from the improvements in symptoms observed in the nCPAP and placebo groups (range of P values: 0·090-0·897). It can be concluded that there is no significant difference between MAD and nCPAP in their positive effects on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. These beneficial effects may be a result of placebo effects. © 2017 John Wiley & Sons Ltd.

Effects of bedding systems selected by manual muscle testing on sleep and sleep-related respiratory disturbances.

PubMed

Tsai, Ling-Ling; Liu, Hau-Min

2008-03-01

In this study, we investigated the feasibility of applying manual muscle testing (MMT) for bedding selection and examined the bedding effect on sleep. Four lay testers with limited training in MMT performed muscle tests for the selection of the bedding systems from five different mattresses and eight different pillows for 14 participants with mild sleep-related respiratory disturbances. For each participant individually, two bedding systems-one inducing stronger muscle forces and the other inducing weaker forces-were selected. The tester-participant pairs showed 85% and 100% agreement, respectively, for the selection of mattresses and pillows that induced the strongest muscle forces. The firmness of the mattress and the height of the pillow were significantly correlated with the body weight and body mass index of the participants for the selected strong bedding system but not for the weak bedding system. Finally, differences were observed between the strong and the weak bedding systems with regard to sleep-related respiratory disturbances and the percentage of slow-wave sleep. It was concluded that MMT can be performed by inexperienced testers for the selection of bedding systems.

Pain-related and Psychological Symptoms in Adolescents With Musculoskeletal and Sleep Problems

PubMed Central

Wilson, Sue; Munafò, Marcus R.

2016-01-01

Objectives: Two-thirds of adolescents with chronic musculoskeletal pain report a concurrent sleep problem. Both musculoskeletal pain and sleep problems can have deleterious effects on physiological and psychological well-being. We explored the prevalence of sleep problems and musculoskeletal pain, using data on 3568 adolescents from the Avon Longitudinal Study of Children. Materials and Methods: A comprehensive battery of questionnaires was administered to derive clinical phenotypes of musculoskeletal pain. Adolescents with single symptoms were compared with those reporting both musculoskeletal pain and sleep problems. Linear and logistic regression analyses were used to compare groups on pain-related variables and psychological complaints. The association between sociodemographic variables and comorbid musculoskeletal pain and sleep problems was assessed using logistic regression. Results: Over half the sample was female (n=2076, 58.2%) and the majority of European ancestry (n=3174, 97.7%). Only 5.5% (n=196) of participants were identified as having a pain condition, while 21.2% (n=749) reported a significant sleep problem, and 2.8% (n=99) reported comorbid musculoskeletal pain and sleep problems. Adolescents with comorbid problems experienced greater pain intensity and pain-related anxiety. Other psychological complaints were also higher in those who experienced concurrent problems, including depression, fatigue, concentration, and overall severity of psychological symptoms. Discussion: Comorbid sleep and pain problems were associated with a higher incidence of pain-related and psychological symptoms. Sleep problems may therefore be an important modifiable risk factor for alleviating distress in adolescents with musculoskeletal pain. PMID:25974623

Age-Related Reduction of Recovery Sleep and Arousal Threshold in Drosophila

PubMed Central

Vienne, Julie; Spann, Ryanne; Guo, Fang; Rosbash, Michael

2016-01-01

Study Objectives: Physiological studies show that aging affects both sleep quality and quantity in humans, and sleep complaints increase with age. Along with knowledge about the negative effects of poor sleep on health, understanding the enigmatic relationship between sleep and aging is important. Because human sleep is similar to Drosophila (fruit fly) sleep in many ways, we addressed the effects of aging on sleep in this model organism. Methods: Baseline sleep was recorded in five different Drosophila genotypes raised at either 21°C or 25°C. The amount of sleep recovered was then investigated after a nighttime of sleep deprivation (12 h) and after chronic sleep deprivation (3 h every night for multiple nights). Finally, the effects of aging on arousal, namely, sensitivity to neuronal and mechanical stimuli, were studied. Results: We show that fly sleep is affected by age in a manner similar to that of humans and other mammals. Not only do older flies of several genotypes have more fragmented sleep and reduced total sleep time compared to young flies, but older flies also fail to recover as much sleep after sleep deprivation. This suggests either lower sleep homeostasis and/or a failure to properly recover sleep. Older flies also show a decreased arousal threshold, i.e., an increased response to neuronal and mechanical wake-promoting stimuli. The reduced threshold may either reflect or cause the reduced recovery sleep of older flies compared to young flies after sleep deprivation. Conclusions: Further studies are certainly needed, but we suggest that the lower homeostatic sleep drive of older flies causes their decreased arousal threshold. Citation: Vienne J, Spann R, Guo F, Rosbash M. Age-related reduction of recovery sleep and arousal threshold in Drosophila. SLEEP 2016;39(8):1613–1624. PMID:27306274

Sleep-related attentional bias in poor versus good sleepers is independent of affective valence.

PubMed

Barclay, Nicola L; Ellis, Jason G

2013-08-01

Contradictory evidence exists relating to the presence of an attention bias to sleep-related stimuli in poor sleepers/insomnia using the emotional Stroop task (EST). These inconsistencies may be due to methodological issues related to the affective valence of the sleep-related stimuli. Thus, individuals may attend differentially to sleep-related stimuli not because of their 'sleep' properties, but their negativity. The current study addresses this by controlling the affective valence of sleep-related words. A total of 107 participants [mean age = 33.22 years, standard deviation (SD) = 12.31 years; 61.7% female] were recruited during an evening event at the Newcastle Science Festival. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and a computerized EST containing 20 non-affective sleep-related, 20 neutral and 20 negatively valenced threat words. Good and poor sleepers were categorized using the PSQI. There were no significant differences between groups on response latency to sleep-related words (t(105) = -0.30, P = 0.76). However, the interaction between good versus poor sleepers and word-type on response latency was significant (F(2,210) = 3.06, P < 0.05). Poor sleepers took longer to respond to sleep-related words (mean = 723.35, SD = 172.55) compared to threat words (mean = 694.63, SD = 162.17) than good sleepers (mean = 713.20, SD = 166.32; and mean = 716.65, SD = 181.14). The results demonstrate the presence of an attention bias towards sleep-related stimuli compared to threat stimuli in poor sleepers. Accordingly, poor sleepers may be consumed by stimuli relevant to their specific difficulties, as well as being more highly attuned to negative cues that signal anxious states. Thus, the present research suggests that there are two opposing forces at play: one which facilitates performance (non-specific threats) and one which hinders performance (personally relevant threats). © 2013 European Sleep Research Society.

Respiratory flow-sound relationship during both wakefulness and sleep and its variation in relation to sleep apnea.

PubMed

Yadollahi, Azadeh; Montazeri, Aman; Azarbarzin, Ali; Moussavi, Zahra

2013-03-01

Tracheal respiratory sound analysis is a simple and non-invasive way to study the pathophysiology of the upper airway and has recently been used for acoustic estimation of respiratory flow and sleep apnea diagnosis. However in none of the previous studies was the respiratory flow-sound relationship studied in people with obstructive sleep apnea (OSA), nor during sleep. In this study, we recorded tracheal sound, respiratory flow, and head position from eight non-OSA and 10 OSA individuals during sleep and wakefulness. We compared the flow-sound relationship and variations in model parameters from wakefulness to sleep within and between the two groups. The results show that during both wakefulness and sleep, flow-sound relationship follows a power law but with different parameters. Furthermore, the variations in model parameters may be representative of the OSA pathology. The other objective of this study was to examine the accuracy of respiratory flow estimation algorithms during sleep: we investigated two approaches for calibrating the model parameters using the known data recorded during either wakefulness or sleep. The results show that the acoustical respiratory flow estimation parameters change from wakefulness to sleep. Therefore, if the model is calibrated using wakefulness data, although the estimated respiratory flow follows the relative variations of the real flow, the quantitative flow estimation error would be high during sleep. On the other hand, when the calibration parameters are extracted from tracheal sound and respiratory flow recordings during sleep, the respiratory flow estimation error is less than 10%.

Daily stress interacts with trait dissociation to predict sleep-related experiences in young adults.

PubMed

Soffer-Dudek, Nirit; Shahar, Golan

2011-08-01

Building on the previously documented effects of stress and dissociation on sleep and dreaming, we examined their interactive role in general sleep-related experiences (GSEs; e.g., nightmares, falling dreams, hypnagogic hallucinations; see Watson, 2001). Stress, sleep quality, and GSEs were assessed daily for 14 days among young adults. Baseline assessment included life stress, sleep quality, psychopathology, dissociation, and related dimensions. Multilevel analyses indicated that daily stress brings about GSEs among highly dissociative young adults. Additionally, baseline trait dissociation predicted within-subject elevation in GSEs when daily stress was high. Flawed sleep-wake transitions, previously linked to dissociation and sleep-related experiences, might account for this effect. © 2011 American Psychological Association

Children's Emotional Security and Sleep: Longitudinal Relations and Directions of Effects

ERIC Educational Resources Information Center

Keller, Peggy; El-Sheikh, Mona

2011-01-01

Background: We examined longitudinal relations between children's sleep and their emotional security in the mother-child, father-child, and parental marital relationships, with the goal of explicating the direction of association over time. Gender-related effects were also examined. Method: Sleep duration was examined through actigraphy, and sleep…

Sleep Duration and Quality as Related to Left Ventricular Structure and Function.

PubMed

Lee, Jae-Hon; Park, Sung Keun; Ryoo, Jae-Hong; Oh, Chang-Mo; Kang, Jeong Gyu; Mansur, Rodrigo B; Alfonsi, Jeffrey E; Lee, Yena; Shin, Sun-Han; McIntyre, Roger S; Jung, Ju Young

2018-01-01

Inadequate sleep is associated with increased risk of cardiovascular events; however, the associations between sleep duration or quality and cardiac function or structure are not well understood. This cross-sectional study was conducted to investigate to what extent sleep duration and quality are associated with left ventricular (LV) diastolic dysfunction or structural deterioration. A total of 31,598 healthy Korean adults who received echocardiography and completed the Pittsburg Sleep Quality Index were enrolled in this study. Participants were stratified into three groups by self-reported sleep duration (i.e., <7, 7-9, >9 hours) and into two groups by subjective sleep quality. Sleep duration was also assessed as a continuous variable. The odds ratios for impaired LV diastolic function, increased relative wall thickness, and LV hypertrophy (LVH) were compared between groups using multivariable logistic regression analyses. After adjustment for confounding variables (e.g., age, smoking, body mass index), there was a statistically significant association between short sleep duration (<7 hours) and greater LVH (fully adjusted odds ratio = 1.32 [95% confidence interval {CI} = 1.02-1.73]). Short sleep duration was also significantly associated with greater LVH (0.87 per hour [95% CI = 0.78-0.98]) and increased relative wall thickness (0.92 [95% CI = 0.86-0.99]), but there was no significant association between sleep and LV diastolic function. Among individuals with normal sleep duration, poor quality of sleep was not associated with adverse cardiac measures. These results indicate that short sleep duration (<7 hours) is associated with unfavorable LV structural characteristics. The association of insufficient sleep with adverse cardiovascular health outcomes may be mediated in part by adverse changes in cardiac structure and function.

Sleep duration and sleep-related problems in different occupations in the Hordaland Health Study.

PubMed

Ursin, Reidun; Baste, Valborg; Moen, Bente E

2009-05-01

The aim of this study was to examine the relationship between occupation and sleep duration, sleepiness, insufficient sleep, and insomnia in day and shift workers (including night work and watches). The study was population-based and cross-sectional, and relied on self-administered questionnaires. It was conducted as part of the 1997-1999 Hordaland Health Study in collaboration with the Norwegian National Health Screening Service. Aged 40-45 years, 7782 participants answered a sleep questionnaire, reporting their occupation and whether or not they were employed in shift work. Our study found differences in sleep duration during the working week between occupational groups; in both shift and day workers. Craft workers, plant operators, and drivers slept less than leaders, and non-personal and personal service workers. Within some occupations (leaders, personal service workers, and plant operators), shift workers slept less than day workers. The mean sleep duration of shift workers was 15 minutes shorter than that of day workers. Rise times, but not bedtimes, were earlier in craft-and construction workers, plant operators, and drivers than in leaders and non-personal and personal service workers, particularly day workers. When adjusted for shift work and working hours - compared to leaders - craft workers, plant operators, and drivers had an increased risk of daytime sleepiness (odds ratio 1.5, 1.8, and 1.8 respectively) and of falling asleep at work (odds ratio 1.6, 2.1 and 2.0 respectively). Shift workers had an increased risk of falling asleep at work and insomnia. Occupation has separate effects on sleep duration and sleep-related problems, independent of the effects of shift work.

Sleep Duration and Health-Related Quality of Life in Predialysis CKD.

PubMed

Sung, Su-Ah; Hyun, Young Youl; Lee, Kyu Beck; Park, Hayne Cho; Chung, Wookyung; Kim, Yeong Hoon; Kim, Yong-Soo; Park, Sue Kyung; Oh, Kook-Hwan; Ahn, Curie

2018-06-07

Sleep duration has been associated with cardiometabolic risk and mortality. The health-related quality of life represents a patient's comprehensive perception of health and is accepted as a health outcome. We examined the relationship between sleep duration and health-related quality of life in predialysis CKD. In this cross-sectional study, data from 1910 adults with CKD enrolled in the Korean Cohort Study for Outcome in Patients with CKD were analyzed. Health-related quality of life was assessed with the physical component summary and mental component summary of the Short Form-36 Health Survey. Low health-related quality of life was defined as a Short Form-36 Health Survey score >1 SD below the mean. Using a generalized additive model and multivariable logistic regression analysis, the relationship between self-reported sleep duration and health-related quality of life was examined. Seven-hour sleepers showed the highest health-related quality of life. We found an inverted U-shaped relationship between sleep duration and health-related quality of life as analyzed by a generalized additive model. In multivariable logistic analysis, short sleepers (≤5 h/d) had lower health-related quality of life (odds ratio, 3.23; 95% confidence interval, 1.86 to 5.60 for the physical component summary; odds ratio, 2.37; 95% confidence interval, 1.43 to 3.94 for the mental component summary), and long sleepers (≥9 h/d) had lower health-related quality of life (odds ratio, 2.80; 95% confidence interval, 1.55 to 5.03 for the physical component summary; odds ratio, 2.08; 95% confidence interval, 1.20 to 3.60 for the mental component summary) compared with 7-hour sleepers. Sleep duration had a significant U-shaped association with low health-related quality of life. These findings suggest that short or long sleep duration is independently associated with low health-related quality of life in adults with CKD. Copyright © 2018 by the American Society of Nephrology.

The effect of preinjury sleep difficulties on neurocognitive impairment and symptoms after sport-related concussion.

PubMed

Sufrinko, Alicia; Pearce, Kelly; Elbin, R J; Covassin, Tracey; Johnson, Eric; Collins, Michael; Kontos, Anthony P

2015-04-01

Researchers have reported that sleep duration is positively related to baseline neurocognitive performance. However, researchers have yet to examine the effect of preinjury sleep difficulties on postconcussion impairments. To compare neurocognitive impairment and symptoms of athletes with preinjury sleep difficulties to those without after a sport-related concussion (SRC). Cohort study; Level of evidence, 3. The sample included 348 adolescent and adult athletes (age, mean ± SD, 17.43 ± 2.34 years) with a diagnosed SRC. The sample was divided into 2 groups: (1) 34 (10%) participants with preinjury sleep difficulties (sleeping less as well as having trouble falling asleep; SLEEP SX) and (2) 231 (66%) participants without preinjury sleep difficulties (CONTROL). The remaining 84 (24%) participants with minimal sleep difficulties (1 symptom) were excluded. Participants completed the Immediate Postconcussion Assessment and Cognitive Test (ImPACT) and Postconcussion Symptom Scale (PCSS) at baseline and 3 postinjury intervals (2, 5-7, and 10-14 days after injury). A series of repeated-measures analyses of covariance with Bonferroni correction, controlling for baseline non-sleep-related symptoms, were conducted to compare postinjury neurocognitive performance between groups. Follow-up exploratory t tests examined between-group differences at each time interval. A series of analyses of variance were used to examine total PCSS score, sleep-related, and non-sleep-related symptoms across time intervals between groups. Groups differed significantly in PCSS scores across postinjury intervals for reaction time (P < .001), with the preinjury SLEEP SX group performing worse than controls at 5-7 days (mean ± SD, 0.70 ± 0.32 [SLEEP SX], 0.60 ± 0.14 [CONTROL]) and 10-14 days (0.61 ± 0.17 [SLEEP SX]; 0.57 ± 0.10 [CONTROL]) after injury. Groups also differed significantly on verbal memory performance (P = .04), with the SLEEP SX (68.21 ± 18.64) group performing worse than the

Rapid Eye Movement Sleep in Relation to Overweight in Children and Adolescents

PubMed Central

Liu, Xianchen; Forbes, Erika E.; Ryan, Neal D.; Rofey, Dana; Hannon, Tamara S.; Dahl, Ronald E.

2009-01-01

Context Short sleep duration is associated with obesity, but few studies have examined the relationship between obesity and specific physiological stages of sleep. Objective To examine specific sleep stages, including rapid eye movement (REM) sleep and stages 1 through 4 of non-REM sleep, in relation to overweight in children and adolescents. Design, Setting, and Participants A total of 335 children and adolescents (55.2% male; aged 7-17 years) underwent 3 consecutive nights of standard polysomnography and weight and height assessments as part of a study on the development of internalizing disorders (depression and anxiety). Main Outcome Measures Body mass index (calculated as weight in kilograms divided by height in meters squared) z score and weight status (normal, at risk for overweight, overweight) according to the body mass index percentile for age and sex. Results The body mass index z score was significantly related to total sleep time (β=-0.174), sleep efficiency (β=-0.027), and REM density (β=-0.256). Compared with normal-weight children, overweight children slept about 22 minutes less and had lower sleep efficiency, shorter REM sleep, lower REM activity and density, and longer latency to the first REM period. After adjustment for demographics, pubertal status, and psychiatric diagnosis, 1 hour less of total sleep was associated with approximately 2-fold increased odds of overweight (odds ratio=1.85), 1 hour less of REM sleep was associated with about 3-fold increased odds (odds ratio=2.91), and REM density and activity below the median increased the odds of overweight by 2-fold (odds ratio=2.18) and 3-fold (odds ratio=3.32), respectively. Conclusions Our results confirm previous epidemiological observations that short sleep time is associated with overweight in children and adolescents. A core aspect of the association between short sleep duration and overweight may be attributed to reduced REM sleep. Further studies are needed to investigate possible

Otorhinolaryngological aspects of sleep-related breathing disorders

PubMed Central

Virk, Jagdeep S.

2016-01-01

Snoring and obstructive sleep apnoea (OSA) are disorders within a wide spectrum of sleep-related breathing disorders (SRBD). Given the obesity epidemic, these conditions will become increasingly prevalent and continue to serve as a large economic burden. A thorough clinical evaluation and appropriate investigations will allow stratification of patients into appropriate treatment groups. A multidisciplinary team is required to manage these patients. Patient selection is critical in ensuring successful surgical and non-surgical outcomes. A wide range of options are available and further long term prospective studies, with standardised data capture and outcome goals, are required to evaluate the most appropriate techniques and long term success rates. PMID:26904262

Update on obstructive sleep apnea and its relation to COPD

PubMed Central

Mieczkowski, Brian; Ezzie, Michael E

2014-01-01

Chronic obstructive pulmonary disease (COPD) is a common and preventable lung disease that affects millions of people in the United States. Sleep disorders including obstructive sleep apnea (OSA) are also common. It is not surprising that many people with COPD also suffer from OSA. This relationship, however, puts people at risk for more nocturnal desaturations and potential complications related to this, including pulmonary hypertension and heart rhythm disturbances. This update focuses on the physiology of sleep disturbances in COPD as well as the clinical implications of OSA in COPD. PMID:24748786

Day-to-day relations between stress and sleep and the mediating role of perseverative cognition.

PubMed

Van Laethem, Michelle; Beckers, Debby G J; van Hooff, Madelon L M; Dijksterhuis, Ap; Geurts, Sabine A E

2016-08-01

The goals of this longitudinal diary-based study were to shed light on the day-level relationship between stress and subsequent sleep, and to examine whether perseverative cognition is a mediating factor in this relation. A total of 44 Dutch PhD students were followed during a two-month period, from one month before their public thesis defense (ie, a stressful life event), until one month thereafter. Participants completed short evening and morning questionnaires on eight occasions (in anticipation of and following the defense), including questions about day-level stress, sleep quality, and perseverative cognition. Objective sleep parameters were collected with the SenseWear Pro Armband. Multilevel analysis was used to analyze daily observations nested within individuals. Analyses revealed that day-level stress was not directly related to subsequent subjective sleep indicators or to subsequent objective sleep indicators. Day-level stress was significantly associated with day-level perseverative cognition, and daily variations in perseverative cognition were significantly related to several day-level objective sleep parameters (sleep efficiency, marginally to number of awakenings, and wake after sleep onset), and to several day-level subjective sleep parameters (sleep quality, number of awakenings, wake after sleep onset). Finally, mediation analyses using path analysis suggested that, on the day level, perseverative cognition functions as a mediator between stress and several sleep parameters, namely, subjective sleep quality, objective sleep efficiency, and subjective wake after sleep onset. Perseverative cognition is a promising explanatory mechanism linking day-level stress to subjective and objective measures of sleep. Copyright © 2016 Elsevier B.V. All rights reserved.

Clinical trial: esomeprazole for moderate-to-severe nighttime heartburn and gastro-oesophageal reflux disease-related sleep disturbances.

