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Sample records for nocturnal sleep disruption

  1. Trauma Associated Sleep Disorder: A Proposed Parasomnia Encompassing Disruptive Nocturnal Behaviors, Nightmares, and REM without Atonia in Trauma Survivors

    PubMed Central

    Mysliwiec, Vincent; O'Reilly, Brian; Polchinski, Jason; Kwon, Herbert P.; Germain, Anne; Roth, Bernard J.

    2014-01-01

    Study Objectives: To characterize the clinical, polysomnographic and treatment responses of patients with disruptive nocturnal behaviors (DNB) and nightmares following traumatic experiences. Methods: A case series of four young male, active duty U.S. Army Soldiers who presented with DNB and trauma related nightmares. Patients underwent a clinical evaluation in a sleep medicine clinic, attended overnight polysomnogram (PSG) and received treatment. We report pertinent clinical and PSG findings from our patients and review prior literature on sleep disturbances in trauma survivors. Results: DNB ranged from vocalizations, somnambulism to combative behaviors that injured bed partners. Nightmares were replays of the patient's traumatic experiences. All patients had REM without atonia during polysomnography; one patient had DNB and a nightmare captured during REM sleep. Prazosin improved DNB and nightmares in all patients. Conclusions: We propose Trauma associated Sleep Disorder (TSD) as a unique sleep disorder encompassing the clinical features, PSG findings, and treatment responses of patients with DNB, nightmares, and REM without atonia after trauma. Citation: Mysliwiec V, O'Reilly B, Polchinski J, Kwon HP, Germain A, Roth BJ. Trauma associated sleep disorder: a proposed parasomnia encompassing disruptive nocturnal behaviors, nightmares, and REM without atonia in trauma survivors. J Clin Sleep Med 2014;10(10):1143-1148. PMID:25317096

  2. Alcohol disrupts sleep homeostasis.

    PubMed

    Thakkar, Mahesh M; Sharma, Rishi; Sahota, Pradeep

    2015-06-01

    Alcohol is a potent somnogen and one of the most commonly used "over the counter" sleep aids. In healthy non-alcoholics, acute alcohol decreases sleep latency, consolidates and increases the quality (delta power) and quantity of NREM sleep during the first half of the night. However, sleep is disrupted during the second half. Alcoholics, both during drinking periods and during abstinences, suffer from a multitude of sleep disruptions manifested by profound insomnia, excessive daytime sleepiness, and altered sleep architecture. Furthermore, subjective and objective indicators of sleep disturbances are predictors of relapse. Finally, within the USA, it is estimated that societal costs of alcohol-related sleep disorders exceeds $18 billion. Thus, although alcohol-associated sleep problems have significant economic and clinical consequences, very little is known about how and where alcohol acts to affect sleep. In this review, we have described our attempts to unravel the mechanism of alcohol-induced sleep disruptions. We have conducted a series of experiments using two different species, rats and mice, as animal models. We performed microdialysis, immunohistochemical, pharmacological, sleep deprivation and lesion studies which suggest that the sleep-promoting effects of alcohol may be mediated via alcohol's action on the mediators of sleep homeostasis: adenosine (AD) and the wake-promoting cholinergic neurons of the basal forebrain (BF). Alcohol, via its action on AD uptake, increases extracellular AD resulting in the inhibition of BF wake-promoting neurons. Since binge alcohol consumption is a highly prevalent pattern of alcohol consumption and disrupts sleep, we examined the effects of binge drinking on sleep-wakefulness. Our results suggest that disrupted sleep homeostasis may be the primary cause of sleep disruption observed following binge drinking. Finally, we have also shown that sleep disruptions observed during acute withdrawal, are caused due to impaired

  3. Nocturnal Sleep Dynamics Identify Narcolepsy Type 1

    PubMed Central

    Pizza, Fabio; Vandi, Stefano; Iloti, Martina; Franceschini, Christian; Liguori, Rocco; Mignot, Emmanuel; Plazzi, Giuseppe

    2015-01-01

    Study Objectives: To evaluate the reliability of nocturnal sleep dynamics in the differential diagnosis of central disorders of hypersomnolence. Design: Cross-sectional. Setting: Sleep laboratory. Patients: One hundred seventy-five patients with hypocretin-deficient narcolepsy type 1 (NT1, n = 79), narcolepsy type 2 (NT2, n = 22), idiopathic hypersomnia (IH, n = 22), and “subjective” hypersomnolence (sHS, n = 52). Interventions: None. Methods: Polysomnographic (PSG) work-up included 48 h of continuous PSG recording. From nocturnal PSG conventional sleep macrostructure, occurrence of sleep onset rapid eye movement period (SOREMP), sleep stages distribution, and sleep stage transitions were calculated. Patient groups were compared, and receiver operating characteristic (ROC) curve analysis was used to test the diagnostic utility of nocturnal PSG data to identify NT1. Results: Sleep macrostructure was substantially stable in the 2 nights of each diagnostic group. NT1 and NT2 patients had lower latency to rapid eye movement (REM) sleep, and NT1 patients showed the highest number of awakenings, sleep stage transitions, and more time spent in N1 sleep, as well as most SOREMPs at daytime PSG and at multiple sleep latency test (MSLT) than all other groups. ROC curve analysis showed that nocturnal SOREMP (area under the curve of 0.724 ± 0.041, P < 0.0001), percent of total sleep time spent in N1 (0.896 ± 0.023, P < 0.0001), and the wakefulness-sleep transition index (0.796 ± 0.034, P < 0.0001) had a good sensitivity and specificity profile to identify NT1 sleep, especially when used in combination (0.903 ± 0.023, P < 0.0001), similarly to SOREMP number at continuous daytime PSG (0.899 ± 0.026, P < 0.0001) and at MSLT (0.956 ± 0.015, P < 0.0001). Conclusions: Sleep macrostructure (i.e. SOREMP, N1 timing) including stage transitions reliably identifies hypocretin-deficient narcolepsy type 1 among central disorders of hypersomnolence. Citation: Pizza F, Vandi S

  4. Temporal Relationships Between Napping and Nocturnal Sleep in Healthy Adolescents.

    PubMed

    Jakubowski, Karen P; Hall, Martica H; Lee, Laisze; Matthews, Karen A

    2017-01-01

    Many adolescents do not achieve the recommended 9 hr of sleep per night and report daytime napping, perhaps because it makes up for short nocturnal sleep. This article tests temporal relationships between daytime naps and nighttime sleep as measured by actigraphy and diary among 236 healthy high school students during one school week. Mixed model analyses adjusted for age, race, and gender demonstrated that shorter actigraphy-assessed nocturnal sleep duration predicted longer napping (measured by actigraphy and diary) the next day. Napping (by actigraphy and diary) predicted shorter nocturnal sleep duration and worse sleep efficiency that night measured by actigraphy. Diary-reported napping also predicted poorer self-reported sleep quality that night. Frequent napping may interfere with nocturnal sleep during adolescence.

  5. Nocturnal Hot Flashes: Relationship to Objective Awakenings and Sleep Stage Transitions

    PubMed Central

    Bianchi, Matt T.; Kim, Semmie; Galvan, Thania; White, David P.; Joffe, Hadine

    2016-01-01

    Study Objectives: While women report sleep interruption secondary to nighttime hot flashes, the sleep disrupting impact of nocturnal hot flashes (HF) is not well characterized. We utilized a model of induced HF to investigate the relationship of nighttime HF to sleep architecture and sleep-stage transitions. Methods: Twenty-eight healthy, premenopausal volunteers received the depot gonadotropin-releasing hormone agonist (GnRHa) leuprolide to rapidly induce menopause, manifesting with HF. Sleep disruption was measured on 2 polysomnograms conducted before and after 4–5 weeks on leuprolide, when HF had developed. Results: 165 HF episodes were recorded objectively during 48 sleep studies (mean 3.4 HF/night). After standardizing to sleep-stage time distribution, the majority of HF were recorded during wake (51.0%) and stage N1 (18.8%). Sixty-six percent of HF occurred within 5 minutes of an awakening, with 80% occurring just before or during the awakening. Objective HF were not associated with sleep disruption as measured by increased transitions to wake or N1, but self-reported nocturnal HF correlated with an increase from pre- to post-leuprolide in the rate of transitions to wake (p = 0.01), and to N1 (p = 0.008). Conclusions: By isolating the effect of HF on sleep in women without the confound of age-related sleep changes associated with natural menopause, this experimental model shows that HF arise most commonly during N1 and wake, typically preceding or occurring simultaneously with wake episodes. Perception of HF, but not objective HF, is linked to increased sleep-stage transitions, suggesting that sleep disruption increases awareness of and memory for nighttime HF events. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT01116401. Citation: Bianchi MT, Kim S, Galvan T, White DP, Joffe H. Nocturnal hot flashes: relationship to objective awakenings and sleep stage transitions. J Clin Sleep Med 2016;12(7):1003–1009. PMID:26951410

  6. Nocturnal oxygen enrichment in sleep apnoea.

    PubMed

    Pokorski, M; Jernajczyk, U

    2000-01-01

    We hypothesized that a modest oxygen enrichment, rather than 100% oxygen supplementation as used in previous trials, could result in improvement in ventilatory and cardiac symptoms, in patients with obstructive sleep apnoea (OSA), without jeopardizing the chemostimulant ventilatory drive. This hypothesis was tested in five male patients with OSA in a single-blinded trial consisting of one night spent sleeping in control room air (control night), followed by one night spent sleeping while exposed to air with a 9% enriched oxygen content (oxygen-enriched night). Oxygen enrichment resulted in a significant shift in the oxygen saturation profile towards values of > or = 95% and to decrease desaturation dips throughout the night. The apnoea index decreased from the control night to the oxygen-enriched night from 52.7 +/- 10.4 to 38.9 +/- 9.3; the decrease being greatest for the longest apnoeas (> or = 30 s). Additionally, the cardiovascular status improved. No signs of depressed chemostimulant drive in the oxygen-enriched night were detected. We conclude that nocturnal oxygen enrichment merits consideration for therapeutic trial in the prevention of long apnoeic and desaturation episodes.

  7. [Disruptive nocturnal behavior in elderly subjects: could it be a parasomnia?].

    PubMed

    Leu-Semenescu, Smaranda; Arnulf, Isabelle

    2010-06-01

    Parasomnias are sleep-related abnormal behaviors. They are frequent and overlooked causes of nocturnal disruptive behavior in the elderly, especially when patients are cognitively impaired. Confusion and violence can result in sleep disruption, injuries for the patients or their bed partners, caregivers distress, and they can be a motive for institutionalization. Parasomnias include the NonREM sleep disorders of arousal (sleepwalking, sleep terrors, confusional arousals and sleep-related eating disorder), the REM sleep behavior disorder (RBD) and more rarely the parasomnia overlap syndrome, which associates both NREM and REM parasomnias. Patients with NREM sleep parasomnias are confused, eyes open, with a glazed look during their nocturnal behaviors, and they have a post-episode amnesia. They shout and bolt from the bed (night terrors), look about in a confused manner, walk and speak (sleepwalking), and eat peculiar or inedible food (sleep-related eating disorders). These behaviors, which are frequent in young adults, may be triggered by short-half live hypnotics in elderly. During the parasomnia, the brain is partially awake (enough to perform complex motor and verbal action), and partially asleep (without conscious awareness or responsibility). RBD is characterized by a loss of the normal muscle atonia that accompanies REM sleep. Patients have excessive motor activity such as punching, kicking, or crying out in association with dream content. RBD are frequent in Parkinson's disease and dementia with Lewy bodies and may precede the cognitive or motor symptoms of these diseases by 5 to 10 years. RBD can also be promoted by antidepressants. When combined with thorough clinical interviews, the video-polysomnography is a powerful tool, especially for discriminating the parasomnia from nocturnal frontal lobe epilepsy, sleep apneas and periodic leg movements. Ensuring safety and withdrawing deleterious treatments are useful in patients with violent activities, potential

  8. Effects of exercise intensity and duration on nocturnal heart rate variability and sleep quality.

    PubMed

    Myllymäki, Tero; Rusko, Heikki; Syväoja, Heidi; Juuti, Tanja; Kinnunen, Marja-Liisa; Kyröläinen, Heikki

    2012-03-01

    Acute physical exercise may affect cardiac autonomic modulation hours or even days during the recovery phase. Although sleep is an essential recovery period, the information on nocturnal autonomic modulation indicated by heart rate variability (HRV) after different exercises is mostly lacking. Therefore, this study investigated the effects of exercise intensity and duration on nocturnal HR, HRV, HR, and HRV-based relaxation, as well as on actigraphic and subjective sleep quality. Fourteen healthy male subjects (age 36 ± 4 years, maximal oxygen uptake 49 ± 4 ml/kg/min) performed five different running exercises on separate occasions starting at 6 p.m. with HR guidance at home. The effect of intensity was studied with 30 min of exercises at intensities corresponding to HR level at 45% (easy), 60% (moderate) and 75% (vigorous) of their maximal oxygen uptake. The effect of duration was studied with 30, 60, and 90 min of moderate exercises. Increased exercise intensity elevated nocturnal HR compared to control day (p < 0.001), but it did not affect nocturnal HRV. Nocturnal HR was greater after the day with 90- than 30- or 60-min exercises (p < 0.01) or control day (p < 0.001). Nocturnal HRV was lower after the 90-min exercise day compared to control day (p < 0.01). Neither exercise intensity nor duration had any impact on actigraphic or subjective sleep quality. The results suggest that increased exercise intensity and/or duration cause delayed recovery of nocturnal cardiac autonomic modulation, although long exercise duration was needed to induce changes in nocturnal HRV. Increased exercise intensity or duration does not seem to disrupt sleep quality.

  9. Nocturnal hyperglycaemia in type 2 diabetes with sleep apnoea syndrome.

    PubMed

    Fendri, Salha; Rose, Dominique; Myambu, Sonia; Jeanne, Sandrine; Lalau, Jean-Daniel

    2011-01-01

    We assessed glycaemic status in 26 overweight or obese people with type 2 diabetes suspected of having sleep apnoea syndrome (SAS). In people with SAS (n=13), nocturnal glycaemia was 38% higher, independent of body mass index (particularly during rapid eye movement sleep) compared with non-SAS subjects (p<0.008).

  10. Nocturnal psychophysiological correlates of somatic conditions and sleep disorders.

    PubMed

    Kales, J D; Kales, A

    1975-01-01

    Modern sleep research studies have provided the practicing physician with considerable new information concerning the basic psychophysiology of sleep, the effects of medical conditions on sleep and the role of maturational and emotional factors in producing certain sleep disorders. Medical and psychiatric disorders, sleep disorders and drug-induced sleep stage alterations are studied in the sleep laboratory using the same techniques developed to analyze sleep patterns in normal subjects. After initial sleep laboratory adaptation, a profile of the sleep characteristics of various clinical conditions is obtained. This profile can be compared to sleep profiles of normal subjects as well as to the effects on sleep of subsequent experimental or therapeutic procedures. Various studies have shown that coronary artery, duodenal ulcer and nocturnal headache patients experience angina, increased gastric acid secretion and migraine or cluster headaches, respectively during REM sleep. Adult nocturnal asthamtic episodes occur out of all sleep stages while attacks of dyspnea in asthmatic children occur in all stages except stage 4 sleep. Hypothyroid patients show decreases in stages 3 and 4 sleep, while in hyperthyroid patients the percentage of time spent in stages 3 and 4 sleep is markedly increased. Enuretic episodes occur predominantly in non-rapid eye movement (NREM) sleep. Sleepwalking and night terror episodes occur exclusively out of NREM sleep, particularly from stages 3 and 4 sleep. Most child somnambulists and children with night terrors "outgrow" this disorder, suggesting a delayed maturation of the central nervous system. Stimulant drugs are effective in the treatment of the sleep attacks of narcolepsy and in treating certain cases of hypersomnia, while imipramine is an effective treatment for the auxillary symptoms of narcolepsy. Psychological disturbances are frequent in adult somnambulism and night terrors as well as in hypersomnia and insomnia. Proper

  11. Optimizing sleep/wake schedules in space: Sleep during chronic nocturnal sleep restriction with and without diurnal naps

    NASA Astrophysics Data System (ADS)

    Mollicone, Daniel J.; Van Dongen, Hans P. A.; Dinges, David F.

    2007-02-01

    Effective sleep/wake schedules for space operations must balance severe time constraints with allocating sufficient time for sleep in order to sustain high levels of neurobehavioral performance. Developing such schedules requires knowledge about the relationship between scheduled "time in bed" (TIB) and actual physiological sleep obtained. A ground-based laboratory study in N=93 healthy adult subjects was conducted to investigate physiological sleep obtained in a range of restricted sleep schedules. Eighteen different conditions with restricted nocturnal anchor sleep, with and without diurnal naps, were examined in a response surface mapping paradigm. Sleep efficiency was found to be a function of total TIB per 24 h regardless of how the sleep was divided among nocturnal anchor sleep and diurnal nap sleep periods. The amounts of sleep stages 1+2 and REM showed more complex relationships with the durations of the anchor and nap sleep periods, while slow-wave sleep was essentially preserved among the different conditions of the experiment. The results of the study indicated that when sleep was chronically restricted, sleep duration was largely unaffected by whether the sleep was placed nocturnally or split between nocturnal anchor sleep periods and daytime naps. Having thus assessed that split-sleep schedules are feasible in terms of obtaining physiological sleep, further research will reveal whether these schedules and the associated variations in the distribution of sleep stages may be advantageous in mitigating neurobehavioral performance impairment in the face of limited time for sleep.

  12. Sleep disorders and acute nocturnal delirium in the elderly: a comorbidity not to be overlooked.

    PubMed

    Terzaghi, Michele; Sartori, Ivana; Rustioni, Valter; Manni, Raffaele

    2014-04-01

    Delirium is a disturbance of consciousness and cognition that results in a confusional state. It tends to fluctuate in intensity and is often observed in older patients. Sleep is a window of vulnerability for the occurrence of delirium and sleep disorders can play a role in its appearance. In particular, delirious episodes have been associated with obstructive sleep apnoea syndrome, which is reported to be frequent in the elderly. Hereby, we present a case-report documenting the sudden onset of a confusional state triggered by obstructive sleep apnoea-induced arousal, together with a review of the literature on the topic. We emphasise that, among the many pathogenic factors implicated in delirium, it is worth considering the possible link between nocturnal delirium and the occurrence of impaired arousals. Indeed, the complex confusional manifestations of delirium could be due, in part, to persistence of dysfunctional sleep activity resulting in an inability to sustain full arousal during behavioural wakefulness. Arousals can be triggered by sleep disturbances or other medical conditions. Clinicians should be aware that older patients may present disordered sleep patterns, and make investigation of sleep patterns and disorders potentially affecting sleep continuity a key part of their clinical workup, especially in the presence of cognitive comorbidities. Correct diagnosis and optimal treatment of sleep disorders and disrupted sleep can have a significant impact in the elderly, improving sleep quality and reducing the occurrence of abnormal sleep-related behaviours.

  13. Minimal Effect of Daytime Napping Behavior on Nocturnal Sleep in Pregnant Women

    PubMed Central

    Ebert, Rebecca M.; Wood, Annette; Okun, Michele L.

    2015-01-01

    Study Objectives: To assess whether daytime naps negatively impact nocturnal sleep. Design: Longitudinal, prospective cohort design. Participants: 161 pregnant women recruited and evaluated in early gestation (10–20 weeks). Measurements and Results: Daily sleep information was collected in three 2-week periods (10–12, 14–16, and 18–20 weeks gestation) with a daily sleep diary and an actigraph. The average number of naps, as well as the average length of each nap, were calculated from sleep diaries. Women were categorized first as non nappers (0 naps/2-week period), moderate nappers (1–3 naps/2-week period), or frequent nappers (≥ 4 naps/2-week period). Then, based on the average nap length, they were categorized as short (< 90 min) or long (≥ 90 min) nappers. Nocturnal sleep parameters included SOL, WASO, SE, and TST. SAS procedure MIXED was used for modeling the main effects of nap group and time, and time by nap group interactions. Women who took naps had a decrease in diary-assessed nocturnal TST, but not actigraphy-assessed TST. This observation was group- and time-specific. There were no other group differences. Women who napped ≥ 90 min had poorer diary-assessed SE and lower diary-assessed TST than those who took shorter naps. Length of nap was not associated with any other sleep measures. Conclusions: The number of daytime naps have minimal impact on nocturnal sleep parameters; however, long nappers did exhibit modestly impaired sleep continuity and sleep quality. Overall, we propose that daytime naps provide a beneficial countermeasure to the sleep disruption commonly reported by pregnant women. This may be clinically beneficial given that sleep continuity and quality are important correlates of pregnancy outcomes. Commentary: A commentary on this article appears in this issue on page 593. Citation: Ebert RM, Wood A, Okun ML. Minimal effect of daytime napping behavior on nocturnal sleep in pregnant women. J Clin Sleep Med 2015;11(6):635

  14. Sleeping in fits and starts: a practical guide to distinguishing nocturnal epilepsy from sleep disorders.

    PubMed

    Derry, Christopher P

    2014-12-01

    Accurately diagnosing sleep-related events, and particularly distinguishing nocturnal frontal lobe seizures from other sleep disorders such as parasomnias, can be challenging. This article reviews the differential diagnosis of paroxysmal events from sleep, epileptic and non-epileptic, considers important diagnostic points in the history, and evaluates the role of investigations in this setting.

  15. Nocturnal sleep and daytime alertness of aircrew after transmeridian flights

    NASA Technical Reports Server (NTRS)

    Nicholson, Anthony N.; Pascoe, Peta A.; Spencer, Michael B.; Stone, Barbara M.; Green, Roger L.

    1986-01-01

    The nocturnal sleep and daytime alertness of aircrew were studied by electroencephalography and the multiple sleep latency test. After a transmeridian flight from London To San Francisco, sleep onset was faster and, although there was increased wakefulness during the second half of the night, sleep duration and efficiency over the whole night were not changed. The progressive decrease in sleep latencies observed normally in the multiple sleep latency test during the morning continued throughout the day after arrival. Of the 13 subjects, 12 took a nap of around 1-h duration in the afternoon preceding the return flight. These naps would have been encouraged by the drowsiness at this time and facilitated by the departure of the aircraft being scheduled during the early evening. An early evening departure had the further advantage that the circadian increase in vigilance expected during the early part of the day would occur during the latter part of the return flight.

  16. Polysomnographic assessment of spells in sleep: nocturnal seizures versus parasomnias.

    PubMed

    Dyken, M E; Yamada, T; Lin-Dyken, D C

    2001-12-01

    A dilemma can arise when attempting to distinguish a nocturnal seizure from a parasomnia because both phenomena can be characterized by a general increase in motor and autonomic activity with a transient reduction in the level of consciousness. An additional problem is that an accurate clinical diagnosis generally relies heavily on a detailed history. As sleep related disorders occur at a time when the patient is not fully cognizant, polysomnographic analysis can on occasion supplement for the intrinsic paucity of detailed history. Simultaneously, correlating the clinical and polysomnographic analysis immediately prior to, during, and following an event of interest, can be helpful in differentiating nocturnal seizures from parasomnias.

  17. Sleep in the nocturnal primate, Aotus trivirgatus.

    NASA Technical Reports Server (NTRS)

    Perachio, A. A.

    1971-01-01

    Measurement of the cycles of wakefulness and stages of sleep in owl monkeys during 24-hr periods divided into half dark and half light segments. Recordings of electrophysiological activity were used. Reversal of the sequence of light and dark served to test the influence of environmental lighting on the sleep-wakefulness cycles. The sleep patterns of owl monkeys expressed in percentage of rapid eye movement (REM) and nonrapid eye movement (NREM) were compared with those of a closely related New World monkey species, Saimiri Sciureus.

  18. Nocturnal oscillations of plasma aldosterone in relation to sleep stages.

    PubMed

    Krauth, M O; Saini, J; Follenius, M; Brandenberger, G

    1990-10-01

    This study examined the relationship between aldosterone secretion and sleep stages in conjunction with two aldosterone regulating hormone systems, the renin-angiotensin system (RAS) and adrenocorticotropin (ACTH), and also K+. Nocturnal plasma patterns of aldosterone, plasma renin activity (PRA), ACTH and K+ were established in blood collected at 10-min intervals in two groups of 6 subjects. Both groups underwent two 9 hour overnight-studies, consisting of one control night and one experimental night. The first group was maintained on a low Na diet and the other was given a beta-blocker, atenolol. Polygraphic recordings of sleep were scored according to established criteria. For the control night, REM sleep usually began at peak level or in the descending phase of aldosterone oscillations. As previously described, PRA reflected REM-NREM sleep alteration, levels increased in NREM and decreased during REM sleep. ACTH fluctuations did not oscillate with sleep stages, but levels were very seldom in the ascending phase at REM sleep onset. Plasma K+ remained almost constant throughout the night. The relative importance of the ACTH and the RAS on nocturnal aldosterone secretion and the relationship between aldosterone oscillations and sleep stages remained unclear. Modulating renin levels by either consuming a low Na diet or administration of a beta-blocker enabled this relationship to be clarified. The RAS dominated aldosterone secretion when stimulated by a low sodium diet. Aldosterone oscillations then reflected PRA oscillations with a delay of about 20 min and the relationship of aldosterone to sleep stages was dependent on the relationship of PRA with sleep stages.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Nocturnal eczema: Review of sleep and circadian rhythms in children with atopic dermatitis and future research directions.

    PubMed

    Fishbein, Anna B; Vitaterna, Olivia; Haugh, Isabel M; Bavishi, Aakash A; Zee, Phyllis C; Turek, Fred W; Sheldon, Stephen H; Silverberg, Jonathan I; Paller, Amy S

    2015-11-01

    Children with atopic dermatitis (AD) experience significant sleep disruption, and clinically, the disease is noted to worsen in a circadian manner at night. Epidemiologic findings highlight many negative consequences of AD, such as impaired linear growth, which is uniquely related to disturbed sleep. Clinical guidelines currently recommend assessing sleep in patients with AD as a crucial parameter of disease control with appropriate treatment. In this review we describe our current understanding of the roles of sleep cycles and circadian rhythms in the nighttime exacerbation of AD (nocturnal eczema). We present a schematic to explain the mechanism of nocturnal eczema. Treatment options for sleep disturbance and future directions for research are discussed in the context of AD.

  20. Distinct Mechanisms Underlie Associations Between Forms of Childhood Maltreatment and Disruptive Nocturnal Behaviors.

    PubMed

    Cecil, Charlotte A M; Viding, Essi; McCrory, Eamon J; Gregory, Alice M

    2015-01-01

    Childhood maltreatment is associated with risk for sleep disturbances, including Disruptive Nocturnal Behaviors (DNBs). Yet, little is known regarding associations between specific forms of maltreatment and DNBs, or factors that mediate and moderate these associations. Data from a community sample of high-risk youth (n = 193; M = 18.87 years old) indicated that self-reported emotional and sexual abuse during childhood made specific contributions to DNBs at the time of assessment. Trauma-related psychopathology mediated the effects of emotional abuse. Furthermore, executive function moderated the effects of sexual abuse. Findings suggest that distinct mechanisms underlie associations between maltreatment types and DNBs.

  1. [Development of nocturnal sleep behaviors in very low birth infants].

    PubMed

    Asaka, Yoko; Takada, Satoshi

    2011-11-01

    The objective of this study is to identify the developmental changes in nocturnal sleep behaviors among preterm infants in comparison with full-term infants (control group). The subjects were 18 preterm infants and 23 full-term infants with mean gestational weeks of 26.5 +/- 2.3 and 39.1 +/- 1.3, and average weights of 879 +/- 188 g and 2,940 +/- 352 g, respectively. Sleep measures were obtained through Actigraph (Micro-mini RC, Ambulatory Monitoring Inc., Ardsley, NY) over a week-long period. Results showed that the sleep duration was significantly different depending on the corrected age of months in only the preterm group (Preterm group: 504 +/- 55 min in under 12 months group, 543 +/- 68 min in over 13 months group. Full-term group: 548 +/- 68 min in under 12 months group, 544 +/- 79 min in over 13 months group). ACTX (percentage of minutes with higher than 0 activity score) was significantly higher for the preterm infants at both age groups in months. In conclusion, the nocturnal sleep duration of preterm infants reached the same level as those of full-term infants after the age of 13 corrected months. Also preterm infants were found to have a higher percentage of less restful sleep during nighttime. Further research is needed to understand the developmental course of physical activity during night time of preterm infants.

  2. [Nocturnal eating disorder--sleep or eating disorder?].

    PubMed

    Tzischinski, O; Lazer, Y

    2000-02-01

    Nocturnal eating disorder (NED) is a rare syndrome that includes disorders of both eating and sleeping. It is characterized by awakening in the middle of the night, getting out of bed, and consuming large quantities of food quickly and uncontrollably, then returning to sleep. This may occur several times during the night. Some patients are fully conscious during their nocturnal eating, while some indicate total amnesia. The etiology of NED is still unclear, as research findings are contradictory. Those suffering from NED exhibit various levels of anxiety and depression, and many lead stressful life-styles. Familial conflict, loneliness and personal crises are commonly found. Recently, a connection has been discovered between NED and unclear self-definition, faulty interpersonal communication, and low frustration threshold. Several authors link it to sleepwalking, leg movements during sleep, and sleep apnea. Treatment is still unclear and there have been trials of pharmacotherapy, psychotherapy, or a combination of both. However, pharmacological treatment has generally been found to be the most effective, although each case must be considered individually. In 1998, 7 women referred to our Eating Disorders Clinic, 5% of all referrals, were subsequently diagnosed as suffering from NED. Of these, 3 suffered from concurrent binge-eating disorder and 4 also from bulimia nervosa. 2 case studies representative of NED are presented.

  3. Comparing the effects of nocturnal sleep and daytime napping on declarative memory consolidation.

    PubMed

    Lo, June C; Dijk, Derk-Jan; Groeger, John A

    2014-01-01

    Nocturnal sleep and daytime napping facilitate memory consolidation for semantically related and unrelated word pairs. We contrasted forgetting of both kinds of materials across a 12-hour interval involving either nocturnal sleep or daytime wakefulness (experiment 1) and a 2-hour interval involving either daytime napping or wakefulness (experiment 2). Beneficial effects of post-learning nocturnal sleep and daytime napping were greater for unrelated word pairs (Cohen's d=0.71 and 0.68) than for related ones (Cohen's d=0.58 and 0.15). While the size of nocturnal sleep and daytime napping effects was similar for unrelated word pairs, for related pairs, the effect of nocturnal sleep was more prominent. Together, these findings suggest that sleep preferentially facilitates offline memory processing of materials that are more susceptible to forgetting.