PubMed

Johnson, D; Crawley, J A; Hwang, C; Brown, K

2010-07-01

Nighttime heartburn, common among patients with gastro-oesophageal reflux disease (GERD), is associated with substantial clinical effects. GERD-related sleep disturbances are underappreciated and undertreated. To evaluate the efficacy of esomeprazole on GERD-related nighttime heartburn and associated sleep disturbances. In this multicentre, randomized, double-blind, placebo-controlled study, patients with moderate-to-severe nighttime heartburn and GERD-related sleep disturbances (endoscopies not required) received esomeprazole 20 mg or placebo each morning for 4 weeks. Heartburn symptoms and GERD-related sleep disturbances were evaluated using the validated Pittsburgh Sleep Quality Index and validated Work Productivity and Activity Impairment Questionnaire. The analysis included 262 patients (esomeprazole, n = 137; placebo, n = 125). Significantly more patients receiving esomeprazole achieved nighttime heartburn relief (primary end point) than those receiving placebo (34.3% vs. 10.4%; P < 0.0001). Secondary end points such as relief of GERD-related sleep disturbances (P = 0.006), days without GERD-related sleep disturbances (P = 0.0003) and complete resolution of sleep disturbances (P < 0.0001) favoured esomeprazole over placebo. Sleep quality, work productivity and regular daily activities also improved significantly with esomeprazole vs. placebo. Esomeprazole 20 mg is effective for patients with moderate-to-severe nighttime heartburn and GERD-related sleep disturbances, improving heartburn symptoms, sleep quality, work productivity and functionality.

Reciprocal Relations between Children's Sleep and Their Adjustment over Time

ERIC Educational Resources Information Center

Kelly, Ryan J.; El-Sheikh, Mona

2014-01-01

Child sleep and adjustment research with community samples is on the rise with a recognized need of explicating this association. We examined reciprocal relations between children's sleep and their internalizing and externalizing symptoms using 3 waves of data spanning 5 years. Participants included 176 children at Time 1 (M = 8.68 years; 69%…

Sociodemographic and socioeconomic differences in sleep duration and insomnia-related symptoms in Finnish adults

PubMed Central

2012-01-01

Background Poor sleep tends to be patterned by sociodemographic and socioeconomic factors. The aim of this study was to examine the associations of sociodemographic and socioeconomic factors with sleep duration and insomnia-related symptoms across life course. Methods We used cross-sectional Health 2000 Survey (2000–2001) among a total of 5,578 adult Finns, aged 30–79 years, representative of adult Finnish population. Data about sociodemographic and socioeconomic circumstances, insomnia-related symptoms over the previous month as well as average sleep duration were collected by questionnaires. Multinomial logistic regression models were adjusted first for gender and age, second for sociodemographic factors, third additionally for socioeconomic factors, and fourth for all covariates and self-perceived health simultaneously. Results On average 70% of Finnish adults slept 7–8 hours a day. Frequent insomnia-related symptoms were more prevalent among women (14%) than men (10%). Not being married, not having children, having low education, low income, being unemployed, and being a disability retiree were associated with frequent insomnia-related symptoms. Similar factors were associated with short and long sleep duration. However, childhood socioeconomic position was mostly unrelated to sleep in adulthood except parental education had some associations with short sleep duration. Conclusions Disadvantaged socioeconomic position in adulthood, in particular income and employment status, is associated with poorer sleep. When promoting optimal sleep duration and better sleep quality, families with low incomes, unemployed people, and disability retirees should be targeted. PMID:22839359

Reciprocal Relations Between Objectively Measured Sleep Patterns and Diurnal Cortisol Rhythms in Late Adolescents

PubMed Central

Zeiders, Katharine H.; Doane Sampey, Leah D.; Adam, Emma K.

2011-01-01

Purpose To examine how hours of sleep and wake times relate to between-person differences and day-to-day changes in diurnal cortisol rhythms in late adolescents Methods Older adolescents (N = 119) provided six cortisol samples (wakeup, +30min, + 2 hours, +8 hours, + 12 hours, and bedtime) on each of three consecutive days while wearing an actigraph. We examined how average (across 3 days) and day-to-day changes in hours of sleep and wake times related to diurnal cortisol patterns. Results On average, greater hours of sleep related steeper decline in cortisol across the days. Day-to-day analyses revealed that prior night’s hours of sleep predicted steeper diurnal slopes the next day, while greater waking cortisol levels and steeper slopes predicted greater hours of sleep and a later wake time the next day. Conclusions Our results suggest a bidirectional relationship between sleep and HPA axis activity. PMID:21575815

Reward-related brain function and sleep in pre/early pubertal and mid/late pubertal adolescents.

PubMed

Holm, Stephanie M; Forbes, Erika E; Ryan, Neal D; Phillips, Mary L; Tarr, Jill A; Dahl, Ronald E

2009-10-01

The onset of adolescence is a time of dramatic changes, including changes in sleep, and a time of new health concerns related to increases in risk-taking, sensation seeking, depression, substance use, and accidents. As part of a larger study examining puberty-specific changes in adolescents' reward-related brain function, the current article focuses on the relationship between functional neuroimaging measures of reward and measures of sleep. A total of 58 healthy participants 11-13 years of age completed a functional magnetic resonance imaging scan using a guessing task with monetary rewards and 4 days of at-home actigraphy and self-reported sleep ratings. Sleep variables included actigraph measures of mean weekend minutes asleep, sleep onset time, and sleep offset time, as well as self-reported sleep quality. During reward anticipation, less activation in the caudate (part of the ventral striatum) was associated with fewer minutes asleep, later sleep onset time, and lower sleep quality. During reward outcome, less caudate activation was associated with later sleep onset time, earlier sleep offset time, and lower sleep quality. It has been hypothesized that adolescents' low reactivity in reward-related brain areas could lead to compensatory increases in reward-driven behavior. This study's findings suggest that sleep could contribute to such behavior. Because decreased sleep has been associated with risky behavior and negative mood, these findings raise concerns about a negative spiral whereby the effects of puberty and sleep deprivation may have synergistic effects on reward processing, contributing to adolescent behavioral and emotional health problems.

Subjective Sleep Related to Post Traumatic Stress Disorder Symptoms among Trauma-Exposed Men and Women.

PubMed

Gibson, Carolyn J; Richards, Anne; Villanueva, Cynthia; Barrientos, Maureen; Neylan, Thomas C; Inslicht, Sabra S

2017-11-27

Sleep difficulty is both a common symptom of posttraumatic stress disorder (PTSD) and a risk factor for the development and maintenance of PTSD symptomatology. Gender differences in sleep following trauma exposure have been posited to contribute to the increased risk for the development of PTSD among women, but the persistence and long-term contributions of these potential differences to the maintenance and severity of PTSD symptoms is unclear. Men and women reporting a history of trauma exposure (n = 112, 63% female) participated in this study. Subjective sleep complaints and PTSD symptom severity were assessed using well-validated measures (Pittsburgh Sleep Quality Index, PTSD Symptom Checklist). Multivariable regression models (full sample and gender-stratified) were used to predict PTSD symptom severity from global, subscale, and individual item sleep parameters, adjusted for gender, age, race/ethnicity, education, and body mass index. In the full sample, traditional measures of sleep quality and sleep disturbance were associated with PTSD symptom severity. Difficulty falling asleep, poor sleep quality, and sleep disturbance from a variety of sources were related to higher PTSD symptom severity in men, while self-reported sleep disturbance related to nightmares and emotional regulation were associated with PTSD symptom severity among women. These findings add to the limited literature on gender-specific risk factors related to sleep and PTSD, and may inform intervention development and implementation related to PTSD severity among vulnerable adults.

Socioeconomic factors affecting infant sleep-related deaths in St. Louis.

PubMed

Hogan, Cathy

2014-01-01

Though the Back to Sleep Campaign that began in 1994 caused an overall decrease in sudden infant death syndrome (SIDS) rates, racial disparity has continued to increase in St. Louis. Though researchers have analyzed and described various sociodemographic characteristics of SIDS and infant deaths by unintentional suffocation in St. Louis, they have not simultaneously controlled for contributory risk factors to racial disparity such as race, poverty, maternal education, and number of children born to each mother (parity). To determine whether there is a relationship between maternal socioeconomic factors and sleep-related infant death. This quantitative case-control study used secondary data collected by the Missouri Department of Health and Senior Services between 2005 and 2009. The sample includes matched birth/death certificates and living birth certificates of infants who were born/died within time frame. Descriptive analysis, Chi-square, and logistic regression. The controls were birth records of infants who lived more than 1 year. Chi-square and logistic regression analyses confirmed that race and poverty have significant relationships with infant sleep-related deaths. The social significance of this study is that the results may lead to population-specific modifications of prevention messages that will reduce infant sleep-related deaths. © 2013 Wiley Periodicals, Inc.

Somnambulism in Verdi's Macbeth and Bellini's La Sonnambula: opera, sleepwalking, and medicine.

PubMed

Finger, Stanley; Sironi, Vittorio Alessandro; Riva, Michele Augusto

2015-01-01

The arts can provide unique ways for determining how people not directly involved in medicine were viewing and informing others about physical and mental disorders. With operas, one need only think about how various perturbations of madness have been portrayed. Somnambulism has long been a particularly perplexing disorder, both to physicians and the laity, and it features in a number of operas. Two mid-nineteenth-century masterpieces are examined in detail in this contribution: Verdi's Macbeth and Bellini's La Sonnambula. In the former, the sleepwalking scene is faithful to what Shakespeare's had written early in the seventeenth century, a time of witchcraft, superstition, and the belief that nocturnal wanderings might be caused by guilt. In Bellini's opera, in contrast, the victim is an innocent girl who suffers from a quirk of nature, hence eliciting sympathy and compassion. By examining the early literature on somnambulism and comparing this disorder in these operas, we can see how thinking about this condition has changed and, more generally, how music was helping to generate new ways of thinking about specific diseases and medicine. © 2015 Elsevier B.V. All rights reserved.

Sleeping distance in relation to sexual state in the Arctic blue fox.

PubMed

Korhonen, H; Alasuutari, S

1992-01-01

The paper provides comparative data concerning sleeping distance in relation to sexual state and hierarchical dominance in the Arctic blue fox. Increasing levels of vulval swelling and electrical resistance of vaginal tract were inversely related to sleeping distance between the highest-ranking male and each female on heat. A mating pair typically slept no further than 50 cm from each other. One month after copulation, the distance was already more than 200-250 cm. It can be concluded that oestrus-associated changes in sexual hormone levels have an influence on observed changes in sleeping distance.

Sleep quality is negatively related to video gaming volume in adults.

PubMed

Exelmans, Liese; Van den Bulck, Jan

2015-04-01

Most literature on the relationship between video gaming and sleep disturbances has looked at children and adolescents. There is little research on such a relationship in adult samples. The aim of the current study was to investigate the association of video game volume with sleep quality in adults via face-to-face interviews using standardized questionnaires. Adults (n = 844, 56.2% women), aged 18-94 years old, participated in the study. Sleep quality was measured using the Pittsburgh Sleep Quality Index, and gaming volume was assessed by asking the hours of gaming on a regular weekday (Mon-Thurs), Friday and weekend day (Sat-Sun). Adjusting for gender, age, educational level, exercise and perceived stress, results of hierarchical regression analyses indicated that video gaming volume was a significant predictor of sleep quality (β = 0.145), fatigue (β = 0.109), insomnia (β = 0.120), bedtime (β = 0.100) and rise time (β = 0.168). Each additional hour of video gaming per day delayed bedtime by 6.9 min (95% confidence interval 2.0-11.9 min) and rise time by 13.8 min (95% confidence interval 7.8-19.7 min). Attributable risk for having poor sleep quality (Pittsburgh Sleep Quality Index > 5) due to gaming >1 h day was 30%. When examining the components of the Pittsburgh Sleep Quality Index using multinomial regression analysis (odds ratios with 95% confidence intervals), gaming volume significantly predicted sleep latency, sleep efficiency and use of sleep medication. In general, findings support the conclusion that gaming volume is negatively related to the overall sleep quality of adults, which might be due to underlying mechanisms of screen exposure and arousal. © 2014 European Sleep Research Society.

A Nationwide Cross-Sectional Survey of Sleep-Related Problems in Japanese Visually Impaired Patients: Prevalence and Association with Health-Related Quality of Life.

PubMed

Tamura, Norihisa; Sasai-Sakuma, Taeko; Morita, Yuko; Okawa, Masako; Inoue, Shigeru; Inoue, Yuichi

2016-12-15

This questionnaire-based cross-sectional study was conducted (1) to estimate the prevalence of sleep-related problems, and (2) to explore factors associated with lower physical/mental quality of life (QOL), particularly addressing sleep-related problems among Japanese visually impaired people. This nationwide questionnaire-based survey was administered to visually impaired individuals through the Japan Federation of the Blind. Visually impaired individuals without light perception (LP) (n = 311), those with LP (n = 287), and age-matched and gender-matched controls (n = 615) were eligible for this study. Study questionnaires elicited demographic information, and information about visual impairment status, sleep-related problems, and health-related quality of life. Visually impaired individuals with and without LP showed higher prevalence rates of irregular sleep-wake patterns and difficulty maintaining sleep than controls (34.7% and 29.4% vs. 15.8%, 60.1% and 46.7% vs. 26.8%, respectively; p < 0.001). These sleep-related problems were observed more frequently in visually impaired individuals without LP than in those with LP. Non-restorative sleep or excessive daytime sleepiness was associated with lower mental/physical QOL in visually impaired individuals with LP and in control subjects. However, visually impaired individuals without LP showed irregular sleep-wake pattern or difficulty waking up at the desired time, which was associated with lower mental/physical QOL. Sleep-related problems were observed more frequently in visually impaired individuals than in controls. Moreover, the rates of difficulties were higher among subjects without LP. Sleep-related problems, especially circadian rhythm-related ones, can be associated with lower mental/physical QOL in visually impaired individuals without LP. © 2016 American Academy of Sleep Medicine

Sleep-Related Orgasms in a 57-Year-Old Woman: A Case Report.

PubMed

Irfan, Muna; Schenck, Carlos H

2018-01-15

We report a case of problematic spontaneous orgasms during sleep in a 57-year-old woman who also complained of hypnic jerks and symptoms of exploding head syndrome. To our knowledge, this is the first case report in the English language literature of problematic spontaneous orgasms during sleep. She had a complex medical and psychiatric history, and was taking oxycontin, venlafaxine, amitriptyline, and lurasidone. Prolonged video electroencephalogram monitoring did not record any ictal or interictal electroencephalogram discharges, and nocturnal video polysomnography monitoring did not record any behavioral or orgasmic event. Periodic limb movement index was zero events/h. Severe central sleep apnea was detected with apnea-hypopnea index = 130 events/h, but she could not tolerate positive airway pressure titration. Sleep architecture was disturbed, with 96.4% of sleep spent in stage N2 sleep. Bedtime clonazepam therapy (1.5 mg) was effective in suppressing the sleep-related orgasms and hypnic jerks. © 2018 American Academy of Sleep Medicine

A Nationwide Cross-Sectional Survey of Sleep-Related Problems in Japanese Visually Impaired Patients: Prevalence and Association with Health-Related Quality of Life

PubMed Central

Tamura, Norihisa; Sasai-Sakuma, Taeko; Morita, Yuko; Okawa, Masako; Inoue, Shigeru; Inoue, Yuichi

2016-01-01

Study Objectives: This questionnaire-based cross-sectional study was conducted (1) to estimate the prevalence of sleep-related problems, and (2) to explore factors associated with lower physical/mental quality of life (QOL), particularly addressing sleep-related problems among Japanese visually impaired people. Methods: This nationwide questionnaire-based survey was administered to visually impaired individuals through the Japan Federation of the Blind. Visually impaired individuals without light perception (LP) (n = 311), those with LP (n = 287), and age-matched and gender-matched controls (n = 615) were eligible for this study. Study questionnaires elicited demographic information, and information about visual impairment status, sleep-related problems, and health-related quality of life. Results: Visually impaired individuals with and without LP showed higher prevalence rates of irregular sleep-wake patterns and difficulty maintaining sleep than controls (34.7% and 29.4% vs. 15.8%, 60.1% and 46.7% vs. 26.8%, respectively; p < 0.001). These sleep-related problems were observed more frequently in visually impaired individuals without LP than in those with LP. Non-restorative sleep or excessive daytime sleepiness was associated with lower mental/physical QOL in visually impaired individuals with LP and in control subjects. However, visually impaired individuals without LP showed irregular sleep-wake pattern or difficulty waking up at the desired time, which was associated with lower mental/physical QOL. Conclusions: Sleep-related problems were observed more frequently in visually impaired individuals than in controls. Moreover, the rates of difficulties were higher among subjects without LP. Sleep-related problems, especially circadian rhythm-related ones, can be associated with lower mental/physical QOL in visually impaired individuals without LP. Citation: Tamura N, Sasai-Sakuma T, Morita Y, Okawa M, Inoue S, Inoue Y. A nationwide cross-sectional survey of sleep-related

Molecular approaches towards the isolation of sleep-related genes.

PubMed

Schibler, U; Tafti, M

1999-06-01

Behavioural genetics is one of the most enticing fields in modern biology. Owing to straightforward and semiautomated techniques that can be used to measure locomotor activity, circadian rhythmicity is perhaps the best studied behaviour in animals. Thus, during the past decade, five essential circadian clock genes have been isolated in Drosophila, and homologous counterparts for all of these genes have also been found in mammals. As the sleep-wake cycle is under the control of the circadian clock, these circadian master genes are expected to influence sleeping behaviour. However, different vigilance states are regulated by additional mechanisms that also have a genetic basis. In this article we discuss molecular approaches that may prove useful in the search for sleep-related genes.

Medical Care Tasks among Spousal Dementia Caregivers: Links to Care-Related Sleep Disturbances.

PubMed

Polenick, Courtney A; Leggett, Amanda N; Maust, Donovan T; Kales, Helen C

2018-05-01

Medical care tasks are commonly provided by spouses caring for persons living with dementia (PLWDs). These tasks reflect complex care demands that may interfere with sleep, yet their implications for caregivers' sleep outcomes are unknown. The authors evaluated the association between caregivers' medical/nursing tasks (keeping track of medications; managing tasks such as ostomy care, intravenous lines, or blood testing; giving shots/injections; and caring for skin wounds/sores) and care-related sleep disturbances. A retrospective analysis of cross-sectional data from the 2011 National Health and Aging Trends Study and National Study of Caregiving was conducted. Spousal caregivers and PLWDs/proxies were interviewed by telephone at home. The U.S. sample included 104 community-dwelling spousal caregivers and PLWDs. Caregivers reported on their sociodemographic and health characteristics, caregiving stressors, negative caregiving relationship quality, and sleep disturbances. PLWDs (or proxies) reported on their health conditions and sleep problems. Caregivers who performed a higher number of medical/nursing tasks reported significantly more frequent care-related sleep disturbances, controlling for sociodemographic and health characteristics, caregiving stressors, negative caregiving relationship quality, and PLWDs' sleep problems and health conditions. Post hoc tests showed that wound care was independently associated with more frequent care-related sleep disturbances after accounting for the other medical/nursing tasks and covariates. Spousal caregivers of PLWDs who perform medical/nursing tasks may be at heightened risk for sleep disturbances and associated adverse health consequences. Interventions to promote the well-being of both care partners may benefit from directly addressing caregivers' needs and concerns about their provision of medical/nursing care. Copyright © 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights

Circadian regulation of human sleep and age-related changes in its timing, consolidation and EEG characteristics

NASA Technical Reports Server (NTRS)

Dijk, D. J.; Duffy, J. F.

1999-01-01

The light-entrainable circadian pacemaker located in the suprachiasmatic nucleus of the hypothalamus regulates the timing and consolidation of sleep by generating a paradoxical rhythm of sleep propensity; the circadian drive for wakefulness peaks at the end of the day spent awake, ie close to the onset of melatonin secretion at 21.00-22.00 h and the circadian drive for sleep crests shortly before habitual waking-up time. With advancing age, ie after early adulthood, sleep consolidation declines, and time of awakening and the rhythms of body temperature, plasma melatonin and cortisol shift to an earlier clock hour. The variability of the phase relationship between the sleep-wake cycle and circadian rhythms increases, and in old age sleep is more susceptible to internal arousing stimuli associated with circadian misalignment. The propensity to awaken from sleep advances relative to the body temperature nadir in older people, a change that is opposite to the phase delay of awakening relative to internal circadian rhythms associated with morningness in young people. Age-related changes do not appear to be associated with a shortening of the circadian period or a reduction of the circadian drive for wake maintenance. These changes may be related to changes in the sleep process itself, such as reductions in slow-wave sleep and sleep spindles as well as a reduced strength of the circadian signal promoting sleep in the early morning hours. Putative mediators and modulators of circadian sleep regulation are discussed.

The Relation Between Use of Mobile Electronic Devices and Bedtime Resistance, Sleep Duration, and Daytime Sleepiness Among Preschoolers.

PubMed

Nathanson, Amy I; Beyens, Ine

2018-01-01

This study investigated the relation between preschoolers' mobile electronic device (MED) use and sleep disturbances. A national sample of 402 predominantly college-educated and Caucasian mothers of 3-5-year-olds completed a survey assessing their preschoolers' MED use, bedtime resistance, sleep duration, and daytime sleepiness. Heavier evening and daily tablet use (and to some extent, smartphone use) were related to sleep disturbances. Other forms of MED use were not consistently related to sleep disturbances. In addition, playing games on MEDs at bedtime was related to compromised sleep duration, although other forms of MED use at bedtime were not related to sleep outcomes. Although the relations between MED use and sleep disturbances were small in size, they were larger than the relations between sleep and other predictors in the models. Continued work should investigate how MED exposure is related to children's cognitive, psychological, emotional, and physiological development, particularly given the popularity and widespread use of these devices.

Relationships of Sleep Duration With Weight-Related Behaviors of U.S. College Students.

PubMed

Quick, Virginia; Byrd-Bredbenner, Carol; Shoff, Suzanne; White, Adrienne A; Lohse, Barbara; Horacek, Tanya; Colby, Sarah; Brown, Onikia; Kidd, Tandalayo; Greene, Geoffrey

2016-01-01

This study describes sleep behaviors of U.S. college students (N = 1,252; 18-24 years old; 59% female) and examines associations of sleep duration with weight-related behaviors. More than one quarter of participants slept < 7 hr/night and had mean Pittsburgh Sleep Quality Index (PSQI) scores indicating poor sleep quality. There were significant differences for all PSQI scales among sleep duration categories, < 7 hr (n = 344), 7-8 hr (n = 449), ≥ 8 hr (n = 459) sleep/night. Compared to those who slept ≥ 8 hr, those who slept < 8 hr had significantly more negative eating attitudes (2% higher), poorer internal regulation of food (4% lower), and greater binge eating (4% higher) scores. Findings advocate for health care professionals to evaluate sleep behaviors of college students during office visits and promote good sleep behaviors.

Sex-Related Differences in the Effects of Sleep Habits on Verbal and Visuospatial Working Memory.