  4. Polysomnographic study of nocturnal sleep in idiopathic hypersomnia without long sleep time.

    PubMed

    Pizza, Fabio; Ferri, Raffaele; Poli, Francesca; Vandi, Stefano; Cosentino, Filomena I I; Plazzi, Giuseppe

    2013-04-01

    We investigated nocturnal sleep abnormalities in 19 patients with idiopathic hypersomnia without long sleep time (IH) in comparison with two age- and sex- matched control groups of 13 normal subjects (C) and of 17 patients with narcolepsy with cataplexy (NC), the latter considered as the extreme of excessive daytime sleepiness (EDS). Sleep macro- and micro- (i.e. cyclic alternating pattern, CAP) structure as well as quantitative analysis of EEG, of periodic leg movements during sleep (PLMS), and of muscle tone during REM sleep were compared across groups. IH and NC patients slept more than C subjects, but IH showed the highest levels of sleep fragmentation (e.g. awakenings), associated with a CAP rate higher than NC during lighter sleep stages and lower than C during slow wave sleep respectively, and with the highest relative amount of A3 and the lowest of A1 subtypes. IH showed a delta power in between C and NC groups, whereas muscle tone and PLMS had normal characteristics. A peculiar profile of microstructural sleep abnormalities may contribute to sleep fragmentation and, possibly, EDS in IH.

  5. Nocturnal Pruritus: The Battle for a Peaceful Night’s Sleep

    PubMed Central

    Lavery, Michael Joseph; Stull, Carolyn; Kinney, Michael Owen; Yosipovitch, Gil

    2016-01-01

    Chronic pruritus is a debilitating condition with numerous etiologies. Many patients suffer from nocturnal pruritus, which can decrease quality of life and affect mortality in hemodialysis patients. Nocturnal pruritus may occur in all sleep stages but is most prevalent in stages N1 and N2. Further research is needed to elucidate the pathophysiology of nocturnal itch, which will aid in the development of tailored management strategies. PMID:27011178

  6. Social ties and adolescent sleep disruption.

    PubMed

    Maume, David J

    2013-01-01

    Teens tend go to bed later, get less sleep, and report more daytime sleepiness. Medical research emphasizes biological determinants of teens' disrupted sleep (i.e., the timing of puberty and resultant drops in melatonin), rarely or inadequately considering youths' social ties as a determinant of sleep behaviors. Sociologists recognize how social ties affect health behaviors but have generally neglected sleep, especially among teens. Drawing on a sample of 974 teens from the Study of Early Child Care and Youth Development, this study controls for developmental and social relational factors to predict changes in youths' sleep patterns between 12 and 15 years of age. In general, social relational factors outperform developmental factors in determining youths' sleep patterns, particularly pointing to the importance of parental, peer, and school ties in promoting healthy sleep behaviors. The implications of these findings for further research are briefly discussed.

  7. On the Influence of Freight Trains on Humans: A Laboratory Investigation of the Impact of Nocturnal Low Frequency Vibration and Noise on Sleep and Heart Rate

    PubMed Central

    Smith, Michael G.; Croy, Ilona; Ögren, Mikael; Persson Waye, Kerstin

    2013-01-01

    Background A substantial increase in transportation of goods on railway may be hindered by public fear of increased vibration and noise leading to annoyance and sleep disturbance. As the majority of freight trains run during night time, the impact upon sleep is expected to be the most serious adverse effect. The impact of nocturnal vibration on sleep is an area currently lacking in knowledge. We experimentally investigated sleep disturbance with the aim to ascertain the impact of increasing vibration amplitude. Methodology/Principal Findings The impacts of various amplitudes of horizontal vibrations on sleep disturbance and heart rate were investigated in a laboratory study. Cardiac accelerations were assessed using a combination of polysomnography and ECG recordings. Sleep was assessed subjectively using questionnaires. Twelve young, healthy subjects slept for six nights in the sleep laboratory, with one habituation night, one control night and four nights with a variation of vibration exposures whilst maintaining the same noise exposure. With increasing vibration amplitude, we found a decrease in latency and increase in amplitude of heart rate as well as a reduction in sleep quality and increase in sleep disturbance. Conclusions/Significance We concluded that nocturnal vibration has a negative impact on sleep and that the impact increases with greater vibration amplitude. Sleep disturbance has short- and long-term health consequences. Therefore, it is necessary to define levels that protect residents against sleep disruptive vibrations that may arise from night time railway freight traffic. PMID:23409055

  8. Spontaneous awakening from nocturnal sleep and cardiac autonomic function in preschool children.

    PubMed

    Sampei, Mari; Dakeishi, Miwako; Wood, Donald C; Iwata, Toyoto; Murata, Katsuyuki

    2007-05-30

    A cross-sectional study was carried out to clarify the physiological features of spontaneous awakening from nocturnal sleep (i.e., whether a child can spontaneously wake up on weekday mornings). The study population comprised 116 children at ages 5 and 6 years. Heart rate variability reflecting cardiac sympathetic and parasympathetic activities was measured. Children's typical bedtimes and wake times for weekdays and the presence/absence of spontaneous awakening from nocturnal sleep were reported by parents, and information about obligatory naptimes was provided by preschool teachers. The mean total sleep duration in the children was 625+/-56 (standard deviation) min. Total and nocturnal sleep durations were significantly shorter in 52 children without spontaneous awakening than in 64 children with it. Similarly, the parasympathetic activity was significantly lower in the children without spontaneous awakening, even in using analysis of covariance. Heart rate was significantly increased in the children without spontaneous awakening, but neither total nor nocturnal sleep durations were significant covariates in the analysis of covariance. In conclusion, the absence of spontaneous awakening from nocturnal sleep in preschool children is suggested to be characterized by short sleep duration, parasympathetic hypoactivity, and elevated heart rate.

  9. Self-reported napping and nocturnal sleep in Taiwanese elderly insomniacs.

    PubMed

    Lai, Hui-Ling

    2005-01-01

    Abstract The aim of this study was to investigate the relationships between self-reported nocturnal sleep quality and napping patterns in elderly persons with insomnia and to compare the nocturnal sleep quality between napping and non-napping groups. Convenience sampling was used to recruit 60 community-dwelling elderly residents of Taichung City, Taiwan (age range 60-83 years, mean 67.1 years) who reported insomnia. All participants scored greater than 5 on the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Napping prevalence, frequency, and duration were assessed by participant interview. Self-reported sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleep medication, and daytime dysfunction were measured with the PSQI. Sixty-four percentage of participants (n = 38) reported napping. There were no age, gender, and ethnicity differences on napping patterns. Global sleep quality, sleep efficiency, and sleep disturbance were significantly associated with prevalence of napping (r = 0.24-0.26, p < 0.05). A significant correlation was also found between global sleep quality and nap duration (r = 0.31, p < 0.05). Elders in the napping group reported better global sleep quality (t = 2.2, p < 0.05) and sleep efficiency (t = 2.1, p < 0.05) than those in the non-napping group. The findings suggest that there is no need for health care providers to restrict elderly insomniacs' daytime napping.

  10. Preoperative Sleep Disruption and Postoperative Delirium

    PubMed Central

    Leung, Jacqueline M.; Sands, Laura P.; Newman, Stacey; Meckler, Gabriela; Xie, Yimeng; Gay, Caryl; Lee, Kathryn

    2015-01-01

    Study Objectives: To describe preoperative and postoperative sleep disruption and its relationship to postoperative delirium. Design: Prospective cohort study with 6 time points (3 nights pre-hospitalization and 3 nights post-surgery). Setting: University medical center. Patients: The sample consisted of 50 English-speaking patients ≥ 40 years of age scheduled for major non-cardiac surgery, with an anticipated hospital stay ≥ 3 days. Interventions: None. Measurements and results: Sleep was measured before and after surgery for a total of 6 days using a wrist actigraph to quantify movement in a continuous fashion. Postoperative delirium was measured by a structured interview using the Confusion Assessment Method. Sleep variables for patients with (n = 7) and without (n = 43) postoperative delirium were compared using the unpaired Student t-tests or χ2 tests. Repeated measures analysis of variance for the 6 days was used to examine within-subject changes over time and between group differences. The mean age of the patients was 66 ± 11 years (range 43–91 years), and it was not associated with sleep variables or postoperative delirium. The incidence of postoperative delirium observed during any of the 3 postoperative days was 14%. For the 7 patients who subsequently developed postoperative delirium, wake after sleep onset (WASO) as a percentage of total sleep time was significantly higher (44% ± 22%) during the night before surgery compared to the patients who did not subsequently developed delirium (21% ± 20%, p = 0.012). This sleep disruption continued postoperatively, and to a greater extent, for the first 2 nights after surgery. Patients with WASO < 10% did not experience postoperative delirium. Self-reported sleep disturbance did not differ between patients with vs. without postoperative delirium. Conclusions: In this pilot study of adults over 40 years of age, sleep disruption was more severe before surgery in the patients who experienced postoperative

  11. Sleep disruption and the sequelae associated with traumatic brain injury

    PubMed Central

    Lucke-Wold, Brandon P.; Smith, Kelly E.; Nguyen, Linda; Turner, Ryan C.; Logsdon, Aric F.; Jackson, Garrett J.; Huber, Jason D.; Rosen, Charles L.; Miller, Diane B.

    2016-01-01

    Sleep disruption, which includes a loss of sleep as well as poor quality fragmented sleep, frequently follows traumatic brain injury (TBI) impacting a large number of patients each year in the United States. Fragmented and/or disrupted sleep can worsen neuropsychiatric, behavioral, and physical symptoms of TBI. Additionally, sleep disruption impairs recovery and can lead to cognitive decline. The most common sleep disruption following TBI is insomnia, which is difficulty staying asleep. The consequences of disrupted sleep following injury range from deranged metabolomics and blood brain barrier compromise to altered neuroplasticity and degeneration. There are several theories for why sleep is necessary (e.g., glymphatic clearance and metabolic regulation) and these may help explain how sleep disruption contributes to degeneration within the brain. Experimental data indicate disrupted sleep allows hyperphosphorylated tau and amyloid β plaques to accumulate. As sleep disruption may act as a cellular stressor, target areas warranting further scientific investigation include the increase in endoplasmic reticulum and oxidative stress following acute periods of sleep deprivation. Potential treatment options for restoring the normal sleep cycle include melatonin derivatives and cognitive behavioral therapy. PMID:25956251

  12. Sleep disruption and the sequelae associated with traumatic brain injury.

    PubMed

    Lucke-Wold, Brandon P; Smith, Kelly E; Nguyen, Linda; Turner, Ryan C; Logsdon, Aric F; Jackson, Garrett J; Huber, Jason D; Rosen, Charles L; Miller, Diane B

    2015-08-01

    Sleep disruption, which includes a loss of sleep as well as poor quality fragmented sleep, frequently follows traumatic brain injury (TBI) impacting a large number of patients each year in the United States. Fragmented and/or disrupted sleep can worsen neuropsychiatric, behavioral, and physical symptoms of TBI. Additionally, sleep disruption impairs recovery and can lead to cognitive decline. The most common sleep disruption following TBI is insomnia, which is difficulty staying asleep. The consequences of disrupted sleep following injury range from deranged metabolomics and blood brain barrier compromise to altered neuroplasticity and degeneration. There are several theories for why sleep is necessary (e.g., glymphatic clearance and metabolic regulation) and these may help explain how sleep disruption contributes to degeneration within the brain. Experimental data indicate disrupted sleep allows hyperphosphorylated tau and amyloid β plaques to accumulate. As sleep disruption may act as a cellular stressor, target areas warranting further scientific investigation include the increase in endoplasmic reticulum and oxidative stress following acute periods of sleep deprivation. Potential treatment options for restoring the normal sleep cycle include melatonin derivatives and cognitive behavioral therapy.

  13. Effect of sodium oxybate on disrupted nighttime sleep in patients with narcolepsy.

    PubMed

    Roth, Thomas; Dauvilliers, Yves; Guinta, Diane; Alvarez-Horine, Sarah; Dynin, Efim; Black, Jed

    2016-11-03

    This post hoc analysis evaluated the dose-related effects of sodium oxybate on sleep continuity and nocturnal sleep quality in patients with narcolepsy-cataplexy. Polysomnography data, including shifts to Stage N1/Wake, were from a randomized, placebo-controlled trial of sodium oxybate. Patients were ≥16 years old with a diagnosis of narcolepsy including symptoms of cataplexy and excessive daytime sleepiness. Treatment was for 8 weeks with placebo or sodium oxybate 4.5, 6 or 9 g administered as two equally divided nightly doses. Relative to baseline, significant dose-dependent reductions in the number of shifts per hour from Stages N2/3/rapid eye movement and Stages N2/3 to Stage N1/Wake were observed at week 8 with sodium oxybate (P < 0.05); sodium oxybate 6- and 9-g doses also resulted in similar reductions in shifts per hour of rapid eye movement to Stage N1/Wake (both P < 0.05). Across all shift categories, the shift reductions with sodium oxybate 9 g were significantly greater than those observed with placebo (P < 0.05). Improvements from baseline in reported sleep quality were significantly greater with sodium oxybate 4.5 and 9 g at week 8 (P < 0.05). Correlations between change from baseline in number of shifts per hour to Stage N1/Wake and cataplexy frequency, patient-reported nocturnal sleep quality, and excessive daytime sleepiness assessed using the Epworth Sleepiness Scale were numerically highest for the sodium oxybate 9-g dose across all sleep stage shift categories. In these patients with narcolepsy, sodium oxybate showed improvements in the sleep continuity and nocturnal sleep quality that are characteristic of disrupted nighttime sleep (ClinicalTrials.gov identifier NCT00049803).

  14. Effects of Zolpidem CR on Sleep and Nocturnal Ventilation in Patients with Heart Failure

    PubMed Central

    Gatti, Rodrigo C.; Burke, Patrick R.; Otuyama, Leonardo J.; Almeida, Dirceu R.; Tufik, Sergio; Poyares, Dalva

    2016-01-01

    Study Objective: This study aimed to evaluate the effects of zolpidem CR (controlled release) on sleep and nocturnal ventilation in patients with congestive heart failure, a population at risk for insomnia and poor sleep quality. Methods: Fifteen patients with heart failure (ischemic cardiomyopathy) and ejection fraction ≤ 45% in NYHA functional class I or II were evaluated with full polysomnography in a placebo-controlled, double-blind, randomized trial. Patients underwent three tests: (1) baseline polysomnography and, after randomization, (2) a new test with zolpidem CR 12.5 mg or placebo, and after 1 week, (3) a new polysomnography, crossing the “medication” used. Results: A 16% increase in total sleep time was found with the use of zolpidem CR and an increase in stage 3 NREM sleep (slow wave sleep). The apnea hypopnea index (AHI) did not change with zolpidem CR even after controlling for supine position; however, a slight but significant decrease was observed in lowest oxygen saturation compared with baseline and placebo conditions (83.60 ± 5.51; 84.43 ± 3.80; 80.71 ± 5.18, P = 0.002). Conclusion: Zolpidem CR improved sleep structure in patients with heart failure, did not change apnea hypopnea index, but slightly decreased lowest oxygen saturation. Citation: Gatti RC, Burke PR, Otuyama LJ, Almeida DR, Tufik S, Poyares D. Effects of zolpidem CR on sleep and nocturnal ventilation in patients with heart failure. SLEEP 2016;39(8):1501–1505. PMID:27166233

  15. Nocturnal bruxing events in subjects with sleep-disordered breathing and control subjects.

    PubMed

    Okeson, J P; Phillips, B A; Berry, D T; Cook, Y R; Cabelka, J F

    1991-01-01

    Nocturnal bruxing events were recorded during a single night of sleep for 12 subjects with sleep-disordered breathing and 12 age- and sex-matched controls. The results suggest that bruxing events are very common in both groups and are closely associated with sleep arousals. There were few differences in the number, duration, or type of bruxing events between these two groups. Bruxing events were common during stage 1, stage 2, and REM sleep, while they rarely occurred during stage 3 and 4 sleep. The average duration of bruxing events ranged from 3.82 to 6.68 seconds. There was a trend toward more bruxing events occurring while sleeping on the back than on the side.

  16. From nocturnal frontal lobe epilepsy to Sleep-Related Hypermotor Epilepsy: A 35-year diagnostic challenge.

    PubMed

    Tinuper, Paolo; Bisulli, Francesca

    2017-01-01

    Nocturnal frontal lobe epilepsy (NFLE) is a focal epilepsy with seizures arising mainly during sleep and characterized by complex, often bizarre, motor behavior or sustained dystonic posturing. First described in 1981, it was initially considered a motor disorder of sleep and was named nocturnal paroxysmal dystonia (NPD). The unusual seizure semiology, onset during sleep, and often uninformative scalp EEG and brain MRI make it difficult to distinguish NPD attacks from other non-epileptic nocturnal paroxysmal events, namely parasomnias. The long-debated epileptic origin of the condition was finally demonstrated in 1990 and the term NFLE introduced. Even though many aspects of parasomnias and NFLE have been clarified in the last two decades, the differential diagnosis remains a challenge for clinicians. To address controversial issues and define the diagnostic criteria for NFLE, a Consensus Conference was held in Bologna, Italy in 2014. Major points of agreement emerged on: (i) the relationship of the seizures with sleep and not with the circadian pattern of seizure occurrence; (ii) the possible extrafrontal origin of hypermotor seizures, without substantial differences in seizure semiology. In the wake of the Consensus, the syndrome was renamed Sleep-Related Hypermotor Epilepsy (SHE).

  17. Associations of Sleep Quality and Awake Physical Activity with Fluctuations in Nocturnal Blood Pressure in Patients with Cardiovascular Risk Factors

    PubMed Central

    Kadoya, Manabu; Koyama, Hidenori; Kurajoh, Masafumi; Naka, Mariko; Miyoshi, Akio; Kanzaki, Akinori; Kakutani, Miki; Shoji, Takuhito; Moriwaki, Yuji; Yamamoto, Tetsuya; Inaba, Masaaki; Namba, Mitsuyoshi

    2016-01-01

    Background Sleep quality and awake physical activity are important behavioral factors involved in the occurrence of cardiovascular diseases, potentially through nocturnal blood pressure (BP) changes. However, the impacts of quantitatively measured sleep quality and awake physical activity on BP fluctuation, and their relationships with several candidate causal factors for nocturnal hypertension are not well elucidated. Methods This cross-sectional study included 303 patients registered in the HSCAA study. Measurements included quantitatively determined sleep quality parameters and awake physical activity obtained by actigraph, nocturnal systolic BP (SBP) fall [100 × (1- sleep SBP/awake SBP ratio)], apnea hypopnea index, urinary sodium and cortisol secretion, plasma aldosterone concentration and renin activity, insulin resistance index, parameters of heart rate variability (HRV), and plasma brain-derived neurotrophic factor (BDNF). Results Simple regression analysis showed that time awake after sleep onset (r = -0.150), a parameter of sleep quality, and awake physical activity (r = 0.164) were significantly correlated with nocturnal SBP fall. Among those, time awake after sleep onset (β = -0.179) and awake physical activity (β = 0.190) were significantly and independently associated with nocturnal SBP fall in multiple regression analysis. In a subgroup of patients without taking anti-hypertensive medications, both time awake after sleep onset (β = -0.336) and awake physical activity (β = 0.489) were more strongly and independently associated with nocturnal SBP falls. Conclusion Sleep quality and awake physical activity were found to be significantly associated with nocturnal SBP fall, and that relationship was not necessarily confounded by candidate causal factors for nocturnal hypertension. PMID:27166822

  18. Nocturnal light pollution and underexposure to daytime sunlight: Complementary mechanisms of circadian disruption and related diseases.

    PubMed

    Smolensky, Michael H; Sackett-Lundeen, Linda L; Portaluppi, Francesco

    2015-01-01

    Routine exposure to artificial light at night (ALAN) in work, home, and community settings is linked with increased risk of breast and prostate cancer (BC, PC) in normally sighted women and men, the hypothesized biological rhythm mechanisms being frequent nocturnal melatonin synthesis suppression, circadian time structure (CTS) desynchronization, and sleep/wake cycle disruption with sleep deprivation. ALAN-induced perturbation of the CTS melatonin synchronizer signal is communicated maternally at the very onset of life and after birth via breast or artificial formula feedings. Nighttime use of personal computers, mobile phones, electronic tablets, televisions, and the like--now epidemic in adolescents and adults and highly prevalent in pre-school and school-aged children--is a new source of ALAN. However, ALAN exposure occurs concomitantly with almost complete absence of daytime sunlight, whose blue-violet (446-484 nm λ) spectrum synchronizes the CTS and whose UV-B (290-315 nm λ) spectrum stimulates vitamin D synthesis. Under natural conditions and clear skies, day/night and annual cycles of UV-B irradiation drive corresponding periodicities in vitamin D synthesis and numerous bioprocesses regulated by active metabolites augment and strengthen the biological time structure. Vitamin D insufficiency and deficiency are widespread in children and adults in developed and developing countries as a consequence of inadequate sunlight exposure. Past epidemiologic studies have focused either on exposure to too little daytime UV-B or too much ALAN, respectively, on vitamin D deficiency/insufficiency or melatonin suppression in relation to risk of cancer and other, e.g., psychiatric, hypertensive, cardiac, and vascular, so-called, diseases of civilization. The observed elevated incidence of medical conditions the two are alleged to influence through many complementary bioprocesses of cells, tissues, and organs led us to examine effects of the totality of the artificial light

  19. Effects of aerobic exercise in early evening on the following nocturnal sleep and its haemodynamic response.

    PubMed

    Miura, Akira; Myouken, Shizuka; Yamada, Masako; Fujihara, Chizuko; Miura, Kouhei; Kashima, Hideaki; Eguchi, Kouhei; Endo, Masako Y; Koga, Shunsaku; Fukuba, Yoshiyuki

    2016-01-01

    We determined effect of aerobic exercise in early evening on the quality, quantity, and haemodynamic response of subsequent nocturnal sleep in the home. Ten healthy young participants performed two protocols, with/without cycle ergometer exercise (60 min at 50% heart rate reserve) in early evening. Blood pressure (BP) (Holter) and physical activity (accelerometer) were measured from late afternoon of day 1 until noon of next day (day 2). Additionally, at bedtime participants were equipped with a small device worn on the wrist that identified sleep stage. There were no substantial differences in objective indices of sleep between two protocols (total sleep time: 438 ± 76 vs. 457 ± 64 min; P > 0.10). BP during nocturnal sleep tended to be lowered by prior exercise (MAP: 71 ± 5 vs. 68 ± 6 mmHg; P = 0.08). Aerobic exercise in early evening apparently has no acute effect on sleep per se, but seems to have a residual effect on haemodynamics, i.e. prolongation of post-exercise hypotension.

  20. Primary sleep disorders and paroxysmal nocturnal nonepileptic events in adults with epilepsy from the perspective of sleep specialists.

    PubMed

    Grigg-Damberger, Madeleine; Ralls, Frank

    2011-04-01

    Sleep specialists are frequently referred adults with epilepsy to evaluate their sleep/wake complaints, sometimes to determine whether their paroxysmal nocturnal behaviors are epileptic or not. Many patients with epilepsy have at least one parasomnia (some more than one), and the sleep specialists are often asked to differentiate and treat these. Sleep specialists review which primary sleep disorders are more common in adults with epilepsy and how to evaluate and best treat these. The authors summarize (1) how to evaluate and differentiate parasomnias using video-polysomnography; (2) the value of sleep deprivation and loud auditory stimuli to increase the likelihood of provoking a non-rapid eye movement arousal parasomnia with a single night of video-polysomnography; and (3) how to score excessive muscle activity during rapid eye movement sleep to confirm a diagnosis of rapid eye movement sleep behavior disorder. The clinical semiology and video-polysomnography features of simple and complex sleep-related movement disorders and parasomnias are reviewed.

  1. A Relationship between Periodic Limb Movements in Sleep and High Nocturnal Blood Pressure Values in Patients with Insomnia

    PubMed Central

    Sieminski, Mariusz; Partinen, Markku

    2016-01-01

    Study Objectives: Insomnia, which is the most common sleep disorder, is a significant public health burden. Growing evidence suggests the existence of a relationship between insomnia and hypertension. The aim of this study was to verify the hypothesis that periodic limb movements in sleep (PLMS) are related to increased nocturnal blood pressure (BP) values in patients with insomnia. Methods: We retrospectively analyzed polysomnographic recordings of patients with insomnia who were seen in our clinic from January to December 2012. Patients were divided into two groups based on their nocturnal BP values: group I had normal nocturnal BP values (n = 27) and group II (n = 29) had elevated nocturnal BP values. The sleep architecture of the groups was compared. Results: The groups did not differ in terms of age, sex, or the prevalence of cardiovascular disorders. However, we found that the number of PLMS was significantly higher in group II than in group I (PLMS index: 18.8 vs. 6.5; p = 0.01). Conclusions: Our results suggest that PLMS are related to increased nocturnal BP values in patients with insomnia, which may partly explain the relationship between insomnia and hypertension. Therefore, it is possible that treatment of PLMS may normalize nocturnal BP in patients with insomnia. Citation: Sieminski M, Partinen M. A relationship between periodic limb movements in sleep and high nocturnal blood pressure values in patients with insomnia. J Clin Sleep Med 2016;12(6):865–869. PMID:27070247

  2. Self-Reported Sleep Bruxism and Nocturnal Gastroesophageal Reflux Disease in Patients with Obstructive Sleep Apnea: Relationship to Gender and Ethnicity§

    PubMed Central

    Hesselbacher, Sean; Subramanian, Shyam; Rao, Shweta; Casturi, Lata; Surani, Salim

    2014-01-01

    Study Objectives : Nocturnal bruxism is associated with gastroesophageal reflux disease (GERD), and GERD is strongly associated with obstructive sleep apnea (OSA). Gender and ethnic differences in the prevalence and clinical presentation of these often overlapping sleep disorders have not been well documented. Our aim was to examine the associations between, and the symptoms associated with, nocturnal GERD and sleep bruxism in patients with OSA, and to examine the influence of gender and ethnicity. Methods : A retrospective chart review was performed of patients diagnosed with OSA at an academic sleep center. The patients completed a sleep questionnaire prior to undergoing polysomnography. Patients with confirmed OSA were evaluated based on gender and ethnicity. Associations were determined between sleep bruxism and nocturnal GERD, and daytime sleepiness, insomnia, restless legs symptoms, and markers of OSA severity in each group. Results : In these patients with OSA, the prevalence of nocturnal GERD (35%) and sleep bruxism (26%) were higher than the general population. Sleep bruxism was more common in Caucasians than in African Americans or Hispanics; there was no gender difference. Nocturnal GERD was similar among all gender and ethnic groups. Bruxism was associated with nocturnal GERD in females, restless legs symptoms in all subjects and in males, sleepiness in African Americans, and insomnia in Hispanics. Nocturnal GERD was associated with sleepiness in males and African Americans, insomnia in females, and restless legs symptoms in females and in Caucasians. Conclusion : Patients with OSA commonly have comorbid sleep bruxism and nocturnal GERD, which may require separate treatment. Providers should be aware of differences in clinical presentation among different ethnic and gender groups. PMID:25352924

  3. Association of Obstructive Sleep Apnea Risk Factors with Nocturnal Enuresis in Postmenopausal Women

    PubMed Central

    Koo, Patrick; McCool, F. Dennis; Hale, Lauren; Stone, Katie; Eaton, Charles B.

    2015-01-01

    Objective The prevalence of obstructive sleep apnea (OSA) in women increases significantly after menopause. However, identifying at-risk women in this population is difficult because they tend to underreport symptoms and their complaints may differ from those traditionally associated with OSA. We investigated whether OSA risk factors are associated with the presence of a “non-traditional” complaint such as nocturnal enuresis in postmenopausal women. Methods A cross-sectional study of postmenopausal women ages 50–79, who participated in the Women Health Initiative Observational and Clinical Trial Studies (1993–2005) at 40 Clinical Centers in the United States, was performed. Multiple variable logistic regression analysis was employed to determine the association of OSA risk factors with nocturnal enuresis. Results A cohort of 2,789 women (1.7%) reported having nocturnal enuresis. Obesity (Odds ratio (OR)=2.29, 95% Confidence Interval (CI) 2.00–2.62), snoring (OR=2.01, 95% CI 1.74–2.32), poor sleep quality (OR=1.70, 95% CI 1.52–1.91), sleep fragmentation (OR=2.44, 95% CI 2.14–2.79), daytime sleepiness (OR=1.50, 95% CI 1.33–1.68), and hypertension (OR=1.13, 95% CI 1.01–1.26) were associated with nocturnal enuresis. Each additional OSA risk factor in a predefined OSA score significantly increased the odds of having nocturnal enuresis in a dose-response fashion (OR=1.38, 2.00, 2.80, 3.87, 5.10, and 7.02 for scores of 1–6, respectively) compared to no risk factors. Conclusion OSA risk factors are associated with nocturnal enuresis in postmenopausal women. Mechanisms relating nocturnal enuresis to OSA may include apnea-associated changes of intra-thoracic pressure leading to increased urine output. Questioning at-risk postmenopausal women presenting with nocturnal enuresis about other OSA risk factors should be considered. PMID:26325085

  4. Effects of resistance exercise timing on sleep architecture and nocturnal blood pressure.

    PubMed

    Alley, Jessica R; Mazzochi, John W; Smith, Caroline J; Morris, David M; Collier, Scott R

    2015-05-01

    Short sleep duration and poor quality of sleep have been associated with health risks including cardiovascular disease, diabetes, and obesity. Prior research has suggested that regular aerobic exercise improves the quality of sleep; however, less is known regarding resistance exercise (RE) and how RE may affect sleep architecture. The purpose of this study was to investigate the acute effects of timing of RE on sleep architecture and nocturnal blood pressure. College-aged subjects engaged in 5 laboratory visits. Visits 1 (C) and 2 provided a non-RE control day and established the 10-repetition maximum on each of 9 RE machines, respectively. During visits 3-5, the subjects reported at 0700 hours (7A), 1300 hours (1P), and 1900 hours (7P) in a randomized order to perform 30 minutes of RE. Ambulatory blood pressure and sleep-monitoring devices were worn during sleep after C, 7A, 1P, and 7P. Time to fall asleep was significantly different between RE conditions 7A and 1P and between 7A and 7P. All exercise conditions exhibited significantly fewer times woken than the non-RE control day, with 7P resulting in significantly less time awake after initially falling asleep as compared with C. Although timing of RE does not seem to statistically impact sleep stages or nocturnal blood pressure, these data indicate that engaging in RE at any time of the day may improve quality of sleep as compared with no RE. Resistance exercise may offer additional benefits regarding the ability to fall asleep and stay asleep to populations with osteoporosis, sarcopenia, anxiety, or depression.

  5. Atypical patterns in portable monitoring for sleep apnoea: features of nocturnal epilepsy?

    PubMed

    Parrino, Liborio; Milioli, Giulia; Grassi, Andrea; De Paolis, Fernando; Riccardi, Silvia; Colizzi, Elena; Bosi, Marcello; Terzano, Mario Giovanni

    2013-02-01

    Atypical cardiorespiratory patterns can be found during routine clinical use of portable monitoring for diagnosis of sleep-disordered breathing (SDB). Over 1,000 consecutive portable recordings were analysed to study the potential ictal nature of stereotyped cardiorespiratory and motor patterns. Snoring, airflow, thoracic effort, pulse rate, body position, oxygen saturation and activity of the anterior tibialis muscles were quantified. Recordings showing stereotyped polygraphic patterns recurring throughout the night, but without the features of sleep apnoea (apnoea/hypopnoea index <5 events·h(-1)), were selected for investigation. Once included in the study, patients underwent attended nocturnal video polysomnography. A total of 15 recordings showing repeated polygraphic patterns characterised by a sequence of microphone activation, respiratory activity atypical for sleep and wakefulness, heart rate acceleration and limb movements, followed by body position change, were selected for investigation. Once included in the study, patients underwent attended nocturnal video polysomnography that showed frontal epileptic discharges triggering periodic electroencephalographic arousals, autonomic activation and stereotyped motor patterns. A diagnosis of nocturnal frontal lobe epilepsy (NFLE) was established for all patients. NFLE should be taken into consideration in patients with stereotyped and recurrent behavioural features during portable monitoring carried out for diagnosis of SDB.