PubMed

Nakagawa, Seishu; Takeuchi, Hikaru; Taki, Yasuyuki; Nouchi, Rui; Sekiguchi, Atsushi; Kotozaki, Yuka; Miyauchi, Carlos M; Iizuka, Kunio; Yokoyama, Ryoichi; Shinada, Takamitsu; Yamamoto, Yuki; Hanawa, Sugiko; Araki, Tsuyoshi; Kunitoki, Keiko; Sassa, Yuko; Kawashima, Ryuta

2016-01-01

Poor sleep quality negatively affects memory performance, and working memory in particular. We investigated sleep habits related to sleep quality including sleep duration, daytime nap duration, nap frequency, and dream content recall frequency (DCRF). Declarative working memory can be subdivided into verbal working memory (VWM) and visuospatial working memory (VSWM). We hypothesized that sleep habits would have different effects on VWM and VSWM. To our knowledge, our study is the first to investigate differences between VWM and VSWM related to daytime nap duration, nap frequency, and DCRF. Furthermore, we tested the hypothesis that the effects of duration and frequency of daytime naps and DCRF on VWM and VSWM differed according to sex. We assessed 779 healthy right-handed individuals (434 males and 345 females; mean age: 20.7 ± 1.8 years) using a digit span forward and backward VWM task, a forward and backward VSWM task, and sleep habits scales. A correlation analysis was used to test the relationships between VWM capacity (VWMC) and VSWM capacity (VSWMC) scores and sleep duration, nap duration, nap frequency, and DCRF. Furthermore, multiple regression analyses were conducted to identify factors associated with VWMC and VSWMC scores and to identify sex-related differences. We found significant positive correlations between VSWMC and nap duration and DCRF, and between VWMC and sleep duration in all subjects. Furthermore, we found that working memory capacity (WMC) was positively correlated with nap duration in males and with sleep duration in females, and DCRF was positively correlated with VSWMC in females. Our finding of sex-related differences in the effects of sleep habits on WMC has not been reported previously. The associations between WMC and sleep habits differed according to sex because of differences in the underlying neural correlates of VWM and VSWM, and effectiveness of the sleep habits in males and females.

Sex-Related Differences in the Effects of Sleep Habits on Verbal and Visuospatial Working Memory

PubMed Central

Nakagawa, Seishu; Takeuchi, Hikaru; Taki, Yasuyuki; Nouchi, Rui; Sekiguchi, Atsushi; Kotozaki, Yuka; Miyauchi, Carlos M.; Iizuka, Kunio; Yokoyama, Ryoichi; Shinada, Takamitsu; Yamamoto, Yuki; Hanawa, Sugiko; Araki, Tsuyoshi; Kunitoki, Keiko; Sassa, Yuko; Kawashima, Ryuta

2016-01-01

Poor sleep quality negatively affects memory performance, and working memory in particular. We investigated sleep habits related to sleep quality including sleep duration, daytime nap duration, nap frequency, and dream content recall frequency (DCRF). Declarative working memory can be subdivided into verbal working memory (VWM) and visuospatial working memory (VSWM). We hypothesized that sleep habits would have different effects on VWM and VSWM. To our knowledge, our study is the first to investigate differences between VWM and VSWM related to daytime nap duration, nap frequency, and DCRF. Furthermore, we tested the hypothesis that the effects of duration and frequency of daytime naps and DCRF on VWM and VSWM differed according to sex. We assessed 779 healthy right-handed individuals (434 males and 345 females; mean age: 20.7 ± 1.8 years) using a digit span forward and backward VWM task, a forward and backward VSWM task, and sleep habits scales. A correlation analysis was used to test the relationships between VWM capacity (VWMC) and VSWM capacity (VSWMC) scores and sleep duration, nap duration, nap frequency, and DCRF. Furthermore, multiple regression analyses were conducted to identify factors associated with VWMC and VSWMC scores and to identify sex-related differences. We found significant positive correlations between VSWMC and nap duration and DCRF, and between VWMC and sleep duration in all subjects. Furthermore, we found that working memory capacity (WMC) was positively correlated with nap duration in males and with sleep duration in females, and DCRF was positively correlated with VSWMC in females. Our finding of sex-related differences in the effects of sleep habits on WMC has not been reported previously. The associations between WMC and sleep habits differed according to sex because of differences in the underlying neural correlates of VWM and VSWM, and effectiveness of the sleep habits in males and females. PMID:27516751

Childhood Sleep Duration and Quality in Relation to Leptin Concentration in Two Cohort Studies

PubMed Central

Boeke, Caroline E.; Storfer-Isser, Amy; Redline, Susan; Taveras, Elsie M.

2014-01-01

Study Objectives: Poor sleep in childhood is associated with increased obesity risk, possibly by affecting appetite-regulating hormones such as leptin. We examined short- and long-term sleep duration and quality in relation to leptin in two US pediatric cohorts. Design: Analysis of data from two prospective cohort studies. Setting: Population-based. Adolescent polysomnography assessments performed in a clinical research unit. Patients or Participants: Children in Project Viva (n = 655) and adolescents in the Cleveland Children's Sleep & Health Study (n = 502). Interventions: N/A. Measurements and Results: In Project Viva, mothers reported average child sleep duration annually from infancy through age 7, and we measured leptin at ages 3 and 7. In the Cleveland Children's Sleep & Health Study, we collected self-reported sleep duration, polysomnography-derived measures of sleep quality, and fasting leptin at ages 16-19. In sex-stratified linear regression analyses adjusted for sociodemographic characteristics and adiposity, chronic curtailed sleep was associated with lower leptin at age 7 in girls; a one-unit decrease in sleep score was associated with a 0.08 decrease in log leptin (95%CI: 0.01,0.15). The association was stronger in girls with greater adiposity (P = 0.01). Among adolescents, shorter sleep was associated with lower leptin in males; each one-hour decrease in sleep duration was associated with a 0.06 decrease in log leptin (95%CI: 0.00, 0.11). Sleep duration was not associated with leptin at other ages. Sleep quality indices were not associated with leptin. Conclusions: Our results suggest possible age-specific sexual dimorphism in the influence of sleep on leptin, which may partly explain inconsistencies in the literature. Citation: Boeke CE; Storfer-Isser A; Redline S; Taveras EM. Childhood sleep duration and quality in relation to leptin concentration in two cohort studies. SLEEP 2014;37(3):613-620. PMID:24587585

Poor sleep in relation to natural menopause: a population-based 14-year follow-up of midlife women.

PubMed

Freeman, Ellen W; Sammel, Mary D; Gross, Stephanie A; Pien, Grace W

2015-07-01

This study aims to estimate the prevalence and predictors of moderate/severe poor sleep in relation to the final menstrual period (FMP) in midlife women. Annual assessments were conducted in a population-based cohort of 255 women. All were premenopausal at cohort enrollment and reached natural menopause during the 16-year follow-up. The outcome measure was severity of poor sleep, as reported by participants in annual interviews for 16 years and as evaluated in relation to the FMP. The annual prevalence of moderate/severe poor sleep largely ranged from about 28% to 35%, with no significant differences in any year relative to the FMP for the sample overall. When sleep status was stratified at premenopausal baseline, premenopausal sleep status strongly predicted poor sleep around the FMP. Women with moderate/severe poor sleep in premenopause were approximately 3.5 times more likely to have moderate/severe poor sleep around menopause than those with no poor sleep at baseline in adjusted analysis (odds ratio, 3.58; 95% CI, 2.50-5.11; P < 0.0001), whereas mild poor sleepers in premenopause were approximately 1.5 times more likely to have moderate/severe poor sleep around menopause (odds ratio, 1.57; 95% CI, 0.99-2.47; P = 0.053). There was no significant association between poor sleep and time relative to the FMP among women who had no poor sleep at premenopausal baseline. Hot flashes were significantly associated with poor sleep (odds ratio, 1.79; 95% CI, 1.44-2.21; P < 0.0001 in adjusted analysis) but had no interaction with baseline sleep severity (interaction P = 0.25), indicating that hot flashes contributed to poor sleep regardless of baseline sleep status. Findings show a high prevalence of moderate/severe poor sleep in midlife women, with only a small "at-risk" subgroup having a significant increase in poor sleep in relation to the FMP. Sleep status at premenopausal baseline and concurrent hot flashes strongly and consistently predict poor sleep in the menopausal

Self-evaluated and Close Relative-Evaluated Epworth Sleepiness Scale vs. Multiple Sleep Latency Test in Patients with Obstructive Sleep Apnea

PubMed Central

Li, Yun; Zhang, Jihui; Lei, Fei; Liu, Hong; Li, Zhe; Tang, Xiangdong

2014-01-01

Objectives: The aims of this study were to determine (1) the agreement in Epworth Sleepiness Scale (ESS) evaluated by patients and their close relatives (CRs), and (2) the correlation of objective sleepiness as measured by multiple sleep latency test (MSLT) with self-evaluated and close relative-evaluated ESS. Methods: A total of 85 consecutive patients with obstructive sleep apnea (OSA) (70 males, age 46.7 ± 12.9 years old) with an apnea-hypopnea index (AHI) > 5 events per hour (mean 38.9 ± 26.8/h) were recruited into this study. All participants underwent an overnight polysomnographic assessment (PSG), MSLT, and ESS rated by both patients and their CRs. Mean sleep latency < 8 min on MSLT was considered objective daytime sleepiness. Results: Self-evaluated global ESS score (ESSG) was closely correlated with evaluation by CRs (r = 0.79, p < 0.001); the mean ESSG score evaluated by patients did not significantly differ from that evaluated by CRs (p > 0.05). However, Bland- Altman plot showed individual differences between self-evaluated and CR-evaluated ESS scores, with a 95%CI of -9.3 to 7.0. The mean sleep latency on MSLT was significantly associated with CR-evaluated ESSG (r = -0.23, p < 0.05); significance of association with self-evaluated ESSG was marginal (r = -0.21, p = 0.05). Conclusions: CR-evaluated ESS has a good correlation but also significant individual disagreement with self-evaluated ESS in Chinese patients with OSA. CR-evaluated ESS performs as well as, if not better than, self-evaluated ESS in this population when referring to MSLT. Citation: Li Y; Zhang J; Lei F; Liu H; Li Z; Tang X. Self-evaluated and close relative-evaluated Epworth Sleepiness Scale vs. multiple sleep latency test in patients with obstructive sleep apnea. J Clin Sleep Med 2014;10(2):171-176. PMID:24533000

Health-related behaviors associated with subjective sleep insufficiency in Japanese workers: A cross-sectional study.

PubMed

Kageyama, Makoto; Odagiri, Keiichi; Mizuta, Isagi; Yamamoto, Makoto; Yamaga, Keiko; Hirano, Takako; Onoue, Kazue; Uehara, Akihiko

2017-03-28

Sleep disturbances are related to somatic and mental disorders, industrial accidents, absenteeism, and retirement because of disability. We aimed to identify health-related behaviors associated with subjective sleep insufficiency in Japanese workers. This cross-sectional study included 5,297 employees (mean age: 43.6±11.3 years; 4,039 men). Multiple logistic regression analysis was used to identify health-related behaviors associated with subjective sleep insufficiency. Overall, 28.2% of participants experienced subjective sleep insufficiency. There was a significant difference between the genders in the proportion of participants with subjective sleep insufficiency (male: 26.4%; female: 34.3%; p<0.001). Multiple logistic regression analysis revealed that being a female or ≥40 years, experiencing a weight change of ≥3 kg during the preceding year, not exercising regularly, not walking quickly, and eating a late-evening or fourth meal were associated with subjective sleep insufficiency. After stratifying by gender, age ≥40 years, not exercising regularly, and eating a late-evening or fourth meal were significantly associated with subjective sleep insufficiency in both genders. Not walking quickly, experiencing a weight change, and eating quickly were positively associated with subjective sleep insufficiency only for males. Females who did not engage in physical activity were more likely to have experienced subjective sleep insufficiency, but this relationship was not observed in males. The results indicated that certain health-related behaviors, specifically not exercising regularly and nocturnal eating habits, were associated with subjective sleep insufficiency in a group of Japanese workers.

The relation among sleep duration, homework burden, and sleep hygiene in chinese school-aged children.

PubMed

Sun, Wan-Qi; Spruyt, Karen; Chen, Wen-Juan; Jiang, Yan-Rui; Schonfeld, David; Adams, Ryan; Tseng, Chia-Huei; Shen, Xiao-Ming; Jiang, Fan

2014-09-03

Insufficient sleep in school-aged children is common in modern society, with homework burden being a potential risk factor. The aim of this article is to explore the effect of sleep hygiene on the association between homework and sleep duration. Children filled out the Chinese version of the Adolescent Sleep Hygiene Scale, and parents filled out a sociodemographic questionnaire. The final sample included 363 boys and 371 girls with a mean age of 10.82 ± 0.38 years. Children with more homework went to bed later and slept less. Better sleep hygiene was associated with earlier bedtimes and longer sleep duration. Findings suggest that homework burden had a larger effect on sleep duration than sleep hygiene. Fifth-grade children in Shanghai have an excessive homework burden, which overwrites the benefit of sleep hygiene on sleep duration.

Increased Sympathetic and Decreased Parasympathetic Cardiac Tone in Patients with Sleep Related Alveolar Hypoventilation

PubMed Central

Palma, Jose-Alberto; Urrestarazu, Elena; Lopez-Azcarate, Jon; Alegre, Manuel; Fernandez, Secundino; Artieda, Julio; Iriarte, Jorge

2013-01-01

Objective: To assess autonomic function by heart rate variability (HRV) during sleep in patients with sleep related alveolar hypoventilation (SRAH) and to compare it with that of patients with obstructive sleep apnea (OSA) and control patients. Design: Cross-sectional study. Setting: Sleep Unit, University Hospital of University of Navarra. Patients: Fifteen idiopathic and obesity related-SRAH patients were studied. For each patient with SRAH, a patient with OSA, matched in age, sex, body mass index (BMI), minimal oxygen saturation (SatO2), and mean SatO2 was selected. Control patients were also matched in age, sex, and BMI with patients with OSA and those with SRAH, and in apnea/hypopnea index (AHI) with patients with SRAH. Interventions: N/A. Measurements and Results: Time- and frequency-domain HRV measures (R-R, standard deviation of normal-to-normal RR interval [SDNN], very low frequency [VLF], low frequency [LF], high frequency [HF], LF/HF ratio) were calculated across all sleep stages as well as during wakefulness just before and after sleep during a 1-night polysomnography. In patients with SRAH and OSA, LF was increased during rapid eye movement (REM) when compared with control patients, whereas HF was decreased during REM and N1-N2 sleep stages. The LF/HF ratio was equally increased in patients with SRAH and OSA during REM and N1-N2. Correlation analysis showed that LF and HF values during REM sleep were correlated with minimal SatO2 and mean SatO2. Conclusions: Patients with SRAH exhibited an abnormal cardiac tone during sleep. This fact appears to be related to the severity of nocturnal oxygen desaturation. Moreover, there were no differences between OSA and SRAH, supporting the hypothesis that autonomic changes in OSA are primarily related to a reduced nocturnal oxygen saturation, rather than a consequence of other factors such as nocturnal respiratory events. Citation: Palma JA; Urrestarazu E; Lopez-Azcarate J; Alegre M; Fernandez S; Artieda J; Iriarte

Quality of sleep and health-related quality of life in renal transplant recipients.

PubMed

Liu, Hong-Xia; Lin, Jun; Lin, Xiao-Hong; Wallace, Linda; Teng, Sha; Zhang, Shu-Ping; Hao, Yu-Fang

2015-01-01

The purpose of this study was to examine the sleep quality and health-related quality of life (HRQOL) in patients after renal transplantation and to explore the relationship between the quality of sleep and the HRQOL. Sleep disorders are still an important clinical problem after renal transplantation. Previous studies mainly focused on patients' sleep quality before kidney transplant. More studies are needed to document sleep quality after renal transplantation. A cross-sectional design was used in this study. A convenience sample of renal transplant recipients was recruited at an outpatient transplant clinic of a general hospital in Beijing, China. The Pittsburgh Sleep Quality Index (PSQI) was used to measure quality of sleep. The Medical Outcomes Study 36-item Short Form (MOS SF-36) was used to measure health-related quality of life. The average PSQI score of the 204 renal transplant recipients was 5.81±3.52, significantly lower than the norm. Fifty (24.5%) recipients were classified as having poor sleep quality (global PSQI > 7). The mean scores of renal transplant recipients for SF-36 Mental Component Summary (MCS) and Physical Component Summary (PCS) were 47.57±6.71 and 48.26±9.66 respectively. Compared with residents in Sichuan province, recipients' scores for SF-36 dimensions were statistically lower except the dimension of mental health. SF-36 scores of poor sleepers (PSQI > 7) were significantly lower than the good sleepers (PSQI ≤ 7) in both the MCS and PCS. Significant differences exist between the groups in physical function, bodily pain, vitality, and mental health dimensions. Sleep quality and HRQOL of patients after renal transplantation were lower than the norm. Poor sleep is associated with lower HRQOL. Health professionals need to pay attention to sleep quality and HRQOL in renal transplant recipients and take appropriate measures to improve patients' sleep quality and HRQOL.

Sleep Related Changes in Blood Pressure in Hypocretin-Deficient Narcoleptic Mice

PubMed Central

Bastianini, Stefano; Silvani, Alessandro; Berteotti, Chiara; Elghozi, Jean-Luc; Franzini, Carlo; Lenzi, Pierluigi; Lo, Martire Viviana; Zoccoli, Giovanna

2011-01-01

Study Objectives: Although blood pressure during sleep and the difference in blood pressure between sleep and wakefulness carry prognostic information, little is known on their central neural mechanisms. Hypothalamic neurons releasing hypocretin (orexin) peptides control wake-sleep behavior and autonomic functions and are lost in narcolepsy-cataplexy. We investigated whether chronic lack of hypocretin signaling alters blood pressure during sleep. Design: Comparison of blood pressure as a function of the wake-sleep behavior between 2 different hypocretin-deficient mouse models and control mice with the same genetic background. Setting: N/A. Subjects: Hypocretin-ataxin3 transgenic mice with genetic ablation of hypocretin neurons (TG, n = 12); hypocretin gene knock-out mice (KO, n = 8); congenic wild-type controls (WT, n = 10). Interventions: Instrumentation with electrodes for sleep recordings and a telemetric blood pressure transducer. Measurements and Results: Blood pressure was significantly higher in either TG or KO than in WT during non–rapid eye movement sleep (NREMS; 4 ± 2 and 7 ± 2 mm Hg, respectively) and rapid eye movement sleep (REMS; 11 ± 2 and 12 ± 3 mm Hg, respectively), whereas it did not differ significantly between groups during wakefulness. Accordingly, the decrease in blood pressure between either NREMS or REMS and wakefulness was significantly blunted in TG and KO with respect to WT. Conclusions: Chronic lack of hypocretin signaling may entail consequences on blood pressure that are potentially adverse and that vary widely among wake-sleep states. Citation: Bastianini S; Silvani A; Berteotti C; Elghozi JL; Franzini C; Lenzi P; Lo Martire V; Zoccoli G. Sleep related changes in blood pressure in hypocretin-deficient narcoleptic mice. SLEEP 2011;34(2):213-218. PMID:21286242

Respiratory-related activity in hypoglossal neurons across sleep-waking states in cats.

PubMed

Richard, C A; Harper, R M

1991-02-22

Activity of behaviorally identified neurons in the hypoglossal nuclei supplying the genioglossal muscles was assessed in intact, unanesthetized cats across sleep-wake states. Nineteen of 37 recorded cells discharged on a breath-by-breath or tonic basis with the respiratory cycle in at least one state. Most respiratory-related cells discharged more slowly during quiet sleep, whereas rates during rapid eye movement sleep were similar to those of waking.

Sleep-related erections throughout the ages.

PubMed

van Driel, Mels F

2014-07-01

The occurrence of sleep-related erections (SREs) has been known since antiquity. To highlight historical, theological, and sexual medicine-related aspects of SREs throughout the ages. Review of old medical books on male sexual functioning and review of scientific medical and theological articles on SREs from about 1900 on. The cyclic character of SREs was first noted by German researchers in the forties of the 20th century. However, already before the beginning of the Christian era, one knew that men had erections and ejaculations during sleep. In the Middle Ages, SREs were generally considered to be rebellious manifestations of the male body, while it seemed to disobey its owner and showed up its perverted and sinful side. From the fifteenth to the end of the 17th century, severe erectile dysfunction (ED) was ground for divorce. The ecclesiastical court records show that if necessary, the members of the jury sat at the defendant's bedside at night to be able to judge any SREs occurring. Since the 17th century, SREs were considered to be part of masturbation, which could cause many ailments and diseases. Psychoanalyst Stekel acknowledged in 1920 that a morning erection, the last SRE, is a naturally occurring phenomenon in healthy men from infancy to old age. Today, some scientists assume that SREs protect the integrity of the penile cavernous bodies. Throughout the ages, philosophers, theologians, physicians, members of ecclesial law courts, psychoanalysts, psychiatrists, sexologists, physiologists, and urologists have shown interest in SREs. Obviously, the observations and testing of SREs have a long history, from antiquity to modern sleep labs, in men and in women, in newborns and old adults, by penis rings with sharp spikes to fancy strain gauge devices. Despite all these efforts, the mechanisms leading to SREs and its function are however not yet completely understood. © 2014 International Society for Sexual Medicine.

Traffic-related air pollution and sleep in the Boston Area Community Health Survey.

PubMed

Fang, Shona C; Schwartz, Joel; Yang, May; Yaggi, H Klar; Bliwise, Donald L; Araujo, Andre B

2015-01-01

Little is known about environmental determinants of sleep. We investigated the association between black carbon (BC), a marker of traffic-related air pollution, and sleep measures among participants of the Boston Area Community Health Survey. We also sought to assess the impact of sociodemographic factors, health conditions, and season on associations. Residential 24-h BC was estimated from a validated land-use regression model for 3821 participants and averaged over 1-6 months and 1 year. Sleep measures included questionnaire-assessed sleep duration, sleep latency, and sleep apnea. Linear and logistic regression models controlling for confounders estimated the association between sleep measures and BC. Effect modification was tested with interaction terms. Main effects were not observed between BC and sleep measures. However, in stratified models, males experienced 0.23 h less sleep (95% CI: -0.42, -0.03) and those with low SES 0.25 h less sleep (95% CI: -0.48, -0.01) per IQR increase in annual BC (0.21 μg/m(3)). In blacks, sleep duration increased with annual BC (β=0.34 per IQR; 95% CI: 0.12, 0.57). Similar findings were observed for short sleep (≤5 h). BC was not associated with sleep apnea or sleep latency, however, long-term exposure may be associated with shorter sleep duration, particularly in men and those with low SES, and longer sleep duration in blacks.

Sleep and Recovery in Team Sport: Current Sleep-Related Issues Facing Professional Team-Sport Athletes.

PubMed

Fullagar, Hugh H K; Duffield, Rob; Skorski, Sabrina; Coutts, Aaron J; Julian, Ross; Meyer, Tim

2015-11-01

While the effects of sleep loss on performance have previously been reviewed, the effects of disturbed sleep on recovery after exercise are less reported. Specifically, the interaction between sleep and physiological and psychological recovery in team-sport athletes is not well understood. Accordingly, the aim of the current review was to examine the current evidence on the potential role sleep may play in postexercise recovery, with a tailored focus on professional team-sport athletes. Recent studies show that team-sport athletes are at high risk of poor sleep during and after competition. Although limited published data are available, these athletes also appear particularly susceptible to reductions in both sleep quality and sleep duration after night competition and periods of heavy training. However, studies examining the relationship between sleep and recovery in such situations are lacking. Indeed, further observational sleep studies in team-sport athletes are required to confirm these concerns. Naps, sleep extension, and sleep-hygiene practices appear advantageous to performance; however, future proof-of-concept studies are now required to determine the efficacy of these interventions on postexercise recovery. Moreover, more research is required to understand how sleep interacts with numerous recovery responses in team-sport environments. This is pertinent given the regularity with which these teams encounter challenging scenarios during the course of a season. Therefore, this review examines the factors that compromise sleep during a season and after competition and discusses strategies that may help improve sleep in team-sport athletes.

Poor Sleep and Its Relation to Impulsivity in Patients with Antisocial or Borderline Personality Disorders.

PubMed

Van Veen, M M; Karsten, J; Lancel, M

2017-01-01

Studies investigating sleep and personality disorders consistently demonstrate a relation between personality disorders characterized by behavioral disinhibition and/or emotional dysregulation (traditionally termed cluster B personality disorders) and poor sleep. This finding is in line with previous studies associating insomnia with impulsive behavior, since this is a core characteristic of both antisocial and borderline personality disorder. The current study investigates a group (n = 112) of forensic psychiatric inpatients with antisocial or borderline personality disorder or traits thereof. Subjective sleep characteristics and impulsivity were assessed with the Pittsburgh Sleep Quality Index, the Sleep Diagnosis List, and the Barratt Impulsiveness Scale, respectively. More than half of the patients (53.6%) report poor sleep quality and 22.3% appears to suffer from severe chronic insomnia. Both poor sleep quality and chronic insomnia are significantly associated with self-reported impulsivity, in particular with attentional impulsiveness. This association was not significantly influenced by comorbid disorders. Actively treating sleep problems in these patients may not only improve sleep quality, mental health, and physical well-being, but may also have impact on impulsivity-related health risks by increasing self-control.

NREM sleep architecture and relation to GH/IGF-1 axis in Laron syndrome.

PubMed

Verrillo, Elisabetta; Bizzarri, Carla; Cappa, Marco; Bruni, Oliviero; Pavone, Martino; Cutrera, Renato

2010-01-01

Laron syndrome (LS), known as growth hormone (GH) receptor deficiency, is a rare form of inherited GH resistance. Sleep disorders were described as a common feature of adult LS patients, while no data are available in children. Bi-directional interactions between human sleep and the somatotropic system were previously described, mainly between slow wave sleep and the nocturnal GH surge. To analyze the sleep macro- and microstructure in LS and to evaluate the influence of substitutive insulin-like growth factor 1 (IGF-1) therapy on it. Two young LS females underwent polysomnography; the first study was performed during IGF-1 therapy, the second one after a 3-month wash-out period. In both patients, the sleep macrostructure showed that time in bed, sleep period time, total sleep time, sleep efficiency and rapid eye movement (REM) percentage were all increased during wash-out. The sleep microstructure (cyclic alternating pattern: CAP) showed significantly higher EEG slow oscillations (A1%) in NREM sleep, both during IGF-1 therapy and wash-out. Sleep macrostructure in LS children is slightly affected by substitutive IGF-1 therapy. Sleep microstructure shows an increase of A1%, probably related to abnormally high hypothalamic GHRH secretion, due to GH insensitivity. Copyright 2010 S. Karger AG, Basel.

Increased risk for school violence-related behaviors among adolescents with insufficient sleep.

PubMed

Hildenbrand, Aimee K; Daly, Brian P; Nicholls, Elizabeth; Brooks-Holliday, Stephanie; Kloss, Jacqueline D

2013-06-01

School violence is associated with significant acute and long-term negative health outcomes. Previous investigations have largely neglected the role of pertinent health behaviors in school violence, including sleep. Insufficient sleep is associated with adverse physical, behavioral, and psychosocial consequences among adolescents, many of which are concurrently implicated in youth violence. This study examined the relationship between insufficient sleep and school violence behaviors in a nationally representative sample of high school students. We used data from the 2009 National Youth Risk Behavior Survey (YRBS). Logistic regression analyses evaluated the association between insufficient sleep and school violence behaviors, controlling for demographic factors. In addition to examining main effects, interaction terms were entered into the models to examine whether potential associations varied by sex or race/ethnicity. Students with insufficient sleep had higher odds of engaging in the majority of school violence-related behaviors examined compared to students with sufficient sleep. Males with insufficient sleep were at increased risk of weapon carrying at school, a finding not observed for females with insufficient sleep. White students with insufficient sleep had higher odds of missing school because of safety concerns, a pattern that did not emerge among Black and Hispanic/Latino students. Results highlight the potential value of incorporating sleep education interventions into school-based violence prevention programs and underline the need for further examination of the relationship between sleep and school violence among adolescents. © 2013, American School Health Association.

Comparison of Infant Sleep Practices in African-American and US Hispanic Families: Implications for Sleep-Related Infant Death.

PubMed

Mathews, Anita A; Joyner, Brandi L; Oden, Rosalind P; Alamo, Ines; Moon, Rachel Y

2015-06-01

African-American and Hispanic families share similar socioeconomic profiles. Hispanic rates of sleep-related infant death are four times lower than African-American rates. We conducted a cross-sectional, multi-modal (surveys, qualitative interviews) study to compare infant care practices that impact risk for sleep-related infant death in African-American and Hispanic families. We surveyed 422 African-American and 90 Hispanic mothers. Eighty-three African-American and six Hispanic mothers participated in qualitative interviews. African-American infants were more likely to be placed prone (p < 0.001), share the bed with the parent (p < 0.001), and to be exposed to smoke (p < 0.001). Hispanic women were more likely to breastfeed (p < .001), while African-American women were more knowledgeable about SIDS. Qualitative interviews indicate that, although African-American and Hispanic parents had similar concerns, behaviors differed. Although the rationale for infant care decisions was similar for African-American and Hispanic families, practices differed. This may help to explain the racial/ethnic disparity seen in sleep-related infant deaths.

Sleep patterns of offshore day-workers in relation to overtime work and age.

PubMed

Parkes, Katharine R

2015-05-01

In addition to long contractual hours during offshore weeks (14 × 12 h shifts), many personnel on North Sea oil/gas installations also work overtime, but little is known about the implications of overtime for sleep patterns offshore. In this study, the additive and interactive effects of overtime and age were analysed as predictors of sleep duration and sleep quality among offshore day-workers (N = 551), 54% of whom reported overtime. Sleep duration and quality were impaired among personnel who worked overtime, relative to those who worked only standard shifts; there was also an inverse dose-response relationship between overtime hours and sleep duration. Although the sleep measures were more favourable during shore leave than during offshore weeks, there was little evidence of compensatory sleep patterns. These findings are discussed with reference to known performance and health effects of short sleep hours; formal guidance on overtime work offshore is noted; and methodological issues are considered. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Obesity and Sleep-Related Breathing Disorders in Middle East and UAE.

PubMed

Vats, Mayank G; Mahboub, Bassam H; Al Hariri, Hassan; Al Zaabi, Ashraf; Vats, Deepa

2016-01-01

A pandemic of obesity is sweeping all across the globe and the Middle East region also does not remain untouched by this prevailing pandemic. In fact, as per WHO report, Kuwait has the second highest obesity prevalence followed closely by other Middle East (ME) countries, namely, Qatar, Saudi Arabia, and United Arab Emirates (UAE). Apart from direct medical, psychological, and quality of life related adverse effects of obesity, many indirect medical comorbidities, namely, obstructive sleep apnea (OSA), obesity hypoventilation syndrome (OHS), diabetes mellitus (DM), hypertension (HTN), and metabolic syndrome, imposes a significant health burden on the individual and community with consequent morbidity and mortality. The purpose of this review is to shed light on the very high prevalence of obesity, undiagnosed sleep apnea, and other obesity related disorders with discussion of the contributing factors specific to the region including the fair insight into the current status of sleep medicine services in Middle East and UAE despite huge number of patients having undiagnosed sleep disorders. We will also suggest to control this epidemic of obesity and OSA so that the corrective measure could be taken at health ministry level to help people of this region to fight against obesity and related disorders, primarily OSA.

Obesity and Sleep-Related Breathing Disorders in Middle East and UAE

PubMed Central

Mahboub, Bassam H.; Al Hariri, Hassan; Al Zaabi, Ashraf; Vats, Deepa

2016-01-01

A pandemic of obesity is sweeping all across the globe and the Middle East region also does not remain untouched by this prevailing pandemic. In fact, as per WHO report, Kuwait has the second highest obesity prevalence followed closely by other Middle East (ME) countries, namely, Qatar, Saudi Arabia, and United Arab Emirates (UAE). Apart from direct medical, psychological, and quality of life related adverse effects of obesity, many indirect medical comorbidities, namely, obstructive sleep apnea (OSA), obesity hypoventilation syndrome (OHS), diabetes mellitus (DM), hypertension (HTN), and metabolic syndrome, imposes a significant health burden on the individual and community with consequent morbidity and mortality. The purpose of this review is to shed light on the very high prevalence of obesity, undiagnosed sleep apnea, and other obesity related disorders with discussion of the contributing factors specific to the region including the fair insight into the current status of sleep medicine services in Middle East and UAE despite huge number of patients having undiagnosed sleep disorders. We will also suggest to control this epidemic of obesity and OSA so that the corrective measure could be taken at health ministry level to help people of this region to fight against obesity and related disorders, primarily OSA. PMID:28070158

"Every shut eye, ain't sleep": The role of racism-related vigilance in racial/ethnic disparities in sleep difficulty.

PubMed

Hicken, Margaret T; Lee, Hedwig; Ailshire, Jennifer; Burgard, Sarah A; Williams, David R

2013-06-01

Although racial/ethnic disparities in health have been well-characterized in biomedical, public health, and social science research, the determinants of these disparities are still not well-understood. Chronic psychosocial stress related specifically to the American experience of institutional and interpersonal racial discrimination may be an important determinant of these disparities, as a growing literature in separate scientific disciplines documents the adverse health effects of stress and the greater levels of stress experienced by non-White compared to White Americans. However, the empirical literature on the importance of stress for health and health disparities specifically due to racial discrimination, using population-representative data, is still small and mixed. In this paper, we explore the association between a novel measure of racially-salient chronic stress - "racism-related vigilance" - and sleep difficulty. We found that, compared to the White adults in our sample, Black (but not Hispanic) adults reported greater levels of vigilance. This vigilance was positively associated with sleep difficulty to similar degrees for all racial/ethnic groups in our sample (White, Black, Hispanic). Black adults reported greater levels of sleep difficulty compared to White adults. This disparity was slightly attenuated after adjustment for education and income. However, this disparity was completely attenuated after adjustment for racism-related vigilance. We found similar patterns of results for Hispanic compared to White adults, however, the disparities in sleep difficulty were smaller and not statistically significant. Because of the importance of sleep quality to health, our results suggest that the anticipation of and perseveration about racial discrimination is an important determinant of racial disparities in health.

Mental health, sleep quality, drinking motives, and alcohol-related consequences: a path-analytic model.

PubMed

Kenney, Shannon R; Lac, Andrew; Labrie, Joseph W; Hummer, Justin F; Pham, Andy

2013-11-01

Poor mental health, sleep problems, drinking motivations, and high-risk drinking are prevalent among college students. However, research designed to explicate the interrelationships among these health risk behaviors is lacking. This study was designed to assess the direct and indirect influences of poor mental health (a latent factor consisting of depression, anxiety, and stress) to alcohol use and alcohol-related consequences through the mediators of global sleep quality and drinking motives in a comprehensive model. Participants were 1,044 heavy-drinking college students (66.3% female) who completed online surveys. A hybrid structural equation model tested hypotheses involving relations leading from poor mental health to drinking motives and poorer global sleep quality to drinking outcomes. Results showed that poor mental health significantly predicted all four subscales of drinking motivations (social, coping, conformity, and enhancement) as well as poor sleep. Most of the drinking motives and poor sleep were found to explain alcohol use and negative alcohol consequences. Poor sleep predicted alcohol consequences, even after controlling for all other variables in the model. The hypothesized mediational pathways were examined with tests of indirect effects. This is the first study to assess concomitantly the relationships among three vital health-related domains (mental health, sleep behavior, and alcohol risk) in college students. Findings offer important implications for college personnel and interventionists interested in reducing alcohol risk by focusing on alleviating mental health problems and poor sleep quality.

Age-Related Sleep Disruption and Reduction in the Circadian Rhythm of Urine Output: Contribution to Nocturia?

PubMed Central

Duffy, Jeanne F.; Scheuermaier, Karine; Loughlin, Kevin R.

2015-01-01

Aging is associated with a marked increase in sleep complaints, and one factor causing sleep disruption is waking to void (nocturia). Urological surveys have found that few young adults report nocturia symptoms, but about half of those in their 60’s and nearly 80% of older age groups are affected. Sleep surveys have found nocturia is a major cause of sleep disruption, with a majority of older adults with sleep disruption citing the need to void as the cause of their awakening. While much of the urological literature implies that nocturia causes sleep disruption, age-related changes in sleep depth and continuity may make it more likely that an older adult will wake in response to a filling bladder, or that an older adult will wake for another reason and then decide to void. There is also evidence that age-related changes in the amplitude of circadian rhythms contribute to nocturia. There is a well-described circadian rhythm in urine output, and evidence of circadian rhythmicity in some diuretic and anti-diuretic hormones. In this article we describe how age-related changes in sleep depth and continuity and age-related changes in circadian rhythm amplitude may contribute to nocturia, and how nocturia in turn leads to sleep disruption. Better understanding of how changes in sleep and circadian rhythmicity impact nocturia may lead to improved treatments and better quality of life for older adults. PMID:26632430

Lack of Resilience Is Related to Stress-Related Sleep Reactivity, Hyperarousal, and Emotion Dysregulation in Insomnia Disorder

PubMed Central

Palagini, Laura; Moretto, Umberto; Novi, Martina; Masci, Isabella; Caruso, Danila; Drake, Christopher L.; Riemann, Dieter

2018-01-01

Study Objectives: According to the diathesis-stress model of insomnia, insomnia may develop in vulnerable individuals in response to stress. Resilience is a psychobiological factor that determines an individual's capacity to adapt successfully to stressful events and low resilience increases vulnerability for development of mental disorders. The aim was to explore resilience in subjects with insomnia and its relationship with the factors that contribute to its development and perpetuation. Methods: The study consisted of 58 subjects with Insomnia Disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and 38 good sleepers. Resilience Scale for Adults (RSA), Ford Insomnia Response to Stress Test (FIRST), Pre-sleep Arousal Scale (PSAS), and Difficulties in Emotion Regulation Scale (DERS) were administered while taking into account psychiatric symptoms. Differences in means between groups were assessed using t test or Mann-Whitney U/Wilcoxon test. Linear/multivariable regression analyses and mediation analyses were performed. Results: Subjects with insomnia (24 females, mean age 49 ± 2.1 years) had lower RSA and higher FIRST, DERS, and PSAS scores than good sleepers (22 females, mean age 47.2 ± 1.2 years). After controlling for anxiety/depressive symptoms, low resilience correlated with high stress-related sleep reactivity (P = .004), pre-sleep cognitive hyperarousal (P = .01) and emotion dysregulation (P = .01). Emotion dysregulation mediated the relationship between low resilience and cognitive hyperarousal (Z = 2.06, P = .03). Conclusions: Subjects with insomnia showed low resilience, which was related to high stress-related sleep reactivity, emotional dysregulation, and hyperarousal. If resilience helps to minimize the extent of pathogenesis in the developmental process, an early identification of vulnerable candidates should be useful for preventing insomnia development and maintenance. Commentary: A commentary on this

Sleep apnea syndrome and snoring in patients with hypothyroidism with relation to overweight.

PubMed

Misiolek, M; Marek, B; Namyslowski, G; Scierski, W; Zwirska-Korczala, K; Kazmierczak-Zagorska, Z; Kajdaniuk, D; Misiolek, H

2007-03-01

The relation between snoring and obstructive sleep apnea as well as hypothyroidism is the object of interest of many authors. The respiratory disturbances during sleep are often observed in patients suffering from hypothyroidism. The relation of snoring to overweight in those patients has not been taken into account. The aim of the study was to evaluate the relations between hypothyroidism and quantitative and qualitative respiratory disturbances during sleep. Additional aim was to establish the relations of sleep apnea syndrome, snoring, hypothyroidism and overweight. The subjects included 15 patients (11 females and 4 males) aged from 28 to 73 (mean 50.3) suffering from hypothyroidism. All of them underwent thyroid testing before and after the hormonal treatment. TSH and fT4 concentrations were determined. At the same time the sleep assessment (PolyMESAM) was performed twice. Data were obtained from sleep studies and questionnaires (Epworth sleepiness scale). After the thyroid hormones stabilization significant decrease of snoring severity was observed. On the contrary, the respiratory disturbance index (RDI), desaturation index (DI), the lowest saturation (LSAT) did not change significantly, however, the Epworth scale score showed significant improvement. The correlations showed the strong relation between loud snoring and TSH (r=0.73, p<0.01) and fT4 (r=-0.66, p<0.003) concentrations before the treatment. The analysis showed no correlation between body mass (BMI) and snoring. The hormonal stabilization in patients suffering from hypothyroidism causes improvement in snoring severity. Based on our investigation the relationship between hypothyroidism and severity of snoring and excessive daytime somnolence was confirmed. It indicates a possible connection between hypothyroidism and upper airway resistance syndrome.

Chronic hypoventilation syndromes and sleep-related hypoventilation

PubMed Central

Böing, Sebastian

2015-01-01

Chronic hypoventilation affects patients with disorders on any level of the respiratory system. The generation of respiratory impulses can be impaired in congenital disorders, such as central congenital alveolar hypoventilation, in alterations of the brain stem or complex diseases like obesity hypoventilation. The translation of the impulses via spinal cord and nerves to the respiratory muscles can be impaired in neurological diseases. Thoraco-skeletal or muscular diseases may inhibit the execution of the impulses. All hypoventilation disorders are characterized by a reduction of the minute ventilation with an increase of daytime hypercapnia. As sleep reduces minute ventilation substantially in healthy persons and much more pronounced in patients with underlying thoraco-pulmonary diseases, hypoventilation manifests firstly during sleep. Therefore, sleep related hypoventilation may be an early stage of chronic hypoventilation disorders. After treatment of any prevailing underlying disease, symptomatic therapy with non-invasive ventilation (NIV) is required. The adaptation of the treatment should be performed under close medical supervision. Pressure support algorithms have become most frequently used. The most recent devices automatically apply pressure support and vary inspiratory and expiratory pressures and breathing frequency in order to stabilize upper airways, normalize ventilation, achieve best synchronicity between patient and device and aim at optimizing patients’ adherence. PMID:26380756

Event-related potential measures of gap detection threshold during natural sleep.

PubMed

Muller-Gass, Alexandra; Campbell, Kenneth

2014-08-01

The minimum time interval between two stimuli that can be reliably detected is called the gap detection threshold. The present study examines whether an unconscious state, natural sleep affects the gap detection threshold. Event-related potentials were recorded in 10 young adults while awake and during all-night sleep to provide an objective estimate of this threshold. These subjects were presented with 2, 4, 8 or 16ms gaps occurring in 1.5 duration white noise. During wakefulness, a significant N1 was elicited for the 8 and 16ms gaps. N1 was difficult to observe during stage N2 sleep, even for the longest gap. A large P2 was however elicited and was significant for the 8 and 16ms gaps. Also, a later, very large N350 was elicited by the 16ms gap. An N1 and P2 was significant only for the 16ms gap during REM sleep. ERPs to gaps occurring in noise segments can therefore be successfully elicited during natural sleep. The gap detection threshold is similar in the waking and sleeping states. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

The missing link between sleep disorders and age-related dementia: recent evidence and plausible mechanisms.

PubMed

Zhang, Feng; Zhong, Rujia; Li, Song; Chang, Raymond Chuen-Chung; Le, Weidong

2017-05-01

Sleep disorders are among the most common clinical problems and possess a significant concern for the geriatric population. More importantly, while around 40% of elderly adults have sleep-related complaints, sleep disorders are more frequently associated with co-morbidities including age-related neurodegenerative diseases and mild cognitive impairment. Recently, increasing evidence has indicated that disturbed sleep may not only serve as the consequence of brain atrophy, but also contribute to the pathogenesis of dementia and, therefore, significantly increase dementia risk. Since the current therapeutic interventions lack efficacies to prevent, delay or reverse the pathological progress of dementia, a better understanding of underlying mechanisms by which sleep disorders interact with the pathogenesis of dementia will provide possible targets for the prevention and treatment of dementia. In this review, we briefly describe the physiological roles of sleep in learning/memory, and specifically update the recent research evidence demonstrating the association between sleep disorders and dementia. Plausible mechanisms are further discussed. Moreover, we also evaluate the possibility of sleep therapy as a potential intervention for dementia.

"Sleep well, our tough heroes!"--in adolescence, greater mental toughness is related to better sleep schedules.