  6. Inhibition of hippocampal neurogenesis by sleep deprivation is independent of circadian disruption and melatonin suppression.

    PubMed

    Mueller, A D; Mear, R J; Mistlberger, R E

    2011-10-13

    Procedures that restrict or fragment sleep can inhibit neurogenesis in the hippocampus of adult rodents, although the underlying mechanism is unknown. We showed that rapid-eye-movement (REM) sleep deprivation (RSD) by the platform-over-water method inhibits hippocampal cell proliferation in adrenalectomized rats with low-dose corticosterone clamp. This procedure also greatly disrupts daily behavioral rhythms. Given recent evidence for circadian clock regulation of cell proliferation, we asked whether disruption of circadian rhythms might play a role in the anti-neurogenic effects of sleep loss. Male Sprague-Dawley rats were subjected to a 4-day RSD procedure or were exposed to constant bright light (LL) for 4 days or 10 weeks, a non-invasive procedure for eliminating circadian rhythms of behavior and physiology in this species. Proliferating cells in the granule cell layer of the dentate gyrus were identified by immunolabeling for the thymidine analogue 5-bromo-2-deoxyuridine. Consistent with our previous results, the RSD procedure suppressed cell proliferation by ∼50%. By contrast, although LL attenuated or eliminated daily rhythms of activity and sleep-wake without affecting daily amounts of REM sleep, cell proliferation was not affected. Melatonin, a nocturnally secreted neurohormone that is inhibited by light, has been shown to promote survival of new neurons. We found that 3-weeks of LL eliminated daily rhythms and decreased plasma melatonin by 88% but did not significantly affect either total cell survival or survival of new neurons (doublecortin+). Finally, we measured cell proliferation rates at the beginning and near the end of the daily light period in rats entrained to a 12:12 light/lark (LD) cycle, but did not detect a daily rhythm. These results indicate that the antineurogenic effect of RSD is not secondary to disruption of circadian rhythms, and provide no evidence that hippocampal cell proliferation and survival are regulated by the circadian

  7. The Parkinson's disease sleep scale: a new instrument for assessing sleep and nocturnal disability in Parkinson's disease

    PubMed Central

    Chaudhuri, K; Pal, S; DiMarco, A; Whately-Smith, C; Bridgman, K; Mathew, R; Pezzela, F; Forbes, A; Hogl, B; Trenkwalder, C

    2002-01-01

    Background: No formal instruments are available for quantifying sleep problems in Parkinson's disease. Objective: To develop a new sleep scale to quantify the various aspects of nocturnal sleep problems in Parkinson's disease, which may occur in up to 96% of affected individuals. Methods: Employing a multidisciplinary team approach, a visual analogue scale was devised addressing 15 commonly reported symptoms associated with sleep disturbance in Parkinson's disease—the Parkinson's disease sleep scale (PDSS). In all, 143 patients with Parkinson's disease completed the PDSS, covering the entire spectrum of disease from newly diagnosed to advanced stage. As controls, 137 age healthy matched subjects also completed the scale. Test–retest reliability was assessed in a subgroup of subjects. The Epworth sleepiness scale was also satisfactorily completed by 103 of the patients with Parkinson's disease. Results: PDSS scores in the Parkinson group were significantly different from the healthy controls. Patients with advanced Parkinson's disease had impaired scores compared with early/moderate disease. Individual items of the scale showed good discriminatory power between Parkinson's disease and healthy controls. Relevant items of the PDSS correlated with excessive daytime sleepiness. The scale showed robust test–retest reliability. Conclusions: This appears to be the first description of a simple bedside screening instrument for evaluation of sleep disturbances in Parkinson's disease. A combination of subitems may help identify specific aspects of sleep disturbance, which in turn may help target treatment. PMID:12438461

  8. Severity of nocturnal cardiac arrhythmias correlates with intensity of sleep apnea in men.

    PubMed

    Szaboova, E; Holoubek, D; Tomori, Z; Szabo, P; Donic, V; Stancak, B

    2013-01-01

    Various cardiac arrhythmias frequently occur in patients with sleep apnea, but complex analysis of the relationship between their severity and the probable arrhythmogenic risk factors is conflicting. The question is what cardiovascular risk factors and how strongly they are associated with the severity of cardiac arrhythmias in sleep apnea. Adult males (33 with and 16 without sleep apnea), matched for cardiovascular co-morbidity were studied by polysomnography with simultaneous ECG monitoring. Arrhythmia severity was evaluated for each subject by a special 7-degree scoring system. Laboratory, clinical, echocardiographic, carotid ultrasonographic, ambulatory blood pressure, and baroreflex sensitivity values were also assessed. Moderate sleep apnea patients had benign, but more exaggerated cardiac arrhythmias than control subjects (2.53 ± 2.49 vs. 1.13 ± 1.64 degrees of cumulative severity, p < 0.05). We confirmed strong correlations between the arrhythmia severity and known arrhythmogenic risk factors (left ventricular ejection fraction and dimensions, right ventricular diameter, baroreflex sensitivity, carotid intima-media thickness, age, previous myocardial infarction, and also apnea-hypopnea index). In multivariate modelling only the apnea-hypopnea index indicating the sleep apnea intensity remained highly significantly correlated with the cumulative arrhythmia severity (beta = 0.548, p < 0.005). In conclusion, sleep apnea modifying cardiovascular risk factors and structures or functions provoked various nocturnal arrhythmias. The proposed scoring system allowed a complex analysis of the contribution of various triggers to arrhythmogenesis and confirmed the apnea-hypopnea index as an independent risk for nocturnal cardiac arrhythmia severity in sleep apnea.

  9. Energy content of the evening meal alters nocturnal body temperature but not sleep.

    PubMed

    Driver, H S; Shulman, I; Baker, F C; Buffenstein, R

    Meals of varying energy content and episodes of sleep influence body temperature. We compared the effect of an evening meal, varying from high-energy (11.91 +/- 0.86 MJ) to average (5.74 +/- 0.88 MJ) and a 10-h fast (no evening meal), on nocturnal body temperature and sleep. Seven healthy men (20-24 years, mean body mass index of 23.4 +/- 2.6 kg/m2) reported to the laboratory for an evening meal at 2000 h having consumed similar amounts of food before 1300 h. After completing the meal, subjective hunger ratings were assessed, and a venous blood sample taken. The subjects spent 4 nonconsecutive nights (an adaptation night, followed by either of the two meal conditions or the fast in random order) in the sleep laboratory when polysomnographic recordings were made from 2300 to 0700 h. Meal energy content and serum concentrations of insulin, triglyceride, and low-density lipoproteins (LDL) varied significantly. Lower rectal temperatures were measured during the fast than following the meals. Over the 8-h recording period, thermal response indices (TRI) varied with higher body temperatures following the higher energy meal. Similar rectal temperatures were attained by the end of the sleep periods. There were no significant differences in any of the subjective or objective sleep measures. The physiological responses associated with the transient dietary changes of an evening meal or a 10-h fast altered nocturnal body temperature but did not significantly affect sleep of good sleepers when sleep was initiated 2 to 3 h after finishing the meal.

  10. Beneficial effects of severe sleep apnea therapy on nocturnal glucose control in persons with type 2 diabetes mellitus.

    PubMed

    Pallayova, Maria; Donic, Viliam; Tomori, Zoltan

    2008-07-01

    Given the consequences of sleep apnea and coexisting diabetes, satisfactory treatment of both diseases is required. Our results of continuous glucose monitoring in severe sleep apnea diabetic patients before and during continuous positive airway pressure/CPAP therapy showed significant reduction of nocturnal glucose variability and improved overnight glucose control on CPAP.

  11. Nighttime Breastfeeding Behavior Is Associated with More Nocturnal Sleep among First-Time Mothers at One Month Postpartum

    PubMed Central

    Doan, Therese; Gay, Caryl L.; Kennedy, Holly P.; Newman, Jack; Lee, Kathryn A.

    2014-01-01

    Study Objective: To describe sleep duration and quality in the first month postpartum and compare the sleep of women who exclusively breastfed at night to those who used formula. Methods: We conducted a longitudinal study in a predominantly low-income and ethnically diverse sample of 120 first-time mothers. Both objective and subjective measures of sleep were obtained using actigraphy, diary, and self-report data. Measures were collected in the last month of pregnancy and at one month postpartum. Infant feeding diaries were used to group mothers by nighttime breastfeeding behavior. Results: Mothers who used at least some formula at night (n = 54) and those who breastfed exclusively (n = 66) had similar sleep patterns in late pregnancy. However, there was a significant group difference in nocturnal sleep at one month postpartum as measured by actigraphy. Total nighttime sleep was 386 ± 66 minutes for the exclusive breastfeeding group and 356 ± 67 minutes for the formula group. The groups did not differ with respect to daytime sleep, wake after sleep onset (sleep fragmentation), or subjective sleep disturbance at one month postpartum. Conclusion: Women who breastfed exclusively averaged 30 minutes more nocturnal sleep than women who used formula at night, but measures of sleep fragmentation did not differ. New mothers should be encouraged to breastfeed exclusively since breastfeeding may promote sleep during postpartum recovery. Further research is needed to better understand how infant feeding method affects maternal sleep duration and fragmentation. Citation: Doan T; Gay CL; Kennedy HP; Newman J; Lee KA. Nighttime breastfeeding behavior is associated with more nocturnal sleep among first-time mothers at one month postpartum. J Clin Sleep Med 2014;10(3):313-319. PMID:24634630

  12. 9. Common causes of sleep disruption and daytime sleepiness: childhood sleep disorders II.

    PubMed

    Heussler, Helen S

    2005-05-02

    There are strong associations between childhood sleep disorders and behavioural, concentration and mood problems. Sleep disorders caused and maintained by behavioural factors (eg, sleep-onset association disorder) are common in young children, and have a significant impact on families. Evaluation should include a medical history, a physical, neurological and developmental examination, a description of any nocturnal events or daytime effects of the child's disturbed sleep, and a good understanding of the family situation and parental management of the child. Management involves recognising the developmental age of the child and the family dynamics, and educating and supporting families in applying behavioural techniques to establish good sleep hygiene. Children with parasomnias (eg, night terrors) also benefit from good sleep hygiene, while those with respiratory or neurological causes of sleep disturbance should be referred for specialist treatment.

  13. Noninvasive imaging of brain oxygen metabolism in children with primary nocturnal enuresis during natural sleep.

    PubMed

    Yu, Bing; Huang, Mingzhu; Zhang, Xu; Ma, Hongwei; Peng, Miao; Guo, Qiyong

    2017-02-14

    A series of studies have revealed that nocturnal enuresis is closely related to hypoxia in children with primary nocturnal enuresis (PNE). However, brain oxygen metabolism of PNE children has not been investigated before. The purpose of this study was to investigate changes in whole-brain cerebral metabolic rate of oxygen (CMRO2 ), cerebral blood flow (CBF), and oxygen extraction fraction (OEF) in children suffering from PNE. We used the newly developed T2-relaxation-under-spin-tagging (TRUST) magnetic resonance imaging technique. Neurological evaluation, structural imaging, phase-contrast, and the TRUST imaging method were applied in children with PNE (n = 37) and healthy age- and sex-matched control volunteers (n = 39) during natural sleep to assess whole-brain CMRO2 , CBF, OEF, and arousal from sleep scores. Results showed that whole-brain CMRO2 and OEF values of PNE children were higher in controls, while there was no significant difference in CBF. Consequently, OEF levels of PNE children were increased to maintain oxygen supply. The elevation of OEF was positively correlated with the difficulty of arousal. Our results provide the first evidence that high oxygen consumption and high OEF values could make PNE children more susceptible to hypoxia, which may induce cumulative arousal deficits and make them more prone to nocturnal enuresis. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc.

  14. Sleepiness and nocturnal hypoxemia in Peruvian men with obstructive sleep apnea

    PubMed Central

    de Castro, Jorge Rey; Mezones-Holguín, Edward

    2014-01-01

    Purpose To evaluate the intensity of nocturnal hypoxemia associated with sleepiness in Peruvian men with a diagnosis of obstructive sleep apnea (OSA). Methods We carried out a secondary data analysis based on a study which includes patients with OSA who were seen in a private hospital in Lima, Peru from 2006 to 2012. We included male adults who had polysomnographic recordings and who answered the Epworth sleepiness scale (ESE). The intensity of nocturnal hypoxemia (oxygen saturation ≤90 %) was classified in four new categories: 0, <1, 1 to 10 and >10 % total sleep time with nocturnal hypoxemia (NH). When the ESE score was higher than 10, we used the definitions presence or absence of sleepiness. We used Poisson regression models with robust variance to estimate crude and adjusted prevalence ratios (PR) for association between sleepiness and NH. Results 518 male patients with OSA were evaluated. Four hundred and fifty-two (87 %) patients had NH and 262 (51 %) had sleepiness. Of the 142 (27.4 %) patients who had >10 % total sleep time with NH, 98 (69.0 %) showed sleepiness and had a greater probability of sleepiness prevalence, with a crude PR of 1.82 (95 % CI 1.31–2.53). This association persisted in the multivariate models. Conclusions We found an association between NH and sleepiness. Only patients with the major intensity of NH (over 10 % of the total sleep time) had a greater probability of sleepiness. This suggests that sleepiness probably occurs after a chronic process and after overwhelming compensatory mechanisms. PMID:24249663

  15. Morning and evening physical exercise differentially regulate the autonomic nervous system during nocturnal sleep in humans.

    PubMed

    Yamanaka, Yujiro; Hashimoto, Satoko; Takasu, Nana N; Tanahashi, Yusuke; Nishide, Shin-Ya; Honma, Sato; Honma, Ken-Ichi

    2015-11-01

    Effects of daily physical exercise in the morning or in the evening were examined on circadian rhythms in plasma melatonin and core body temperature of healthy young males who stayed in an experimental facility for 7 days under dim light conditions (<10 lux). Sleep polysomnogram (PSG) and heart rate variability (HRV) were also measured. Subjects performed 2-h intermittent physical exercise with a bicycle ergometer at ZT3 or at ZT10 for four consecutive days, where zeitgeber time 0 (ZT0) was the time of wake-up. The rising phase of plasma melatonin rhythm was delayed by 1.1 h without exercise. Phase-delay shifts of a similar extent were detected by morning and evening exercise. But the falling phase shifted only after evening exercise by 1.0 h. The sleep PSG did not change after morning exercise, while Stage 1+2 sleep significantly decreased by 13.0% without exercise, and RE sleep decreased by 10.5% after evening exercise. The nocturnal decline of rectal temperature was attenuated by evening exercise, but not by morning exercise. HRV during sleep changed differentially. Very low frequency (VLF) waves increased without exercise. VLF, low frequency (LF), and high frequency (HF) waves increased after morning exercise, whereas HR increased after evening exercise. Morning exercise eventually enhanced the parasympathetic activity, as indicated by HRV, while evening exercise activated the sympathetic activity, as indicated by increase in heart rate in the following nocturnal sleep. These findings indicated differential effects of morning and evening exercise on the circadian melatonin rhythm, PSG, and HRV.

  16. Effect of inducing nocturnal serum melatonin concentrations in daytime on sleep, mood, body temperature, and performance

    NASA Technical Reports Server (NTRS)

    Dollins, A. B.; Zhdanova, I. V.; Wurtman, R. J.; Lynch, H. J.; Deng, M. H.

    1994-01-01

    We examined effects of very low doses of melatonin (0.1-10 mg, orally) or placebo, administered at 1145 h, on sleep latency and duration, mood, performance, oral temperature, and changes in serum melatonin levels in 20 healthy male volunteers. A repeated-measure double-blind Latin square design was used. Subjects completed a battery of tests designed to assess mood and performance between 0930 and 1730 h. The sedative-like effects of melatonin were assessed by a simple sleep test: at 1330 h subjects were asked to hold a positive pressure switch in each hand and to relax with eyes closed while reclining in a quiet darkened room. Latency and duration of switch release, indicators of sleep, were measured. Areas under the time-melatonin concentration curve varied in proportion to the different melatonin doses ingested, and the 0.1- and 0.3-mg doses generated peak serum melatonin levels that were within the normal range of nocturnal melatonin levels in untreated people. All melatonin doses tested significantly increased sleep duration, as well as self-reported sleepiness and fatigue, relative to placebo. Moreover, all of the doses significantly decreased sleep-onset latency, oral temperature, and the number of correct responses on the Wilkinson auditory vigilance task. These data indicate that orally administered melatonin can be a highly potent hypnotic agent; they also suggest that the physiological increase in serum melatonin levels, which occurs around 2100 h daily, may constitute a signal initiating normal sleep onset.

  17. Effect of inducing nocturnal serum melatonin concentrations in daytime on sleep, mood, body temperature, and performance.

    PubMed

    Dollins, A B; Zhdanova, I V; Wurtman, R J; Lynch, H J; Deng, M H

    1994-03-01

    We examined effects of very low doses of melatonin (0.1-10 mg, orally) or placebo, administered at 1145 h, on sleep latency and duration, mood, performance, oral temperature, and changes in serum melatonin levels in 20 healthy male volunteers. A repeated-measure double-blind Latin square design was used. Subjects completed a battery of tests designed to assess mood and performance between 0930 and 1730 h. The sedative-like effects of melatonin were assessed by a simple sleep test: at 1330 h subjects were asked to hold a positive pressure switch in each hand and to relax with eyes closed while reclining in a quiet darkened room. Latency and duration of switch release, indicators of sleep, were measured. Areas under the time-melatonin concentration curve varied in proportion to the different melatonin doses ingested, and the 0.1- and 0.3-mg doses generated peak serum melatonin levels that were within the normal range of nocturnal melatonin levels in untreated people. All melatonin doses tested significantly increased sleep duration, as well as self-reported sleepiness and fatigue, relative to placebo. Moreover, all of the doses significantly decreased sleep-onset latency, oral temperature, and the number of correct responses on the Wilkinson auditory vigilance task. These data indicate that orally administered melatonin can be a highly potent hypnotic agent; they also suggest that the physiological increase in serum melatonin levels, which occurs around 2100 h daily, may constitute a signal initiating normal sleep onset.

  18. Optogenetic disruption of sleep continuity impairs memory consolidation.

    PubMed

    Rolls, Asya; Colas, Damien; Adamantidis, Antoine; Carter, Matt; Lanre-Amos, Tope; Heller, H Craig; de Lecea, Luis

    2011-08-09

    Memory consolidation has been proposed as a function of sleep. However, sleep is a complex phenomenon characterized by several features including duration, intensity, and continuity. Sleep continuity is disrupted in different neurological and psychiatric conditions, many of which are accompanied by memory deficits. This finding has raised the question of whether the continuity of sleep is important for memory consolidation. However, current techniques used in sleep research cannot manipulate a single sleep feature while maintaining the others constant. Here, we introduce the use of optogenetics to investigate the role of sleep continuity in memory consolidation. We optogenetically targeted hypocretin/orexin neurons, which play a key role in arousal processes. We used optogenetics to activate these neurons at different intervals in behaving mice and were able to fragment sleep without affecting its overall amount or intensity. Fragmenting sleep after the learning phase of the novel object recognition (NOR) task significantly decreased the performance of mice on the subsequent day, but memory was unaffected if the average duration of sleep episodes was maintained at 62-73% of normal. These findings demonstrate the use of optogenetic activation of arousal-related nuclei as a way to systematically manipulate a specific feature of sleep. We conclude that regardless of the total amount of sleep or sleep intensity, a minimal unit of uninterrupted sleep is crucial for memory consolidation.

  19. A Gonadotropin-Releasing Hormone Agonist Model Demonstrates That Nocturnal Hot Flashes Interrupt Objective Sleep

    PubMed Central

    Joffe, Hadine; Crawford, Sybil; Economou, Nicole; Kim, Semmie; Regan, Susan; Hall, Janet E.; White, David

    2013-01-01

    gonadotropin-releasing hormone agonist model demonstrates that nocturnal hot flashes interrupt objective sleep. SLEEP 2013;36(12):1977-1985. PMID:24293774

  20. Sleep disruption and motor development: Does pulling-to-stand impacts sleep-wake regulation?

    PubMed

    Atun-Einy, Osnat; Scher, Anat

    2016-02-01

    During the second half of the 1st year, periods of increased sleep disruption have been documented alongside overall improvement in sleep-wake regulation. The objective of the present research was to test if pulling-to-stand (PTS), a milestone typically achieved during the latter part of the 1st year, co-occurs with a period of disrupted sleep. In a longitudinal design, 20 healthy infants were followed-up, from 7 to 11-12 months, at 3-week intervals. Each measurement consisted of filmed motor observations and sleep recordings (actigraphy), both conducted at home. It was found that among early achievers of PTS (by 8 months), the milestone was time-linked to a period of disrupted sleep. The results point to the significance of timing in the interplay between domains of development, and highlight the importance of considering both chronological and developmental metrics in studying changes in sleep-wake regulation.

  1. Sleep in children with disruptive behavioral disorders.

    PubMed

    Aronen, Eeva T; Lampenius, Tuulikki; Fontell, Tuija; Simola, Petteri

    2014-09-03

    This study compared sleep in patients with Conduct Disorder/Oppositional Defiant Disorder (CD/ODD) and normative children and evaluated the associations between sleep and behavioral symptoms in patients. Participants were 30 patients, aged 7 to 12 years, with diagnoses of CD/ODD and their age and gender matched controls. Patients with CD/ODD and their parents reported significantly more sleep problems than did the control children and their parents (p values < 0.01). By actigraphy, CD/ODD children with comorbid ADHD slept significantly less than did the patients with CD/ODD alone and the controls. In patients, low sleep amount and efficiency associated with increased amount of parent-reported externalizing symptoms (r = -0.72, 0.66, p values < 0.001). Results highlight the need of evaluating sleep in children with CD/ODD. Improving their sleep may ease their symptoms.

  2. Sleep and wakefulness state detection in nocturnal actigraphy based on movement information.

    PubMed

    Domingues, Alexandre; Paiva, Teresa; Sanches, J Miguel

    2014-02-01

    Wrist actigraphy (ACT) is a low-cost and well-established technique for long-term monitoring of human activity. It has a special relevance in sleep studies, where its noninvasive nature makes it a valuable tool for behavioral characterization and for the detection and diagnosis of some sleep disorders. The traditional sleep/wakefulness state estimation algorithms from the nocturnal ACT data are unbalanced from a sensitivity and specificity points of view since they tend to overestimate sleep state, with severe consequences from a diagnosis point of view. They usually maximize the overall accuracy that does not take into account the highly unbalanced state distribution. In this paper, a method is proposed to appropriately deal with this unbalanced problem, achieving similar sensitivity and specificity scores in the state estimation process. The proposed method combines two linear discriminant classifiers, trained with two different criteria involving movement detection to generate a first state estimate. This result is then refined by a Hidden Markov Model-based algorithm. The global accuracy, the sensitivity, and the specificity of the method are 77.8%, 75.6%, and 81.6%, respectively, performing better than the tested algorithms. If the performance is assessed only for movement periods, this improvement is even higher.

  3. Sleep Disruption in Young Foster Children

    ERIC Educational Resources Information Center

    Tininenko, Jennifer R.; Fisher, Philip A.; Bruce, Jacqueline; Pears, Katherine C.

    2010-01-01

    In the current study, sleep actigraphy and parent-report measures were used to investigate differences in sleeping behavior among four groups of 3- to 7-year-olds (N = 79): children in regular foster care (n = 15); children receiving a therapeutic intervention in foster care (n = 17); low income community children (n = 18); and upper middle income…

  4. Sleep Disruption in Young Foster Children

    PubMed Central

    Tininenko, Jennifer R.; Fisher, Philip A.; Bruce, Jacqueline; Pears, Katherine C.

    2010-01-01

    In the current study, sleep actigraphy and parent-report measures were used to investigate differences in sleeping behavior among four groups of 3- to 7-year-olds (N = 79): children in regular foster care (n = 15); children receiving a therapeutic intervention in foster care (n = 17); low income community children (n = 18); and upper middle income community children (n = 29). The children in therapeutic foster care exhibited longer sleep latency and increased variability of sleep duration than the upper middle income community children. In addition, there was indication of a treatment effect: the therapeutic foster care children slept longer than the regular foster care and low income community children and had earlier bedtimes, fell asleep earlier, and spent more time in bed than the regular foster care children. The results are discussed in terms of the effectiveness of early intervention for enhancing sleep in foster children. PMID:20221849

  5. Nocturnal sustained attention during sleep deprivation can be predicted by specific periods of subjective daytime alertness in normal young humans.

    PubMed

    Taillard, Jacques; Moore, Nicholas; Claustrat, Bruno; Coste, Olivier; Bioulac, Bernard; Philip, Pierre

    2006-03-01

    In our 24-h society, nocturnal sleep-related accidents are common. Because all individuals are not equal in their responses to sleep loss, it is very important to identify predictors of vulnerability to sleep deprivation in normal subjects. We investigated the performance of a cognitive test of sustained attention, electroencephalogram theta/alpha power, subjective sleepiness, and two circadian markers (core temperature and melatonin) in 18 healthy men (nine morning types and nine evening types, 21.4 +/- 1.9 years) during a 36-h sleep deprivation in a constant routine protocol. Sleep need (self-reported) and baseline sleep structure were also investigated. Nighttime performance impairment was defined as the difference between the mean nocturnal number of lapses (00:00-07:30 [corrected] hours) and the mean diurnal number of lapses (07:30-20:30 hours) expressed as a percentage. Feeling fully alert in the morning just after awakening and/or sleepy in early afternoon were the only two factors (Multiple R > 0.80, > 60% of explained variance) which better predicted the decrease in performances of nocturnal operational tasks requiring sustained attention.

  6. Effects of filtering visual short wavelengths during nocturnal shiftwork on sleep and performance.

    PubMed

    Rahman, Shadab A; Shapiro, Colin M; Wang, Flora; Ainlay, Hailey; Kazmi, Syeda; Brown, Theodore J; Casper, Robert F

    2013-10-01

    under baseline on the first night shift. By the middle night shift, the difference in performance was no longer significant between day shift and either of the two night shift conditions, suggesting some adaptation to the night shift had occurred under baseline conditions. These results suggest that both daytime and nighttime sleep are adversely affected in rotating-shift workers and that filtering short wavelengths may be an approach to reduce sleep disruption and improve performance in rotating-shift workers.

  7. Effects of work stress on work-related rumination, restful sleep, and nocturnal heart rate variability experienced on workdays and weekends.

    PubMed

    Vahle-Hinz, Tim; Bamberg, Eva; Dettmers, Jan; Friedrich, Niklas; Keller, Monika

    2014-04-01

    The present study reports the lagged effects of work stress on work-related rumination, restful sleep, and nocturnal heart rate variability experienced during both workdays and weekends. Fifty employees participated in a diary study. Multilevel and regression analyses revealed a significant relationship between work stress measured at the end of a workday, work-related rumination measured during the evening, and restful sleep measured the following morning. Work stress, measured as the mean of 2 consecutive workdays, was substantially but not significantly related to restful sleep on weekends. Work stress was unrelated to nocturnal heart rate variability. Work-related rumination was related to restful sleep on weekends but not on workdays. Additionally, work-related rumination on weekends was positively related to nocturnal heart rate variability during the night between Saturday and Sunday. No mediation effects of work stress on restful sleep or nocturnal heart rate variability via work-related rumination were confirmed.

  8. Circadian Rhythm and Sleep Disruption: Causes, Metabolic Consequences, and Countermeasures

    PubMed Central

    Skene, Debra J.; Arendt, Josephine; Cade, Janet E.; Grant, Peter J.; Hardie, Laura J.

    2016-01-01

    Circadian (∼24-hour) timing systems pervade all kingdoms of life and temporally optimize behavior and physiology in humans. Relatively recent changes to our environments, such as the introduction of artificial lighting, can disorganize the circadian system, from the level of the molecular clocks that regulate the timing of cellular activities to the level of synchronization between our daily cycles of behavior and the solar day. Sleep/wake cycles are intertwined with the circadian system, and global trends indicate that these, too, are increasingly subject to disruption. A large proportion of the world's population is at increased risk of environmentally driven circadian rhythm and sleep disruption, and a minority of individuals are also genetically predisposed to circadian misalignment and sleep disorders. The consequences of disruption to the circadian system and sleep are profound and include myriad metabolic ramifications, some of which may be compounded by adverse effects on dietary choices. If not addressed, the deleterious effects of such disruption will continue to cause widespread health problems; therefore, implementation of the numerous behavioral and pharmaceutical interventions that can help restore circadian system alignment and enhance sleep will be important. PMID:27763782

  9. Nocturnal sleep-related variables from 24-h free-living waist-worn accelerometry: International Study of Childhood Obesity, Lifestyle and the Environment

    PubMed Central

    Tudor-Locke, C; Mire, E F; Barreira, T V; Schuna, J M; Chaput, J-P; Fogelholm, M; Hu, G; Kurpad, A; Kuriyan, R; Lambert, E V; Maher, C; Maia, J; Matsudo, V; Olds, T; Onywera, V; Sarmiento, O L; Standage, M; Tremblay, M S; Zhao, P; Church, T S; Katzmarzyk, P T

    2015-01-01

    Objectives: We describe the process of identifying and defining nocturnal sleep-related variables (for example, movement/non-movement indicators of sleep efficiency, waking episodes, midpoint and so on) using the unique 24-h waist-worn free-living accelerometer data collected in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). Methods: Seven consecutive days of 24-h waist-worn accelerometer (GT3X+, ActiGraph LLC) data were collected from over 500 children at each site. An expert subgroup of the research team with accelerometry expertize, frontline data collectors and data managers met on several occasions to categorize and operationally define nocturnal accelerometer signal data patterns. The iterative process was informed by the raw data drawn from a sub set of the US data, and culminated in a refined and replicable delineated definition for each identified nocturnal sleep-related variable. Ultimately based on 6318 participants from all 12 ISCOLE sites with valid total sleep episode time (TSET), we report average clock times for nocturnal sleep onset, offset and midpoint in addition to sleep period time, TSET and restful sleep efficiency (among other derived variables). Results: Nocturnal sleep onset occurred at 2218 hours and nocturnal sleep offset at 0707 hours. The mean midpoint was 0243 hours. The sleep period time of 529.6 min (8.8 h) was typically accumulated in a single episode, making the average TSET very similar in duration (529.0 min). The mean restful sleep efficiency ranged from 86.8% (based on absolute non-movement of 0 counts per minute) to 96.0% (based on relative non-movement of <100 counts per minute). Conclusions: These variables extend the potential of field-based 24-h waist-worn accelerometry to distinguish and categorize the underlying robust patterns of movement/non-movement signals conveying magnitude, duration, frequency and periodicity during the nocturnal sleep period. PMID:27152185

  10. Obstructive sleep apnea detection using clustering classification of nonlinear features from nocturnal oximetry.

    PubMed

    Alvarez, Daniel; Hornero, Roberto; Marcos, J Víctor; del Campo, Félix; López, Miguel

    2007-01-01

    This study is focused on the classification of patients suspected of suffering from obstructive sleep apnea (OSA) by means of cluster analysis. We assessed the diagnostic ability of three clustering algorithms: k-means, hierarchical and fuzzy c-means (FCM). Nonlinear features of blood oxygen saturation (SaO2) from nocturnal oximetry were used as inputs to the clustering methods. Three nonlinear methods were used: approximate entropy (ApEn), central tendency measure (CTM) and Lempel-Ziv (LZ) complexity. A population of 74 subjects (44 OSA positive and 30 OSA negative) was studied. 90.5%, 87.8% and 86.5% accuracies were reached with k-means, hierarchical and FCM algorithms, respectively. The diagnostic accuracy values improved those obtained with each nonlinear method individually. Our results suggest that nonlinear analysis and clustering classification could provide useful information to help in the diagnosis of OSA syndrome.