PubMed

Brand, Serge; Gerber, Markus; Kalak, Nadeem; Kirov, Roumen; Lemola, Sakari; Clough, Peter J; Pühse, Uwe; Holsboer-Trachsler, Edith

2014-01-01

Mental toughness (MT) is understood as the display of confidence, commitment, challenge, and control. The aim of this study was to explore the extent to which greater MT is associated with subjectively assessed sleep among adolescents. A total of 284 adolescents (M = 18.26 years) completed a series of questionnaires assessing MT, psychological functioning, and sleep. Greater MT was significantly associated with better sleep quality, shorter sleep onset latency, fewer awakenings after sleep onset, and longer sleep duration. Greater MT was also associated with less perceived stress and less depressive symptoms. MT was directly and indirectly associated with sleep quality. Mentally tough adolescents report good sleep quality and sleep schedules, along with psychological wellbeing.

Youth internalizing symptoms, sleep-related problems, and disordered eating attitudes and behaviors: A moderated mediation analysis.

PubMed

Chardon, Marie L; Janicke, David M; Carmody, Julia K; Dumont-Driscoll, Marilyn C

2016-04-01

Internalizing symptoms increase the risk for disordered eating; however, the mechanism through which this relationship occurs remains unclear. Sleep-related problems may be a potential link as they are associated with both emotional functioning and disordered eating. The present study aims to evaluate the mediating roles of two sleep-related problems (sleep disturbance and daytime sleepiness) in the relationship between youth internalizing symptoms and disordered eating, and to explore if age moderates these relations. Participants were 225 youth (8-17years) attending a primary care appointment. Youth and legal guardians completed questionnaires about youth disordered eating attitudes and behaviors, internalizing symptoms, sleep disturbance, and daytime sleepiness. Mediation and moderated mediation analyses were utilized. The mediation model revealed both youth sleep disturbance and daytime sleepiness independently mediated the association between internalizing symptoms and disordered eating attitudes and behaviors, and explained 18% of the variance in disordered eating. The moderated mediation model including youth age accounted for 21% of the variance in disordered eating; youth age significantly interacted with sleep disturbance, but not with daytime sleepiness, to predict disordered eating. Sleep disturbance only mediated the relationship between internalizing symptoms and disordered eating in youth 12years old and younger, while daytime sleepiness was a significant mediator regardless of age. As sleep-related problems are frequently improved with the adoption of health behaviors conducive to good sleep, these results may suggest a relatively modifiable and cost-effective target to reduce youth risk for disordered eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

Children's Sleep Regulation Is Linked to Mothers' Sleep-Related Childhood Experiences

ERIC Educational Resources Information Center

Aviezer, Ora; Scher, Anat

2013-01-01

The present research explored how mothers' own childhood experiences are linked to their perceptions of their children's sleep regulation. It focused on collective sleeping; a practice used in the past in the Israeli kibbutz, and used a quasi-experimental research design to examine whether mothers who were raised in collective sleeping…

Sleep and Mental Health in Undergraduate Students with Generally Healthy Sleep Habits

PubMed Central

Milojevich, Helen M.; Lukowski, Angela F.

2016-01-01

Whereas previous research has indicated that sleep problems tend to co-occur with increased mental health issues in university students, relatively little is known about relations between sleep quality and mental health in university students with generally healthy sleep habits. Understanding relations between sleep and mental health in individuals with generally healthy sleep habits is important because (a) student sleep habits tend to worsen over time and (b) even time-limited experience of sleep problems may have significant implications for the onset of mental health problems. In the present research, 69 university students with generally healthy sleep habits completed questionnaires about sleep quality and mental health. Although participants did not report clinically concerning mental health issues as a group, global sleep quality was associated with mental health. Regression analyses revealed that nighttime sleep duration and the frequency of nighttime sleep disruptions were differentially related to total problems and clinically-relevant symptoms of psychological distress. These results indicate that understanding relations between sleep and mental health in university students with generally healthy sleep habits is important not only due to the large number of undergraduates who experience sleep problems and mental health issues over time but also due to the potential to intervene and improve mental health outcomes before they become clinically concerning. PMID:27280714

Sleep and Mental Health in Undergraduate Students with Generally Healthy Sleep Habits.

PubMed

Milojevich, Helen M; Lukowski, Angela F

2016-01-01

Whereas previous research has indicated that sleep problems tend to co-occur with increased mental health issues in university students, relatively little is known about relations between sleep quality and mental health in university students with generally healthy sleep habits. Understanding relations between sleep and mental health in individuals with generally healthy sleep habits is important because (a) student sleep habits tend to worsen over time and (b) even time-limited experience of sleep problems may have significant implications for the onset of mental health problems. In the present research, 69 university students with generally healthy sleep habits completed questionnaires about sleep quality and mental health. Although participants did not report clinically concerning mental health issues as a group, global sleep quality was associated with mental health. Regression analyses revealed that nighttime sleep duration and the frequency of nighttime sleep disruptions were differentially related to total problems and clinically-relevant symptoms of psychological distress. These results indicate that understanding relations between sleep and mental health in university students with generally healthy sleep habits is important not only due to the large number of undergraduates who experience sleep problems and mental health issues over time but also due to the potential to intervene and improve mental health outcomes before they become clinically concerning.

Integration of immigrants into a new culture is related to poor sleep quality.

PubMed

Voss, Ursula; Tuin, Inka

2008-08-10

This article reports on the relationship between cultural influences on life style, coping style, and sleep in a sample of female Portuguese immigrants living in Germany. Sleep quality is known to be poorer in women than in men, yet little is known about mediating psychological and sociological variables such as stress and coping with stressful life circumstances. Migration constitutes a particularly difficult life circumstance for women if it involves differing role conceptions in the country of origin and the emigrant country. The study investigated sleep quality, coping styles and level of integration in a sample of Portuguese (N = 48) and Moroccan (N = 64) immigrant women who took part in a structured personal interview. Sleep quality was poor in 54% of Portuguese and 39% of Moroccan women, which strongly exceeds reports of sleep complaints in epidemiologic studies of sleep quality in German women. Reports of poor sleep were associated with the degree of adoption of a German life style. Women who had integrated more into German society slept worse than less integrated women in both samples, suggesting that non-integration serves a protective function. An unusually large proportion of women preferred an information-seeking (monitoring) coping style and adaptive coping. Poor sleep was related to high monitoring in the Portuguese but not the Moroccan sample. Sleep quality appears to be severely affected in women with a migration background. Our data suggest that non-integration may be less stressful than integration. This result points to possible benefits of non-integration. The high preference for an information-seeking coping style may be related to the process of migration, representing the attempt at regaining control over an uncontrollable and stressful life situation.

Sleep, health-related quality of life, and functional outcomes in adults with diabetes.

PubMed

Chasens, Eileen R; Sereika, Susan M; Burke, Lora E; Strollo, Patrick J; Korytkowski, Mary

2014-11-01

This study explored the association of sleep quality with physical and mental health-related quality of life (HRQoL) and functional outcomes in 116 participants with type 2 diabetes. The study is a secondary analysis of baseline data from a clinical trial that examined treatment of obstructive sleep apnea on physical activity and glucose control. Instruments included the Pittsburgh Sleep Quality Index, Medical Outcomes Short-Form Physical Component and Mental Component Scores, and Functional Outcomes of Sleep Questionnaire. Higher physical HRQoL was significantly associated with better sleep quality and improved functional outcomes of increased activity and productivity. Higher mental HRQoL was associated with improved sleep quality and improved functional outcomes of increased activity, social interactions, vigilance, and productivity. Poor sleep quality was a predictor of decreased functional outcomes while controlling for age, race, education, BMI, marital status and physical and mental HRQoL. Poor sleep quality is associated with negative physical, mental, and functional outcomes in adults with type 2 diabetes. Copyright © 2014 Elsevier Inc. All rights reserved.

Sleep disturbances in young and middle-aged adults - Empirical patterns and related factors from an epidemiological survey.

PubMed

Rössler, Wulf; AjdacicGross, Vladeta; Glozier, Nick; Rodgers, Stephanie; Haker, Helene; Müller, Mario

2017-10-01

Previous research suggests that sleep disorders are highly associated with other mental health problems. However, sleep problems even below the diagnostic threshold of sleep disorders are very common in the general population, which highly affects wellbeing and functioning. In order to broaden the focus beyond those severe cases we explored empirical patterns across the whole spectrum of sleep problems as well as associated clinical and other factors. A representative community sample of N=1274 residents from the canton of Zurich was interviewed for sleep problems and diagnostic criteria for mental disorders as well as was given a number of mental health-related psychometrical checklists. Based on a broader spectrum of sleep problems we conducted a latent class analysis (LCA) to derive distinct classes of such disturbances. Classes were compared regarding their associations to mental health-relevant and other risk factors. The LCA revealed four classes - no sleep disturbances (72.6%), difficulties initiating and maintaining sleep (15.8%), delayed sleep (5.3%), and severe sleep problems (6.4%). Severe sleep problems were related to female gender and generalized anxiety disorder, while depression was linked to all sleep problem classes. Persons with difficulties initiating and maintaining sleep and severe sleep problems reported higher levels of psychopathology, burnout and neuroticism, while all sleep problem types were tied to stress-related variables, but not alcohol use disorder. Sleep problems are highly prevalent among the young and middle-aged adults in our representative sample of young and middle-aged adults and as such represent a serious public mental health problem. Our findings indicate sleep problems to have a multi-dimensional structure with some differential associations. While all subtypes were associated with poorer mental health and particularly more depression, severe sleep problems appeared to be the sleep subtype seen in agoraphobia and GAD

Artificial light at night affects sleep behaviour differently in two closely related songbird species.

PubMed

Sun, Jiachen; Raap, Thomas; Pinxten, Rianne; Eens, Marcel

2017-12-01

Artificial light at night (ALAN) or light pollution is an increasing and worldwide problem. There is growing concern that because of the disruption of natural light cycles, ALAN may pose serious risks for wildlife. While ALAN has been shown to affect many aspects of animal behaviour and physiology, few studies have experimentally studied whether individuals of different species in the wild respond differently to ALAN. Here, we investigated the effect of ALAN on sleep behaviour in two closely related songbird species inhabiting the same study area and roosting/breeding in similar nest boxes. We experimentally exposed free-living great tits (Parus major) and blue tits (Cyanistes caeruleus) to artificial light inside their nest boxes and observed changes in their sleep behaviour compared to the previous night when the nest boxes were dark. In line with previous studies, sleep behaviour of both species did not differ under dark conditions. ALAN disrupted sleep in both great and blue tits. However, compared to blue tits, great tits showed more pronounced effects and more aspects of sleep were affected. Light exposed great tits entered the nest boxes and fell asleep later, woke up and exited the nest boxes earlier, and the total sleep amount and sleep percentage were reduced. By contrast, these changes in sleep behaviour were not found in light exposed blue tits. Our field experiment, using exactly the same light manipulation in both species, provides direct evidence that two closely related species respond differently to ALAN, while their sleep behaviour under dark conditions was similar. Our research suggests that findings for one species cannot necessarily be generalised to other species, even closely-related species. Furthermore, species-specific effects could have implications for community dynamics. Copyright © 2017 Elsevier Ltd. All rights reserved.

Deep Sleep and Parietal Cortex Gene Expression Changes Are Related to Cognitive Deficits with Age

PubMed Central

Buechel, Heather M.; Popovic, Jelena; Searcy, James L.; Porter, Nada M.; Thibault, Olivier; Blalock, Eric M.

2011-01-01

Background Age-related cognitive deficits negatively affect quality of life and can presage serious neurodegenerative disorders. Despite sleep disruption's well-recognized negative influence on cognition, and its prevalence with age, surprisingly few studies have tested sleep's relationship to cognitive aging. Methodology We measured sleep stages in young adult and aged F344 rats during inactive (enhanced sleep) and active (enhanced wake) periods. Animals were behaviorally characterized on the Morris water maze and gene expression profiles of their parietal cortices were taken. Principal Findings Water maze performance was impaired, and inactive period deep sleep was decreased with age. However, increased deep sleep during the active period was most strongly correlated to maze performance. Transcriptional profiles were strongly associated with behavior and age, and were validated against prior studies. Bioinformatic analysis revealed increased translation and decreased myelin/neuronal pathways. Conclusions The F344 rat appears to serve as a reasonable model for some common sleep architecture and cognitive changes seen with age in humans, including the cognitively disrupting influence of active period deep sleep. Microarray analysis suggests that the processes engaged by this sleep are consistent with its function. Thus, active period deep sleep appears temporally misaligned but mechanistically intact, leading to the following: first, aged brain tissue appears capable of generating the slow waves necessary for deep sleep, albeit at a weaker intensity than in young. Second, this activity, presented during the active period, seems disruptive rather than beneficial to cognition. Third, this active period deep sleep may be a cognitively pathologic attempt to recover age-related loss of inactive period deep sleep. Finally, therapeutic strategies aimed at reducing active period deep sleep (e.g., by promoting active period wakefulness and/or inactive period deep sleep) may

Association between stress-related sleep reactivity and cognitive processes in insomnia disorder and insomnia subgroups: preliminary results.

PubMed

Palagini, Laura; Faraguna, Ugo; Mauri, Mauro; Gronchi, Alessia; Morin, Charles M; Riemann, Dieter

2016-03-01

Stress-related sleep reactivity, sleep-related cognitions, and psychological factors play an important role in insomnia. The aim was to investigate their possible association in Insomnia Disorder, insomnia subgroups, and healthy subjects. The cross-sectional study consisted of 93 subjects who met diagnostic criteria for Insomnia Disorder according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and of 30 healthy subjects. Survey instruments included the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Ford Insomnia Response to Stress Test (FIRST), Dysfunctional Beliefs about Sleep scale (DBAS), Beck Depression Inventory (BDI), and Zung Self-Rating Anxiety Scale (SAS). Descriptive statistics, Pearson correlations, χ(2)-test, and multiple linear regression were performed. FIRST and SAS best determined the insomnia subjects vs good sleepers (FIRST χ(2) = 109.6, p <0.001, SAS χ(2) = 120.3, p <0.001). FIRST was best predicted by DBAS (p <0.001), PSQI (p <0.001), and SAS by PSQI (p <0.001), ISI (p <0.05), BDI (p <0.001). In the sleep onset subgroup FIRST was related to ISI, PSQI, and DBAS and in the combined subgroup with DBAS. In both subgroups SAS was related to PSQI, ISI, and BDI. Findings suggest potential implications: (1) among the factors that may contribute to insomnia, stress-related sleep reactivity, and psychological factors, such as anxiety symptoms, may distinguish insomnia subjects from good sleepers; (2) sleep reactivity and sleep-related cognitions seem interrelated, unhelpful beliefs may affect the stress reactivity; (3) psychological factors may influence sleep quality and the severity of insomnia; (4) these important sleep-related variables may have similar associations in insomnia subgroups; they may constitute the core factors for insomnia development and maintenance. Copyright © 2015 Elsevier B.V. All rights reserved.

Autonomic Arousals Related to Traffic Noise during Sleep

PubMed Central

Griefahn, Barbara; Bröde, Peter; Marks, Anke; Basner, Mathias

2008-01-01

Aim: To analyze the heart rate (HR) response to traffic noise during sleep and the influence of acoustic parameters, time of night, and momentary sleep stage on these responses. Participants: Twelve women and 12 men (19–28 years). Measurements and Results: The participants slept in the laboratory for 4 consecutive nights in each of 3 consecutive weeks and were exposed to aircraft, road, or rail traffic noise with weekly permutations. The 4 nights of each week consisted of a random sequence of a quiet night (32 dBA) and 3 nights during which aircraft, rail traffic, or road traffic noises occurred with maximum levels of 45–77 dBA. The polysomnogram and the electrocardiogram were recorded during all nights. In case of awakenings, the HR alterations consisted of monophasic elevations for >1 min, with mean maximum HR elevations of 30 bpm. Though obviously triggered by the noise events, the awakenings per se rather than the acoustical parameters determined the extent and pattern of the response. Without awakenings, HR responses were biphasic and consisted of initial accelerations with maximum HR elevations of about 9 bpm followed by decelerations below the baseline. These alterations were clearly influenced by the acoustic parameters (traffic mode, maximum level, rate of rise) as well as by the momentary sleep stage. Conclusions: Cardiac responses did not habituate to traffic noise within the night and may therefore play a key role in promoting traffic noise induced cardiovascular disease. If so, these consequences are more likely for responses accompanied by awakenings than for situations without awakenings. Citation: Griefahn B; Bröde P; Marks A; Basner M. Autonomic arousals related to traffic noise during sleep. SLEEP 2008;31(4):569-577. PMID:18457245

Poor Sleep in Relation to Natural Menopause: A Population-Based 14-Year Follow-up of Mid-Life Women

PubMed Central

Freeman, Ellen W.; Sammel, Mary D.; Gross, Stephanie A.; Pien, Grace W.

2014-01-01

Objective To estimate the prevalence and predictors of moderate/severe poor sleep in relation to the final menstrual period (FMP) of mid-life women. Methods Annual assessments were conducted in a population-based cohort of 255 women. All were premenopausal at cohort enrollment and reached natural menopause during the 16-year follow-up. The outcome measure was the severity of poor sleep, as reported by the participants in annual interviews for 16 years and evaluated in relation to the FMP. Results The annual prevalence of moderate/severe poor sleep largely ranged from about 28% to 35%, with no significant differences in any year relative to the FMP for the sample overall. When sleep status was stratified at the premenopausal baseline, the premenopausal sleep status strongly predicted poor sleep around the FMP. Women with moderate/severe poor sleep when premenopausal were approximately 3 ½ times more likely to have moderate/severe poor sleep around menopause compared to those with no poor sleep at baseline in adjusted analysis (OR 3.58, 95% CI: 2.50-5.11, P<0.0001), while mild poor sleepers premenopause were approximately 1 ½ times more likely to have moderate/severe poor sleep around menopause (OR 1.57, 95% CI: 0.99-2.47, P=0.053). There was no significant association between poor sleep and time relative to the FMP among women who had no poor sleep at the premenopausal baseline. Hot flashes were significantly associated with poor sleep (OR 1.79, 95% CI: 1.44-2.21, P<0.0001 in adjusted analysis), but had no interaction with baseline sleep severity (interaction P=0.25), indicating that hot flashes contributed to poor sleep regardless of baseline sleep status. Conclusion The findings showed a high prevalence of moderate/severe poor sleep in mid-life women, with only a small “at risk” subgroup having a significant increase in poor sleep in relation to the FMP. Sleep status at the premenopausal baseline and concurrent hot flashes strongly and consistently predicted

A nationwide, cross-sectional survey on unusual sleep postures and sleep-disordered breathing-related symptoms in people with Down syndrome.

PubMed

Kuroda, H; Sawatari, H; Ando, S; Ohkusa, T; Rahmawati, A; Ono, J; Nishizaka, M; Hashiguchi, N; Matsuoka, F; Chishaki, A

2017-07-01

People with Down syndrome (DS) often have sleep-disordered breathing (SDB). Unusual sleep postures, such as leaning forward and sitting, are observed in people with DS. This study aimed to clarify the prevalence of unusual sleep postures and their relationships with SDB-related symptoms (SDB-RSs), such as snoring, witnessed apnoea, nocturnal awakening and excessive daytime sleepiness. A questionnaire, including demographic characteristics and the presence of unusual sleep postures, as well as SDB-RSs, was completed by 1149 parents of people with DS from Japan. Unusual sleep postures were recorded in 483 (42.0%) people with DS. These participants were significantly younger and had a history of low muscle tone more frequently than people without unusual sleep postures. In all ages, the leaning forward posture was more frequent than sitting. People with DS with unusual sleep postures suffered from SDB-RSs. Those who slept in the sitting posture had more frequent SDB-RSs than did those who slept with the leaning forward posture. Snoring, witnessed apnoea and nocturnal awakening were observed in 73.6, 27.2 and 58.2% of participants, respectively. Snoring increased with aging. Witnessed apnoea was more common in males and in those with hypothyroidism than in females and in those without hypothyroidism. Our study shows that there is a close relationship between unusual sleep postures and SDB-RSs. We recommend that all people with DS with unusual sleep postures should be checked for the presence of SDB. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Work-Related Sleep Disturbances and Sickness Absence in the Swedish Working Population, 1993–1999

PubMed Central

Westerlund, Hugo; Alexanderson, Kristina; Åkerstedt, Torbjörn; Hanson, Linda Magnusson; Theorell, Töres; Kivimäki, Mika

2008-01-01

Study Objectives: To examine secular trends in work-related sleep disturbances and their association with sickness absence in the Swedish working population. Design. Nationally representative cross-sectional samples of the Swedish working population aged 16–64 (the biennial Swedish Work Environment Survey) in 1993, 1995, and 1999 respectively. Questionnaire data on work-related sleep disturbances were linked to records of medically-certified sick-leave spells exceeding 14 days obtained from national registers. Setting: All Sweden. Participants: A total of 28,424 individuals aged 16–65 with complete data (5162/5173 women/men in 1993; 4635/4764 in 1995; and 4422/4268 in 1999). Interventions: N/A. Measurements and Results: The age-adjusted proportion of women with work-related sleep disturbances at least once a week increased from 12.3% in 1993 to 21.7% in 1999 (P < 0.001). The corresponding figures for men were 12.5% to 18.6% (P < 0.001). There was a strong cross-sectional association between work-related sleep disturbances and sickness absence in both genders and in each studied year. Using binary logistic regressions and adjusting for age, supervisory position, and geographical region, the odds ratios for sickness absence for those who reported work-related sleep disturbances every day, compared with those who answered “not at all/seldom last 3 months” varied between 3.22 (1.88–5.50) and 4.26 (2.56–7.19), with the strongest associations seen in 1999. Adjustment for health indicators, especially depressive symptoms, attenuated the relationship substantially. Conclusions: Self-reported sleep disturbances attributed to work-related causes were on the rise in Sweden and were associated with medically-certified sickness absence. Most of this association seems to be accounted for by depressive symptoms. Citation: Westerlund H; Alexanderson K; Åkerstedt T; Hanson LM; Theorell T; Kivimäki M. Work-related sleep disturbances and sickness absence in the swedish

Sleep less and bite more: sleep disorders associated with occlusal loads during sleep.

PubMed

Kato, Takafumi; Yamaguchi, Taihiko; Okura, Kazuo; Abe, Susumu; Lavigne, Gilles J

2013-04-01

Occlusal overload during sleep is a significant clinical issue that has negative impacts on the maintenance of teeth and the longevity of dental prostheses. Sleep is usually viewed as an 'out-of-functional' mode for masticatory muscles. However, orodental structures and prostheses are not free from occlusal loads during sleep since masticatory muscles can be activated at a low level within normal sleep continuity. Thus, an increase in masticatory muscle contractions, by whatever the cause, can be associated with a risk of increased occlusal loads during sleep. Among such conditions, sleep bruxism (SB) is a type of sleep-related movement disorders with potential load challenge to the tooth and orofacial structures. Patients with SB usually report frequent tooth grinding noises during sleep and there is a consecutive increase in number and strength of rhythmic masticatory muscle activity (RMMA). Other types of masticatory muscle contractions can be non-specifically activated during sleep, such as brief contractions with tooth tapping, sleep talking, non-rhythmic contractions related to non-specific body movements, etc.; these occur more frequently in sleep disorders. Studies have shown that clinical signs and symptoms of SB can be found in patients with sleep disorders. In addition, sleep becomes compromised with aging process, and a prevalence of most sleep disorders is high in the elderly populations, in which prosthodontic rehabilitations are more required. Therefore, the recognition and understanding of the role of sleep disorders can provide a comprehensive vision for prosthodontic rehabilitations when prosthodontists manage complex orodental cases needing interdisciplinary collaborations between dentistry and sleep medicine. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

The association of sleep difficulties with health-related quality of life among patients with fibromyalgia

PubMed Central

2012-01-01

Background Difficulty sleeping is common among patients with fibromyalgia (FM); however, its impact on health-related quality of life (HRQoL) is not well understood. The aim of the current study was to assess the burden of sleep difficulty symptoms on HRQoL among patients with FM. Methods The current study included data from the 2009 National Health and Wellness Survey (N=75,000), which is a cross-sectional, Internet-based survey representative of the adult US population. The prevalence of sleep difficulty symptoms among patients with FM (n=2,196) were compared with matched controls (n=2,194), identified using propensity-score matching. Additionally, the relationship between the number of sleep difficulty symptoms (none, one, or two or more) and HRQoL (using the SF-12v2) was assessed using regression modeling, controlling for demographic and health history variables. Results Of the 2,196 patients with FM, 11.2% reported no sleep difficulty symptoms, 25.7% reported one sleep difficulty symptom, and 63.05% reported two or more sleep difficulty symptoms. The prevalence of sleep difficulty symptoms was significantly higher than matched controls. Patients with one and two sleep difficulty symptoms both reported significantly worse HRQoL summary and domain scores relative to those with no sleep difficulty symptoms (all p<.05). Further, the relationship between sleep difficulty symptoms and HRQoL was significantly different between those with FM than matched controls, suggesting a uniqueness of the burden of sleep difficulties within the FM population. Conclusions Among the FM population, sleep difficulty symptoms were independently associated with clinically-meaningful decrements in mental and physical HRQoL. These results suggest that greater emphasis in the treatment of sleep difficulty symptoms among the FM population may be warranted. PMID:23072292

The association of sleep difficulties with health-related quality of life among patients with fibromyalgia.

PubMed

Wagner, Jan-Samuel; DiBonaventura, Marco D; Chandran, Arthi B; Cappelleri, Joseph C

2012-10-17

Difficulty sleeping is common among patients with fibromyalgia (FM); however, its impact on health-related quality of life (HRQoL) is not well understood. The aim of the current study was to assess the burden of sleep difficulty symptoms on HRQoL among patients with FM. The current study included data from the 2009 National Health and Wellness Survey (N=75,000), which is a cross-sectional, Internet-based survey representative of the adult US population. The prevalence of sleep difficulty symptoms among patients with FM (n=2,196) were compared with matched controls (n=2,194), identified using propensity-score matching. Additionally, the relationship between the number of sleep difficulty symptoms (none, one, or two or more) and HRQoL (using the SF-12v2) was assessed using regression modeling, controlling for demographic and health history variables. Of the 2,196 patients with FM, 11.2% reported no sleep difficulty symptoms, 25.7% reported one sleep difficulty symptom, and 63.05% reported two or more sleep difficulty symptoms. The prevalence of sleep difficulty symptoms was significantly higher than matched controls. Patients with one and two sleep difficulty symptoms both reported significantly worse HRQoL summary and domain scores relative to those with no sleep difficulty symptoms (all p<.05). Further, the relationship between sleep difficulty symptoms and HRQoL was significantly different between those with FM than matched controls, suggesting a uniqueness of the burden of sleep difficulties within the FM population. Among the FM population, sleep difficulty symptoms were independently associated with clinically-meaningful decrements in mental and physical HRQoL. These results suggest that greater emphasis in the treatment of sleep difficulty symptoms among the FM population may be warranted.

Integration of immigrants into a new culture is related to poor sleep quality

PubMed Central

Voss, Ursula; Tuin, Inka

2008-01-01

Background This article reports on the relationship between cultural influences on life style, coping style, and sleep in a sample of female Portuguese immigrants living in Germany. Sleep quality is known to be poorer in women than in men, yet little is known about mediating psychological and sociological variables such as stress and coping with stressful life circumstances. Migration constitutes a particularly difficult life circumstance for women if it involves differing role conceptions in the country of origin and the emigrant country. Methods The study investigated sleep quality, coping styles and level of integration in a sample of Portuguese (N = 48) and Moroccan (N = 64) immigrant women who took part in a structured personal interview. Results Sleep quality was poor in 54% of Portuguese and 39% of Moroccan women, which strongly exceeds reports of sleep complaints in epidemiologic studies of sleep quality in German women. Reports of poor sleep were associated with the degree of adoption of a German life style. Women who had integrated more into German society slept worse than less integrated women in both samples, suggesting that non-integration serves a protective function. An unusually large proportion of women preferred an information-seeking (monitoring) coping style and adaptive coping. Poor sleep was related to high monitoring in the Portuguese but not the Moroccan sample. Conclusion Sleep quality appears to be severely affected in women with a migration background. Our data suggest that non-integration may be less stressful than integration. This result points to possible benefits of non-integration. The high preference for an information-seeking coping style may be related to the process of migration, representing the attempt at regaining control over an uncontrollable and stressful life situation. PMID:18691437

Sleep Architecture Relates to Daytime Affect and Somatic Complaints in Clinically Anxious but Not Healthy Children.

PubMed

Palmer, Cara A; Alfano, Candice A

2017-01-01

It is increasingly clear that seminal sleep-affective relationships begin to take root in childhood, yet studies exploring how nighttime sleep characteristics relate to daytime affective symptoms, both in clinical and healthy populations of children, are lacking. The current study sought to explore these relationships by investigating whether trait-like and/or daily reports of affective and somatic symptoms of children with generalized anxiety disorder and matched controls relate to sleep architecture. Sixty-six children (ages 7-11; 54.4% female; 56.1% Caucasian; 18.2% biracial; 6.1% African American; 3% Asian; 16.7% Hispanic) participated including 29 with primary generalized anxiety disorder (without comorbid depression) and 37 healthy controls matched on age and race/ethnicity. Participants underwent structured diagnostic assessments including child-report measures and subsequently reported on their negative affect and somatic symptoms over the course of 1 week. Children also completed 1 night of polysomnography. Among children with generalized anxiety disorder only, greater amounts of slow wave sleep corresponded with less negative affect, and greater amounts of rapid eye movement sleep was related to more somatic complaints across the week. Similarly, for trait-like measures, more rapid eye movement sleep and shorter latency to rapid eye movement sleep were related to greater depressive symptoms in the anxious group only. The current findings suggest that physiologic sleep characteristics may contribute in direct ways to the symptom profiles of clinically anxious children. The functional relevance of such findings (e.g., how specific sleep characteristics serve to either increase or reduce long-term risk) is a vital direction for future research.

Gratitude influences sleep through the mechanism of pre-sleep cognitions.

PubMed

Wood, Alex M; Joseph, Stephen; Lloyd, Joanna; Atkins, Samuel

2009-01-01

To test whether individual differences in gratitude are related to sleep after controlling for neuroticism and other traits. To test whether pre-sleep cognitions are the mechanism underlying this relationship. A cross-sectional questionnaire study was conducted with a large (186 males, 215 females) community sample (ages=18-68 years, mean=24.89, S.D.=9.02), including 161 people (40%) scoring above 5 on the Pittsburgh Sleep Quality Index, indicating clinically impaired sleep. Measures included gratitude, the Pittsburgh Sleep Quality Index (PSQI), self-statement test of pre-sleep cognitions, the Mini-IPIP scales of Big Five personality traits, and the Social Desirability Scale. Gratitude predicted greater subjective sleep quality and sleep duration, and less sleep latency and daytime dysfunction. The relationship between gratitude and each of the sleep variables was mediated by more positive pre-sleep cognitions and less negative pre-sleep cognitions. All of the results were independent of the effect of the Big Five personality traits (including neuroticism) and social desirability. This is the first study to show that a positive trait is related to good sleep quality above the effect of other personality traits, and to test whether pre-sleep cognitions are the mechanism underlying the relationship between any personality trait and sleep. The study is also the first to show that trait gratitude is related to sleep and to explain why this occurs, suggesting future directions for research, and novel clinical implications.

Syndrome of Electrical Status Epilepticus During Sleep: Epileptic Encephalopathy Related to Brain Development.

PubMed

Chen, Xiao-Qiao; Zhang, Wei-Na; Hu, Lin-Yan; Liu, Meng-Jia; Zou, Li-Ping

2016-03-01

Epileptic encephalopathy with electrical status epilepticus during sleep is an age-related and self-limited disorder. The present study analyzed the etiology, demographics, and pathogenesis of patients with electrical status epilepticus during sleep to provide information on the diagnosis and therapy of this syndrome. The etiologies of epileptic encephalopathy with electrical status epilepticus during sleep in patients admitted in Chinese People's Liberation Army General Hospital from 2009 to 2014 were retrospectively analyzed. Patients were classified into the genetic, structural-metabolic, and unknown groups according to the etiology. Demographics and clinical characteristics of all the patients were then analyzed and compared among groups. The etiologies of epileptic encephalopathy with electrical status epilepticus during sleep in 75 patients mainly included benign childhood epilepsy with centrotemporal spikes, Landau-Kleffner syndrome, polymicrogyria, and migration disorders. Age at onset of epilepsy did not show a specific pattern, but age at onset of epileptic encephalopathy with electrical status epilepticus during sleep was concentrated at age 6-9 years. The mean age at onset of epilepsy in the genetic group was significantly older than that in the structural-metabolic group (P < 0.05). Age at onset of epileptic encephalopathy with electrical status epilepticus during sleep did not significantly differ between the two groups. Electrical status epilepticus during sleep is an epileptic encephalopathy related to brain development and presents an age-dependent occurrence. Copyright © 2016 Elsevier Inc. All rights reserved.

Association between delayed bedtime and sleep-related problems among community-dwelling 2-year-old children in Japan.

PubMed

Kitamura, Shingo; Enomoto, Minori; Kamei, Yuichi; Inada, Naoko; Moriwaki, Aiko; Kamio, Yoko; Mishima, Kazuo

2015-03-13

Although delayed sleep timing causes many socio-psycho-biological problems such as sleep loss, excessive daytime sleepiness, obesity, and impaired daytime neurocognitive performance in adults, there are insufficient data showing the clinical significance of a 'night owl lifestyle' in early life. This study examined the association between habitual delayed bedtime and sleep-related problems among community-dwelling 2-year-old children in Japan. Parents/caregivers of 708 community-dwelling 2-year-old children in Nishitokyo City, Tokyo, participated in the study. The participants answered a questionnaire to evaluate their child's sleep habits and sleep-related problems for the past 1 month. Of the 425 children for whom complete data were collected, 90 (21.2%) went to bed at 22:00 or later. Children with delayed bedtime showed significantly more irregular bedtime, delayed wake time, shorter total sleep time, and difficulty in initiating and terminating sleep. Although this relationship indicated the presence of sleep debt in children with delayed bedtime, sleep onset latency did not differ between children with earlier bedtime and those with delayed bedtime. Rather, delayed bedtime was significantly associated with bedtime resistance and problems in the morning even when adjusting for nighttime and daytime sleep time. Even in 2-year-old children, delayed bedtime was associated with various sleep-related problems. The causal factors may include diminished homeostatic sleep drive due to prolonged daytime nap as well as diurnal preference (morning or night type) regulated by the biological clock.

Why babies should never sleep alone: a review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding.

PubMed

McKenna, James J; McDade, Thomas

2005-06-01

There has been much controversy over whether infants should co-sleep or bedshare with an adult caregiver and over whether such practises increase the risk of SIDS or fatal accident. However, despite opposition from medical authorities or the police, many western parents are increasingly adopting night-time infant caregiving patterns that include some co-sleeping, especially by those mothers who choose to breast feed. This review will show that the relationships between infant sleep patterns, infant sleeping arrangements and development both in the short and long term, whether having positive or negative outcomes, is anything but simple and the traditional habit of labelling one sleeping arrangement as being superior to another without an awareness of family, social and ethnic context is not only wrong but possibly harmful. We will show that there are many good reasons to insist that the definitions of different types of co-sleeping and bedsharing be recognised and distinguished. We will examine the conceptual issues related to the biological functions of mother-infant co-sleeping, bedsharing and what relationship each has to SIDS. At very least, we hope that the studies and data described in this paper, which show that co-sleeping at least in the form of roomsharing especially with an actively breast feeding mother saves lives, is a powerful reason why the simplistic, scientifically inaccurate and misleading statement 'never sleep with your baby' needs to be rescinded, wherever and whenever it is published.

Changes in sleep theta rhythm are related to episodic memory impairment in early Alzheimer's disease.

PubMed

Hot, Pascal; Rauchs, Géraldine; Bertran, Françoise; Denise, Pierre; Desgranges, Béatrice; Clochon, Patrice; Eustache, Francis

2011-07-01

Impairments have been reported both in sleep structure and episodic memory in Alzheimer's disease [AD]. Our objective was to investigate the relationships between episodic memory deficits and electro-encephalography [EEG] abnormalities occurring during sleep in patients with early AD. Postlearning sleep was recorded in 14 patients with mild to moderate AD, and 14 healthy elderly controls after they performed an episodic memory task derived from the Grober and Buschke's procedure. For each sleep stage, the relative power and mean frequency in each band were analyzed. Relative to agematched controls, AD patients presented faster mean theta frequency in both REM sleep and slow wave sleep [SWS]. In AD patients, a correlative analysis revealed that faster theta frequency during SWS was associated with better delayed episodic recall. We assume that increased theta activity reflects changes in neuronal activity to maintain memory performance, indicating that compensatory mechanisms already described at the waking state could also be engaged during SWS. Copyright © 2011 Elsevier B.V. All rights reserved.

Topographic and sex-related differences in sleep spindles in major depressive disorder: a high-density EEG investigation.

PubMed

Plante, D T; Goldstein, M R; Landsness, E C; Peterson, M J; Riedner, B A; Ferrarelli, F; Wanger, T; Guokas, J J; Tononi, G; Benca, R M

2013-03-20

Sleep spindles are believed to mediate several sleep-related functions including maintaining disconnection from the external environment during sleep, cortical development, and sleep-dependent memory consolidation. Prior studies that have examined sleep spindles in major depressive disorder (MDD) have not demonstrated consistent differences relative to control subjects, which may be due to sex-related variation and limited spatial resolution of spindle detection. Thus, this study sought to characterize sleep spindles in MDD using high-density electroencephalography (hdEEG) to examine the topography of sleep spindles across the cortex in MDD, as well as sex-related variation in spindle topography in the disorder. All-night hdEEG recordings were collected in 30 unipolar MDD participants (19 women) and 30 age and sex-matched controls. Topography of sleep spindle density, amplitude, duration, and integrated spindle activity (ISA) were assessed to determine group differences. Spindle parameters were compared between MDD and controls, including analysis stratified by sex. As a group, MDD subjects demonstrated significant increases in frontal and parietal spindle density and ISA compared to controls. When stratified by sex, MDD women demonstrated increases in frontal and parietal spindle density, amplitude, duration, and ISA; whereas MDD men demonstrated either no differences or decreases in spindle parameters. Given the number of male subjects, this study may be underpowered to detect differences in spindle parameters in male MDD participants. This study demonstrates topographic and sex-related differences in sleep spindles in MDD. Further research is warranted to investigate the role of sleep spindles and sex in the pathophysiology of MDD. Copyright © 2012 Elsevier B.V. All rights reserved.

Is somnambulism a distinct disorder of humans and not seen in non-human primates?

PubMed

Kantha, S S

2003-01-01

Though somnambulism (sleepwalking) is a well-recognized sleep disorder in humans, a biomedical literature search in Medline and Primate Literature bibliographic databases showed no publications on sleepwalking in non-human primates. From this finding, two inferences can be made. First is that somnambulism may be present in non-human primates; but due to limitations in expertise and methodological resources as well as narrow focus of research interest, until now researchers have not detected it in wild and/or captive conditions. Second, somnambulism does not exist in non-human primates including apes (chimpanzee, gorilla, orang-utan and gibbon); and thus, it is a unique behavioral disorder present only in humans. It is premature to conclude which of these two inferences is correct. In Jane Goodall's view, sleepwalking behavior is absent in chimpanzees. If further field observations can confirm Goodall's assertion that somnambulism is indeed absent in chimpanzees, it will be of evolutionary and medical interest to know why this parasomnic behavior became established in humans during the past 5.5 million years or so.

Sleep-related intermittent hypoxemia and glucose intolerance: a community-based study.

PubMed

Tanno, Sakurako; Tanigawa, Takeshi; Saito, Isao; Nishida, Wataru; Maruyama, Koutatsu; Eguchi, Eri; Sakurai, Susumu; Osawa, Haruhiko; Punjabi, Naresh M

2014-10-01

Intermittent hypoxemia is a fundamental pathophysiological consequence of sleep-disordered breathing and may alter glucose metabolism. To characterize the association between sleep-related intermittent hypoxemia and glucose metabolism, overnight pulse-oximetry and an oral glucose tolerance test were completed in a cohort of middle-aged and older Japanese adults. The study sample consisted of 1836 community-dwelling Japanese (age, 30-79 years; women, 65.5%; mean body mass index, 23.1 kg/m(2)). The oxygen desaturation index (ODI) was quantified during sleep using a ≥3% oxygen desaturation threshold and categorized as normal (<5.0 events/h), mild (5.0-15.0 events/h), and moderate to severe (≥15.0 events/h). The independent associations between the ODI and the prevalence of impaired fasting glucose, impaired glucose tolerance, diabetes, and two metrics of insulin resistance [homeostasis model assessment index for insulin resistance (HOMA-IR) and Matsuda index] were examined. Compared with subjects with an ODI < 5 events/h, the adjusted odds ratio for prevalent impaired fasting glucose, glucose intolerance, and diabetes for subjects with an ODI ≥15.0 events/h were 1.27 (95% confidence interval, 0.72-2.23), 1.69 (1.03-2.76), and 1.28 (0.59-2.79), respectively. Both HOMA-IR and Matsuda index were significantly associated with the severity of sleep-related intermittent hypoxemia as assessed by the ODI (P for trend = 0.03 and 0.007, respectively). Among middle-aged and older Japanese adults, sleep-related intermittent hypoxemia is associated with glucose intolerance and insulin resistance, and may contribute to the development of type 2 diabetes mellitus. Copyright © 2014 Elsevier B.V. All rights reserved.

Infant sleep and its relation with cognition and growth: a narrative review

PubMed Central

Tham, Elaine KH; Schneider, Nora; Broekman, Birit FP

2017-01-01

Objective Infant sleep development is a highly dynamic process occurring in parallel to and in interaction with cognitive and physical growth. This narrative review aims to summarize and discuss recent literature and provide an overview of the relation between infant sleep and cognitive development as well as physical growth. Methods We conducted online literature search using MEDLINE, Embase, and Cochrane Library databases. We considered original research on humans published in the English language from January 2005 to December 2015. Search terms included “sleep” AND “infant” AND “cognition” OR “memory” OR “executive functioning”, OR “growth” OR “obesity” OR “growth hormone” OR “stunting”, and combinations thereof. Results Ten studies on infant sleep and cognition were included in this review. Overall, findings indicated a positive association between sleep, memory, language, executive function, and overall cognitive development in typically developing infants and young children. An additional 20 studies support the positive role of infant sleep in physical growth, with the current literature focusing largely on weight gain and obesity rather than healthy growth. Existing evidence in both the domains is mainly based on cross-sectional designs, on association studies, and on parental reports. In contrast, there were limited studies on longitudinal sleep trajectories and intervention effects, or studies have not used more objective sleep measures such as actigraphy and polysomnography. Conclusion The reviewed studies support a critical and positive role of infant sleep in cognition and physical growth. Future studies should consider key environmental and parental confounders, include a combination of more objective (actigraphy) and subjective measures (sleep diaries and questionnaires), and move towards longitudinal trajectory designs of infant sleep and development. PMID:28553151

Changes in Subjective Sleep Quality Before a Competition and Their Relation to Competitive Anxiety.

PubMed

Ehrlenspiel, Felix; Erlacher, Daniel; Ziegler, Matthias

2016-12-09

The aim of this study was to examine the effects of competitions on subjective sleep quality. Previous studies have been inconclusive and lack differentiated and standardized measurements of subjective sleep quality. Furthermore the temporal relation between precompetitive anxiety and sleep quality was investigated. Anxiety and nervousness associated with competitions are considered to cause sleep impairments. A convenience sample of N = 79 elite male athletes from various sports participated. In a time-to-event paradigm, sleep quality and competitive anxiety were assessed via standardized self-report measurements 4 days before a competition and on the day of the competition. Univariate analyses were used to examine differences between time points. To examine cross-lagged effects between anxiety and sleep quality a latent change score model (LCSM) was specified that tested an effect of anxiety on changes in sleep quality. Evaluations of nocturnal sleep deteriorated significantly from 4 days before competition to the day of competition, but there were no differences regarding perceptions of the restorative value of sleep. LCSM revealed that athletes who reported more intense worry symptoms 4 days before competition also reported greater deterioration in evaluations of nocturnal sleep. The findings support earlier reports of impaired subjective sleep quality before competitions. Precompetitive sleep impairments appear also to be preceded by cognitive anxiety. Whereas interventions should thus address worry-cognitions associated with competition and sleep, research should address the practical importance of these perceptions of sleep impairments.