  11. Watch out where you sleep: nocturnal sleeping behaviour of Bay Island lizards.

    PubMed

    Mohanty, Nitya Prakash; Harikrishnan, Surendran; Vasudevan, Karthikeyan

    2016-01-01

    Sleeping exposes lizards to predation. Therefore, sleeping strategies must be directed towards avoiding predation and might vary among syntopic species. We studied sleeping site characteristics of two syntopic, congeneric lizards-the Bay Island forest lizard, Coryphophylax subcristatus and the short-tailed Bay Island lizard, C. brevicaudus and evaluated inter-specific differences. We measured structural, microclimatic and potential predator avoidance at the sleeping perches of 386 C. subcristatus and 185 C. brevicaudus. Contrary to our expectation, we found similar perch use in both species. The lizards appeared to use narrow girth perch plants and accessed perches by moving both vertically and horizontally. Most lizards slept on leaves, with their heads directed towards the potential path of a predator approaching from the plant base. There was no inter-specific competition in the choices of sleeping perches. These choices indicate an anti-predator strategy involving both tactile and visual cues. This study provides insight into a rarely studied behaviour in reptiles and its adaptive significance.

  12. Watch out where you sleep: nocturnal sleeping behaviour of Bay Island lizards

    PubMed Central

    Mohanty, Nitya Prakash; Harikrishnan, Surendran

    2016-01-01

    Sleeping exposes lizards to predation. Therefore, sleeping strategies must be directed towards avoiding predation and might vary among syntopic species. We studied sleeping site characteristics of two syntopic, congeneric lizards—the Bay Island forest lizard, Coryphophylax subcristatus and the short-tailed Bay Island lizard, C. brevicaudus and evaluated inter-specific differences. We measured structural, microclimatic and potential predator avoidance at the sleeping perches of 386 C. subcristatus and 185 C. brevicaudus. Contrary to our expectation, we found similar perch use in both species. The lizards appeared to use narrow girth perch plants and accessed perches by moving both vertically and horizontally. Most lizards slept on leaves, with their heads directed towards the potential path of a predator approaching from the plant base. There was no inter-specific competition in the choices of sleeping perches. These choices indicate an anti-predator strategy involving both tactile and visual cues. This study provides insight into a rarely studied behaviour in reptiles and its adaptive significance. PMID:27168958

  13. Light pollution disrupts sleep in free-living animals.

    PubMed

    Raap, Thomas; Pinxten, Rianne; Eens, Marcel

    2015-09-04

    Artificial lighting can alter individual behaviour, with often drastic and potentially negative effects on biological rhythms, daily activity and reproduction. Whether this is caused by a disruption of sleep, an important widespread behaviour enabling animals to recover from daily stress, is unclear. We tested the hypothesis that light pollution disrupts sleep by recording individual sleep behaviour of great tits, Parus major, that were roosting in dark nest-boxes and were exposed to light-emitting diode light the following night. Their behaviour was compared to that of control birds sleeping in dark nest-boxes on both nights. Artificial lighting caused experimental birds to wake up earlier, sleep less (-5%) and spent less time in the nest-box as they left their nest-box earlier in the morning. Experimental birds did not enter the nest-box or fall asleep later than controls. Although individuals in lit nest-boxes did not wake up more often nor decreased the length of their sleep bouts, females spent a greater proportion of the night awake. Our study provides the first direct proof that light pollution has a significant impact on sleep in free-living animals, in particular in the morning, and highlights a mechanism for potential effects of light pollution on fitness.

  14. Light pollution disrupts sleep in free-living animals

    PubMed Central

    Raap, Thomas; Pinxten, Rianne; Eens, Marcel

    2015-01-01

    Artificial lighting can alter individual behaviour, with often drastic and potentially negative effects on biological rhythms, daily activity and reproduction. Whether this is caused by a disruption of sleep, an important widespread behaviour enabling animals to recover from daily stress, is unclear. We tested the hypothesis that light pollution disrupts sleep by recording individual sleep behaviour of great tits, Parus major, that were roosting in dark nest-boxes and were exposed to light-emitting diode light the following night. Their behaviour was compared to that of control birds sleeping in dark nest-boxes on both nights. Artificial lighting caused experimental birds to wake up earlier, sleep less (–5%) and spent less time in the nest-box as they left their nest-box earlier in the morning. Experimental birds did not enter the nest-box or fall asleep later than controls. Although individuals in lit nest-boxes did not wake up more often nor decreased the length of their sleep bouts, females spent a greater proportion of the night awake. Our study provides the first direct proof that light pollution has a significant impact on sleep in free-living animals, in particular in the morning, and highlights a mechanism for potential effects of light pollution on fitness. PMID:26337732

  15. Sleep disruption increases seizure susceptibility: Behavioral and EEG evaluation of an experimental model of sleep apnea.

    PubMed

    Hrnčić, Dragan; Grubač, Željko; Rašić-Marković, Aleksandra; Šutulović, Nikola; Šušić, Veselinka; Bjekić-Macut, Jelica; Stanojlović, Olivera

    2016-03-01

    Sleep disruption accompanies sleep apnea as one of its major symptoms. Obstructive sleep apnea is particularly common in patients with refractory epilepsy, but causing factors underlying this are far from being resolved. Therefore, translational studies regarding this issue are important. Our aim was to investigate the effects of sleep disruption on seizure susceptibility of rats using experimental model of lindane-induced refractory seizures. Sleep disruption in male Wistar rats with implanted EEG electrodes was achieved by treadmill method (belt speed set on 0.02 m/s for working and 0.00 m/s for stop mode, respectively). Animals were assigned to experimental conditions lasting 6h: 1) sleep disruption (sleep interrupted, SI; 30s working and 90 s stop mode every 2 min; 180 cycles in total); 2) activity control (AC, 10 min working and 30 min stop mode, 9 cycles in total); 3) treadmill chamber control (TC, only stop mode). Afterwards, the animals were intraperitoneally treated with lindane (L, 4 mg/kg, SI+L, AC+L and TC+L groups) or dimethylsulfoxide (DMSO, SIc, ACc and TCc groups). Convulsive behavior was assessed by seizure incidence, latency time to first seizure, and its severity during 30 min after drug administration. Number and duration of ictal periods were determined in recorded EEGs. Incidence and severity of lindane-induced seizures were significantly increased, latency time significantly decreased in animals undergoing sleep disruption (SI+L group) compared with the animals from TC+L. Seizure latency was also significantly decreased in SI+L compared to AC+L groups. Number of ictal periods were increased and duration of it presented tendency to increase in SI+L comparing to AC+L. No convulsive signs were observed in TCc, ACc and SIc groups, as well as no ictal periods in EEG. These results indicate sleep disruption facilitates induction of epileptic activity in rodent model of lindane-epilepsy enabling translational research of this phenomenon.

  16. Positive airway pressure improves nocturnal beat-to-beat blood pressure surges in obesity hypoventilation syndrome with obstructive sleep apnea.

    PubMed

    Carter, Jason R; Fonkoue, Ida T; Grimaldi, Daniela; Emami, Leila; Gozal, David; Sullivan, Colin E; Mokhlesi, Babak

    2016-04-01

    Positive airway pressure (PAP) treatment has been shown to have a modest effect on ambulatory blood pressure (BP) in patients with obstructive sleep apnea (OSA). However, there is a paucity of data on the effect of PAP therapy on rapid, yet significant, BP swings during sleep, particularly in obesity hypoventilation syndrome (OHS). The present study hypothesizes that PAP therapy will improve nocturnal BP on the first treatment night (titration PAP) in OHS patients with underlying OSA, and that these improvements will become more significant with 6 wk of PAP therapy. Seventeen adults (7 men, 10 women; age 50.4 ± 10.7 years, BMI 49.3 ± 2.4 kg/m(2)) with OHS and clinically diagnosed OSA participated in three overnight laboratory visits that included polysomnography and beat-to-beat BP monitoring via finger plethysmography. Six weeks of PAP therapy, but not titration PAP, lowered mean nocturnal BP. In contrast, when nocturnal beat-to-beat BPs were aggregated into bins consisting of at least three consecutive cardiac cycles with a >10 mmHg BP surge (i.e., Δ10-20, Δ20-30, Δ30-40, and Δ>40 mmHg), titration, and 6-wk PAP reduced the number of BP surges per hour (time × bin, P < 0.05). PAP adherence over the 6-wk period was significantly correlated to reductions in nocturnal systolic (r = 0.713, P = 0.001) and diastolic (r = 0.497, P = 0.043) BP surges. Despite these PAP-induced improvements in nocturnal beat-to-beat BP surges, 6 wk of PAP therapy did not alter daytime BP. In conclusion, PAP treatment reduces nocturnal beat-to-beat BP surges in OHS patients with underlying OSA, and this improvement in nocturnal BP regulation was greater in patients with higher PAP adherence.

  17. Short-term sleep deprivation with nocturnal light exposure alters time-dependent glucagon-like peptide-1 and insulin secretion in male volunteers.

    PubMed

    Gil-Lozano, Manuel; Hunter, Paola M; Behan, Lucy-Ann; Gladanac, Bojana; Casper, Robert F; Brubaker, Patricia L

    2016-01-01

    The intestinal L cell is the principal source of glucagon-like peptide-1 (GLP-1), a major determinant of insulin release. Because GLP-1 secretion is regulated in a circadian manner in rodents, we investigated whether the activity of the human L cell is also time sensitive. Rhythmic fluctuations in the mRNA levels of canonical clock genes were found in the human NCI-H716 L cell model, which also showed a time-dependent pattern in their response to well-established secretagogues. A diurnal variation in GLP-1 responses to identical meals (850 kcal), served 12 h apart in the normal dark (2300) and light (1100) periods, was also observed in male volunteers maintained under standard sleep and light conditions. These findings suggest the existence of a daily pattern of activity in the human L cell. Moreover, we separately tested the short-term effects of sleep deprivation and nocturnal light exposure on basal and postprandial GLP-1, insulin, and glucose levels in the same volunteers. Sleep deprivation with nocturnal light exposure disrupted the melatonin and cortisol profiles and increased insulin resistance. Moreover, it also induced profound derangements in GLP-1 and insulin responses such that postprandial GLP-1 and insulin levels were markedly elevated and the normal variation in GLP-1 responses was abrogated. These alterations were not observed in sleep-deprived participants maintained under dark conditions, indicating a direct effect of light on the mechanisms that regulate glucose homeostasis. Accordingly, the metabolic abnormalities known to occur in shift workers may be related to the effects of irregular light-dark cycles on these glucoregulatory pathways.

  18. Screening of obstructive sleep apnoea: heart rate spectral analysis of nocturnal pulse oximetric recording.

    PubMed

    Zamarrón, C; Romero, P V; Gude, F; Amaro, A; Rodriguez, J R

    2001-09-01

    Using heart rate spectral analysis of nocturnal pulse oximetry, we prospectively evaluated the utility of this methodology in patients clinically suspected of having obstructive sleep apnoea (OSA). A hundred and ninety-seven outpatients referred with symptoms compatible with the diagnosis of OSA were studied. All participants had nocturnal pulse oximetry performed simultaneously with conventional polysomnography. Power density of heart rate obtained by nocturnal pulse oximetry was analysed using fast Fourier transformation of a Hamming-windowed signal. Recording test results were classified as abnormal (suspicion of OSA) in the presence of a peak in the periodogram between period boundaries 30-70 sec. A normal test result was defined as the absence of the 30-70 sec peak in the periodogram. The total area of the periodogram (S(TOT)), the area enclosed in the periodogram between the period boundaries 30-70 sec (S(30-70)), the area enclosed in the period boundaries 30-70 sec with respect to the total area of the periodogram (S) and the peak amplitude 30-70 sec (PA) were measured. The presence of a peak in the periodogram has a sensitivity of 81.3%, a specificity of 91.5% a positive predictive value of 89.1% and a negative predictive value of 85.1% for OSA diagnosis. The OSA patients were found to have higher values of S(TOT), S(30-70), S and PA than the non OSA patients. Receiver operating characteristics (ROC) curve was constructed at different thresholds of S(TOT), S(30-70) S and PA. For a PA threshold of 10(%)2, heart rate spectra analysis sensitivity for OSA was 58% and specificity was 92%. Furthermore, the positive and negative predictive values for diagnosis of OSA were 87 and 72% respectively. Apnoea hypopnea index (AHI) correlated significantly with S(TOT) (r=0.44; P<0.001), S(30-70) (r=0.59: P<0.001), S (r=0.58; P<0.001) and PA (r=0.58; P<0.001). According to our results, heart rate spectral analys s obtained by nocturnal pulse oximetry and identification of

  19. Decreased nocturnal awakenings in young adults performing bikram yoga: a low-constraint home sleep monitoring study.

    PubMed

    Kudesia, Ravi S; Bianchi, Matt T

    2012-01-01

    This pilot study evaluated the impact of Bikram Yoga on subjective and objective sleep parameters. We compared subjective (diary) and objective (headband sleep monitor) sleep measures on yoga versus nonyoga days during a 14-day period. Subjects (n = 13) were not constrained regarding yoga-practice days, other exercise, caffeine, alcohol, or naps. These activities did not segregate by choice of yoga days. Standard sleep metrics were unaffected by yoga, including sleep latency, total sleep time, and percentage of time spent in rapid eye movement (REM), light non-REM, deep non-REM, or wake after sleep onset (WASO). Consistent with prior work, transition probability analysis was a more sensitive index of sleep architecture changes than standard metrics. Specifically, Bikram Yoga was associated with significantly faster return to sleep after nocturnal awakenings. We conclude that objective home sleep monitoring is feasible in a low-constraint, real-world study design. Further studies on patients with insomnia will determine whether the results generalize or not.

  20. Is sleep disruption a trigger for postpartum psychosis?

    PubMed

    Lewis, Katie J S; Foster, Russell G; Jones, Ian R

    2016-05-01

    An episode of postpartum psychosis can be devastating for a woman and her family, and it is vital we understand the factors involved in the aetiology of this condition. Sleep and circadian rhythm disruption is a plausible candidate but further research is needed that builds on the latest advances in chronobiology and neuroscience.

  1. The Experiences of Sleep Disruption in Families of Technology-Dependent Children Living at Home

    ERIC Educational Resources Information Center

    Heaton, Janet; Noyes, Jane; Sloper, Patricia; Shah, Robina

    2006-01-01

    This paper examines the sleep disruption experienced by 36 families of technology-dependent children living at home in the United Kingdom. The paper begins with an overview of the qualitative study in which parents' experiences of sleep disruption emerged as a major theme. We then describe the nature of and reasons for the sleep disruption, the…

  2. Effects of sleep disruption and high fat intake on glucose metabolism in mice.

    PubMed

    Ho, Jacqueline M; Barf, R Paulien; Opp, Mark R

    2016-06-01

    Poor sleep quality or quantity impairs glycemic control and increases risk of disease under chronic conditions. Recovery sleep may offset adverse metabolic outcomes of accumulated sleep debt, but the extent to which this occurs is unclear. We examined whether recovery sleep improves glucose metabolism in mice subjected to prolonged sleep disruption, and whether high fat intake during sleep disruption exacerbates glycemic control. Adult male C57BL/6J mice were subjected to 18-h sleep fragmentation daily for 9 days, followed by 1 day of recovery. During sleep disruption, one group of mice was fed a high-fat diet (HFD) while another group was fed standard laboratory chow. Insulin sensitivity and glucose tolerance were assessed by insulin and glucose tolerance testing at baseline, after 3 and 7 days of sleep disruption, and at the end of the protocol after 24h of undisturbed sleep opportunity (recovery). To characterize changes in sleep architecture that are associated with sleep debt and recovery, we quantified electroencephalogram (EEG) recordings during sleep fragmentation and recovery periods from an additional group of mice. We now report that 9 days of 18-h daily sleep fragmentation significantly reduces rapid eye movement sleep (REMS) and non-rapid eye movement sleep (NREMS). Mice respond with increases in REMS, but not NREMS, during the daily 6-h undisturbed sleep opportunity. However, both REMS and NREMS increase significantly during the 24-h recovery period. Although sleep disruption alone has no effect in this protocol, high fat feeding in combination with sleep disruption impairs glucose tolerance, effects that are reversed by recovery sleep. Insulin sensitivity modestly improves after 3 days of sleep fragmentation and after 24h of recovery, with significantly greater improvements in mice exposed to HFD during sleep disruption. Improvements in both glucose tolerance and insulin sensitivity are associated with NREMS rebound, raising the possibility that this

  3. Central Nervous Insulin Administration before Nocturnal Sleep Decreases Breakfast Intake in Healthy Young and Elderly Subjects

    PubMed Central

    Santiago, João C. P.; Hallschmid, Manfred

    2017-01-01

    Peripheral insulin acts on the brain to regulate metabolic functions, in particular decreasing food intake and body weight. This concept has been supported by studies in humans relying on the intranasal route of administration, a method that permits the direct permeation of insulin into the CNS without substantial absorption into the blood stream. We investigated if intranasal insulin administration before nocturnal sleep, a period of reduced metabolic activity and largely absent external stimulation, affects food intake and energy turnover on the subsequent morning. Healthy participants who were either young (16 men and 16 women; mean age ± SEM, 23.68 ± 0.40 years, mean BMI ± SEM, 22.83 ± 0.33 kg/m2) or elderly (10 men, 9 women; 70.79 ± 0.81 years, 25.27 ± 0.60 kg/m2) were intranasally administered intranasal insulin (160 IU) or placebo before a night of regular sleep that was polysomnographically recorded. Blood was repeatedly sampled for the determination of circulating glucose, insulin, leptin and total ghrelin. In the morning, energy expenditure was assessed via indirect calorimetry and subjects were offered a large standardized breakfast buffet from which they could eat ad libitum. Insulin compared to placebo reduced breakfast size by around 110 kcal (1,054.43 ± 50.91 vs. 1,162.36 ± 64.69 kcal, p = 0.0095), in particular decreasing carbohydrate intake (502.70 ± 25.97 vs. 589.82 ± 35.03 kcal, p = 0.0080). This effect was not dependent on sex or age (all p > 0.11). Sleep architecture, blood glucose and hormonal parameters as well as energy expenditure were not or only marginally affected. Results show that intranasal insulin administered to healthy young and elderly humans before sleep exerts a delayed inhibitory effect on energy intake that is not compensated for by changes in energy expenditure. While the exact underlying mechanisms cannot be derived from our data, findings indicate a long-lasting catabolic effect of central nervous insulin delivery

  4. Central Nervous Insulin Administration before Nocturnal Sleep Decreases Breakfast Intake in Healthy Young and Elderly Subjects.

    PubMed

    Santiago, João C P; Hallschmid, Manfred

    2017-01-01

    Peripheral insulin acts on the brain to regulate metabolic functions, in particular decreasing food intake and body weight. This concept has been supported by studies in humans relying on the intranasal route of administration, a method that permits the direct permeation of insulin into the CNS without substantial absorption into the blood stream. We investigated if intranasal insulin administration before nocturnal sleep, a period of reduced metabolic activity and largely absent external stimulation, affects food intake and energy turnover on the subsequent morning. Healthy participants who were either young (16 men and 16 women; mean age ± SEM, 23.68 ± 0.40 years, mean BMI ± SEM, 22.83 ± 0.33 kg/m(2)) or elderly (10 men, 9 women; 70.79 ± 0.81 years, 25.27 ± 0.60 kg/m(2)) were intranasally administered intranasal insulin (160 IU) or placebo before a night of regular sleep that was polysomnographically recorded. Blood was repeatedly sampled for the determination of circulating glucose, insulin, leptin and total ghrelin. In the morning, energy expenditure was assessed via indirect calorimetry and subjects were offered a large standardized breakfast buffet from which they could eat ad libitum. Insulin compared to placebo reduced breakfast size by around 110 kcal (1,054.43 ± 50.91 vs. 1,162.36 ± 64.69 kcal, p = 0.0095), in particular decreasing carbohydrate intake (502.70 ± 25.97 vs. 589.82 ± 35.03 kcal, p = 0.0080). This effect was not dependent on sex or age (all p > 0.11). Sleep architecture, blood glucose and hormonal parameters as well as energy expenditure were not or only marginally affected. Results show that intranasal insulin administered to healthy young and elderly humans before sleep exerts a delayed inhibitory effect on energy intake that is not compensated for by changes in energy expenditure. While the exact underlying mechanisms cannot be derived from our data, findings indicate a long-lasting catabolic effect of central nervous insulin

  5. Effects of non-invasive ventilation on objective sleep and nocturnal respiration in patients with amyotrophic lateral sclerosis.

    PubMed

    Boentert, Matthias; Brenscheidt, Inga; Glatz, Christian; Young, Peter

    2015-09-01

    In amyotrophic lateral sclerosis (ALS), non-invasive ventilation (NIV) is indicated if sleep-disordered breathing (SDB), daytime hypercapnia, or significant diaphragmatic weakness is present. We investigated both short-term and long-term effects of NIV on objective measures of sleep and nocturnal respiration in patients with ALS. Polysomnography (PSG) and transcutaneous capnography were conducted for diagnosis of SDB (T0), for treatment initiation (T1), and follow-up 3, 9, and 15 months later (T2, T3, and T4, respectively). Records from 65 patients were retrospectively analyzed at T0 and T1. At subsequent timepoints, the number of full data sets decreased since follow-up sleep studies frequently included polygraphy rather than PSG (T2, 38 patients, T3, 17 patients, T4, 11 patients). At T0, mean age was 63.2 years, 29 patients were female, and 22 patients had bulbar ALS. Immediate sequelae of NIV initiation included significant increases of slow wave sleep, rapid eye movement sleep, and oxygen saturation. Mean apnea-hypopnea index, respiratory rate, and the maximum transcutaneous carbon dioxide tension were reduced. At T2-T4, normoxia and normocapnia were preserved. Sleep quality measures showed no alteration as diurnal use of NIV gradually increased reflecting disease progression. In contrast to previous reports, improvement of sleep and respiratory outcomes was found in both non-bulbar and bulbar patients. NIV significantly improves objective sleep quality and SDB in the first night of treatment in patients with bulbar and non-bulbar ALS. NIV warrants nocturnal normoventilation without deterioration of sleep quality in the long run with only minor changes to ventilator settings.

  6. Role of nocturnal rostral fluid shift in the pathogenesis of obstructive and central sleep apnoea

    PubMed Central

    White, Laura H; Bradley, T Douglas

    2013-01-01

    Obstructive sleep apnoea (OSA) is common in the general population and increases the risk of motor vehicle accidents due to hypersomnolence from sleep disruption, and risk of cardiovascular diseases owing to repetitive hypoxia, sympathetic nervous system activation, and systemic inflammation. In contrast, central sleep apnoea (CSA) is rare in the general population. Although their pathogenesis is multifactorial, the prevalence of both OSA and CSA is increased in patients with fluid retaining states, especially heart failure, where they are associated with increased mortality risk. This observation suggests that fluid retention may contribute to the pathogenesis of both OSA and CSA. According to this hypothesis, during the day fluid accumulates in the intravascular and interstitial spaces of the legs due to gravity, and upon lying down at night redistributes rostrally, again owing to gravity. Some of this fluid may accumulate in the neck, increasing tissue pressure and causing the upper airway to narrow, thereby increasing its collapsibility and predisposing to OSA. In heart failure patients, with increased rostral fluid shift, fluid may additionally accumulate in the lungs, provoking hyperventilation and hypocapnia, driving below the apnoea threshold, leading to CSA. This review article will explore mechanisms by which overnight rostral fluid shift, and its prevention, can contribute to the pathogenesis and therapy of sleep apnoea. PMID:23230237

  7. Role of nocturnal rostral fluid shift in the pathogenesis of obstructive and central sleep apnoea.

    PubMed

    White, Laura H; Bradley, T Douglas

    2013-03-01

    Obstructive sleep apnoea (OSA) is common in the general population and increases the risk of motor vehicle accidents due to hypersomnolence from sleep disruption, and risk of cardiovascular diseases owing to repetitive hypoxia, sympathetic nervous system activation, and systemic inflammation. In contrast, central sleep apnoea (CSA) is rare in the general population. Although their pathogenesis is multifactorial, the prevalence of both OSA and CSA is increased in patients with fluid retaining states, especially heart failure, where they are associated with increased mortality risk. This observation suggests that fluid retention may contribute to the pathogenesis of both OSA and CSA. According to this hypothesis, during the day fluid accumulates in the intravascular and interstitial spaces of the legs due to gravity, and upon lying down at night redistributes rostrally, again owing to gravity. Some of this fluid may accumulate in the neck, increasing tissue pressure and causing the upper airway to narrow, thereby increasing its collapsibility and predisposing to OSA. In heart failure patients, with increased rostral fluid shift, fluid may additionally accumulate in the lungs, provoking hyperventilation and hypocapnia, driving below the apnoea threshold, leading to CSA. This review article will explore mechanisms by which overnight rostral fluid shift, and its prevention, can contribute to the pathogenesis and therapy of sleep apnoea.

  8. Metabolic Consequences in Humans of Prolonged Sleep Restriction Combined with Circadian Disruption

    PubMed Central

    Buxton, Orfeu M.; Cain, Sean W.; O’Connor, Shawn P.; Porter, James H.; Duffy, Jeanne F.; Wang, Wei; Czeisler, Charles A.; Shea, Steven A.

    2013-01-01

    Epidemiological studies link short sleep and circadian disruption with risk of metabolic syndrome and diabetes. We tested the hypotheses that prolonged sleep restriction with concurrent circadian disruption, as can occur with shift work, impairs glucose regulation and metabolism. Healthy adults spent >5 weeks in controlled laboratory conditions including: sleep extension (baseline), 3-week sleep restriction (5.6 h sleep/24 h) combined with circadian disruption (recurring 28-h ‘days’), and 9-day recovery sleep with circadian re-entrainment. Prolonged sleep restriction with concurrent circadian disruption significantly decreased resting metabolic rate, and increased postprandial plasma via inadequate pancreatic beta cell responsivity; these normalized with 9 days of recovery sleep and stable circadian reentrainment. Thus, in humans, prolonged sleep restriction with concurrent circadian disruption alters metabolism and could increase risk of obesity and diabetes. PMID:22496545

  9. Nocturnal Melatonin Profiles in Patients with Delayed Sleep-Wake Phase Disorder and Control Sleepers.

    PubMed

    Micic, Gorica; Lovato, Nicole; Gradisar, Michael; Burgess, Helen J; Ferguson, Sally A; Kennaway, David J; Lack, Leon

    2015-10-01

    A significant delay in the timing of endogenous circadian rhythms has been associated with delayed sleep phase disorder (DSPD). More recently, other mechanisms have also been proposed to account for this disorder. To further explore the etiology of DSPD, the present study compared nocturnal melatonin profiles of 26 DSPD patients (18 males, 8 females; age, 21.73 ± 4.98 years) and 17 normally timed good sleepers (10 males, 7 females; age, 23.82 ± 5.23 years) in a time-free, dim-light (<10 lux) laboratory environment. A 30-h modified constant routine with alternating 20-min sleep opportunities and 40 min of enforced wakefulness was used to measure the endogenous melatonin circadian rhythm. Salivary melatonin was sampled half-hourly from 1820 h to 0020 h and then hourly from 0120 h to 1620 h. DSPD patients had significantly later timed melatonin profiles that were delayed by approximately 3 h compared to normal sleepers, and there were no notable differences in the relative duration of secretion between groups. However, melatonin secretion between dim-light melatonin onset (DLMO) and acrophase was less prominent in DSPD patients compared to good sleepers, who showed a more acute initial surge of melatonin following the DLMO. Although the regulatory role of melatonin is unknown, abnormal melatonin profiles have been linked to psychiatric and neurological disorders (e.g., major depression, obsessive compulsive disorder, Parkinson disease). These results therefore suggest that in addition to a delayed endogenous circadian rhythm, a diminished initial surge of melatonin secretion following DLMO may contribute to the etiology of DSPD.

  10. Sleep Disruption in Hematopoietic Cell Transplant Recipients: Prevalence, Severity, and Clinical Management

    PubMed Central

    Jim, Heather S.L.; Evans, Bryan; Jeong, Jiyeon M.; Gonzalez, Brian D.; Johnston, Laura; Nelson, Ashley M.; Kesler, Shelli; Phillips, Kristin M.; Barata, Anna; Pidala, Joseph; Palesh, Oxana

    2014-01-01

    Sleep disruption is common among hematopoietic cell transplant (HCT) recipients, with over 50% of patients experiencing sleep disruption pre-transplant, up to 82% experiencing moderate to severe sleep disruption during hospitalization for transplant, and up to 43% in the post-transplant period. These rates of sleep disruption are substantially higher than the general population. Although sleep disruption can be distressing to patients and contribute to diminished quality of life, it is rarely discussed during clinical visits. The goal of the current review is to draw attention to sleep disruption as a clinical problem in HCT in order to facilitate patient education, intervention, and research. The review opens with a discussion of sleep disruption measurement and clinical diagnosis of sleep disorders. An overview of the prevalence, severity, and chronicity of sleep disruption and disorders in patients receiving HCT follows. Current evidence regarding sociodemographic and clinical predictors of sleep disruption and disorders is summarized. The review concludes with suggestions for behavioral and pharmacologic management of sleep disruption and disorders as well as directions for future research. PMID:24747335

  11. Safe enough to sleep: sleep disruptions associated with trauma, posttraumatic stress, and anxiety in children and adolescents.

    PubMed

    Charuvastra, Anthony; Cloitre, Marylene

    2009-10-01

    Sleep disturbance is an essential symptom of posttraumatic stress disorder, and recent evidence suggests that disrupted sleep may play an important role in the development of posttraumatic stress disorder following traumatic stress. The authors review several aspects of sleep as it relates to posttraumatic stress disorder. First, there is an association between traumatic stress and different components of disrupted sleep in children and adolescents. Second, sleep disruption appears to be a core feature of other pediatric anxiety disorders, and the authors consider if this preexisting sleep vulnerability may explain in part why preexisting anxiety disorders are a risk factor for developing posttraumatic stress disorder following a traumatic event. Third, the authors consider attachment theory and the social context of trauma and sleep disruption. This article concludes with a consideration of the therapeutic implications of these findings.