Caregiving-Related Sleep Problems and Their Relationship to Mental Health and Daytime Function in Female Veterans.

PubMed

Song, Yeonsu; Washington, Donna L; Yano, Elizabeth M; McCurry, Susan M; Fung, Constance H; Dzierzewski, Joseph M; Rodriguez, Juan Carlos; Jouldjian, Stella; Mitchell, Michael N; Alessi, Cathy A; Martin, Jennifer L

2018-01-01

To identify caregiving-related sleep problems and their relationship to mental health and daytime function in female Veterans. Female Veterans (N = 1,477) from cross-sectional, nationwide, postal survey data. The survey respondent characteristics included demographics, comorbidity, physical activity, health, use of sleep medications, and history of sleep apnea. They self-identified caregiving- related sleep problems (i.e., those who had trouble sleeping because of caring for a sick adult, an infant/child, or other respondents). Patient Health Questionnaire (PHQ-4) was used to assess mental health, and daytime function was measured using 11 items of International Classification of Sleep Disorders-2 (ICSD-2). Female Veterans with self-identified sleep problems due to caring for a sick adult (n = 59) experienced significantly more symptoms of depression and anxiety (p < 0.001) and impairment in daytime function (e.g., fatigue, daytime sleepiness, loss of concentration, p < 0.001) than those with self-identified sleep problems due to caring for an infant or child (n = 95) or all other respondents (n = 1,323) after controlling for the respondent characteristics. Healthcare providers should pay attention to assessing sleep characteristics of female Veterans with caregiving responsibilities, particularly those caregiving for a sick adult.

[The US Government's effort in decreasing the cost of sleep-related problems and its outcome].

PubMed

Song, You Hwi; Nishino, Seiji

2008-09-01

Sleepiness and inattention caused by sleep and circadian rhythm disorders or inadequate sleep habits adversely affect workers in many industries as well as the general public, and these disorders are likely to lead to public health and safety problems and adversely affect civilian life. Evidence is accumulating that these sleep related problems are contributing factors not only in many errors of judgement and accidents, but also related to some highly prevalent diseases, such as diabetes, obesity and hypertension. For each of these societal concerns, sleep science must be translated to the general public and to those in policy positions for improving public policy and public health awareness. In the United State, the National Commission for Sleep Disorders Research (established by the US Congress in 1998) completed a comprehensive report of its findings in 1993 to address these problems. The commission estimated that sleep disorders and sleepiness cost the United States $50 billion and called for permanent and concentrated efforts in expanding basic and clinical research on sleep disorders as well as in improving public awareness of the dangers of inadequate sleep hygiene. As a result of these efforts, the number of sleep centers has increased steadily and the total of the NIH (National Institutes of Health) funding for sleep research has also grown. In response to this progress in the US (together with appeals by Japanese Sleep Specialists), the Science Council of Japan published "The Recommendation of Creation of Sleep Science and Progression of Research" in 2002. In this article, we introduce and detail to the Japanese readers the US Government's efforts focusing on the report of the National Commission for Sleep Disorders Research, and we believe that the US Government's effort is a good example for the Japanese society to follow.

Validation of sleep-2-Peak: A smartphone application that can detect fatigue-related changes in reaction times during sleep deprivation.

PubMed

Brunet, Jean-François; Dagenais, Dominique; Therrien, Marc; Gartenberg, Daniel; Forest, Geneviève

2017-08-01

Despite its high sensitivity and validity in the context of sleep loss, the Psychomotor Vigilance Test (PVT) could be improved. The aim of the present study was to validate a new smartphone PVT-type application called sleep-2-Peak (s2P) by determining its ability to assess fatigue-related changes in alertness in a context of extended wakefulness. Short 3-min versions of s2P and of the classic PVT were administered at every even hour during a 35-h total sleep deprivation protocol. In addition, subjective measures of sleepiness were collected. The outcomes on these tests were then compared using Pearson product-moment correlations, t tests, and repeated measures within-groups analyses of variance. The results showed that both tests significantly correlated on all outcome variables, that both significantly distinguished between the alert and sleepy states in the same individual, and that both varied similarly through the sleep deprivation protocol as sleep loss accumulated. All outcome variables on both tests also correlated significantly with the subjective measures of sleepiness. These results suggest that a 3-min version of s2P is a valid tool for differentiating alert from sleepy states and is as sensitive as the PVT for tracking fatigue-related changes during extended wakefulness and sleep loss. Unlike the PVT, s2P does not provide feedback to subjects on each trial. We discuss how this feature of s2P raises the possibility that the performance results measured by s2P could be less impacted by motivational confounds, giving this tool added value in particular clinical and/or research settings.

Relations among Menopausal Symptoms, Sleep Disturbance and Depressive Symptoms in Midlife

PubMed Central

Brown, Jessica P.; Gallicchio, Lisa; Flaws, Jodi F.; Tracy, J. Kathleen

2009-01-01

Objectives To investigate the relations among hot flashes, other menopausal symptoms, sleep quality and depressive symptoms in midlife women Methods A large population-based cross-sectional study of 639 women (ages 45 to 54 years) consisting of a questionnaire including the Center for Epidemiologic Studies-Depression Scale (CES-D), demographics, health behaviors, menstrual history, and menopausal symptoms Results After controlling for menopausal status, physical activity level, smoking status and current self-reported health status elevated CES-D score is associated with frequent nocturnal hot flashes, frequent trouble sleeping, experiencing hot flashes, nausea, headaches, weakness, visual problems, vaginal discharge, irritability, muscle stiffness, and incontinence. Conclusions The present study found significant links between depressive symptoms and several menopausal symptoms including hot flashes, sleep disturbance, irritability, muscle stiffness, and incontinence after controlling for covariates. These findings suggest that a potential mechanism in which bothersome menopausal symptoms may influence depressed mood during the midlife is through sleep disturbance. PMID:19128903

Poor Sleep Is Related to Lower Emotional Competence Among Adolescents.

PubMed

Brand, Serge; Kirov, Roumen; Kalak, Nadeem; Gerber, Markus; Schmidt, Norman B; Lemola, Sakari; Correll, Christoph U; Holsboer-Trachsler, Edith

2016-01-01

The aim of the present study was to explore the association between subjective insomnia and self-reported emotional competence in areas such as regulating and perceiving one's own emotions and empathy, in a sample of adolescents. Gender differences were also explored. 366 adolescents in 10th to 12th grade (mean age: M = 16.9 years) took part in this cross-sectional study. They completed questionnaires related to emotional competencies, empathy, and sleep. Higher scores for insomnia were associated with lower scores for some aspects of emotional competence and empathy. Compared to males, females generally had higher scores for emotional competence. Poor sleep as subjectively experienced among adolescents is associated with specific impairments in emotional competence and empathy. Gender-related patterns were also observed.

Selective REM Sleep Deprivation Improves Expectation-Related Placebo Analgesia

PubMed Central

Chouchou, Florian; Chauny, Jean-Marc; Rainville, Pierre; Lavigne, Gilles J.

2015-01-01

The placebo effect is a neurobiological and psychophysiological process known to influence perceived pain relief. Optimization of placebo analgesia may contribute to the clinical efficacy and effectiveness of medication for acute and chronic pain management. We know that the placebo effect operates through two main mechanisms, expectations and learning, which is also influenced by sleep. Moreover, a recent study suggested that rapid eye movement (REM) sleep is associated with modulation of expectation-mediated placebo analgesia. We examined placebo analgesia following pharmacological REM sleep deprivation and we tested the hypothesis that relief expectations and placebo analgesia would be improved by experimental REM sleep deprivation in healthy volunteers. Following an adaptive night in a sleep laboratory, 26 healthy volunteers underwent classical experimental placebo analgesic conditioning in the evening combined with pharmacological REM sleep deprivation (clonidine: 13 volunteers or inert control pill: 13 volunteers). Medication was administered in a double-blind manner at bedtime, and placebo analgesia was tested in the morning. Results revealed that 1) placebo analgesia improved with REM sleep deprivation; 2) pain relief expectations did not differ between REM sleep deprivation and control groups; and 3) REM sleep moderated the relationship between pain relief expectations and placebo analgesia. These results support the putative role of REM sleep in modulating placebo analgesia. The mechanisms involved in these improvements in placebo analgesia and pain relief following selective REM sleep deprivation should be further investigated. PMID:26678391

Selective REM Sleep Deprivation Improves Expectation-Related Placebo Analgesia.

PubMed

Chouchou, Florian; Chauny, Jean-Marc; Rainville, Pierre; Lavigne, Gilles J

2015-01-01

The placebo effect is a neurobiological and psychophysiological process known to influence perceived pain relief. Optimization of placebo analgesia may contribute to the clinical efficacy and effectiveness of medication for acute and chronic pain management. We know that the placebo effect operates through two main mechanisms, expectations and learning, which is also influenced by sleep. Moreover, a recent study suggested that rapid eye movement (REM) sleep is associated with modulation of expectation-mediated placebo analgesia. We examined placebo analgesia following pharmacological REM sleep deprivation and we tested the hypothesis that relief expectations and placebo analgesia would be improved by experimental REM sleep deprivation in healthy volunteers. Following an adaptive night in a sleep laboratory, 26 healthy volunteers underwent classical experimental placebo analgesic conditioning in the evening combined with pharmacological REM sleep deprivation (clonidine: 13 volunteers or inert control pill: 13 volunteers). Medication was administered in a double-blind manner at bedtime, and placebo analgesia was tested in the morning. Results revealed that 1) placebo analgesia improved with REM sleep deprivation; 2) pain relief expectations did not differ between REM sleep deprivation and control groups; and 3) REM sleep moderated the relationship between pain relief expectations and placebo analgesia. These results support the putative role of REM sleep in modulating placebo analgesia. The mechanisms involved in these improvements in placebo analgesia and pain relief following selective REM sleep deprivation should be further investigated.

Obstructive sleep apnea related to rapid-eye-movement or non-rapid-eye-movement sleep: comparison of demographic, anthropometric, and polysomnographic features

PubMed Central

Sunnetcioglu, Aysel; Sertogullarından, Bunyamin; Ozbay, Bulent; Gunbatar, Hulya; Ekin, Selami

2016-01-01

Objective : To determine whether there are significant differences between rapid-eye-movement (REM)-related obstructive sleep apnea (OSA) and non-REM (NREM)-related OSA, in terms of the demographic, anthropometric, and polysomnographic characteristics of the subjects. Methods : This was a retrospective study of 110 patients (75 males) with either REM-related OSA (n = 58) or NREM-related OSA (n = 52). To define REM-related and NREM-related OSA, we used a previously established criterion, based on the apnea-hypopnea index (AHI): AHI-REM/AHI-NREM ratio > 2 and ≤ 2, respectively. Results : The mean age of the patients with REM-related OSA was 49.5 ± 11.9 years, whereas that of the patients with NREM-related OSA was 49.2 ± 12.6 years. The overall mean AHI (all sleep stages combined) was significantly higher in the NREM-related OSA group than in the REM-related OSA group (38.6 ± 28.2 vs. 14.8 ± 9.2; p < 0.05). The mean AHI in the supine position (s-AHI) was also significantly higher in the NREM-related OSA group than in the REM-related OSA group (49.0 ± 34.3 vs. 18.8 ± 14.9; p < 0.0001). In the NREM-related OSA group, the s-AHI was higher among the men. In both groups, oxygen desaturation was more severe among the women. We found that REM-related OSA was more common among the patients with mild-to-moderate OSA, whereas NREM-related OSA was more common among those with severe OSA. Conclusions : We found that the severity of NREM-related OSA was associated mainly with s-AHI. Our findings suggest that the s-AHI has a more significant effect on the severity of OSA than does the AHI-REM. When interpreting OSA severity and choosing among treatment modalities, physicians should take into consideration the sleep stage and the sleep posture. PMID:26982041

The sleeping brain in Parkinson's disease: A focus on REM sleep behaviour disorder and related parasomnias for practicing neurologists.

PubMed

Bhidayasiri, Roongroj; Sringean, Jirada; Rattanachaisit, Watchara; Truong, Daniel D

2017-03-15

Sleep disorders are identified as common non-motor symptoms of Parkinson's disease (PD) and recently this recognition has been expanded to include parasomnias, encompassing not only REM sleep behaviour disorder (RBD), but also other non-REM forms. RBD, a prototypical parasomnia in PD, exists even in the prodromal stage of the disease, and is characterized by the presence of dream enactment behaviours occurring alongside a loss of normal skeletal muscle atonia during REM sleep. In contrast, non-REM parasomnias are more frequently observed in the late stage PD. However, the development of these disorders often overlaps and it is not uncommon for PD patients to meet the criteria for more than one type of parasomnias, thus making a clinical distinction challenging for practicing neurologists who are not sleep specialists. Indeed, clinical recognition of the predominant form of parasomnia does not just depend on video-polysomnography, but also on an individual physician's clinical acumen in delineating pertinent clinical history to determine the most likely diagnosis and proceed accordingly. In this review article, we highlight the various forms of parasomnias that have been reported in PD, including, but not limited to, RBD, with a focus on clinical symptomatology and implications for clinical practice. In addition, we review the differences in PD-related parasomnias compared to those seen in general populations. With advances in sleep research and better technology for ambulatory home monitoring, it is likely that many unanswered questions on PD-related parasomnias will soon be resolved resulting in better management of this nocturnal challenge in PD. Copyright © 2017 Elsevier B.V. All rights reserved.

Sleep-related problems and urologic symptoms: Testing the hypothesis of bi-directionality in a longitudinal, population-based study

PubMed Central

Araujo, Andre B.; Yaggi, H. Klar; Yang, May; McVary, Kevin T.; Fang, Shona C.; Bliwise, Donald L.

2013-01-01

Purpose To evaluate the bi-directional association between urologic symptoms (urinary incontinence (UI), lower urinary tract symptoms (LUTS), and nocturia) and sleep-related variables. Materials and Methods Data were obtained from a prospective cohort study of 1,610 men and 2,535 women who completed baseline (2002–05) and follow-up (2006–10) phases of the Boston Area Community Health (BACH) survey, a population-based random sample survey. Sleep restriction (≤5 hours/night), restless sleep, sleep medication use, and urologic symptoms were assessed by self-report. UI was defined as weekly leakage or moderate/severe leakage, LUTS (overall, obstructive, irritative) was defined by American Urological Association Symptom Index, and nocturia was defined as urinary frequency ≥2 times/night. Results At the 5 year follow-up,10.0%, 8.5% and 16.0% of subjects newly reported LUTS, UI and nocturia, respectively, and 24.2%, 13.3%, 11.6% newly reported poor sleep quality, sleep restriction and use of sleep medication, respectively. Controlling for confounders, the odds of developing urologic symptoms was consistently increased for subjects who reported poor sleep quality and sleep restriction at baseline, but only baseline nocturia was positively associated with incident sleep-related problems at follow-up. Body mass index, a potential mediator, reduced selected associations between sleep and incident UI and irritative symptoms, but C-reactive protein did not. Conclusions These data suggest that self-reported sleep-related problems and urologic symptoms are linked bi-directionally, and BMI may be a factor in the relationship between sleep and development of urologic symptoms. PMID:23867307

Sleep-Related Problems among Children and Adolescents with Anxiety Disorders

ERIC Educational Resources Information Center

Alfano, Candice A.; Ginsburg, Golda S.; Kingery, Julie Newman

2007-01-01

Objective: The present study examined sleep-related problems (SRPs) among a large sample (n = 128) of youth with anxiety disorders (i.e., generalized, separation, and social). The frequency of eight specific SRPs was examined in relation to age, gender, type of anxiety disorder, anxiety severity, and functional impairment. The impact of…

Sleep Duration and Injury-Related Risk Behaviors Among High School Students--United States, 2007-2013.

PubMed

Wheaton, Anne G; Olsen, Emily O'Malley; Miller, Gabrielle F; Croft, Janet B

2016-04-08

Insufficient sleep is common among high school students and has been associated with an increased risk for motor vehicle crashes (1), sports injuries (2), and occupational injuries (3). To evaluate the association between self-reported sleep duration on an average school night and several injury-related risk behaviors (infrequent bicycle helmet use, infrequent seatbelt use, riding with a driver who had been drinking, drinking and driving, and texting while driving) among U.S. high school students, CDC analyzed data from 50,370 high school students (grades 9-12) who participated in the national Youth Risk Behavior Surveys (YRBSs) in 2007, 2009, 2011, or 2013. The likelihood of each of the five risk behaviors was significantly higher for students who reported sleeping ≤7 hours on an average school night; infrequent seatbelt use, riding with a drinking driver, and drinking and driving were also more likely for students who reported sleeping ≥10 hours compared with 9 hours on an average school night. Although insufficient sleep directly contributes to injury risk, some of the increased risk associated with insufficient sleep might be caused by engaging in injury-related risk behaviors. Intervention efforts aimed at these behaviors might help reduce injuries resulting from sleepiness, as well as provide opportunities for increasing awareness of the importance of sleep.

Lack of Resilience Is Related to Stress-Related Sleep Reactivity, Hyperarousal, and Emotion Dysregulation in Insomnia Disorder.

PubMed

Palagini, Laura; Moretto, Umberto; Novi, Martina; Masci, Isabella; Caruso, Danila; Drake, Christopher L; Riemann, Dieter

2018-05-15

According to the diathesis-stress model of insomnia, insomnia may develop in vulnerable individuals in response to stress. Resilience is a psychobiological factor that determines an individual's capacity to adapt successfully to stressful events and low resilience increases vulnerability for development of mental disorders. The aim was to explore resilience in subjects with insomnia and its relationship with the factors that contribute to its development and perpetuation. The study consisted of 58 subjects with Insomnia Disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and 38 good sleepers. Resilience Scale for Adults (RSA), Ford Insomnia Response to Stress Test (FIRST), Pre-sleep Arousal Scale (PSAS), and Difficulties in Emotion Regulation Scale (DERS) were administered while taking into account psychiatric symptoms. Differences in means between groups were assessed using t test or Mann-Whitney U /Wilcoxon test. Linear/multivariable regression analyses and mediation analyses were performed. Subjects with insomnia (24 females, mean age 49 ± 2.1 years) had lower RSA and higher FIRST, DERS, and PSAS scores than good sleepers (22 females, mean age 47.2 ± 1.2 years). After controlling for anxiety/depressive symptoms, low resilience correlated with high stress-related sleep reactivity ( P = .004), pre-sleep cognitive hyperarousal ( P = .01) and emotion dysregulation ( P = .01). Emotion dysregulation mediated the relationship between low resilience and cognitive hyperarousal (Z = 2.06, P = .03). Subjects with insomnia showed low resilience, which was related to high stress-related sleep reactivity, emotional dysregulation, and hyperarousal. If resilience helps to minimize the extent of pathogenesis in the developmental process, an early identification of vulnerable candidates should be useful for preventing insomnia development and maintenance. A commentary on this article appears in this issue on page 709. © 2018 American

Effects of exercise and diet interventions on obesity-related sleep disorders in men: study protocol for a randomized controlled trial.

PubMed

Tan, Xiao; Saarinen, Antti; Mikkola, Tuija M; Tenhunen, Jarkko; Martinmäki, Samu; Rahikainen, Aki; Cheng, Shumei; Eklund, Niklas; Pekkala, Satu; Wiklund, Petri; Munukka, Eveliina; Wen, Xinfei; Cong, Fengyu; Wang, Xi; Zhang, Yajun; Tarkka, Ina; Sun, Yining; Partinen, Markku; Alen, Markku; Cheng, Sulin

2013-07-26

Sleep is essential for normal and healthy living. Lack of good quality sleep affects physical, mental and emotional functions. Currently, the treatments of obesity-related sleep disorders focus more on suppressing sleep-related symptoms pharmaceutically and are often accompanied by side effects. Thus, there is urgent need for alternative ways to combat chronic sleep disorders. This study will investigate underlying mechanisms of the effects of exercise and diet intervention on obesity-related sleep disorders, the role of gut microbiota in relation to poor quality of sleep and day-time sleepiness, as well as the levels of hormones responsible for sleep-wake cycle regulation. Participants consist of 330 (target sample) Finnish men aged 30 to 65 years. Among them, we attempt to randomize 180 (target sample) with sleep disorders into exercise and diet intervention. After screening and physician examination, 101 men with sleep disorders are included and are randomly assigned into three groups: exercise (n = 33), diet (n = 35), and control (n = 33). In addition, we attempt to recruit a target number of 150 healthy men without sleep disorders as the reference group. The exercise group undergoes a six-month individualized progressive aerobic exercise program based on initial fitness level. The diet group follows a six month specific individualized diet program. The control group and reference group are asked to maintain their normal activity and diet during intervention. Measurements are taken before and after the intervention. Primary outcomes include objective sleep measurements by polysomnography and a home-based non-contact sleep monitoring system, and subjective sleep evaluation by questionnaires. Secondary outcome measures include anthropometry, body composition, fitness, sleep disorder-related lifestyle risk factors, composition of gut microbiota and adipose tissue metabolism, as well as specific hormone and neurotranmitter levels and inflammatory biomarkers from

Concurrent and longitudinal relations between children's sleep and cognitive functioning: the moderating role of parent education.

PubMed

Buckhalt, Joseph A; El-Sheikh, Mona; Keller, Peggy S; Kelly, Ryan J

2009-01-01

Relations between children's sleep and cognitive functioning were examined over 2 years, and race and socioeconomic status were assessed as moderators of effects. Third-grade African American and European American children (N = 166; M = 8.72 years) participated at Time 1 and again 2 years later (N = 132). At both Time 1 and Time 2, sleep was examined via self-report and actigraphy. Children were administered selected tests from the Woodcock-Johnson III Tests of Cognitive Abilities, and Stanford Achievement Test scores were obtained from schools. Children's sleep was related to intellectual ability and academic achievement. Results build substantially on an emerging literature supportive of the importance of sleep in children.

The Relation among Sleep, Routines, and Externalizing Behavior in Children with an Autism Spectrum Disorder

ERIC Educational Resources Information Center

Henderson, Jill A.; Barry, Tammy D.; Bader, Stephanie H.; Jordan, Sara Sytsma

2011-01-01

The present study examined relations among sleep, routines, and externalizing behavior (based on parent report) in 115 children ages 6 to 12 years in two groups: 58 children with an autism spectrum disorder (age M = 9.0, SD = 2.09) and 57 non-ASD children (age M = 8.25, SD = 1.98). Within the ASD group, sleep hygiene and sleep quality were related…

Childhood obesity and sleep: relatives, partners, or both?--a critical perspective on the evidence.