  12. Regularity analysis of nocturnal oximetry recordings to assist in the diagnosis of sleep apnoea syndrome.

    PubMed

    Marcos, J Víctor; Hornero, Roberto; Nabney, Ian T; Álvarez, Daniel; Gutiérrez-Tobal, Gonzalo C; del Campo, Félix

    2016-03-01

    The relationship between sleep apnoea-hypopnoea syndrome (SAHS) severity and the regularity of nocturnal oxygen saturation (SaO2) recordings was analysed. Three different methods were proposed to quantify regularity: approximate entropy (AEn), sample entropy (SEn) and kernel entropy (KEn). A total of 240 subjects suspected of suffering from SAHS took part in the study. They were randomly divided into a training set (96 subjects) and a test set (144 subjects) for the adjustment and assessment of the proposed methods, respectively. According to the measurements provided by AEn, SEn and KEn, higher irregularity of oximetry signals is associated with SAHS-positive patients. Receiver operating characteristic (ROC) and Pearson correlation analyses showed that KEn was the most reliable predictor of SAHS. It provided an area under the ROC curve of 0.91 in two-class classification of subjects as SAHS-negative or SAHS-positive. Moreover, KEn measurements from oximetry data exhibited a linear dependence on the apnoea-hypopnoea index, as shown by a correlation coefficient of 0.87. Therefore, these measurements could be used for the development of simplified diagnostic techniques in order to reduce the demand for polysomnographies. Furthermore, KEn represents a convincing alternative to AEn and SEn for the diagnostic analysis of noisy biomedical signals.

  13. Sleep Disruptions and Emotional Insecurity Are Pathways of Risk for Children

    ERIC Educational Resources Information Center

    El-Sheikh, Mona; Buckhalt, Joseph A.; Cummings, E. Mark; Keller, Peggy

    2007-01-01

    Background: Sleep problems are prevalent in American children. A critical need is to identify sources and processes related to sleep disruptions and their sequelae. We examined a model linking parental marital conflict and children's emotional insecurity, sleep disruptions, and their adjustment and academic problems. Method: One hundred and…

  14. Associations between nocturnal urinary 6-sulfatoxymelatonin, obstructive sleep apnea severity and glycemic control in type 2 diabetes.

    PubMed

    Reutrakul, Sirimon; Siwasaranond, Nantaporn; Nimitphong, Hataikarn; Saetung, Sunee; Chirakalwasan, Naricha; Chailurkit, La-Or; Srijaruskul, Kriangsuk; Ongphiphadhanakul, Boonsong; Thakkinstian, Ammarin

    2017-01-01

    Reduced nocturnal secretion of melatonin, a pineal hormone under circadian control, and obstructive sleep apnea have been both identified as risk factors for the development of type 2 diabetes mellitus. Whether they interact to impact glycemic control in patients with existing type 2 diabetes is not known. Therefore, this study explores the relationships between obstructive sleep apnea, melatonin and glycemic control in type 2 diabetes. As diabetic retinopathy may affect melatonin secretion, we also explore the relationship between retinopathy, melatonin and glycemic control. Fifty-six non-shift workers with type 2 diabetes, who were not using beta-blockers, participated. Most recent hemoglobin A1c (HbA1c) levels and the results of ophthalmologic examinations were obtained from medical records. Obstructive sleep apnea was diagnosed using an ambulatory device. Sleep duration and fragmentation were recorded by 7-day wrist actigraphy. The urinary 6-sulfatoxymelatonin/creatinine ratio, an indicator of nocturnal melatonin secretion, was measured in an overnight urine sample. Mediation analyses were applied to explore whether low nocturnal urinary 6-sulfatoxymelatonin/creatinine ratio could be a causal link between increasing obstructive sleep apnea severity [as measured by an Apnea Hypopnea Index (AHI)] and poorer glycemic control, and between the presence of retinopathy and glycemic control. AHI and HbA1c were log-scale (ln) transformed. Obstructive sleep apnea was found in 76.8%, and 25.5% had diabetic retinopathy. The median (interquartile range) of urinary 6-sulfatoxymelatonin/creatinine ratio was 12.3 (6.0, 20.1) ng/mg. Higher lnHbA1c significantly correlated with lower 6-sulfatoxymelatonin/creatinine ratio (p = 0.04) but was not directly associated with OSA severity. More severe obstructive sleep apnea (lnAHI, p = 0.01), longer diabetes duration (p = 0.02), retinopathy (p = 0.01) and insulin use (p = 0.03) correlated with lower urinary 6-sulfatoxymelatonin

  15. [Structure of nocturnal sleep if there is a violation of the blood supply in the territory of internal carotid artery].

    PubMed

    Berezina, I Iu; Sumskiĭ, L I; Kudriashova, N E

    2013-01-01

    The work examines the influence of degree ofstenosis or occlusion of the internal carotid artery (ICA) of noc- turnal sleep and discusses possible neurophysiological mechanisms of sleep disorders when blood flow in ca- rotid system. 24 patients (19 male and 5 female) were examined. The mean age of men was 49.75 ± 6.55; women--46.67 ± 5.86. Six patients with a single unilateral internal carotid stenosis (ICA) 50%; seven patients--stenosis of ICA 50-70%; eleven patients--occlusion of ICA completed the study. Polysomnography was recorded with "Neuro-Spectr-5/EP" ("NeuroSoft", Russia) and "Delta Flash" ("Deltamed", France) according to international recommendation. Stages of sleep were identified according to Re- chtschaffen A., Kales A. (1968) criteria. Patients were asked to fill in the questionnaire prior to clinical and polysomnographic evaluation. Regional cerebral blood flow (mL/100g/min) with 99mTechnetium (Gamma-camera, DST-Xli "General electric", USA) was study by single photon emission CT imaging. The result of this study showed that with stenosis of the ICA to 50% structure of nocturnal sleep is not changed: records all phases and stages of sleep, quantitative parameters that match the normative data; or decline in the representation of only the stage II sleep; at stenosis ICA of 50-70% is violation of mostly stage II sleep and slow-wave sleep, and with occlusion ICA violation slow-wave sleep and in 45% of cases--REM-sleep.

  16. Association of Sleep Disordered Breathing with Mono-Symptomatic Nocturnal Enuresis: A Study among School Children of Central India

    PubMed Central

    Pakhare, Abhijit P.; Goyal, Abhishek; P, Aswin; Dhingra, Bhavna; Tamaria, K. C.

    2016-01-01

    Objective To study the prevalence of primary monosymptopomatic nocturnal enuresis (PMNE) in children aged 5–10 year and to find its association with sleep disordered breathing (SDB) by using a 22 item pediatric sleep related breathing disorder (SRBD) scale. Methods This was a school based cross sectional epidemiological study from July 2015 to November 2015. A questionnaire seeking information on socio-demographic variables, nocturnal enuresis (NE) frequency, school performance and a validated 22 item pediatric sleep related breathing disorder scale (SRBDs) was distributed to 1820 pupils in three primary schools. Results A total of 1528(83.95%) questionnaires were retrieved. Out of 1528 forms, 182(11.9%) forms were incomplete for requested information and hence 1346 (73.9%) questionnaires were finally analyzed. The prevalence of NE was found to be 12.7% (95% CI; 11–14.6), whereas prevalence of primary nocturnal enuresis (PMNE) was 8.2% (95% CI; 7.1–10.1). SRBD scale score >0.33 (adjusted OR: 2.87; 95%CI: 1.67–4.92), paternal history of enuresis in childhood (adjusted OR:4.96; 95% CI: 2.36–10.45), and inappropriate toilet training (adjusted OR: 1.64; 95% CI: 1.01–2.66) were independently associated with PMNE. Conclusion Sleep disordered breathing, inappropriate toilet training and a history of childhood NE in father were found to be significant risk factors for PMNE in the present study. Thus, these findings suggest that it is imperative to rule out SDB in PMNE patients as they may require different therapeutic interventions. PMID:27191620

  17. Sleep disruption in hematopoietic cell transplantation recipients: prevalence, severity, and clinical management.

    PubMed

    Jim, Heather S L; Evans, Bryan; Jeong, Jiyeon M; Gonzalez, Brian D; Johnston, Laura; Nelson, Ashley M; Kesler, Shelli; Phillips, Kristin M; Barata, Anna; Pidala, Joseph; Palesh, Oxana

    2014-10-01

    Sleep disruption is common among hematopoietic cell transplant (HCT) recipients, with over 50% of recipients experiencing sleep disruption pre-transplant, with up to 82% of patients experiencing moderate to severe sleep disruption during hospitalization for transplant and up to 43% after transplant. These rates of sleep disruption are substantially higher than what we see in the general population. Although sleep disruption can be distressing to patients and contribute to diminished quality of life, it is rarely discussed during clinical visits. The goal of the current review is to draw attention to sleep disruption and disorders (ie, insomnia, obstructive sleep apnea, restless legs syndrome) as a clinical problem in HCT in order to facilitate patient education, intervention, and research. We identified 35 observational studies published in the past decade that examined sleep disruption or disorders in HCT. Most studies utilized a single item measure of sleep, had small sample size, and included heterogeneous samples of patients. Six studies of the effects of psychosocial and exercise interventions on sleep in HCT have reported no significant improvements. These results highlight the need for rigorous observational and interventional studies of sleep disruption and disorders in HCT recipients..

  18. Sleep quality and temperament among university students: differential associations with nighttime sleep duration and sleep disruptions.

    PubMed

    Lukowski, Angela F; Milojevich, Helen M

    2015-01-01

    Sleep-temperament associations have not yet been examined among university students, despite awareness of the high incidence of sleep problems in this population. The present study was conducted (a) to examine whether sleep quality was associated with temperament among university-attending young adults and (b) to determine whether particular components of sleep quality were differentially associated with temperament. University students completed questionnaires designed to assess sleep quality and temperament. Poor sleep quality was associated with increased negative affect and orienting sensitivity as well as decreased effortful control; regression analyses revealed differential associations between components of nighttime sleep quality and temperament ratings. The presented study reveals conceptual continuity in sleep-temperament relations from infancy to young adulthood and highlights important avenues for future research.

  19. Effects of oral phentolamine, taken before sleep, on nocturnal erectile activity: a double-blind, placebo-controlled, crossover study.

    PubMed

    Hatzichristou, D G; Apostolidis, A; Tzortzis, V; Hatzimouratidis, K; Kouvelas, D

    2001-10-01

    The objective of this study was to determine the effects of oral phentolamine, administered before sleep, on nocturnal penile erectile activity of men with mild to moderate erectile dysfunction (ED). We studied five patients with mild to moderate ED (mean age 34.8 +/- 8.13 and mean duration of ED 31.8 +/- 23.5 months), in a double-blind, placebo-controlled, crossover study. All patients received oral phentolamine (Vasomax) at a dose of 40 mg and placebo for three consecutive nights respectively and were submitted to nocturnal penile tumescence and rigidity monitoring (NPTR) with the Rigiscan device. NPTR parameters of the two 3-night recordings were evaluated and compared. Administration of oral phentolamine before sleep was associated with a statistically significant increase in the number of erectile events with rigidity > or = 60% lasting > or = 10 min (P = 0.02), as well as the rigidity activity units (RAU) value per hour sleep, both at the base (P = 0.023) and the tip of the penis (P = 0.019). The number of events as measured by Rigiscan software (20% change in circumference), as well as tumescence activity units (TAU)/h values did not show any statistical difference. No adverse effects were recorded. It is concluded that oral phentolamine administered before sleep enhanced NPTR parameters associated with the quality of the erectile events. Such results provide a pathway for the development of a prevention strategy for ED. Future studies will elucidate whether vasoactive agents taken on a regular basis before sleep, can prevent ED in men at risk, protecting also minimally and moderately impotent patients to become moderately and severely impotent respectively.

  20. Are Nocturnal Breathing, Sleep, and Cognitive Performance Impaired at Moderate Altitude (1,630-2,590 m)?

    PubMed Central

    Latshang, Tsogyal D.; Lo Cascio, Christian M.; Stöwhas, Anne-Christin; Grimm, Mirjam; Stadelmann, Katrin; Tesler, Noemi; Achermann, Peter; Huber, Reto; Kohler, Malcolm; Bloch, Konrad E.

    2013-01-01

    Study Objectives: Newcomers at high altitude (> 3,000 m) experience periodic breathing, sleep disturbances, and impaired cognitive performance. Whether similar adverse effects occur at lower elevations is uncertain, although numerous lowlanders travel to moderate altitude for professional or recreational activities. We evaluated the hypothesis that nocturnal breathing, sleep, and cognitive performance of lowlanders are impaired at moderate altitude. Design: Randomized crossover trial. Setting: University hospital at 490 m, Swiss mountain villages at 1,630 m and 2,590 m. Participants: Fifty-one healthy men, median (quartiles) age 24 y (20-28 y), living below 800 m. Interventions: Studies at Zurich (490 m) and during 4 consecutive days at 1,630 m and 2,590 m, respectively, 2 days each. The order of altitude exposure was randomized. Polysomnography, psychomotor vigilance tests (PVT), the number back test, several other tests of cognitive performance, and questionnaires were evaluated. Measurements and Results: The median (quartiles) apnea-hypopnea index at 490 m was 4.6/h (2.3; 7.9), values at 1,630 and 2,590 m, day 1 and 2, respectively, were 7.0/h (4.1; 12.6), 5.4/h (3.5; 10.5), 13.1/h (6.7; 32.1), and 8.0/h (4.4; 23.1); corresponding values of mean nocturnal oxygen saturation were 96% (95; 96), 94% (93; 95), 94% (93; 95), 90% (89; 91), 91% (90; 92), P < 0.05 versus 490 m, all instances. Slow wave sleep on the first night at 2,590 m was 21% (18; 25) versus 24% (20; 27) at 490 m (P < 0.05). Psychomotor vigilance and various other measures of cognitive performance did not change significantly. Conclusions: Healthy men acutely exposed during 4 days to hypoxemia at 1,630 m and 2,590 m reveal a considerable amount of periodic breathing and sleep disturbances. However, no significant effects on psychomotor reaction speed or cognitive performance were observed. Clinical Trials Registration: Clinicaltrials.gov: NCT01130948. Citation: Latshang TD; Lo Cascio CM; Stöwhas AC

  1. Tryptophan-enriched cereal intake improves nocturnal sleep, melatonin, serotonin, and total antioxidant capacity levels and mood in elderly humans.

    PubMed

    Bravo, R; Matito, S; Cubero, J; Paredes, S D; Franco, L; Rivero, M; Rodríguez, A B; Barriga, C

    2013-08-01

    Melatonin and serotonin rhythms, which exhibit a close association with the endogenous circadian component of sleep, are attenuated with increasing age. This decrease seems to be linked to sleep alterations in the elderly. Chrononutrition is a field of chronobiology that establishes the principle of consuming foodstuffs at times of the day when they are more useful for health, improving, therefore, biorhythms and physical performance. Our aim was to analyze whether the consumption of cereals enriched with tryptophan, the precursor of both serotonin and melatonin, may help in the reconsolidation of the sleep/wake cycle and counteract depression and anxiety in 35 middle-aged/elderly (aged 55-75 year) volunteers in a simple blind assay. Data were collected for 3 weeks according to the following schedule: The control week participants consumed standard cereals (22.5 mg tryptophan in 30 g cereals per dose) at breakfast and dinner; for the treatment week, cereals enriched with a higher dose of tryptophan (60 mg tryptophan in 30 g cereals per dose) were eaten at both breakfast and dinner; the posttreatment week volunteers consumed their usual diet. Each participant wore a wrist actimeter that logged activity during the whole experiment. Urine was collected to analyze melatonin and serotonin urinary metabolites and to measure total antioxidant capacity. The consumption of cereals containing the higher dose in tryptophan increased sleep efficiency, actual sleep time, immobile time, and decreased total nocturnal activity, sleep fragmentation index, and sleep latency. Urinary 6-sulfatoxymelatonin, 5-hydroxyindoleacetic acid levels, and urinary total antioxidant capacity also increased respectively after tryptophan-enriched cereal ingestion as well as improving anxiety and depression symptoms. Cereals enriched with tryptophan may be useful as a chrononutrition tool for alterations in the sleep/wake cycle due to age.

  2. The implications of sleep disruption for cognitive and affective processing in methamphetamine abuse.

    PubMed

    Lipinska, Gosia; Timol, Ridwana; Thomas, Kevin G F

    2015-12-01

    Sleep is disrupted during active use of methamphetamine (MA), during withdrawal from the drug, and during abstinence from its use. However, relatively little is known about possible mediatory functions of disrupted sleep in the emergence, manifestation, and maintenance of cognitive and affective symptoms of MA abuse. We hypothesise that sleep functions as a mediator for stimulant drug effects. Specifically, we propose that objectively-measured sleep parameters can be used to explain some of the variability in the experience and presentation of memory deficits and emotion dysregulation in MA abusers. After describing how important healthy sleep is to unimpaired cognitive and affective functioning, we review literature describing how sleep is disrupted in MA abuse. Then, we provide a conceptual framework for our hypothesis by explaining the relationship between MA abuse, sleep disruption, memory deficits, emotion dysregulation, and changes in reward-related brain networks. We conclude by discussing implications of the hypothesis for research and treatment.

  3. Characterisation of the effects of caffeine on sleep in the rat: a potential model of sleep disruption.

    PubMed

    Paterson, L M; Wilson, S J; Nutt, D J; Hutson, P H; Ivarsson, M

    2009-07-01

    Caffeine is known to disrupt sleep and its administration to human subjects has been used to model sleep disruption. We previously showed that its effects on sleep onset latency are comparable between rats and humans. This study evaluated the potential use of caffeine as a model of sleep disruption in the rat, by assessing its effects on sleep architecture and electroencephalogram (EEG) frequency spectrum, and using sleep-promoting drugs to reverse these effects. Rats were implanted with radiotelemetry devices for body temperature, EEG, electromyogram and locomotor activity. Following recovery, animals were dosed with caffeine (10 mg/kg) alone or in combination with zolpidem (10 mg/kg) or trazodone (20 mg/kg). Sleep was scored for the subsequent 12 h using automated analysis software. Caffeine dose-dependently disrupted sleep: it increased WAKE time, decreased NREM (non-REM) sleep time and NREM bout duration (but not bout number), and decreased delta activity in NREM sleep. It also dose-dependently increased locomotor activity and body temperature. When given alone, zolpidem suppressed REM whilst trazodone increased NREM sleep time at the expense of WAKE, increased NREM bout duration, increased delta activity in NREM sleep and reduced body temperature. In combination, zolpidem attenuated caffeine's effects on WAKE, whilst trazodone attenuated its effects on NREM sleep, NREM bout duration, delta activity, body temperature and locomotor activity. Caffeine administration produced many of the signs of insomnia that were improved by two of its most successful current treatments. This model may therefore be useful in the study of new drugs for the treatment of sleep disturbance.

  4. Daytime Sleepiness, Performance, Mood, Nocturnal Sleep: The Effect of Benzodiazepine and Caffeine on Their Relationship

    DTIC Science & Technology

    1989-03-01

    recovery oversleeping . Sleep 1981, 4:83-92. 19. Valley V, and Broughton R. Daytime performance deficit and physiolog- ical vigilance in untreated...Mancuso J, Keenan S, Littell V, Dement VC. Sleepiness following oversleeping . Sleep Res 1986, 15:70. 29. Carskadon MA, and Dement WC. The Multiple Sleep

  5. The dark side of street lighting: impacts on moths and evidence for the disruption of nocturnal pollen transport.

    PubMed

    Macgregor, Callum J; Evans, Darren M; Fox, Richard; Pocock, Michael J O

    2017-02-01

    Among drivers of environmental change, artificial light at night is relatively poorly understood, yet is increasing on a global scale. The community-level effects of existing street lights on moths and their biotic interactions have not previously been studied. Using a combination of sampling methods at matched-pairs of lit and unlit sites, we found significant effects of street lighting: moth abundance at ground level was halved at lit sites, species richness was >25% lower, and flight activity at the level of the light was 70% greater. Furthermore, we found that 23% of moths carried pollen of at least 28 plant species and that there was a consequent overall reduction in pollen transport at lit sites. These findings support the disruptive impact of lights on moth activity, which is one proposed mechanism driving moth declines, and suggest that street lighting potentially impacts upon pollination by nocturnal invertebrates. We highlight the importance of considering both direct and cascading impacts of artificial light.

  6. Environmental disruption of the circadian clock leads to altered sleep and immune responses in mouse.

    PubMed

    Phillips, Derrick J; Savenkova, Marina I; Karatsoreos, Ilia N

    2015-07-01

    In mammals, one of the most salient outputs of the circadian (daily) clock is the timing of the sleep-wake cycle. Modern industrialized society has led to a fundamental breakdown in the relationship between our endogenous timekeeping systems and the solar day, disrupting normal circadian rhythms. We have argued that disrupted circadian rhythms could lead to changes in allostatic load, and the capacity of organisms to respond to other environmental challenges. In this set of studies, we apply a model of circadian disruption characterized in our lab in which mice are housed in a 20h long day, with 10h of light and 10h of darkness. We explored the effects of this environmental disruption on sleep patterns, to establish if this model results in marked sleep deprivation. Given the interaction between circadian, sleep, and immune systems, we further probed if our model of circadian disruption also alters the innate immune response to peripheral bacterial endotoxin challenge. Our results demonstrate that this model of circadian disruption does not lead to marked sleep deprivation, but instead affects the timing and quality of sleep. We also show that while circadian disruption does not lead to basal changes in the immune markers we explored, the immune response is affected, both in the brain and the periphery. Together, our findings further strengthen the important role of the circadian timing system in sleep regulation and immune responses, and provide evidence that disrupting the circadian clock increases vulnerability to further environmental stressors, including immunological challenges.

  7. Dietary Carbohydrate and Nocturnal Sleep Duration in Relation to Children's BMI: Findings from the IDEFICS Study in Eight European Countries.

    PubMed

    Hunsberger, Monica; Mehlig, Kirsten; Börnhorst, Claudia; Hebestreit, Antje; Moreno, Luis; Veidebaum, Toomas; Kourides, Yiannis; Siani, Alfonso; Molnar, Dénes; Sioen, Isabelle; Lissner, Lauren

    2015-12-08

    Previous research has found an association between being overweight and short sleep duration. We hypothesized that this association could be modified by a high carbohydrate (HC) diet and that the timing and type (starch or sugar) of intake may be an important factor in this context. Participants in the prospective, eight-country European study IDEFICS were recruited from September 2007 to June 2008, when they were aged two to nine years. Data on lifestyle, dietary intake and anthropometry were collected on two occasions. This study included 5944 children at baseline and 4301 at two-year follow-up. For each meal occasion (morning, midday, and evening), starch in grams and sugar in grams were divided by total energy intake (EI), and quartiles calculated. HC-starch and HC-sugar intake categories were defined as the highest quartile for each meal occasion. In a mutually adjusted linear regression model, short sleep duration as well as HC-starch in the morning were positively associated with body mass index (BMI) z-scores at baseline. HC-starch at midday was positively associated with body mass index (BMI) z-scores in children with short sleep duration, and negatively associated with BMI z-scores in those with normal sleep. After adjustment for baseline BMI z-scores, associations between total HC from starch or sugar and high BMI z-scores at two-year follow-up did not persist. Our observations offer a perspective on optimal timing for macronutrient consumption, which is known to be influenced by circadian rhythms. Reduced carbohydrate intake, especially during morning and midday meals, and following nocturnal sleep duration recommendations are two modifiable factors that may protect children from being overweight in the future.

  8. Disrupted rapid eye movement sleep predicts poor declarative memory performance in post-traumatic stress disorder.

    PubMed

    Lipinska, Malgorzata; Timol, Ridwana; Kaminer, Debra; Thomas, Kevin G F

    2014-06-01

    Successful memory consolidation during sleep depends on healthy slow-wave and rapid eye movement sleep, and on successful transition across sleep stages. In post-traumatic stress disorder, sleep is disrupted and memory is impaired, but relations between these two variables in the psychiatric condition remain unexplored. We examined whether disrupted sleep, and consequent disrupted memory consolidation, is a mechanism underlying declarative memory deficits in post-traumatic stress disorder. We recruited three matched groups of participants: post-traumatic stress disorder (n = 16); trauma-exposed non-post-traumatic stress disorder (n = 15); and healthy control (n = 14). They completed memory tasks before and after 8 h of sleep. We measured sleep variables using sleep-adapted electroencephalography. Post-traumatic stress disorder-diagnosed participants experienced significantly less sleep efficiency and rapid eye movement sleep percentage, and experienced more awakenings and wake percentage in the second half of the night than did participants in the other two groups. After sleep, post-traumatic stress disorder-diagnosed participants retained significantly less information on a declarative memory task than controls. Rapid eye movement percentage, wake percentage and sleep efficiency correlated with retention of information over the night. Furthermore, lower rapid eye movement percentage predicted poorer retention in post-traumatic stress disorder-diagnosed individuals. Our results suggest that declarative memory consolidation is disrupted during sleep in post-traumatic stress disorder. These data are consistent with theories suggesting that sleep benefits memory consolidation via predictable neurobiological mechanisms, and that rapid eye movement disruption is more than a symptom of post-traumatic stress disorder.

  9. Sleep Disruption Medical Intervention Forecasting (SDMIF) Module for the Integrated Medical Model

    NASA Technical Reports Server (NTRS)

    Lewandowski, Beth; Brooker, John; Mallis, Melissa; Hursh, Steve; Caldwell, Lynn; Myers, Jerry

    2011-01-01

    The NASA Integrated Medical Model (IMM) assesses the risk, including likelihood and impact of occurrence, of all credible in-flight medical conditions. Fatigue due to sleep disruption is a condition that could lead to operational errors, potentially resulting in loss of mission or crew. Pharmacological consumables are mitigation strategies used to manage the risks associated with sleep deficits. The likelihood of medical intervention due to sleep disruption was estimated with a well validated sleep model and a Monte Carlo computer simulation in an effort to optimize the quantity of consumables. METHODS: The key components of the model are the mission parameter program, the calculation of sleep intensity and the diagnosis and decision module. The mission parameter program was used to create simulated daily sleep/wake schedules for an ISS increment. The hypothetical schedules included critical events such as dockings and extravehicular activities and included actual sleep time and sleep quality. The schedules were used as inputs to the Sleep, Activity, Fatigue and Task Effectiveness (SAFTE) Model (IBR Inc., Baltimore MD), which calculated sleep intensity. Sleep data from an ISS study was used to relate calculated sleep intensity to the probability of sleep medication use, using a generalized linear model for binomial regression. A human yes/no decision process using a binomial random number was also factored into sleep medication use probability. RESULTS: These probability calculations were repeated 5000 times resulting in an estimate of the most likely amount of sleep aids used during an ISS mission and a 95% confidence interval. CONCLUSIONS: These results were transferred to the parent IMM for further weighting and integration with other medical conditions, to help inform operational decisions. This model is a potential planning tool for ensuring adequate sleep during sleep disrupted periods of a mission.

  10. Quantity and quality of nocturnal sleep affect morning glucose measurement in acutely burned children.

    PubMed

    Mayes, Theresa; Gottschlich, Michele M; Khoury, Jane; Simakajornboon, Narong; Kagan, Richard J

    2013-01-01

    Hyperglycemia after severe burn injury has long been recognized, whereas sleep deprivation after burns is a more recent finding. The postburn metabolic effects of poor sleep are not clear despite reports in other populations demonstrating the association between sleep insufficiency and deleterious endocrine consequences. The aim of this study was to determine whether a relationship between sleep and glucose dynamics exists in acutely burned children. Two overnight polysomnography runs (2200 to 0600) per subject were conducted in 40 patients with a mean (± SEM) age of 9.4 ± 0.7 years, 50.1 ± 2.9% TBSA burn, and 43.2 ± 3.6% full-thickness injury. Serum glucose was drawn in the morning (0600) immediately after the sleep test. Insulin requirements during the 24-hour period preceding the 0600 glucose measurement were recorded. Generalized linear models were used by the authors to evaluate percent time in each stage of sleep, percent wake time, total sleep time, sleep efficiency, and morning serum glucose, accounting for insulin use. Increased time awake (P = .04, linear; P = .02, quadratic) and reduced time spent in stage 1 sleep (P = .03, linear) were associated with higher glucose levels. Sleep efficiency (P = .01, linear; P = .02, quadratic) and total sleep time (P = .01 linear; P = .02, quadratic) were inversely associated with glucose level. Morning glucose levels appear to be affected by the quality and quantity of overnight sleep in children who have sustained extensive burn injuries. Future research is needed to elucidate the metabolic and neuroendocrine consequences of sleep deprivation on metabolism after burns.

  11. "Nocturnal seizures" in idiopathic pulmonary arterial hypertension.

    PubMed

    Izzo, Anthony; McSweeney, Julia; Kulik, Thomas; Khatwa, Umakanth; Kothare, Sanjeev V

    2013-10-15

    The usual differential diagnoses of nocturnal events in children include parasomnias, nocturnal seizures, nocturnal reflux (Sandifer syndrome), hypnic jerks, periodic limb movements of sleep, and sleep disordered breathing. We report a previously healthy young girl who presented to the sleep clinic for evaluation of nocturnal events which were diagnosed as medically refractory nocturnal seizures. It was not until a syncopal event occurred in the daytime, which prompted referral for cardiac evaluation, the diagnosis of idiopathic pulmonary arterial hyper-tension (IPAH) was made. Sleep physicians should consider IPAH in the differential diagnosis of nocturnal events in children.

  12. Adverse metabolic consequences in humans of prolonged sleep restriction combined with circadian disruption.

    PubMed

    Buxton, Orfeu M; Cain, Sean W; O'Connor, Shawn P; Porter, James H; Duffy, Jeanne F; Wang, Wei; Czeisler, Charles A; Shea, Steven A

    2012-04-11

    Epidemiological studies link short sleep duration and circadian disruption with higher risk of metabolic syndrome and diabetes. We tested the hypotheses that prolonged sleep restriction with concurrent circadian disruption, as can occur in people performing shift work, impairs glucose regulation and metabolism. Healthy adults spent >5 weeks under controlled laboratory conditions in which they experienced an initial baseline segment of optimal sleep, 3 weeks of sleep restriction (5.6 hours of sleep per 24 hours) combined with circadian disruption (recurring 28-hour "days"), followed by 9 days of recovery sleep with circadian re-entrainment. Exposure to prolonged sleep restriction with concurrent circadian disruption, with measurements taken at the same circadian phase, decreased the participants' resting metabolic rate and increased plasma glucose concentrations after a meal, an effect resulting from inadequate pancreatic insulin secretion. These parameters normalized during the 9 days of recovery sleep and stable circadian re-entrainment. Thus, in humans, prolonged sleep restriction with concurrent circadian disruption alters metabolism and could increase the risk of obesity and diabetes.

  13. Sleep in patients with restrictive lung disease.

    PubMed

    Won, Christine H J; Kryger, Meir

    2014-09-01

    Restrictive lung disease leads to ventilatory defects and diffusion impairments. These changes may contribute to abnormal nocturnal pathophysiology, including sleep architecture disruption and impaired ventilation and oxygenation. Patients with restrictive lung disease may suffer significant daytime fatigue and dysfunction. Hypercarbia and hypoxemia during sleep may impact progression of lung disease and related symptoms. Little is known about the impact of treatment of sleep disruption on sleep quality and overall prognosis in restrictive lung disease. This review discusses the pathophysiology of sleep and comorbid sleep disorders in restrictive lung diseases including interstitial lung disease, neuromuscular disease, and obesity hypoventilation syndrome.