PubMed

Gozal, David; Kheirandish-Gozal, Leila

2012-08-01

In modern life, children are unlikely to obtain sufficient or regular sleep and waking schedules. Inadequate sleep affects the regulation of homeostatic and hormonal systems underlying somatic growth, maturation, and bioenergetics. Therefore, assessments of the obesogenic lifestyle, including as dietary and physical activity, need to be coupled with accurate evaluation of sleep quality and quantity, and coexistence of sleep apnea. Inclusion of sleep as an integral component of research studies on childhood obesity should be done as part of the study planning process. Although parents and health professionals have quantified normal patterns of activities in children, sleep has been almost completely overlooked. As sleep duration in children appears to have declined, reciprocal obesity rates have increased. Also, increases in pediatric obesity rates have markedly increased the risk of obstructive sleep apnea syndrome (OSAS) in children. Obesity and OSAS share common pathways underlying end-organ morbidity, potentially leading to reciprocal amplificatory effects. The relative paucity of data on the topics covered in the perspective below should serve as a major incentive toward future research on these critically important concepts. © 2012 New York Academy of Sciences.

During early and mid-adolescence, greater mental toughness is related to increased sleep quality and quality of life.

PubMed

Brand, Serge; Kalak, Nadeem; Gerber, Markus; Clough, Peter J; Lemola, Sakari; Pühse, Uwe; Holsboer-Trachsler, Edith

2016-06-01

The aim of this study was to explore the association between mental toughness, subjective sleep, physical activity, and quality of life during early and mid-adolescence. A total of 1475 participants (mean age = 13.4 years; range: 11-16 years) took part in the study. They completed questionnaires related to mental toughness, physical activity, subjective sleep, and quality of life. Greater mental toughness was related to more favorable quality of life and increased subjective sleep. Mental toughness was not related to physical activity. Increased mental toughness, favorable quality of life, and sleep are related during early and mid-adolescence. Against our expectations, mental toughness was not related to physical activity. © The Author(s) 2014.

Attention-deficit/hyperactivity disorder dimensions and sluggish cognitive tempo symptoms in relation to college students' sleep functioning.

PubMed

Becker, Stephen P; Luebbe, Aaron M; Langberg, Joshua M

2014-12-01

This study examined separate inattentive, hyperactive, and impulsive dimensions of attention-deficit/hyperactivity disorder (ADHD), as well as sluggish cognitive tempo (SCT) symptoms, in relation to college students' sleep functioning. Participants were 288 college students (ages 17-24; 65 % female; 90 % non-Hispanic White; 12 % self-reported having an ADHD diagnoses) who completed measures of ADHD/SCT symptoms and sleep functioning. Participants reported obtaining an average of 6.8 h of sleep per night (only 26 % reported obtaining ≥8 h of sleep) and having a sleep onset latency of 25 min. 63 % were classified as "poor sleepers," and poor sleepers had higher rates of ADHD and SCT symptoms than "good sleepers". Path analysis controlling for ADHD status and psychiatric medication use was used to determine associations between psychopathology and sleep functioning domains. Above and beyond covariates and other psychopathologies, hyperactivity (but not impulsivity) was significantly associated with poorer sleep quality, longer sleep latency, shorter sleep duration, and more use of sleep medications. SCT symptoms (but not inattention) were significantly associated with poorer sleep quality and increased nighttime sleep disturbance (e.g., having bad dreams, waking up in the middle of the night, feeling too cold or too hot). Both inattention and SCT were associated with greater daytime dysfunction. Regression analyses demonstrated that hyperactivity predicted sleep quality above and beyond the influence of daytime dysfunction, and inattention and SCT predicted daytime dysfunction above and beyond sleep quality. Further studies are needed to examine the interrelations of nighttime sleep functioning, ADHD/SCT, and daytime dysfunction, as well to elucidate mechanisms contributing to related functional impairments.

Sleep disturbances are associated with reduced health-related quality of life in patients with substance use disorders.

PubMed

Magnée, Ellis H B; de Weert-van Oene, Gerdien H; Wijdeveld, Toon A G M; Coenen, Anton M L; de Jong, Cor A J

2015-09-01

Sleep problems and substance use are strongly linked. Sleep problems play a role in the etiology of substance use, but also may be a result of it. After detoxification, sleep problems may worsen leading to relapse. Nowadays, most substance dependence treatment programs aim at recovery rather than total abstinence, and in that view health-related quality of life (HRQL) is a relevant construct. This article describes the association between self-perceived sleep problems and HRQL in a naturalistic population of polydrug-using inpatients. At the start of treatment, 388 polydrug-using inpatients completed questionnaires concerning their sleep quality and HRQL. Three categories were established based on reported sleep problems: patients without sleep problems (21.6%), those with clinically relevant sleep problems (34.5%), and patients with sleep disorders (43.8%). Mean grades for quality of sleep were M = 7.3 (sd 1.7), M = 6.6 (sd 1.7) and M = 5.3 (sd 1.9) for the three categories, respectively. In addition, patients in the disorder category perceived a lower HRQL than those in the other categories. In the explanation of HRQL, both sleep problems and sleep disorders added significantly to the model when controlling for baseline characteristics. Our findings stress the need for clinicians to pay attention to the quality of sleep of recovering polydrug users, since this may play an important role in the recovery process. Monitoring sleep during treatment is advocated. This study adds to the knowledge about the way HRQL and sleep are related in a naturalistic sample of substance-dependent patients. © American Academy of Addiction Psychiatry.

Organization of the sleep-related neural systems in the brain of the minke whale (Balaenoptera acutorostrata).

PubMed

Dell, Leigh-Anne; Karlsson, Karl Ae; Patzke, Nina; Spocter, Muhammad A; Siegel, Jerome M; Manger, Paul R

2016-07-01

The current study analyzed the nuclear organization of the neural systems related to the control and regulation of sleep and wake in the basal forebrain, diencephalon, midbrain, and pons of the minke whale, a mysticete cetacean. While odontocete cetaceans sleep in an unusual manner, with unihemispheric slow wave sleep (USWS) and suppressed REM sleep, it is unclear whether the mysticete whales show a similar sleep pattern. Previously, we detailed a range of features in the odontocete brain that appear to be related to odontocete-type sleep, and here present our analysis of these features in the minke whale brain. All neural elements involved in sleep regulation and control found in bihemispheric sleeping mammals and the harbor porpoise were present in the minke whale, with no specific nuclei being absent, and no novel nuclei being present. This qualitative similarity relates to the cholinergic, noradrenergic, serotonergic and orexinergic systems, and the GABAergic elements of these nuclei. Quantitative analysis revealed that the numbers of pontine cholinergic (274,242) and noradrenergic (203,686) neurons, and hypothalamic orexinergic neurons (277,604), are markedly higher than other large-brained bihemispheric sleeping mammals. Small telencephalic commissures (anterior, corpus callosum, and hippocampal), an enlarged posterior commissure, supernumerary pontine cholinergic and noradrenergic cells, and an enlarged peripheral division of the dorsal raphe nuclear complex of the minke whale, all indicate that the suite of neural characteristics thought to be involved in the control of USWS and the suppression of REM in the odontocete cetaceans are present in the minke whale. J. Comp. Neurol. 524:2018-2035, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Endothelial function and sleep: associations of flow-mediated dilation with perceived sleep quality and rapid eye movement (REM) sleep.

PubMed

Cooper, Denise C; Ziegler, Michael G; Milic, Milos S; Ancoli-Israel, Sonia; Mills, Paul J; Loredo, José S; Von Känel, Roland; Dimsdale, Joel E

2014-02-01

Endothelial function typically precedes clinical manifestations of cardiovascular disease and provides a potential mechanism for the associations observed between cardiovascular disease and sleep quality. This study examined how subjective and objective indicators of sleep quality relate to endothelial function, as measured by brachial artery flow-mediated dilation (FMD). In a clinical research centre, 100 non-shift working adults (mean age: 36 years) completed FMD testing and the Pittsburgh Sleep Quality Index, along with a polysomnography assessment to obtain the following measures: slow wave sleep, percentage rapid eye movement (REM) sleep, REM sleep latency, total arousal index, total sleep time, wake after sleep onset, sleep efficiency and apnea-hypopnea index. Bivariate correlations and follow-up multiple regressions examined how FMD related to subjective (i.e., Pittsburgh Sleep Quality Index scores) and objective (i.e., polysomnography-derived) indicators of sleep quality. After FMD showed bivariate correlations with Pittsburgh Sleep Quality Index scores, percentage REM sleep and REM latency, further examination with separate regression models indicated that these associations remained significant after adjustments for sex, age, race, hypertension, body mass index, apnea-hypopnea index, smoking and income (Ps < 0.05). Specifically, as FMD decreased, scores on the Pittsburgh Sleep Quality Index increased (indicating decreased subjective sleep quality) and percentage REM sleep decreased, while REM sleep latency increased (Ps < 0.05). Poorer subjective sleep quality and adverse changes in REM sleep were associated with diminished vasodilation, which could link sleep disturbances to cardiovascular disease. © 2013 European Sleep Research Society.

Age-Related Reduction of Recovery Sleep and Arousal Threshold in Drosophila.

PubMed

Vienne, Julie; Spann, Ryanne; Guo, Fang; Rosbash, Michael

2016-08-01

Physiological studies show that aging affects both sleep quality and quantity in humans, and sleep complaints increase with age. Along with knowledge about the negative effects of poor sleep on health, understanding the enigmatic relationship between sleep and aging is important. Because human sleep is similar to Drosophila (fruit fly) sleep in many ways, we addressed the effects of aging on sleep in this model organism. Baseline sleep was recorded in five different Drosophila genotypes raised at either 21°C or 25°C. The amount of sleep recovered was then investigated after a nighttime of sleep deprivation (12 h) and after chronic sleep deprivation (3 h every night for multiple nights). Finally, the effects of aging on arousal, namely, sensitivity to neuronal and mechanical stimuli, were studied. We show that fly sleep is affected by age in a manner similar to that of humans and other mammals. Not only do older flies of several genotypes have more fragmented sleep and reduced total sleep time compared to young flies, but older flies also fail to recover as much sleep after sleep deprivation. This suggests either lower sleep homeostasis and/or a failure to properly recover sleep. Older flies also show a decreased arousal threshold, i.e., an increased response to neuronal and mechanical wake-promoting stimuli. The reduced threshold may either reflect or cause the reduced recovery sleep of older flies compared to young flies after sleep deprivation. Further studies are certainly needed, but we suggest that the lower homeostatic sleep drive of older flies causes their decreased arousal threshold. © 2016 Associated Professional Sleep Societies, LLC.

Insufficient sleep rather than the apnea-hypopnea index can be associated with sleepiness-related driving problems of Japanese obstructive sleep apnea syndrome patients residing in metropolitan areas.

PubMed

Matsui, Kentaro; Sasai-Sakuma, Taeko; Ishigooka, Jun; Inoue, Yuichi

2017-05-01

Obstructive sleep apnea syndrome (OSAS) and insufficient sleep might increase the risk of drowsy driving and sleepiness-related vehicular accidents. This study retrospectively investigated the factors associated with these driving problems, particularly addressing OSAS severity and sleep amounts of affected drivers. This study examined 161 patients (146 male and 15 female) with OSAS (apnea-hypopnea index [AHI] ≥ 5) who drove on a routine basis and who completed study questionnaires. To investigate factors associated with drowsy driving during the prior year and sleepiness-related vehicular accidents or near-miss events during the prior five years, logistic regression analyses were performed with age, body mass index, monthly driving distance, habitual sleep duration on weekdays, the Japanese version of Epworth Sleepiness Scale score, AHI, and periodic limb movement index as independent variables. Of the patients, 68 (42.2%) reported drowsy driving experiences, and 86 (53.4%) reported sleepiness-related vehicular accidents or near-miss events. Analyses revealed the following: older age (46-65 years, ≥66 years) was negatively associated with drowsy driving (p <0.05, p <0.05), and habitually shorter sleep duration on weekdays (≤6 hours) was positively associated with drowsy driving (p <0.01). Habitual sleep duration of ≤6 hours (p <0.01) and Epworth Sleepiness Scale score of ≥11 (p <0.01) were positively associated with sleepiness-related vehicular accidents and near-miss events. However, AHI was not associated with these driving problems. Insufficient sleep, rather than severity of OSAS, was associated with sleepiness-related driving problems in these Japanese OSAS patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Sleep patterns and sleep disturbances across pregnancy.

PubMed

Mindell, Jodi A; Cook, Rae Ann; Nikolovski, Janeta

2015-04-01

This study sought to characterize sleep patterns and sleep problems in a large sample of women across all months of pregnancy. A total of 2427 women completed an Internet-based survey that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, vitality scale of the Short Form 36 Health Survey (SF-36), Insomnia Severity Index (ISI), Berlin questionnaire, International Restless Legs Syndrome (IRLS) question set, and a short version of the Pregnancy Symptoms Inventory (PSI). Across all months of pregnancy, women experienced poor sleep quality (76%), insufficient nighttime sleep (38%), and significant daytime sleepiness (49%). All women reported frequent nighttime awakenings (100%), and most women took daytime naps (78%). Symptoms of insomnia (57%), sleep-disordered breathing (19%), and restless legs syndrome (24%) were commonly endorsed, with no difference across the month of pregnancy for insomnia, sleep-disorder breathing, daytime sleepiness, or fatigue. In addition, high rates of pregnancy-related symptoms were found to disturb sleep, especially frequent urination (83%) and difficulty finding a comfortable sleep position (79%). Women experience significant sleep disruption, inadequate sleep, and high rates of symptoms of sleep disorder throughout pregnancy. These results suggest that all women should be screened and treated for sleep disturbances throughout pregnancy, especially given the impact of inadequate sleep and sleep disorders on fetal, pregnancy, and postpartum outcomes. Copyright © 2014 Elsevier B.V. All rights reserved.

Sleep Spindle Characteristics in Children with Neurodevelopmental Disorders and Their Relation to Cognition

PubMed Central

Wise, Merrill S.

2016-01-01

Empirical evidence indicates that sleep spindles facilitate neuroplasticity and “off-line” processing during sleep, which supports learning, memory consolidation, and intellectual performance. Children with neurodevelopmental disorders (NDDs) exhibit characteristics that may increase both the risk for and vulnerability to abnormal spindle generation. Despite the high prevalence of sleep problems and cognitive deficits in children with NDD, only a few studies have examined the putative association between spindle characteristics and cognitive function. This paper reviews the literature regarding sleep spindle characteristics in children with NDD and their relation to cognition in light of what is known in typically developing children and based on the available evidence regarding children with NDD. We integrate available data, identify gaps in understanding, and recommend future research directions. Collectively, studies are limited by small sample sizes, heterogeneous populations with multiple comorbidities, and nonstandardized methods for collecting and analyzing findings. These limitations notwithstanding, the evidence suggests that future studies should examine associations between sleep spindle characteristics and cognitive function in children with and without NDD, and preliminary findings raise the intriguing question of whether enhancement or manipulation of sleep spindles could improve sleep-dependent memory and other aspects of cognitive function in this population. PMID:27478646

Medical consequences and associations with untreated sleep-related breathing disorders and outcomes of treatments.

PubMed

Norman, Daniel; Haberman, Paul B; Valladares, Edwin M

2012-02-01

Sleep-related breathing disorders are a broad group of disorders that include obstructive sleep apnea, central sleep apnea, and periodic breathing disorders. This article reviews the scientific literature that links SRBD to various medical conditions including hypertension, coronary artery disease, cardiac arrhythmias, stroke, diabetes mellitus, obesity, and depression. Pathophysiologic mechanisms by which SRBD may contribute to these disorders will be discussed, as will data on the degree to which treatment of SRBD may improve these conditions.

Sleep Hygiene and Sleep Quality of Third-Trimester Pregnant Women.

PubMed

Tsai, Shao-Yu; Lee, Chien-Nan; Wu, Wei-Wen; Landis, Carol A

2016-02-01

The purpose of this descriptive study was to examine the associations of sleep hygiene and actigraphy measures of sleep with self-reported sleep quality in 197 pregnant women in northern Taiwan. Third-trimester pregnant women completed the Sleep Hygiene Practice Scale (SHPS) and the Pittsburgh Sleep Quality Index (PSQI) as well as the Center for Epidemiologic Studies-Depression Scale (CES-D), and wore an actigraph for 7 consecutive days. Student's t-test was used to compare the SHPS scores and means as well as variability of actigraphy sleep variables between poor sleepers (i.e., PSQI global score >5) and good sleepers (i.e., PSQI global score ≤5). Compared to good sleepers, poor sleepers reported significantly worse sleep hygiene, with higher SHPS scores and higher sleep schedule, arousal-related behavior, and sleep environment subscale scores. Poor sleepers had significantly greater intra-individual variability of sleep onset latency, total nighttime sleep, and wake after sleep onset than good sleepers. In stepwise linear regression, older maternal age (p = .01), fewer employment hours per week (p = .01), higher CES-D total score (p < .01), and higher SHPS arousal-related behavior subscale scores (p < .01) predicted self-reported global sleep quality. Findings support avoiding physically, physiologically, emotionally, or cognitively arousing activities before bedtime as a target for sleep-hygiene intervention in women during pregnancy. © 2015 Wiley Periodicals, Inc.

Sleep-laughing--hypnogely.

PubMed

Trajanovic, Nikola N; Shapiro, Colin M; Milovanovic, Srdjan

2013-07-01

To explain relatively common phenomenon of laughing during sleep and help to better define criteria for differentiating between physiological and pathological sleep-laughing. Observational study of patients who underwent a sleep assessment in a referential tertiary health facility. A total of ten patients exhibited sleep laughing, nine of whom had episodes associated with rapid eye movement (REM) sleep. Also, in one of the patients sleep-laughing was one of the symptoms of REM sleep Behaviour Disorder, and in another patient sleep-laughing was associated with NREM sleep arousal parasomnia. The collected data and review of literature suggests that hypnogely in majority of the cases presents as a benign physiological phenomenon related to dreaming and REM sleep. Typically, these dreams are odd, bizarre or even unfunny for a person when awake. Nevertheless, they bring a sense of mirth and a genuine behavioural response. In a minority of cases, sleep-laughing appears to be a symptom of neurological disorders affecting the central nervous system. In these patients the behavioural substrate differs when compared to physiological laughing, and the sense of mirth is usually absent.

Do Older Adults Need Sleep? A Review of Neuroimaging, Sleep, and Aging Studies.

PubMed

Scullin, Michael K

2017-09-01

Sleep habits, sleep physiology, and sleep disorders change with increasing age. However, there is a longstanding debate regarding whether older adults need sleep to maintain health and daily functioning (reduced-sleep-need view). An alternative possibility is that all older adults need sleep, but that many older adults have lost the ability to obtain restorative sleep (reduced-sleep-ability view). Prior research using behavioral and polysomnography outcomes has not definitively disentangled the reduced-sleep-need and reduced-sleep-ability views. Therefore, this review examines the neuroimaging literature to determine whether age-related changes in sleep cause-or are caused by-age-related changes in brain structure, function, and pathology. In middle-aged and older adults, poorer sleep quality, greater nighttime hypoxia, and shorter sleep duration related to cortical thinning in frontal regions implicated in slow wave generation, in frontoparietal networks implicated in cognitive control, and in hippocampal regions implicated in memory consolidation. Furthermore, poor sleep quality was associated with higher amyloid burden and decreased connectivity in the default mode network, a network that is disrupted in the pathway to Alzheimer's disease. All adults need sleep, but cortical thinning and amyloidal deposition with advancing age may weaken the brain's ability to produce restorative sleep. Therefore, sleep in older adults may not always support identical functions for physical, mental, and cognitive health as in young adults.

The spectrum of REM sleep-related episodes in children with type 1 narcolepsy.

PubMed

Antelmi, Elena; Pizza, Fabio; Vandi, Stefano; Neccia, Giulia; Ferri, Raffaele; Bruni, Oliviero; Filardi, Marco; Cantalupo, Gaetano; Liguori, Rocco; Plazzi, Giuseppe

2017-06-01

.e. status cataplecticus) and more complaints of disrupted nocturnal sleep and of excessive daytime sleepiness. The neurophysiological hallmark of this severe motor dyscontrol during REM sleep was a decreased atonia index. The present study reports for the first time the occurrence of a severe and peculiar motor disorder during REM sleep in paediatric type 1 narcolepsy and confirms the presence of a severe motor dyscontrol in these patients, emerging not only from wakefulness (i.e. status cataplecticus), but also from sleep (i.e. complex behaviours during REM sleep). This is probably related to the acute imbalance of the hypocretinergic system, which physiologically acts by promoting movements during wakefulness and suppressing them during sleep. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The nasal cycle during wakefulness and sleep and its relation to body position.

PubMed

Rohrmeier, Christian; Schittek, Silke; Ettl, Tobias; Herzog, Michael; Kuehnel, Thomas S

2014-06-01

To compare the occurrence, duration, and relative amplitudes of the nasal cycle (NC) during wakefulness and sleep, and to investigate the relationship of the NC to body position. In 20 healthy subjects, the NC was measured by long-term rhinoflowmetry for an average 23.1 hours during wakefulness and sleep. Head and body position were also recorded during the night. A classic NC was displayed by 50% of subjects during wakefulness and by 75% of the subjects during sleep. Cycle duration during wakefulness was 91.1 minutes (± 65.2; 20-337), increasing significantly during sleep to 178 minutes (± 92.8; 21-498) (P < 0.01). The relative mean flow of the working phase during wakefulness was 67.6% (± 8.0; 58-90), and it was significantly higher during sleep at 82.0% (± 6.8; 63-93) (P < 0.01). On recumbency, there was a significant correlation between body position and resting phase side (r = 0.67; P = 0.024). To a significant extent, positional shifts led to subsequent NC laterality changes (22%; P < 0.01). Conversely, to a significant extent, positional shifts preceded NC laterality changes (57.6%; P < 0.01). Body position changed in a nonsignificant number of cases (30.3%; P = 0.16) due to reversal of the congestion side of the inferior turbinates. The results of our study show that the NC during sleep is characterized by longer cycle durations and greater amplitudes than during wakefulness on normal physical activity. Shifts in body position during sleep alter the NC in a specific direction to a significant extent, but the opposite is not the case. 4. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.