  14. Prevalence and mental health correlates of sleep disruption among military members serving in a combat zone.

    PubMed

    Taylor, Marcus K; Hilton, Susan M; Campbell, Justin S; Beckerley, Shiloh E; Shobe, Katharine K; Drummond, Sean P A

    2014-07-01

    Sleep disruption is an emergent military health issue, but remarkably little is known of its prevalence or comorbidities in the combat zone. This study was designed to quantify the prevalence and mental health correlates of sleep disruption among military personnel serving within a ground combat zone during Operation Enduring Freedom. This was a large, cross-sectional survey of active duty and reserve U.S. Navy personnel (N = 3,175). Self-reported sleep measures included total hours of sleep per day, total hours of sleep required to feel well-rested, difficulty falling asleep, and difficulty staying asleep. The survey also measured mental health symptoms, including post-traumatic stress symptoms, anxiety, and depression. Participants reported an average of 5.9 hours of sleep per day despite requiring on average 6.8 hours to feel well rested. More than half (56%) were classified as sleep deficient, and 67% reported 6 or fewer hours of sleep per day. Adjusted for covariates, individuals endorsing sleep disruption were at substantially elevated risk of meeting criteria for post-traumatic stress disorder, generalized anxiety disorder, and major depressive disorder. This study documents the prevalence of sleep disruption in a very large and difficult-to-access sample of military members serving in a combat zone, and details robust associations with mental health.

  15. [Continuous nocturnal automassage of an acupuncture point modifies sleep in healthy subjects].

    PubMed

    Buguet, A; Sartre, M; Le Kerneau, J

    1995-01-01

    To test the somnogenic properties of the automassage of point 7 heart of acupuncture, polygraphic night sleep was studied in six healthy volunteers (age: 27.8 +/- 1.6 years) from 23:00 h to 07:00 h. After one night of adaptation, two PEBA cones (Polyether Block Amides; Isocones) were fixed bilaterally at both points 7 heart (active application, AA) or on the back of hand (placebo application, AP). The alternate application was used 2 weeks later, using a randomized, double-blind, and cross-over protocol. Cyclic alternating patterns (CAP) were also analysed on the electroencephalogram during non-REM sleep. Sleep efficiency increased in AA, due to a decrease in wakefulness, and an increase in total sleep time due to an increase in non-REM sleep. The number of CAP decreased in AA, as did the number of CAP sequences and the ratio of CAP duration to total sleep time (CAP rate) and to the duration of slow-wave sleep. In conclusion, the application of Isocones at point 7 heart during the night induced a decrease in wakefulness and an increase in non-REM sleep during night sleep in healthy subjects.

  16. Field study on the impact of nocturnal road traffic noise on sleep: the importance of in- and outdoor noise assessment, the bedroom location and nighttime noise disturbances.

    PubMed

    Pirrera, Sandra; De Valck, Elke; Cluydts, Raymond

    2014-12-01

    The aim of this field study is to gain more insight into the way nocturnal road traffic noise impacts the sleep of inhabitants living in noisy regions, by taking into account several modifying variables. Participants were tested during five consecutive nights in their homes and comparisons between effective indoor and outdoor noise levels (LAeq, LAmax, number of noise events), sleep (actigraphy and sleep logs) and aspects of well-being (questionnaires) were made. Also, we investigated into what extent nocturnal noise exposure - objectively measured as well as perceived - directly relates to sleep outcomes and how the bedroom location influenced our measurements. We found that subjects living and sleeping in noisy regions correctly perceive their environment in terms of noise exposure and reported an overall discomfort due to traffic noise. In the evaluation of the objective noise levels, the inside noise levels did not follow the outside noise levels, though the different noise patterns could be described as characteristic for a noise and quiet environment. The impact on sleep, however, was only modest and we did not find any influence of noise intrusion on mood or pre-sleep arousal levels. Concerning the subjectively reported noise disturbances during the night, a clear relationship between noise and sleep outcomes could be established; with sleep onset latencies and judged sleep quality being particularly affected. The importance of inside and outside noise assessment as well as the use of multiple noise indicators in a home environment is further described. Additional emphasis is put on the determination of quiet control regions and the bedroom location, as this can alter noise levels and sleep outcomes. Also, including subjective noise evaluations during the night might not only provide crucial information on how participants experience the noise, but also allows for a more qualitative interpretation of the actual noise situation.

  17. Apnea-induced rapid eye movement sleep disruption impairs human spatial navigational memory.

    PubMed

    Varga, Andrew W; Kishi, Akifumi; Mantua, Janna; Lim, Jason; Koushyk, Viachaslau; Leibert, David P; Osorio, Ricardo S; Rapoport, David M; Ayappa, Indu

    2014-10-29

    Hippocampal electrophysiology and behavioral evidence support a role for sleep in spatial navigational memory, but the role of particular sleep stages is less clear. Although rodent models suggest the importance of rapid eye movement (REM) sleep in spatial navigational memory, a similar role for REM sleep has never been examined in humans. We recruited subjects with severe obstructive sleep apnea (OSA) who were well treated and adherent with continuous positive airway pressure (CPAP). Restricting CPAP withdrawal to REM through real-time monitoring of the polysomnogram provides a novel way of addressing the role of REM sleep in spatial navigational memory with a physiologically relevant stimulus. Individuals spent two different nights in the laboratory, during which subjects performed timed trials before and after sleep on one of two unique 3D spatial mazes. One night of sleep was normally consolidated with use of therapeutic CPAP throughout, whereas on the other night, CPAP was reduced only in REM sleep, allowing REM OSA to recur. REM disruption via this method caused REM sleep reduction and significantly fragmented any remaining REM sleep without affecting total sleep time, sleep efficiency, or slow-wave sleep. We observed improvements in maze performance after a night of normal sleep that were significantly attenuated after a night of REM disruption without changes in psychomotor vigilance. Furthermore, the improvement in maze completion time significantly positively correlated with the mean REM run duration across both sleep conditions. In conclusion, we demonstrate a novel role for REM sleep in human memory formation and highlight a significant cognitive consequence of OSA.

  18. Tracking Effects of Problematic Social Networking on Adolescent Psychopathology: The Mediating Role of Sleep Disruptions.

    PubMed

    Vernon, Lynette; Modecki, Kathryn L; Barber, Bonnie L

    2017-01-01

    Concerns are growing about adolescents' problematic social networking and possible links to depressed mood and externalizing behavior. Yet there remains little understanding of underlying processes that may account for these associations, including the mediating role of sleep disruption. This study tests this putative mediating process and examines change in problematic social networking investment and disrupted sleep, in relation to change in depressed mood and externalizing behavior. A sample of 874 students (41% male; 57.2% Caucasian; baseline M age = 14.4 years) from 27 high schools were surveyed. Participants' problematic social networking, sleep disruption, and psychopathology (depressed mood, externalizing behaviors) were measured annually over 3 years. Longitudinal mediation was tested using latent trajectories of problematic social networking use, sleep disruption, and psychopathology. Both problematic social networking and sleep disruption underwent positive linear growth over time. Adolescents who increasingly invested in social networking reported increased depressed mood, with around 53% of this association explained by the indirect effect of increased sleep disruptions. Further, adolescents who increasingly invested in social networking also reported increased externalizing behavior; some of this relation was explained (13%) via increased sleep disruptions. However an alternative model in which increased externalizing was associated with increased social networking, mediated by sleep disruptions, indicated a reciprocal relation of similar magnitude. It is important for parents, teachers, and psychologists to minimize the negative effects of social networking on adolescents' psychopathology. Interventions should potentially target promoting healthy sleep habits through reductions in social networking investment and rescheduling usage away from bedtime.

  19. Amygdala opioid receptors mediate the electroacupuncture-induced deterioration of sleep disruptions in epilepsy rats

    PubMed Central

    2013-01-01

    Background Clinical and experimental evidence demonstrates that sleep and epilepsy reciprocally affect each other. Previous studies indicated that epilepsy alters sleep homeostasis; in contrast, sleep disturbance deteriorates epilepsy. If a therapy possesses both epilepsy suppression and sleep improvement, it would be the priority choice for seizure control. Effects of acupuncture of Feng-Chi (GB20) acupoints on epilepsy suppression and insomnia treatment have been documented in the ancient Chinese literature, Lingshu Jing (Classic of the Miraculous Pivot). Therefore, this study was designed to investigate the effect of electroacupuncture (EA) stimulation of bilateral Feng-Chi acupoints on sleep disruptions in rats with focal epilepsy. Results Our result indicates that administration of pilocarpine into the left central nucleus of amygdala (CeA) induced focal epilepsy and decreased both rapid eye movement (REM) sleep and non-REM (NREM) sleep. High-frequency (100 Hz) EA stimulation of bilateral Feng-Chi acupoints, in which a 30-min EA stimulation was performed before the dark period of the light:dark cycle in three consecutive days, further deteriorated pilocarpine-induced sleep disruptions. The EA-induced exacerbation of sleep disruption was blocked by microinjection of naloxone, μ- (naloxonazine), κ- (nor-binaltorphimine) or δ-receptor antagonists (natrindole) into the CeA, suggesting the involvement of amygdaloid opioid receptors. Conclusion The present study suggests that high-frequency (100 Hz) EA stimulation of bilateral Feng-Chi acupoints exhibits no benefit in improving pilocarpine-induced sleep disruptions; in contrast, EA further deteriorated sleep disturbances. Opioid receptors in the CeA mediated EA-induced exacerbation of sleep disruptions in epileptic rats. PMID:24215575

  20. Nocturnal sleep in isolation-reared monkeys: evidence for enviromental independence.

    PubMed

    Reite, M; Short, R

    1977-11-01

    Thirteen all-night recordings were obtained from 3 infant pigtailed (Macaca nemestrina) monkeys raised on a cloth surrogate mother and under conditions of social isolation. Totally implantable biotelemetry systems were used to record the sleep physiology from the unrestrained animals. Sleep stages and night-to-night variability were virtually identical to values previously found in 8 mother-reared group-living infants. Sustained alterations in the early rearing enviroment, even though considerably modifying the organism's development, did not appear to result in differences in sleep organization.

  1. Living alongside railway tracks: Long-term effects of nocturnal noise on sleep and cardiovascular reactivity as a function of age.

    PubMed

    Tassi, Patricia; Rohmer, Odile; Schimchowitsch, Sarah; Eschenlauer, Arnaud; Bonnefond, Anne; Margiocchi, Florence; Poisson, Franck; Muzet, Alain

    2010-10-01

    Very few studies were devoted to permanent effects of nocturnal railway noise on sleep and cardiovascular reactivity. We investigated the effects of nocturnal railway noise on sleep and cardiovascular response in young and middle-aged adults living for many years either near a railway track or in a quiet area. Forty subjects (50% males) divided into two age groups (juniors: 26.2+/-3.6 and seniors: 56.2+/-4.2) participated in this experiment. Half of them lived near a railway track (RW group: 2.6 to 19 years) and the other half in a quiet environment (QE group: 8.1 to 14.2 years). After an adaptation night, all subjects underwent two nights in the laboratory: one control night and one noisy night (30 by-passes of a freight train). Sleep and cardiovascular modifications were assessed in response to noise. Sleep fragmentation indices were lower in RW subjects compared to QE whatever their age. In response to noise, there was a higher cardiovascular response rate to noise in RW juniors and a lower cardiovascular response rate in RW seniors compared to their age-paired QE counterparts. In conclusion, permanent exposure to nocturnal railway noise leads to decreased sleep fragmentation and to cardiovascular habituation. It is suggested that during the initial period experienced by residents living near railway tracks, nocturnal railway noise could induce a sensitization process on the autonomic response to noise reflecting a startle/defense reflex due to its functional significance, which progressively turns to habituation in the long-term if no adverse effect is experienced.

  2. Actigraphy-Measured Sleep Disruption as a Predictor of Survival among Women with Advanced Breast Cancer

    PubMed Central

    Palesh, Oxana; Aldridge-Gerry, Arianna; Zeitzer, Jamie M.; Koopman, Cheryl; Neri, Eric; Giese-Davis, Janine; Jo, Booil; Kraemer, Helena; Nouriani, Bita; Spiegel, David

    2014-01-01

    Background: Poor sleep, prevalent among cancer survivors, is associated with disrupted hormonal circadian rhythms and poor quality of life. Using a prospective research design, this study aimed to clarify the relationship between objective measures of sleep efficiency and sleep disruption with survival among women with advanced breast cancer. Method: We examined sleep quality and duration via wrist-worn actigraphy and sleep diaries for 3 days among 97 women in whom advanced breast cancer was diagnosed (age = 54.6 ± 9.8 years). Sleep efficiency was operationalized using actigraphy as the ratio of total sleep time to total sleep time plus wake after sleep onset. Results: As hypothesized, better sleep efficiency was found to predict a significant reduction in overall mortality (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.94–0.98; P < 0.001) at median 6 y follow-up. This relationship remained significant (HR, 0.94; 95% CI, 0.91–0.97; P < 0.001) even after adjusting for other known prognostic factors (age, estrogen receptor status, cancer treatment, metastatic spread, cortisol levels, and depression). Secondary hypotheses were also supported (after adjusting for baseline prognostic factors) showing that less wake after sleep onset (HR, 0.41; 95% CI, 0.25–0.67; P < 0.001), fewer wake episodes, (HR, 0.93; 95% CI, 0.88–0.98; P = 0.007); and shorter wake episode duration (HR, 0.29; 95% CI, 0.14–0.58; P < 0.001) also contributed to reductions in overall mortality. Conclusions: These findings show that better sleep efficiency and less sleep disruption are significant independent prognostic factors in women with advanced breast cancer. Further research is needed to determine whether treating sleep disruption with cognitive behavioral and/or pharmacologic therapy could improve survival in women with advanced breast cancer. Citation: Palesh O, Aldridge-Gerry A, Zeitzer JM, Koopman C, Neri E, Giese-Davis J, Jo B, Kraemer H, Nouriani B, Spiegel D

  3. Nocturnal oximetry for the diagnosis of the sleep apnoea hypopnoea syndrome: a method to reduce the number of polysomnographies?

    PubMed Central

    Chiner, E.; Signes-Costa, J.; Arriero, J. M.; Marco, J.; Fuentes, I.; Sergado, A.

    1999-01-01

    BACKGROUND—Polysomnography (PSG) is currently the "gold standard" for the diagnosis of the sleep apnoea hypopnoea syndrome (SAHS). Nocturnal oximetry (NO) has been used with contradictory results. A prospective study was performed to determine the accuracy of NO as a diagnostic tool and to evaluate the reduction in the number of PSGs if the diagnosis of SAHS had been established by this method.
METHODS—Two hundred and seventy five patients with a clinical suspicion of SAHS were admitted to undergo, in the same night, full PSG and NO. Desaturation was defined as a fall in the haemoglobin saturation level (SaO2) to lower than 4% from the baseline level and an oxygen desaturation index per hour (ODI) was obtained in each patient with three cut off points: ⩾5 (ODI-5), ⩾10 (ODI-10), and ⩾15 (ODI-15).
RESULTS—SAHS was diagnosed in 216 patients (194 men). After withdrawing patients with abnormal lung function (forced expiratory volume in one second (FEV1) lower than 80% predicted), sensitivity (SE), specificity (SP), positive and negative predictive values (PPV and NPV) of NO were: ODI-5 (80%, 89%, 97%, 48%); ODI-10 (71%, 93%, 97%, 42%); ODI-15 (63%, 96%, 99%, 38%). The accuracy for each ODI was 0.81, 0.75, and 0.70, respectively. If NO had been considered as a diagnostic tool and PSG had been performed only in patients with a negative NO (false negative and true negative) and those with a positive NO and abnormal pulmonary function tests, 135/275 (ODI-5), 156/275 (ODI-10), and 170/275 (ODI-15) PSGs would have been performed, a reduction of 140, 119, and 105,respectively.
CONCLUSION—Nocturnal oximetry in patients with suspected SAHS and normal spirometric values permits the institution of therapeutic measures in most patients.

 PMID:10525553

  4. [Sleep/wake cycle, circadian disruption and the development of obesity].

    PubMed

    Masaki, Takayuki

    2012-07-01

    It is increasingly recognized that obesity is an important health problem. The mechanisms that underlie obesity have not been fully elucidated, and effective therapeutic approaches are currently of general interest. Recent studies have provided evidence that circadian clock is a crucial factor in the development of obesity and related metabolic disease. Genetic disruption of clock genes in mice displayed metabolic dysfunctions of specific tissues at distinct phases of the sleep/wake cycle. In addition, circadian desynchrony, a characteristic of shift work and short sleep, are associated with obesity in human. Here, I describe the advances in understanding the interrelationship among circadian disruption, sleep deprivation and obesity.

  5. Sleep Disturbances Associated with Parkinson's Disease

    PubMed Central

    Suzuki, Keisuke; Miyamoto, Masayuki; Miyamoto, Tomoyuki; Iwanami, Masaoki; Hirata, Koichi

    2011-01-01

    Sleep disturbances are common problems affecting the quality life of Parkinson's disease (PD) patients and are often underestimated. The causes of sleep disturbances are multifactorial and include nocturnal motor disturbances, nocturia, depressive symptoms, and medication use. Comorbidity of PD with sleep apnea syndrome, restless legs syndrome, rapid eye movement sleep behavior disorder, or circadian cycle disruption also results in impaired sleep. In addition, the involvement of serotoninergic, noradrenergic, and cholinergic neurons in the brainstem as a disease-related change contributes to impaired sleep structures. Excessive daytime sleepiness is not only secondary to nocturnal disturbances or dopaminergic medication but may also be due to independent mechanisms related to impairments in ascending arousal system and the orexin system. Notably, several recent lines of evidence suggest a strong link between rapid eye movement sleep behavior disorder and the risk of neurodegenerative diseases such as PD. In the present paper, we review the current literature concerning sleep disorders in PD. PMID:21876839

  6. Assessment of Sleep Disruption and Sleep Quality in Naval Special Warfare Operators.

    PubMed

    Harris, Erica; Taylor, Marcus K; Drummond, Sean P A; Larson, Gerald E; Potterat, Eric G

    2015-07-01

    Little is known about sleep in elite military populations who are exposed to higher operational demands, unpredictable training, deployment, and mission cycles. Twenty-nine Naval Special Warfare (NSW) Operators wore an actiwatch for an 8-day/7-night period for objective sleep assessment and completed a nightly sleep log. A total of 170 nights of actigraphically recorded sleep were collected. When comparing objectively versus subjectively recorded sleep parameter data, statistically significant differences were found. Compared with sleep log data, actigraphy data indicate NSW Operators took longer to fall asleep (an average of 25.82 minutes), spent more time awake after sleep onset (an average of 39.55 minutes), and demonstrated poorer sleep efficiency (83.88%) (ps < 0.05). Self-reported sleep quality during the study period was 6.47 (maximum score = 10). No relationships existed between the objectively derived sleep indices and the self-reported measure of sleep quality (rs = -0.29 to 0.09, all ps > 0.05). Strong inter-relationships existed among the subjectively derived sleep indices (e.g., between self-reported sleep quality and sleep efficiency; r = 0.61, p < 0.001). To our knowledge, this is the first study to objectively and subjectively quantify sleep among NSW Operators. These findings suggest sleep maintenance and sleep efficiency are impaired when compared to normative population data.

  7. Brief light stimulation during the mouse nocturnal activity phase simultaneously induces a decline in core temperature and locomotor activity followed by EEG-determined sleep.

    PubMed

    Studholme, Keith M; Gompf, Heinrich S; Morin, Lawrence P

    2013-03-15

    Light exerts a variety of effects on mammals. Unexpectedly, one of these effects is the cessation of nocturnal locomotion and the induction of behavioral sleep (photosomnolence). Here, we extend the initial observations in several ways, including the fundamental demonstration that core body temperature (T(c)) drops substantially (about 1.5°C) in response to the light stimulation at CT15 or CT18 in a manner suggesting that the change is a direct response to light rather than simply a result of the locomotor suppression. The results show that 1) the decline of locomotion and T(c) begin soon after nocturnal light stimulation; 2) the variability in the magnitude and onset of light-induced locomotor suppression is very large, whereas the variability in T(c) is very small; 3) T(c) recovers from the light-induced decline in advance of the recovery of locomotion; 4) under entrained and freerunning conditions, the daily late afternoon T(c) increase occurs in advance of the corresponding increase in wheel running; and 5) toward the end of the subjective night, the nocturnally elevated T(c) persists longer than does locomotor activity. Finally, EEG measurements confirm light-induced sleep and, when T(c) or locomotion was measured, show their temporal association with sleep onset. Both EEG- and immobility-based sleep detection methods confirm rapid induction of light-induced sleep. The similarities between light-induced loss of locomotion and drop in T(c) suggest a common cause for parallel responses. The photosomnolence response may be contingent upon both the absence of locomotion and a simultaneous low T(c).

  8. Brief light stimulation during the mouse nocturnal activity phase simultaneously induces a decline in core temperature and locomotor activity followed by EEG-determined sleep

    PubMed Central

    Studholme, Keith M.; Gompf, Heinrich S.

    2013-01-01

    Light exerts a variety of effects on mammals. Unexpectedly, one of these effects is the cessation of nocturnal locomotion and the induction of behavioral sleep (photosomnolence). Here, we extend the initial observations in several ways, including the fundamental demonstration that core body temperature (Tc) drops substantially (about 1.5°C) in response to the light stimulation at CT15 or CT18 in a manner suggesting that the change is a direct response to light rather than simply a result of the locomotor suppression. The results show that 1) the decline of locomotion and Tc begin soon after nocturnal light stimulation; 2) the variability in the magnitude and onset of light-induced locomotor suppression is very large, whereas the variability in Tc is very small; 3) Tc recovers from the light-induced decline in advance of the recovery of locomotion; 4) under entrained and freerunning conditions, the daily late afternoon Tc increase occurs in advance of the corresponding increase in wheel running; and 5) toward the end of the subjective night, the nocturnally elevated Tc persists longer than does locomotor activity. Finally, EEG measurements confirm light-induced sleep and, when Tc or locomotion was measured, show their temporal association with sleep onset. Both EEG- and immobility-based sleep detection methods confirm rapid induction of light-induced sleep. The similarities between light-induced loss of locomotion and drop in Tc suggest a common cause for parallel responses. The photosomnolence response may be contingent upon both the absence of locomotion and a simultaneous low Tc. PMID:23364525

  9. Heart rate variability in cyclic alternating pattern during sleep in healthy and Nocturnal Front Lobe Epilepsy patients.

    PubMed

    Dorantes, Guadalupe; Méndez, Martín; Alba, Alfonso; Gonzaáez, J S; Parrino, Liborio; Milioli, G

    2015-01-01

    The aim of this paper is to assess heart rate variability (HRV) during the cyclic alternating pattern, which is a sleep phenomenon, composed by cortical events that interrupt the basal oscillation of the NREM sleep stage. These cortical events are called A-phases and classified into three subtypes: A1, A2, A3. In addition, a comparison between healthy and Nocturnal Front Lobe Epilepsy (NFLE) patients was carried out. HRV was assessed by means of a time-varying autoregressive (TVAR) model with an adaptive filtering prediction scheme and by the time-varying square root of the mean of the sum of the squares of differences (RMSSD) of the RR intervals. For each A-phase, two signal segments were evaluated, the first one before the onset of the A-phase and the second one after the onset of the A-phase. An increase in the sympathetic outflow was suggested by higher values of low-frequency (LF) power in the three A-phases after the onset of A-phases, where A3-phases showed the largest changes. Increases in LF power were related with increases in heart rate in the same signal segments. These differences were found in both healthy and NFLE patients. LF/HF ratio and normalized LF power in A1-phases resulted significantly higher in NFLE patients in comparison with healthy subjects, which could suggest that there is a shift in the sympatho-vagal balance towards a more sympathetically mediated control of heart rate involving A1-phases in NFLE patients.

  10. Are Absence Epilepsy and Nocturnal Frontal Lobe Epilepsy System Epilepsies of the Sleep/Wake System?

    PubMed Central

    Halász, Péter

    2015-01-01

    System epilepsy is an emerging concept interpreting major nonlesional epilepsies as epileptic dysfunctions of physiological systems. I extend here the concept of reflex epilepsy to epilepsies linked to input dependent physiological systems. Experimental and clinical reseach data were collected to create a coherent explanation of underlying pathomechanism in AE and NFLE. We propose that AE should be interpreted as epilepsy linked to the corticothalamic burst-firing mode of NREM sleep, released by evoked vigilance level oscillations characterized by reactive slow wave response. In the genetic variation of NFLE the ascending cholinergic arousal system plays an essential role being in strong relationship with a gain mutation of the nicotinic acethylcholin receptors, rendering the arousal system hyperexcitable. I try to provide a more unitary interpretation for the variable seizure manifestation integrating them as different degree of pathological arosuals and alarm reactions. As a supporting hypothesis the similarity between arousal parasomnias and FNLE is shown, underpinned by overlaping pathomechanism and shared familiarity, but without epileptic features. Lastly we propose that both AE and NFLE are system epilepsies of the sleep-wake system representing epileptic disorders of the antagonistic sleep/arousal network. This interpretation may throw new light on the pathomechanism of AE and NFLE. PMID:26175547

  11. Cross approximate entropy analysis of nocturnal oximetry signals in the diagnosis of the obstructive sleep apnea syndrome.

    PubMed

    Alvarez, Daniel; Hornero, Roberto; Garcia, Mariá; del Campo, Felix; Zamarron, Carlos; López, Miguel

    2006-01-01

    This study is focused on the analysis of blood oxygen saturation (SaO(2)) and heart rate (HR) from nocturnal oximetry using cross approximate entropy (Cross-ApEn). We assessed its usefulness in screening obstructive sleep apnea (OSA) syndrome. We applied Cross-ApEn(m,r,N) to quantify the asynchrony between paired SaO(2) and HR records of 74 patients (44 with a positive OSA diagnosis and 30 with a negative OSA diagnosis). Cross-ApEn values were significantly lower in the OSA positive group compared with those obtained in the OSA negative group. A receiver operating characteristic (ROC) analysis showed that the best results, in terms of diagnostic accuracy, were achieved with m = 2 and r = 0.6. With these input parameters, the optimum decision threshold was found at 1.7, where we achieved 95.5% sensitivity, 73.3% specificity and 86.5% accuracy. Further analyses should be carried out with new and larger data sets to test the usefulness of our methodology prospectively.

  12. Sleep in the ICU: potential mechanisms and clinical implications.

    PubMed

    Hardin, Kimberly A

    2009-07-01

    Patients in the ICU are known to have severely disrupted sleep with disturbed circadian pattern, decreased nocturnal sleep time, abnormally increased stages 1 and 2 sleep, and reduced or absent deep sleep. Recent data reveal that a subpopulation of critically ill patients manifests unique EEG sleep patterns. The etiology of sleep disruption in the ICU includes the inherent nature of the environment, medications, ventilator-patient interaction, and the effect of acute illness. How sleep disruption contributes to outcomes in critically ill patients, such as recovery time and weaning from mechanical ventilation, is unknown. This article reviews the literature describing sleep in ICU patients, including recent investigations in patients who require mechanical ventilation, factors that affect sleep in critically ill patients, and the potential mechanisms and clinical implications of disturbed sleep in the ICU setting with directions to consider for future investigations.

  13. A Preliminary Study of New Parents, Sleep Disruption, and Driving: A Population at Risk?

    PubMed Central

    Malish, Sterling; Arastu, Fatema; O’Brien, Louise M.

    2015-01-01

    Background Drowsy driving is estimated to be a causal factor in 2–16% of vehicular crashes. Several populations are reported to be at high risk for drowsy driving accidents, including shift workers, teenage drivers, medical residents, and pilots. Although new parents are known to have significant sleep disruption, no study has investigated vehicular accidents or near miss accidents in this population. Methods A preliminary cross-sectional, anonymous survey of parents who had given birth within the previous 12 months. Participants were asked about their sleep, including validated measures of sleep disruption, their driving patterns, and information about near miss traffic accidents and actual crashes. Results Overall, 72 participants were enrolled. A large proportion of participants had poor sleep including approximately 30% with daytime sleepiness, 60% with poor daytime function and two-thirds with poor sleep quality. The mean sleep duration was only 6.4 hours. Although most participants drove <100 miles per week, 22.2% reported at least one near miss accident and 5.6% reported a crash. Sleep problems were more common in those with near miss accidents and actual crashes than in those without. Of note, poor sleep quality was associated with a 6-fold increase in near miss accidents even after accounting for other factors. Conclusion Poor sleep is common in new parents and we provide preliminary evidence that sleep disruption in this population is associated with near miss motor vehicle accidents. Drowsy driving results in thousands of unnecessary serious injuries and fatalities each year; raising public awareness that new parents are a high-risk group is important. PMID:26541593

  14. Major disruptions of sleep during treatment of the opiate withdrawal syndrome: differences between methadone and lofexidine detoxification treatments.

    PubMed

    Beswick, Tracy; Best, David; Rees, Sian; Bearn, Jenny; Gossop, Michael; Strang, John

    2003-03-01

    Sleep disturbance experienced during methadone or lofexidine opiate detoxification was investigated in 118 opiate-dependent patients receiving inpatient detoxification treatment. Sleep was assessed at four time-points during opiate detoxification using a self-report questionnaire. Maximum sleep disruption occurred at completion of detoxification and during the protracted withdrawal period, with patients in the methadone group reporting higher levels of withdrawal symptoms, lower overall sleep, longer sleep latencies and significantly longer periods of time awake than lofexidine patients. Regression analyses demonstrated a significant relationship between sleep disturbance, protracted withdrawal and retention in treatment, in addition to the major treatment benefit of reduced sleep disturbance conferred by lofexidine treatment.

  15. Sleep Loss and the Inflammatory Response in Mice Under Chronic Environmental Circadian Disruption

    PubMed Central

    Castanon-Cervantes, Oscar; Natarajan, Divya; Delisser, Patrick; Davidson, Alec J.; Paul, Ketema N.

    2013-01-01

    Shift work and trans-time zone travel lead to insufficient sleep and numerous pathologies. Here, we examined sleep/wake dynamics during chronic exposure to environmental circadian disruption (ECD), and if chronic partial sleep loss associated with ECD influences the induction of shift-related inflammatory disorder. Sleep and wakefulness were telemetrically recorded across three months of ECD, in which the dark-phase of a light-dark cycle was advanced weekly by 6 h. A three month regimen of ECD caused a temporary reorganization of sleep (NREM and REM) and wake processes across each week, resulting in an approximately 10% net loss of sleep each week relative to baseline levels. A separate group of mice were subjected to ECD or a regimen of imposed wakefulness (IW) aimed to mimic sleep amounts under ECD for one month. Fos-immunoreactivity (IR) was quantified in sleep-wake regulatory areas: the nucleus accumbens (NAc), basal forebrain (BF), and medial preoptic area (MnPO). To assess the inflammatory response, trunk blood was treated with lipopolysaccharide (LPS) and subsequent release of IL-6 was measured. Fos-IR was greatest in the NAc, BF, and MnPO of mice subjected to IW. The inflammatory response to LPS was elevated in mice subjected to ECD, but not mice subjected to IW. Thus, the net sleep loss that occurs under ECD is not associated with a pathological immune response. PMID:23696854

  16. Maternal Ube3a Loss Disrupts Sleep Homeostasis But Leaves Circadian Rhythmicity Largely Intact

    PubMed Central

    Ehlen, J. Christopher; Jones, Kelly A.; Pinckney, Lennisha; Gray, Cloe L.; Burette, Susan; Weinberg, Richard J.; Evans, Jennifer A.; Brager, Allison J.; Zylka, Mark J.

    2015-01-01

    mechanisms underlying sleep disruptions in AS. Here we demonstrate that abnormal sleep patterns arise from a deficit in accumulation of sleep drive, uncovering the Ube3a gene as a novel genetic regulator of sleep homeostasis. Our findings encourage a re-evaluation of current treatment strategies for sleep dysfunction in AS, and suggest that interventions that promote increased sleep drive may alleviate sleep disturbances in individuals with AS. PMID:26446213

  17. Characterization of Maze Performance in Adrenalectomized Sleep Disrupted Rats: A Comparison of Radial Arm Maze Performance between Adrenalectomized and Sham Adrenalectomized Sleep Disrupted Rats

    DTIC Science & Technology

    2007-01-01

    each of the four final trials. Surgical Protocols 1. Venous jugular catheterization : Following induction an adequate level of anesthesia with IP...sleep disruption performances were compared. In addition, animals were implanted with a venous jugular catheter and sampled over a 36 hour period which...In addition, animals were implanted with a venous jugular catheter, and sampled over a 36 hour period which included 12 hours of baseline, 12

  18. Adolescent Problematic Social Networking and School Experiences: The Mediating Effects of Sleep Disruptions and Sleep Quality.

    PubMed

    Vernon, Lynette; Barber, Bonnie L; Modecki, Kathryn L

    2015-07-01

    An important developmental task for adolescents is to become increasingly responsible for their own health behaviors. Establishing healthy sleep routines and controlling media use before bedtime are important for adequate, quality sleep so adolescents are alert during the day and perform well at school. Despite the prevalence of adolescent social media use and the large percentage of computers and cell phones in adolescents' bedrooms, no studies to date have investigated the link between problematic adolescent investment in social networking, their sleep practices, and associated experiences at school. A sample of 1,886 students in Australia aged between 12 and 18 years of age completed self-report data on problematic social networking use, sleep disturbances, sleep quality, and school satisfaction. Structural equation modeling (SEM) substantiated the serial mediation hypothesis: for adolescents, problematic social networking use significantly increased sleep disturbances, which adversely affected perceptions of sleep quality that, in turn, lowered adolescents' appraisals of their school satisfaction. This significant pattern was largely driven by the indirect effect of sleep disturbances. These findings suggest that adolescents are vulnerable to negative consequences from social networking use. Specifically, problematic social networking is associated with poor school experiences, which result from poor sleep habits. Promoting better sleep routines by minimizing sleep disturbances from social media use could improve school experiences for adolescents with enhanced emotional engagement and improved subjective well-being.

  19. Insomnia and sleep disruption: relevance for athletic performance.

    PubMed

    Leger, Damien; Metlaine, Arnaud; Choudat, Dominique

    2005-04-01

    Insomnia is a common sleep complaint even in young adults and has important daytime consequences. Several subjective and objective tools are recommended to assess the magnitude of the problem and to try to find a cause. Chronic insomnia is often caused by precipitating factors, such as acute stress, work conditions, illness, and travel, and perpetuating factors, such as poor sleep hygiene, anxiety, and medications. Insomnia may have implications in athletic performance resulting from physical and cognitive effects. Several pharmacologic and nonpharmacologic approaches are employed in the management of insomnia that have proven effective for short-term treatment. The pharmacologic approaches include the use of zolpidem and specific GABA agonists, benzodiazepines for specific indications, antidepressants, and melatonin. The nonpharmacologic approaches include stimulus control, sleep restriction, relaxation strategies, and cognitive behavioral therapy.

  20. Prevalence and Mental Health Correlates of Sleep Disruption Among Military Members Serving in a Combat Zone

    DTIC Science & Technology

    2014-07-01

    asleep, and difficulty staying asleep. The survey also measured mental health symptoms, including post-traumatic stress symptoms, anxiety, and...disruption were at substantially elevated risk of meeting criteria for post-traumatic stress disorder, generalized anxiety disorder, and major depressive...respect to behavioral health, sleep disruption is also consistently linked to psychiatric sym ptom s,7 post- traum atic stress disorder (PTSD),8

  1. Aligning work and circadian time in shift workers improves sleep and reduces circadian disruption.

    PubMed

    Vetter, Céline; Fischer, Dorothee; Matera, Joana L; Roenneberg, Till

    2015-03-30

    Sleep loss and circadian disruption-a state of misalignment between physiological functions and imposed sleep/wake behavior-supposedly play central roles in the etiology of shift work-related pathologies [1-4]. Circadian entrainment is, however, highly individual [5], resulting in different chronotypes [6, 7]. Chronotype in turn modulates the effects of working times: compared to late chronotypes, earlier ones sleep worse and shorter and show higher levels of circadian misalignment during night shifts, while late types experience more sleep and circadian disruption than early types when working morning shifts [8]. To promote sleep and reduce the mismatch between circadian and working time, we implemented a chronotype-adjusted (CTA) shift schedule in a factory. We abolished the most strenuous shifts for extreme chronotypes (i.e., mornings for late chronotypes, nights for early ones) and examined whether sleep duration and quality, social jetlag [9, 10], wellbeing, subjective stress perception, and satisfaction with leisure time improved in this schedule. Intermediate chronotypes (quartiles 2 and 3) served as a control group, still working morning (6:00-14:00), evening (14:00-22:00), and night (22:00-6:00) shifts, with two strenuous shifts (out of twelve per month) replaced by evening ones. We observed a significant increase of self-reported sleep duration and quality, along with increased wellbeing ratings on workdays among extreme chronotypes. The CTA schedule reduced overall social jetlag by 1 hr, did not alter stress levels, and increased satisfaction with leisure time (early types only). Chronotype-based schedules thus can reduce circadian disruption and improve sleep; potential long-term effects on health and economic indicators need to be elucidated in future studies.

  2. A personal light-treatment device for improving sleep quality in the elderly: dynamics of nocturnal melatonin suppression at two exposure levels.

    PubMed

    Figueiro, Mariana G; Bierman, Andrew; Bullough, John D; Rea, Mark S

    2009-05-01

    Light treatment has been used as a non-pharmacological tool to help mitigate poor sleep quality frequently found in older people. In order to increase compliance to non-pharmacological light treatments, new, more efficacious light-delivery systems need to be developed. A prototype personal light-treatment device equipped with low brightness blue light-emitting diodes (LEDs) (peak wavelength near 470 nm) was tested for its effectiveness in suppressing nocturnal melatonin, a measure of circadian stimulation. Two levels of corneal irradiance were set to deliver two prescribed doses of circadian light exposure. Eleven older subjects, between 51 and 80 yrs of age who met the selection criteria, were exposed to a high and a low level of light for 90 min on separate nights from the personal light-treatment device. Blood and saliva samples were collected at prescribed times for subsequent melatonin assay. After 1 h of light exposure, the light-induced nocturnal melatonin suppression level was about 35% for the low-light level and about 60% for the high-light level. The higher level of blue light suppressed melatonin more quickly, to a greater extent over the course of the 90 min exposure period, and maintained suppression after 60 min. The constant exposure of the low-light level resulted in a decrease in nocturnal melatonin suppression for the last sampling time, whereas for the high-light level, suppression continued throughout the entire exposure period. The present study performed with healthy adults suggests that the tested personal light-treatment device might be a practical, comfortable, and effective way to deliver light treatment to those suffering from circadian sleep disorders; however, the acceptance and effectiveness of personal light-treatment devices by older people and by other segments of the population suffering from sleep disorders in a real-life situation need to be directly tested.

  3. Depressant Effects of Salvia divinorum Involve Disruption of Physiological Sleep.

    PubMed

    González-Trujano, María Eva; Brindis, Fernando; López-Ruiz, Edith; Ramírez-Salado, Ignacio; Martínez, Adrián; Pellicer, Francisco

    2016-07-01

    Although Salvia divinorum is traditionally known as a 'mind-altering' or psychoactive herb used, among others things, as a tranquilizer, this property has not been validated with regard to its efficacy and safety. The objective of this study is to provide evidence for the sedative effects of S. divinorum and discriminate the nature of the responsible constituents by examining different experimental models. A battery of tests, including the open-field, hole-board, exploration cylinder, plus-maze and sodium pentobarbital-induced hypnosis potentiation, were used in mice after administration of non-polar, medium polar and/or polar extracts of the plant (10, 30 and 100 mg/kg). Polysomnographic analysis in rats receiving an active medium polar extract (10 and 100 mg/kg) containing salvinorins was also assessed to study the effects of this plant on sleep architecture. All tested extracts produced significant sedative-like responses, although those of the medium polar extract were more pronounced in mice. The sedative effect of this latter extract, which contains a mixture of salvinorins, caused fragmented sleep architecture in rats by diminishing rapid eye movement (REM) sleep and increased the quiet awake stage at 10 and 100 mg/kg. Our results provide evidence that S. divinorum exhibits sedative-like depressant properties that alter physiological sleep architecture. Copyright © 2016 John Wiley & Sons, Ltd.

  4. 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

  5. Sleep/wake fragmentation disrupts metabolism in a mouse model of narcolepsy.

    PubMed

    Zhang, Shengwen; Zeitzer, Jamie M; Sakurai, Takeshi; Nishino, Seiji; Mignot, Emmanuel

    2007-06-01

    Recent population studies have identified important interrelationships between sleep duration and body weight regulation. The hypothalamic hypocretin/orexin neuropeptide system is able to influence each of these. Disruption of the hypocretin system, such as occurs in narcolepsy, leads to a disruption of sleep and is often associated with increased body mass index. We examined the potential interrelationship between the hypocretin system, metabolism and sleep by measuring locomotion, feeding, drinking, body temperature, sleep/wake and energy metabolism in a mouse model of narcolepsy (ataxin-ablation of hypocretin-expressing neurons). We found that locomotion, feeding, drinking and energy expenditure were significantly reduced in the narcoleptic mice. These mice also exhibited severe sleep/wake fragmentation. Upon awakening, transgenic and control mice displayed a similar rate of increase in locomotion and food/water intake with time. A lack of long wake episodes partially or entirely explains observed differences in overall locomotion, feeding and drinking in these transgenic mice. Like other parameters, energy expenditure also rose and fell depending on the sleep/wake status. Unlike other parameters, however, energy expenditure in control mice increased upon awakening at a greater rate than in the narcoleptic mice. We conclude that the profound sleep/wake fragmentation is a leading cause of the reduced locomotion, feeding, drinking and energy expenditure in the narcoleptic mice under unperturbed conditions. We also identify an intrinsic role of the hypocretin system in energy expenditure that may not be dependent on sleep/wake regulation, locomotion, or food intake. This investigation illustrates the need for coordinated study of multiple phenotypes in mouse models with altered sleep/wake patterns.

  6. Chronic Snoring and Sleep in Children: A Demonstration of Sleep Disruption

    ERIC Educational Resources Information Center

    Lopes, M. Cecilia; Guilleminault, Christian

    2007-01-01

    Objective: Chronic snoring that does not adhere to the criteria for a diagnosis of obstructive sleep apnea syndrome may be associated with learning and behavioral problems. We investigated the sleep structure of chronic snorers who had an apnea-hypopnea index of less than 1 event per hour and analyzed the cyclic alternating pattern. Methods:…

  7. Disrupted Sleep in Narcolepsy: Exploring the Integrity of Galanin Neurons in the Ventrolateral Preoptic Area

    PubMed Central

    Gavrilov, Yury V.; Ellison, Brian A.; Yamamoto, Mihoko; Reddy, Hasini; Haybaeck, Johannes; Mignot, Emmanuel; Baumann, Christian R.; Scammell, Thomas E.; Valko, Philipp O.

    2016-01-01

    Study Objectives: To examine the integrity of sleep-promoting neurons of the ventrolateral preoptic nucleus (VLPO) in postmortem brains of narcolepsy type 1 patients. Methods: Postmortem examination of five narcolepsy and eight control brains. Results: VLPO galanin neuron count did not differ between narcolepsy patients (11,151 ± 3,656) and controls (13,526 ± 9,544). Conclusions: A normal number of galanin-immunoreactive VLPO neurons in narcolepsy type 1 brains at autopsy suggests that VLPO cell loss is an unlikely explanation for the sleep fragmentation that often accompanies the disease. Citation: Gavrilov YV, Ellison BA, Yamamoto M, Reddy H, Haybaeck J, Mignot E, Baumann CR, Scammell TE, Valko PO. Disrupted sleep in narcolepsy: exploring the integrity of galanin neurons in the ventrolateral preoptic area. SLEEP 2016;39(5):1059–1062. PMID:26951397

  8. [Sleep and movement disorders].

    PubMed

    Poryazova, R; Bassetti, C L

    2007-01-01

    The three different states of being (wakefulness, NREM and REM sleep) are associated with profound neurophysiological and neurochemical changes in the brain. These changes explain the existence of movement disorders appearing only or preferentially during sleep, and the effects of sleep on movement disorders. Sleep-related movement disorders are of clinical relevance for multiple reasons: 1) high frequency (e.g. restless legs syndrome (RLS)); 2) diagnostic relevance (e.g. REM sleep behavior disorder (RBD) as first manifestation of Parkinson disorder); 3) diagnostic uncertainty (e.g. parasomnias vs nocturnal epilepsy); 4) association with injuries (e.g. RBD, sleepwalking), sleep disruption/daytime sleepiness (e.g. RLS), and psycho-social burden (e.g. enuresis); 5) requirement of specific treatments (e.g. nocturnal epilepsy, stridor, RBD). This article gives an overview on clinical manifestations, pathophysiology, work-up and treatment of sleep-related movement disorders (e.g. RLS, bruxism), parasomnias (e.g. sleepwalking, RBD), sleep-related epilepsies, and on sleep-associated manifestations of movement disorders (e.g. Parkinson disease, multiple system atrophy).

  9. Association Between Childhood Sleep-Disordered Breathing and Disruptive Behavior Disorders in Childhood and Adolescence.

    PubMed

    Constantin, Evelyn; Low, Nancy C P; Dugas, Erika; Karp, Igor; O'Loughlin, Jennifer

    2015-01-01

    We examined the association between sleep-disordered breathing (SDB) and disruptive behavior disorders in 605 children participating in a population-based cohort study. Nineteen percent of children snored (sometimes or often) and 10% had obstructive sleep apnea (OSA) symptoms. Thirteen percent had an ADHD diagnosis or symptoms and 5-9% had behavioral problems or a conduct disorder. Snoring or OSA symptoms were associated with a twofold difference in the odds of ADHD diagnosis or symptoms. OSA symptoms were associated with a threefold to fourfold difference in the odds of behavioral problems or conduct disorder. Clinicians should consider inquiring about SDB in children with disruptive behavior disorders and should also consider disruptive behavior disorders as potential sequelae of SDB.

  10. Deep brain stimulation of anterior nucleus thalami disrupts sleep in epilepsy patients.

    PubMed

    Voges, Berthold R; Schmitt, Friedhelm C; Hamel, Wolfgang; House, Patrick M; Kluge, Christian; Moll, Christian K E; Stodieck, Stefan R

    2015-08-01

    In view of the regulatory function of the thalamus in the sleep-wake cycle, the impact of deep brain stimulation (DBS) of the anterior nucleus thalami (ANT) on sleep was assessed in a small consecutive cohort of epilepsy patients with standardized polysomnography (PSG). In nine patients treated with ANT-DBS (voltage 5 V, frequency 145 Hz, cyclic mode), the number of arousals during stimulation and nonstimulation periods, neuropsychiatric symptoms (npS), and seizure frequency were determined. Electroclinical arousals were triggered in 14.0 to 67.0% (mean 42.4 ± SD 16.8%) of all deep brain stimuli. Six patients reported npS. Nocturnal DBS voltages were reduced in eight patients (one patient without npS refused) and PSGs were repeated. Electroclinical arousals occurred between 1.4 and 6.7 (mean 3.3 ± 1.7) times more frequently during stimulation periods compared to nonstimulation periods; the number of arousals positively correlated with the level of DBS voltage (range 1 V to 5 V) (Spearman's rank coefficient 0.53121; p < 0.05). No patient experienced seizure deterioration and four patients reported remission of npS. This case-cohort study provides evidence that ANT-DBS interrupts sleep in a voltage-dependent manner, thus putatively resulting in an increase of npS. Reduction of nocturnal DBS voltage seems to lead to improvement of npS without hampering efficacy of ANT-DBS.

  11. The association between insomnia-related sleep disruptions and cognitive dysfunction during the inter-episode phase of bipolar disorder.

    PubMed

    Kanady, Jennifer C; Soehner, Adriane M; Klein, Alexandra B; Harvey, Allison G

    2017-05-01

    Sleep disturbance and cognitive dysfunction are two domains of impairment during inter-episode bipolar disorder. Despite evidence demonstrating the importance of sleep for cognition in healthy and sleep-disordered samples, this link has been minimally examined in bipolar disorder. The present study tested the association between insomnia-related sleep disruptions and cognitive dysfunction during inter-episode bipolar disorder. Forty-seven participants with bipolar disorder and a comorbid insomnia diagnosis (BD-Insomnia) and 19 participants with bipolar disorder without sleep disturbance in the last six months (BD-Control) participated in the study. Two domains of cognition were assessed: working memory and verbal learning. Insomnia-related sleep disruptions were assessed both categorically (i.e., insomnia diagnosis) and dimensionally (i.e., total wake time, total sleep time, total wake time variability, and total sleep time variability). Hierarchical linear regressions, adjusting for participant age, demonstrated that insomnia diagnosis did not have an independent or interactive effect on cognition. However, regardless of insomnia diagnosis, greater total sleep time variability predicted poorer working memory and verbal learning performance. Further, following sleep treatment, a reduction in total wake time predicted improved working memory performance and a reduction in total sleep time variability predicted improved verbal learning performance. These findings raise the possibility that sleep disturbance may contribute to cognitive dysfunction in bipolar disorder and highlight the importance of treating sleep disturbance in bipolar disorder.

  12. Prevalence and clinical characteristics of unremembered nocturnal eating in diabetic subjects: Kurume sleep trouble in obesity and metabolic disorders (KUSTOMED) study.

    PubMed

    Yamada, Kentaro; Nakayama, Hitomi; Kato, Tomoko; Tajiri, Yuji; Sato, Shuichi; Hirao, Saori; Oshige, Tamami; Hara, Kento; Iwata, Shinpei; Kato, Naoka; Sasaki, Yuko; Hasuo, Rika; Yoshinobu, Satoko; Mitsuzaki, Kenshi; Kato, Tamotsu; Hashinaga, Toshihiko; Muraishi, Kazuhisa; Ohki, Tsuyoshi; Kaku, Hiroh

    2013-01-01

    Nighttime food intake is associated with weight gain and higher HbA1c levels. We experienced night eaters who have no memory of their nocturnal eating in the morning. In this study, the curious night eating behavior was designated as "unremembered nocturnal eating syndrome (UNES)". We screened 1,169 patients with diabetes for sleep quality and abnormal eating behavior at night using the Pittsburgh Sleep Quality Index questionnaire with an additional question regarding UNES. When abnormal nocturnal eating behavior was noted, detailed clinical information was extracted from interviews with the patients. We identified 9 patients who experienced UNES. They had a higher BMI compared with subjects who reported no such episodes. Among them, 6 patients who consumed food at night without memory 2-5 times per month or more had significantly higher HbA1c levels. Continuous glucose monitoring in a patient with type 1 diabetes revealed an abrupt elevation of glucose levels from midnight when some foods were consumed. Eight of the 9 patients were taking benzodiazepine and/or non-benzodiazepine hypnotic agents when they experienced the episodes. The prevalence of UNES was 0.8% in all subjects and 4% in those taking hypnotic drugs. The ratio of hypnotic drug use in subjects with UNES was significantly higher than for individuals without UNES (89% vs. 17%, p<0.0001). Although UNES seems to be etiologically heterogeneous, hypnotics-induced parasomnia and/or anterograde amnesia may be associated with the behavior. UNES is not rare in diabetic patients on hypnotic medicine and may be a hidden cause of unexpected morning hyperglycemia.

  13. Sleep disruption and its effect on lymphocyte redeployment following an acute bout of exercise.

    PubMed

    Ingram, Lesley A; Simpson, Richard J; Malone, Eva; Florida-James, Geraint D

    2015-07-01

    Sleep disruption and deprivation are common in contemporary society and have been linked with poor health, decreased job performance and increased life-stress. The rapid redeployment of lymphocytes between the blood and tissues is an archetypal feature of the acute stress response, but it is not known if short-term perturbations in sleep architecture affect lymphocyte redeployment. We examined the effects of a disrupted night sleep on the exercise-induced redeployment of lymphocytes and their subtypes. 10 healthy male cyclists performed 1h of cycling at a fixed power output on an indoor cycle ergometer, following a night of undisrupted sleep (US) or a night of disrupted sleep (DS). Blood was collected before, immediately after and 1h after exercise completion. Lymphocytes and their subtypes were enumerated using direct immunofluorescence assays and 4-colour flow cytometry. DS was associated with elevated concentrations of total lymphocytes and CD3(-)/CD56(+) NK-cells. Although not affecting baseline levels, DS augmented the exercise-induced redeployment of CD8(+) T-cells, with the naïve/early differentiated subtypes (KLRG1(-)/CD45RA(+)) being affected most. While the mobilisation of cytotoxic lymphocyte subsets (NK cells, CD8(+) T-cells γδ T-cells), tended to be larger in response to exercise following DS, their enhanced egress at 1h post-exercise was more marked. This occurred despite similar serum cortisol and catecholamine levels between the US and DS trials. NK-cells redeployed with exercise after DS retained their expression of perforin and Granzyme-B indicating that DS did not affect NK-cell 'arming'. Our findings indicate that short-term changes in sleep architecture may 'prime' the immune system and cause minor enhancements in lymphocyte trafficking in response to acute dynamic exercise.

  14. Impact of Sleep and Circadian Disruption on Energy Balance and Diabetes: A Summary of Workshop Discussions.

    PubMed

    Arble, Deanna M; Bass, Joseph; Behn, Cecilia Diniz; Butler, Matthew P; Challet, Etienne; Czeisler, Charles; Depner, Christopher M; Elmquist, Joel; Franken, Paul; Grandner, Michael A; Hanlon, Erin C; Keene, Alex C; Joyner, Michael J; Karatsoreos, Ilia; Kern, Philip A; Klein, Samuel; Morris, Christopher J; Pack, Allan I; Panda, Satchidananda; Ptacek, Louis J; Punjabi, Naresh M; Sassone-Corsi, Paolo; Scheer, Frank A; Saxena, Richa; Seaquest, Elizabeth R; Thimgan, Matthew S; Van Cauter, Eve; Wright, Kenneth P

    2015-12-01

    A workshop was held at the National Institute for Diabetes and Digestive and Kidney Diseases with a focus on the impact of sleep and circadian disruption on energy balance and diabetes. The workshop identified a number of key principles for research in this area and a number of specific opportunities. Studies in this area would be facilitated by active collaboration between investigators in sleep/circadian research and investigators in metabolism/diabetes. There is a need to translate the elegant findings from basic research into improving the metabolic health of the American public. There is also a need for investigators studying the impact of sleep/circadian disruption in humans to move beyond measurements of insulin and glucose and conduct more in-depth phenotyping. There is also a need for the assessments of sleep and circadian rhythms as well as assessments for sleep-disordered breathing to be incorporated into all ongoing cohort studies related to diabetes risk. Studies in humans need to complement the elegant short-term laboratory-based human studies of simulated short sleep and shift work etc. with studies in subjects in the general population with these disorders. It is conceivable that chronic adaptations occur, and if so, the mechanisms by which they occur needs to be identified and understood. Particular areas of opportunity that are ready for translation are studies to address whether CPAP treatment of patients with pre-diabetes and obstructive sleep apnea (OSA) prevents or delays the onset of diabetes and whether temporal restricted feeding has the same impact on obesity rates in humans as it does in mice.

  15. Impact of Sleep and Circadian Disruption on Energy Balance and Diabetes: A Summary of Workshop Discussions

    PubMed Central

    Arble, Deanna M.; Bass, Joseph; Behn, Cecilia Diniz; Butler, Matthew P.; Challet, Etienne; Czeisler, Charles; Depner, Christopher M.; Elmquist, Joel; Franken, Paul; Grandner, Michael A.; Hanlon, Erin C.; Keene, Alex C.; Joyner, Michael J.; Karatsoreos, Ilia; Kern, Philip A.; Klein, Samuel; Morris, Christopher J.; Pack, Allan I.; Panda, Satchidananda; Ptacek, Louis J.; Punjabi, Naresh M.; Sassone-Corsi, Paolo; Scheer, Frank A.; Saxena, Richa; Seaquest, Elizabeth R.; Thimgan, Matthew S.; Van Cauter, Eve; Wright, Kenneth P.

    2015-01-01

    A workshop was held at the National Institute for Diabetes and Digestive and Kidney Diseases with a focus on the impact of sleep and circadian disruption on energy balance and diabetes. The workshop identified a number of key principles for research in this area and a number of specific opportunities. Studies in this area would be facilitated by active collaboration between investigators in sleep/circadian research and investigators in metabolism/diabetes. There is a need to translate the elegant findings from basic research into improving the metabolic health of the American public. There is also a need for investigators studying the impact of sleep/circadian disruption in humans to move beyond measurements of insulin and glucose and conduct more in-depth phenotyping. There is also a need for the assessments of sleep and circadian rhythms as well as assessments for sleep-disordered breathing to be incorporated into all ongoing cohort studies related to diabetes risk. Studies in humans need to complement the elegant short-term laboratory-based human studies of simulated short sleep and shift work etc. with studies in subjects in the general population with these disorders. It is conceivable that chronic adaptations occur, and if so, the mechanisms by which they occur needs to be identified and understood. Particular areas of opportunity that are ready for translation are studies to address whether CPAP treatment of patients with pre-diabetes and obstructive sleep apnea (OSA) prevents or delays the onset of diabetes and whether temporal restricted feeding has the same impact on obesity rates in humans as it does in mice. Citation: Arble DM, Bass J, Behn CD, Butler MP, Challet E, Czeisler C, Depner CM, Elmquist J, Franken P, Grandner MA, Hanlon EC, Keene AC, Joyner MJ, Karatsoreos I, Kern PA, Klein S, Morris CJ, Pack AI, Panda S, Ptacek LJ, Punjabi NM, Sassone-Corsi P, Scheer FA, Saxena R, Seaquest ER, Thimgan MS, Van Cauter E, Wright KP. Impact of sleep and

  16. Effect of Slow Wave Sleep Disruption on Metabolic Parameters in Adolescents

    PubMed Central

    Shaw, Natalie D.; McHill, Andrew W.; Schiavon, Michele; Kangarloo, Tairmae; Mankowski, Piotr W.; Cobelli, Claudio; Klerman, Elizabeth B.; Hall, Janet E.

    2016-01-01

    Study Objectives: Cross-sectional studies report a correlation between slow wave sleep (SWS) duration and insulin sensitivity (SI) in children and adults. Suppression of SWS causes insulin resistance in adults but effects in children are unknown. This study was designed to determine the effect of SWS fragmentation on SI in children. Methods: Fourteen pubertal children (11.3–14.1 y, body mass index 29th to 97th percentile) were randomized to sleep studies and mixed meal (MM) tolerance tests with and without SWS disruption. Beta-cell responsiveness (Φ) and SI were determined using oral minimal modeling. Results: During the disruption night, auditory stimuli (68.1 ± 10.7/night; mean ± standard error) decreased SWS by 40.0 ± 8.0%. SWS fragmentation did not affect fasting glucose (non-disrupted 76.9 ± 2.3 versus disrupted 80.6 ± 2.1 mg/dL), insulin (9.2 ± 1.6 versus 10.4 ± 2.0 μIU/mL), or C-peptide (1.9 ± 0.2 versus 1.9 ± 0.1 ng/mL) levels and did not impair SI (12.9 ± 2.3 versus 10.1 ± 1.6 10−4 dL/kg/min per μIU/mL) or Φ (73.4 ± 7.8 versus 74.4 ± 8.4 10−9 min−1) to a MM challenge. Only the subjects in the most insulin-sensitive tertile demonstrated a consistent decrease in SI after SWS disruption. Conclusion: Pubertal children across a range of body mass indices may be resistant to the adverse metabolic effects of acute SWS disruption. Only those subjects with high SI (i.e., having the greatest “metabolic reserve”) demonstrated a consistent decrease in SI. These results suggest that adolescents may have a unique ability to adapt to metabolic stressors, such as acute SWS disruption, to maintain euglycemia. Additional studies are necessary to confirm that this resiliency is maintained in settings of chronic SWS disruption. Citation: Shaw ND, McHill AW, Schiavon M, Kangarloo T, Mankowski PW, Cobelli C, Klerman EB, Hall JE. Effect of slow wave sleep disruption on metabolic parameters in adolescents. SLEEP 2016;39(8):1591–1599. PMID:27166229

  17. Delayed thalamic astrocytosis and disrupted sleep-wake patterns in a preclinical model of traumatic brain injury.

    PubMed

    Hazra, Anupam; Macolino, Christine; Elliott, Melanie B; Chin, Jeannie

    2014-11-01

    Traumatic brain injury (TBI) involves diffuse axonal injury and induces subtle but persistent changes in brain tissue and function and poses challenges for early detection of neurological injury. The present study uses an automated behavioral analysis system to assess alterations in rodent behavior in the subacute phase in a preclinical mouse model of TBI, controlled cortical impact (CCI) injury. In the first few weeks following CCI, mice demonstrated normal exploratory behaviors and other typical home-cage behaviors. However, beginning 4 weeks post-injury, CCI mice developed disruptions in sleep-wake patterns, including an increased number of awakenings from sleep. Such impaired sleep maintenance was accompanied by an increased latency to reach peak sleep in CCI mice. These sleep disruptions implicate involvement of the thalamocortical network, the activity of which must be tightly regulated to control sleep maintenance. After injury, there was an increase in reactive microglia in thalamic regions as well as delayed reactive astrocytosis that was evident in the thalamic reticular nucleus, which preceded the development of sleep disruptions. These data suggest that cortical injury may trigger inflammatory responses in deeper neuroanatomical structures, including the thalamic reticular nucleus. Such engagement of the thalamus may perturb the thalamocortical network that regulates sleep/awake patterns and contribute to sleep disruptions observed in this model as well as those documented in patients with TBI.

  18. Disruption of mice sleep stages induced by low doses of organophosphorus compound soman.

    PubMed

    Crouzier, David; Le Crom, Valerie Baille; Four, Elise; Lallement, Guy; Testylier, Guy

    2004-06-01

    We have explored during 7 days, EEG spectral response and sleep pattern of mice after a mild intoxication with soman. Using an automatic staging method, we have quantified the sleep stage of the mice to identify disruptions of the sleep pattern. The 50 microg/kg dose of soman produced several effects during several time windows after intoxication. A first decrease followed by an increase of theta energy, a disturbance of slow wave sleep during 5 days and an increase of the REM sleep during the first and second day after intoxication. During the first 6h, we have observed some effects which were not consistent with a muscarinic activation and might have involved GABA-ergic system. After this early period, the observed effects were in accordance with a muscarinic activation. We observed an increase of energy in the EEG theta band during 3 days after soman injection and an increase of slow wave sleep during the second to the fifth day after soman injection.

  19. Disrupted chronobiology of sleep and cytoprotection in obesity: possible therapeutic value of melatonin.

    PubMed

    Cardinali, Daniel P; Pagano, Eleonora S; Scacchi Bernasconi, Pablo A; Reynoso, Roxana; Scacchi, Pablo

    2011-01-01

    From a physiological perspective the sleep-wake cycle can be envisioned as a sequence of three physiological states (wakefulness, non-rapid eye movement, NREM, sleep and REM sleep) which are defined by a particular neuroendocrine-immune profile regulating the metabolic balance, body weight and inflammatory responses. Sleep deprivation and circadian disruption in contemporary "24/7 Society" lead to the predominance of pro-orexic and proinflammatory mechanisms that contribute to a pandemic metabolic syndrome (MS) including obesity, diabetes and atherosclerotic disease. Thus, a successful management of MS may require a drug that besides antagonizing the trigger factors of MS could also correct a disturbed sleep-wake rhythm. This review deals with the analysis of the therapeutic validity of melatonin in MS. Melatonin is an effective chronobiotic agent changing the phase and amplitude of the sleep/wake rhythm and having cytoprotective and immunomodulatory properties useful to prevent a number of MS sequels. Several studies support that melatonin can prevent hyperadiposity in animal models of obesity. Melatonin at a low dose (2-5 mg/day) has been used for improving sleep in patients with insomnia and circadian rhythm sleep disorders. More recently, attention has been focused on the development of potent melatonin analogs with prolonged effects (ramelteon, agomelatine, tasimelteon, TK 301). In clinical trials these analogs were employed in doses considerably higher than those usually employed for melatonin. In view that the relative potencies of the analogs are higher than that of the natural compound, clinical trials employing melatonin doses in the range of 50-100 mg/day are needed to assess its therapeutic value in MS.

  20. Nocturnal enuresis in sickle cell disease.

    PubMed

    Wolf, Rachel B; Kassim, Adetola A; Goodpaster, Robert L; DeBaun, Michael R

    2014-04-01

    Nocturnal enuresis is a prevalent and challenging problem in children and young adults with sickle cell disease (SCD). Limited progress has been made in elucidating etiology and pathophysiology of nocturnal enuresis in individuals with SCD. Among adults with SCD ages 18-20 years, approximately 9% report nocturnal enuresis. Nocturnal enuresis contributes to decreased health related quality of life in people with SCD, resulting in low self-esteem and sometimes social isolation. Postulated non-mutually exclusive causes of nocturnal enuresis in individuals with SCD include hyposthenuria leading to nocturnal polyuria, decreased bladder capacity or nocturnal bladder overactivity, increased arousal thresholds, and sleep disordered breathing. No evidence-based therapy for nocturnal enuresis in SCD exists. This review is focused on describing the natural history, postulated causes and a rational approach to the evaluation and management of nocturnal enuresis in children and adults with SCD.

  1. Estimating the Need for Medical Intervention due to Sleep Disruption on the International Space Station

    NASA Technical Reports Server (NTRS)

    Myers, Jerry G.; Lewandowski, Beth E.; Brooker, John E.; Hurst, S. R.; Mallis, Melissa M.; Caldwell, J. Lynn

    2008-01-01

    During ISS and shuttle missions, difficulties with sleep affect more than half of all US crews. Mitigation strategies to help astronauts cope with the challenges of disrupted sleep patterns can negatively impact both mission planning and vehicle design. The methods for addressing known detrimental impacts for some mission scenarios may have a substantial impact on vehicle specific consumable mass or volume or on the mission timeline. As part of the Integrated Medical Model (IMM) task, NASA Glenn Research Center is leading the development of a Monte Carlo based forecasting tool designed to determine the consumables required to address risks related to sleep disruption. The model currently focuses on the International Space Station and uses an algorithm that assembles representative mission schedules and feeds this into a well validated model that predicts relative levels of performance, and need for sleep (SAFTE Model, IBR Inc). Correlation of the resulting output to self-diagnosed needs for hypnotics, stimulants, and other pharmaceutical countermeasures, allows prediction of pharmaceutical use and the uncertainty of the specified prediction. This paper outlines a conceptual model for determining a rate of pharmaceutical utilization that can be used in the IMM model for comparison and optimization of mitigation methods with respect to all other significant medical needs and interventions.

  2. Dietary Carbohydrate and Nocturnal Sleep Duration in Relation to Children’s BMI: Findings from the IDEFICS Study in Eight European Countries

    PubMed Central

    Hunsberger, Monica; Mehlig, Kirsten; Börnhorst, Claudia; Hebestreit, Antje; Moreno, Luis; Veidebaum, Toomas; Kourides, Yiannis; Siani, Alfonso; Molnar, Dénes; Sioen, Isabelle; Lissner, Lauren

    2015-01-01

    Previous research has found an association between being overweight and short sleep duration. We hypothesized that this association could be modified by a high carbohydrate (HC) diet and that the timing and type (starch or sugar) of intake may be an important factor in this context. Participants in the prospective, eight-country European study IDEFICS were recruited from September 2007 to June 2008, when they were aged two to nine years. Data on lifestyle, dietary intake and anthropometry were collected on two occasions. This study included 5944 children at baseline and 4301 at two-year follow-up. For each meal occasion (morning, midday, and evening), starch in grams and sugar in grams were divided by total energy intake (EI), and quartiles calculated. HC-starch and HC-sugar intake categories were defined as the highest quartile for each meal occasion. In a mutually adjusted linear regression model, short sleep duration as well as HC-starch in the morning were positively associated with body mass index (BMI) z-scores at baseline. HC-starch at midday was positively associated with body mass index (BMI) z-scores in children with short sleep duration, and negatively associated with BMI z-scores in those with normal sleep. After adjustment for baseline BMI z-scores, associations between total HC from starch or sugar and high BMI z-scores at two-year follow-up did not persist. Our observations offer a perspective on optimal timing for macronutrient consumption, which is known to be influenced by circadian rhythms. Reduced carbohydrate intake, especially during morning and midday meals, and following nocturnal sleep duration recommendations are two modifiable factors that may protect children from being overweight in the future. PMID:26670249

  3. Disruptions of Sleep/Wake Patterns in the Stable Tubule Only Polypeptide (STOP) Null Mouse Model of Schizophrenia.

    PubMed

    Profitt, Maxine F; Deurveilher, Samuel; Robertson, George S; Rusak, Benjamin; Semba, Kazue

    2016-09-01

    Disruption of sleep/wake cycles is common in patients with schizophrenia and correlates with cognitive and affective abnormalities. Mice deficient in stable tubule only polypeptide (STOP) show cognitive, behavioral, and neurobiological deficits that resemble those seen in patients with schizophrenia, but little is known about their sleep phenotype. We characterized baseline sleep/wake patterns and recovery sleep following sleep deprivation in STOP null mice. Polysomnography was conducted in adult male STOP null and wild-type (WT) mice under a 12:12 hours light:dark cycle before, during, and after 6 hours of sleep deprivation during the light phase. At baseline, STOP null mice spent more time awake and less time in non-rapid eye movement sleep (NREMS) over a 24-hour period, with more frequent transitions between wake and NREMS, compared to WT mice, especially during the dark phase. The distributions of wake, NREMS and REMS across the light and the dark phases differed by genotype, and so did features of the electroencephalogram (EEG). Following sleep deprivation, both genotypes showed homeostatic increases in sleep duration, with no significant genotype differences in the initial compensatory increase in sleep intensity (EEG delta power). These results indicate that STOP null mice sleep less overall, and their sleep and wake periods are more fragmented than those of WT mice. These features in STOP null mice are consistent with the sleep patterns observed in patients with schizophrenia.

  4. Role of sleep and circadian disruption on energy expenditure and in metabolic predisposition to human obesity and metabolic disease.

    PubMed

    McHill, A W; Wright, K P

    2017-02-01

    Weight gain, obesity and diabetes have reached alarming levels in the developed world. Traditional risk factors such as over-eating, poor nutritional choices and lack of exercise cannot fully account for the high prevalence of metabolic disease. This review paper examines the scientific evidence on two novel risk factors that contribute to dys-regulated metabolic physiology: sleep disruption and circadian misalignment. Specifically, fundamental relationships between energy metabolism and sleep and circadian rhythms and the impact of sleep and circadian disruption on metabolic physiology are examined. Millions of individuals worldwide do not obtain sufficient sleep for healthy metabolic function, and many participate in shift work and social activities at times when the internal physiological clock is promoting sleep. These behaviours predispose an individual for poor metabolic health by promoting excess caloric intake in response to reduced sleep, food intake at internal biological times when metabolic physiology is not prepared, decreased energy expenditure when wakefulness and sleep are initiated at incorrect internal biological times, and disrupted glucose metabolism during short sleep and circadian misalignment. In addition to the traditional risk factors of poor diet and exercise, disturbed sleep and circadian rhythms represent modifiable risk factors for prevention and treatment of metabolic disease and for promotion of healthy metabolism.

  5. Disrupted Sleep is Associated with Altered Pain Processing by Sex and Ethnicity in Knee Osteoarthritis

    PubMed Central

    Petrov, Megan E.; Goodin, Burel R.; Cruz-Almeida, Yenisel; King, Chris; Glover, Toni L.; Bulls, Hailey W.; Herbert, Matthew; Sibille, Kimberly T.; Bartley, Emily J.; Fessler, Barri J.; Sotolongo, Adriana; Staud, Roland; Redden, David; Fillingim, Roger B.; Bradley, Laurence A.

    2015-01-01

    Studies indicate that improving sleep decreases reported pain in patients with knee osteoarthritis (OA), but it is unclear if this association extends to experimentally-induced pain responses. A community-based sample of 88 African-American and 52 non-Hispanic white adults (45-76y) with knee OA completed the Insomnia Severity Index and the arousal subscale of the Sleep Hygiene and Practices Scale. Participants underwent quantitative sensory testing including measures of pain sensitivity and facilitation at the knee, and pain inhibition. Outcomes were analyzed with multiple Tobit, hierarchical regression models, with adjustment for relevant covariates. Ethnicity and sex by sleep interactions were also entered into the models. After covariate adjustment, main associations were not observed. However, sex interacted with insomnia severity to predict greater temporal summation of heat and punctate pressure pain among women and lower heat temporal summation among men. Men and women who engaged in frequent arousal-associated sleep behaviors demonstrated higher and lower heat temporal summation, respectively. Non-Hispanic whites with greater insomnia severity displayed lower pressure pain thresholds and pain inhibition. Our findings are the first to demonstrate that disrupted sleep is associated with altered pain processing differentially by sex and ethnicity/race among people with knee OA. PMID:25725172

  6. Sleep

    MedlinePlus

    ... is REM sleep? What is the effect of sleep deprivation? What are sleep myths? What are sleep disorders? ... is REM sleep? What is the effect of sleep deprivation? What are sleep myths? What are sleep disorders? ...

  7. The contribution of nocturnal sleep to the consolidation of motor skill learning in healthy ageing and Parkinson's disease.

    PubMed

    Terpening, Zoe; Naismith, Sharon; Melehan, Kerri; Gittins, Catherine; Bolitho, Sam; Lewis, Simon J G

    2013-08-01

    The benefits of sleep for the consolidation of procedural motor skills are less robust in older adults, although the precise reasons for this remain unclear. To date, even less is known about these processes in older adults with neurodegenerative diseases, particularly those which impact on motor functioning. While sleep disturbance and motor symptoms are frequent disabling features of Parkinson's disease, no known studies have directly probed sleep-dependent memory consolidation for motor skill learning in Parkinson's disease. Forty patients with idiopathic Parkinson's disease (age = 63.7 years ± 7.7; disease duration 4.1 years ± 4.4) completed a motor skill learning task pre- and post-sleep and were compared to 20 age- and sex-matched controls recruited from the community. Polysomnography was undertaken during the post-training night and measures of sleep architecture were derived. Parkinson's disease patients did not demonstrate any apparent deficits in within-session learning and overnight stabilization compared to controls, with both groups failing to demonstrate offline improvements in performance (i.e. memory consolidation). In controls, longer duration in slow wave sleep was associated with improved next-day session learning (P = 0.007). However, in Parkinson's disease, no relationships between sleep parameters and learning measures were found. Slow wave sleep microarchitecture and the use of dopaminergic medications may contribute to impaired sleep-dependent multi-session acquisition of motor skill learning in Parkinson's disease.

  8. Recovery of Neurological Function Despite Immediate Sleep Disruption Following Diffuse Brain Injury in the Mouse: Clinical Relevance to Medically Untreated Concussion

    PubMed Central

    Rowe, Rachel K.; Harrison, Jordan L.; O'Hara, Bruce F.; Lifshitz, Jonathan

    2014-01-01

    Study Objective: We investigated the relationship between immediate disruption of posttraumatic sleep and functional outcome in the diffuse brain-injured mouse. Design: Adult male C57BL/6 mice were subjected to moderate midline fluid percussion injury (n = 65; 1.4 atm; 6-10 min righting reflex time) or sham injury (n = 44). Cohorts received either intentional sleep disruption (minimally stressful gentle handling) or no sleep disruption for 6 h following injury. Following disruption, serum corticosterone levels (enzyme-linked immunosorbent assay) and posttraumatic sleep (noninvasive piezoelectric sleep cages) were measured. For 1-7 days postinjury, sensorimotor outcome was assessed by Rotarod and a modified Neurological Severity Score (NSS). Cognitive function was measured using Novel Object Recognition (NOR) and Morris water maze (MWM) in the first week postinjury. Setting: Neurotrauma research laboratory. Measurements and Results: Disrupting posttraumatic sleep for 6 h did not affect serum corticosterone levels or functional outcome. In the hour following the first dark onset, sleep-disrupted mice exhibited a significant increase in sleep; however, this increase was not sustained and there was no rebound of lost sleep. Regardless of sleep disruption, mice showed a time-dependent improvement in Rotarod performance, with brain-injured mice having significantly shorter latencies on day 7 compared to sham. Further, brain-injured mice, regardless of sleep disruption, had significantly higher NSS scores postinjury compared with sham. Cognitive behavioral testing showed no group differences among any treatment group measured by MWM and NOR. Conclusion: Short-duration disruption of posttraumatic sleep did not affect functional outcome, measured by motor and cognitive performance. These data raise uncertainty about posttraumatic sleep as a mechanism of recovery from diffuse brain injury. Citation: Rowe RK; Harrison JL; O'Hara BF; Lifshitz J. Recovery of neurological

  9. Comparison of the Effect of Two Kinds of Iranian Honey and Diphenhydramine on Nocturnal Cough and the Sleep Quality in Coughing Children and Their Parents.

    PubMed

    Ayazi, Parviz; Mahyar, Abolfazl; Yousef-Zanjani, Mahdieh; Allami, Abbas; Esmailzadehha, Neda; Beyhaghi, Taraneh

    2017-01-01

    Coughing in a child induced by upper respiratory tract infections (URTIs) can be a problem, both for the child and its parents. Current studies show a lack of proven efficacy for over-the counter (OTC) medications, but promising data support the use of honey for children. The aim of this study was to compare the effects of two kinds of Iranian honey with diphenhydramine (DPH) on nocturnal pediatric coughs and the sleep quality of children and their parents. This was a clinical trial (registered in IRCT; No.: 28.20.7932, 15 October 2013). The study consisted of 87 patients. All the parents completed a standard previously validated questionnaire. The children were randomly assigned to one of three treatment groups: Group 1, Honey type 1 (Kimia Company, Iran) (n = 42), Group 2, Honey type 2 (Shahde-Golha, Iran) (n = 25), and Group 3, DPH (n = 20). Each group received double doses of the respective treatments on two successive nights. A second survey was then administered via a telephone interview in which the parents were asked the same questions. The mean scores for all aspects of coughs were significantly decreased in each group before and after the treatment. All three treatments improved the cough and sleep scores. Honey type 1 was superior to DPH in improving all aspects of coughs, except the frequency, and Honey type 2 was more effective than DPH in improving all aspects of coughs, except the sleep quality of the child. There was no significant difference between Honey type 1 and 2 in any aspects of cough relief in the present study. The results suggest that honey may provide better cough relief than DPH in children and improve the sleep quality of children and their parents.

  10. Comparison of the Effect of Two Kinds of Iranian Honey and Diphenhydramine on Nocturnal Cough and the Sleep Quality in Coughing Children and Their Parents

    PubMed Central

    Ayazi, Parviz; Mahyar, Abolfazl; Yousef-Zanjani, Mahdieh; Allami, Abbas; Esmailzadehha, Neda; Beyhaghi, Taraneh

    2017-01-01

    Coughing in a child induced by upper respiratory tract infections (URTIs) can be a problem, both for the child and its parents. Current studies show a lack of proven efficacy for over-the counter (OTC) medications, but promising data support the use of honey for children. The aim of this study was to compare the effects of two kinds of Iranian honey with diphenhydramine (DPH) on nocturnal pediatric coughs and the sleep quality of children and their parents. This was a clinical trial (registered in IRCT; No.: 28.20.7932, 15 October 2013). The study consisted of 87 patients. All the parents completed a standard previously validated questionnaire. The children were randomly assigned to one of three treatment groups: Group 1, Honey type 1 (Kimia Company, Iran) (n = 42), Group 2, Honey type 2 (Shahde-Golha, Iran) (n = 25), and Group 3, DPH (n = 20). Each group received double doses of the respective treatments on two successive nights. A second survey was then administered via a telephone interview in which the parents were asked the same questions. The mean scores for all aspects of coughs were significantly decreased in each group before and after the treatment. All three treatments improved the cough and sleep scores. Honey type 1 was superior to DPH in improving all aspects of coughs, except the frequency, and Honey type 2 was more effective than DPH in improving all aspects of coughs, except the sleep quality of the child. There was no significant difference between Honey type 1 and 2 in any aspects of cough relief in the present study. The results suggest that honey may provide better cough relief than DPH in children and improve the sleep quality of children and their parents. PMID:28103276

  11. Sleep apnea and dialysis therapies: things that go bump in the night?

    PubMed

    Unruh, Mark L

    2007-10-01

    Sleep apnea has been linked to excessive daytime sleepiness, depressed mood, hypertension, and cardiovascular disease in the general population. The prevalence of severe sleep apnea in the conventional thrice-weekly hemodialysis population has been estimated to be more than 50%. Sleep apnea leads to repetitive episodes of hypoxemia, hypercapnia, sleep disruption, and activation of the sympathetic nervous system. The hypoxemia, arousals, and intrathoracic pressure changes associated with sleep apnea lead to sympathetic activation, endothelial dysfunction, oxidative stress, and inflammation. Because sleep apnea has been shown to be widespread in the conventional dialysis population, it may be that sleep apnea contributes substantially to the sleepiness, poor quality of life, and cardiovascular disease found in this population. The causal links between conventional dialysis and sleep apnea remain speculative, but there are likely multiple factors related to volume status and azotemia that contribute to the high rate of severe sleep apnea in dialysis patients. Both nocturnal automated peritoneal dialysis and nocturnal hemodialysis have been associated with reduced severity of sleep apnea. Nocturnal dialysis modalities may provide tools to increase our understanding of the uremic sleep apnea and may also provide therapeutic alternatives for end-stage renal disease patients with severe sleep apnea. In conclusion, sleep apnea is an important, but overlooked, public health problem for the dialysis population. The impact of sleep apnea treatment in this high-risk population may include reduced sleepiness, better mood and blood pressure, and lowered risk of cardiovascular disease.

  12. Nocturnal Asthma

    MedlinePlus

    ... night. Exercise-Induced Asthma (EIA) Clinical Trials Asthma: Types Allergic Asthma Exercise-Induced Asthma (EIA) FAQ Cold Weather Activities Symptoms & Diagnosis Treatment & Monitoring Nocturnal Asthma No ...

  13. Differential activation of immune factors in neurons and glia contribute to individual differences in resilience/vulnerability to sleep disruption

    PubMed Central

    Dissel, Stephane; Seugnet, Laurent; Thimgan, Matthew S.; Silverman, Neal; Angadi, Veena; Thacher, Pamela V.; Burnham, Melissa M.; Shaw, Paul J.

    2014-01-01

    Individuals frequently find themselves confronted with a variety of challenges that threaten their wellbeing. While some individuals face these challenges efficiently and thrive (resilient) others are unable to cope and may suffer persistent consequences (vulnerable). Resilience/vulnerability to sleep disruption may contribute to the vulnerability to individuals exposed to challenging conditions. With that in mind we exploited individual differences in a fly’s ability to form short-term memory (STM) following 3 different types of sleep disruption to identify the underlying genes. Our analysis showed that in each category of flies examined, there are individuals that form STM in the face of sleep loss (resilient) while other individuals show dramatic declines in cognitive behavior (vulnerable). Molecular genetic studies revealed that Antimicrobial Peptides, factors important for innate immunity, were candidates for conferring resilience/vulnerability to sleep deprivation. Specifically, Metchnikowin (Mtk), drosocin (dro) and Attacin (Att) transcript levels seemed to be differentially increased by sleep deprivation in glia (Mtk), neurons (dro) or primarily in the head fat body (Att). Follow-up genetic studies confirmed that expressing Mtk in glia but not neurons, and expressing dro in neurons but not glia, disrupted memory while modulating sleep in opposite directions. These data indicate that various factors within glia or neurons can contribute to individual differences in resilience/vulnerability to sleep deprivation. PMID:25451614

  14. Changes in sleep disruption in the treatment of co-occurring posttraumatic stress disorder and substance use disorders.

    PubMed

    McHugh, R Kathryn; Hu, Mei-Chen; Campbell, Aimee N C; Hilario, E Yvette; Weiss, Roger D; Hien, Denise A

    2014-02-01

    Sleep disruption appears not only to reflect a symptom of posttraumatic stress disorder (PTSD), but also a unique vulnerability for its development and maintenance. Studies examining the impact of psychosocial treatments for PTSD on sleep symptoms are few and no studies to date of which we are aware have examined this question in samples with co-occurring substance use disorders. The current study is a secondary analysis of a large clinical trial comparing 2 psychological treatments for co-occurring PTSD and substance use disorders. Women (N = 353) completed measures of PTSD at baseline, end of treatment, and 3-, 6-, and 12-month follow-ups. Results indicated that the prevalence of insomnia, but not nightmares, decreased during treatment, and that 63.8% of participants reported at least 1 clinical-level sleep symptom at the end of treatment. Improvement in sleep symptoms during treatment was associated with better overall PTSD outcomes over time, χ(2) (1) = 33.81, p < .001. These results extend the existing literature to suggest that residual sleep disruption following PTSD treatment is common in women with co-occurring PTSD and substance use disorders. Research on the benefits of adding sleep-specific intervention for those with residual sleep disruption in this population may be a promising future direction.

  15. Sleep in the intensive care unit

    PubMed Central

    Beltrami, Flávia Gabe; Nguyen, Xuân-Lan; Pichereau, Claire; Maury, Eric; Fleury, Bernard; Fagondes, Simone

    2015-01-01

    ABSTRACT Poor sleep quality is a consistently reported by patients in the ICU. In such a potentially hostile environment, sleep is extremely fragmented and sleep architecture is unconventional, with a predominance of superficial sleep stages and a limited amount of time spent in the restorative stages. Among the causes of sleep disruption in the ICU are factors intrinsic to the patients and the acute nature of their condition, as well as factors related to the ICU environment and the treatments administered, such as mechanical ventilation and drug therapy. Although the consequences of poor sleep quality for the recovery of ICU patients remain unknown, it seems to influence the immune, metabolic, cardiovascular, respiratory, and neurological systems. There is evidence that multifaceted interventions focused on minimizing nocturnal sleep disruptions improve sleep quality in ICU patients. In this article, we review the literature regarding normal sleep and sleep in the ICU. We also analyze sleep assessment methods; the causes of poor sleep quality and its potential implications for the recovery process of critically ill patients; and strategies for sleep promotion. PMID:26785964

  16. Artificial light at night disrupts sleep in female great tits (Parus major) during the nestling period, and is followed by a sleep rebound.

    PubMed

    Raap, Thomas; Pinxten, Rianne; Eens, Marcel

    2016-08-01

    Artificial light at night has been linked to a wide variety of physiological and behavioural consequences in humans and animals. Given that little is known about the impact of light pollution on sleep in wild animals, we tested how experimentally elevated light levels affected sleep behaviour of female songbirds rearing 10 day old chicks. Using a within-subject design, individual sleep behaviour was observed over three consecutive nights in great tits (Parus major), with females sleeping in a natural dark situation on the first and third night, whereas on the second night they were exposed to a light-emitting diode (1.6 lux). Artificial light in the nest box dramatically and significantly affected sleep behaviour, causing females to fall asleep later (95 min; while entry time was unaffected), wake up earlier (74 min) and sleep less (56%). Females spent a greater proportion of the night awake and the frequency of their sleep bouts decreased, while the length of their sleep bouts remained equal. Artificial light also increased begging of chicks at night, which may have contributed to the sleep disruption in females or vice versa. The night following the light treatment, females slept 25% more compared to the first night, which was mainly achieved by increasing the frequency of sleep bouts. Although there was a consistent pattern in how artificial light affected sleep, there was also large among-individual variation in how strongly females were affected. When comparing current results with a similar experiment during winter, our results highlight differences in effects between seasons and underscore the importance of studying light pollution during different seasons. Our study shows that light pollution may have a significant impact on sleep behaviour in free-living animals during the reproductive season, which may provide a potential mechanism by which artificial light affects fitness.

  17. Rapid eye movement sleep disruption and sleep fragmentation are associated with increased orexin-A cerebrospinal-fluid levels in mild cognitive impairment due to Alzheimer's disease.

    PubMed

    Liguori, Claudio; Nuccetelli, Marzia; Izzi, Francesca; Sancesario, Giuseppe; Romigi, Andrea; Martorana, Alessandro; Amoroso, Chiara; Bernardini, Sergio; Marciani, Maria Grazia; Mercuri, Nicola Biagio; Placidi, Fabio

    2016-04-01

    The orexin system has been investigated in patients affected by mild cognitive impairment (MCI) due to Alzheimer's disease (AD) by measuring orexin-A concentrations in the cerebrospinal fluid (CSF), and correlated to subjective and objective sleep parameters, quantified by questionnaires and polysomnography, respectively. Twenty drug-naïve patients with MCI due to AD were studied and compared with a population of 26 age and/or sex matched controls, divided into subgroups on the basis of the Pittsburgh Sleep Quality Index (PSQI) score. Increased CSF-orexin levels were detected in patients with MCI due to AD in comparison with controls (p < 0.05). In particular, CSF-orexin concentrations were higher in MCI patients suffering from sleep complaints (PSQI ≥5, n = 10) compared with MCI patients with a regular sleep-wake cycle (PSQI <5, n = 10, p < 0.001) and compared with both control groups (with sleep complaints, PSQI ≥5, n = 11, p < 0.001; without sleep complaints, PSQI <5, n = 15, p < 0.001). Moreover, REM sleep was reduced in MCI patients compared with controls (p < 0.01), and had a negative correlation coupled with a reciprocal influence at the multiple regression analysis with CSF-orexin levels (R = -0.65; β = -8.90). REM sleep disruption and sleep fragmentation are related to higher CSF-orexin levels in patients with MCI due to AD, thus suggesting that the orexin system may be involved even in the earliest stages of AD, resulting in prolonged sleep latency, reduced sleep efficiency, and REM sleep impairment.

  18. Abnormal nocturnal heart rate variability response among chronic kidney disease and dialysis patients during wakefulness and sleep

    PubMed Central

    Roumelioti, Maria-Eleni; Ranpuria, Reena; Hall, Martica; Hotchkiss, John R.; Chan, Chris T.; Unruh, Mark L.; Argyropoulos, Christos

    2010-01-01

    Background. Dialysis patients and patients with chronic kidney disease (CKD) experience a substantial risk for abnormal autonomic function and abnormal heart rate variability (HRV). It remains unknown whether HRV changes across sleep stages in patients with different severity of CKD or dialysis dependency. We hypothesized that high-frequency (HF) HRV (vagal tone) will be attenuated from wakefulness to non-rapid eye movement (NREM) and then to rapid eye movement (REM) sleep in dialysis patients as compared to patients with CKD. Methods. In-home polysomnography was performed in 95 patients with stages 4–5 CKD or end-stage renal disease (ESRD) on haemodialysis (HD) or peritoneal dialysis (PD). HRV was measured using fast Fourier transform of interbeat intervals during wakefulness and sleep. Low-frequency (LF) and HF intervals were generated. Natural logarithm HF (LNHF) and the logarithm LF/HF ratio (sympathovagal tone) were analysed by multivariable quantile regression and generalized estimating equations. Results. Of the 95 patients, 63.2% (n = 60) was male, 35.8% (n = 34) was African American and 20.4% (n = 19) was diabetic. Average age was 51.6 ± 15.1 (range 19–82). HRV variables were significantly associated with diabetic status, higher periodic limb movement indices and lower bicarbonate levels. Patients with advanced CKD did not differ from dialysis patients in their inability to increase vagal tone during sleep. During wakefulness, female gender (P = 0.05) was associated with the increases in the vagal tone. Conclusions. Patients with CKD/ESRD exhibit dysregulation of the autonomic nervous system tone manifesting as a failure to increase HRV during wakefulness and sleep. Different patient characteristics are associated with changes in HRV at different sleep stages. PMID:20466675

  19. Nocturnal mouthpiece ventilation and medical hypnosis to treat severe obstructive sleep apnea in a child with cherubism.

    PubMed

    Khirani, Sonia; Kadlub, Natacha; Delord, Vincent; Picard, Arnaud; Fauroux, Brigitte

    2013-09-01

    A 4-year old boy presented severe obstructive sleep apnoea due to complete nasal obstruction secondary to cherubism. Because of anticipatory anxiety due to numerous surgical interventions, medical hypnosis was proposed to facilitate non-invasive continuous positive pressure ventilation (CPAP) acceptance. CPAP by means of an oral interface was completely accepted after three hypnosis sessions and resulted in the correction of his obstructive sleep apnea (OSA) syndrome. This report highlights the benefit of medical hypnosis in facilitating CPAP acceptance as well as the efficacy of mouthpiece ventilation in a severe form of cherubism with complete nasal obstruction.

  20. Toward optimizing lighting as a countermeasure to sleep and circadian disruption in space flight

    NASA Astrophysics Data System (ADS)

    Fucci, Robert L.; Gardner, James; Hanifin, John P.; Jasser, Samar; Byrne, Brenda; Gerner, Edward; Rollag, Mark; Brainard, George C.

    2005-05-01

    Light is being used as a pre-launch countermeasure to circadian and sleep disruption in astronauts. The effect of light on the circadian system is readily monitored by measurement of plasma melatonin. Our group has established an action spectrum for human melatonin regulation and determined the region of 446-477 nm to be the most potent for suppressing plasma melatonin. The aim of this study was to compare the efficacy of 460 and 555 nm for suppressing melatonin using a within-subjects design. Subjects ( N=12) were exposed to equal photon densities ( 7.18×1012photons/cm2/s) at 460 and 555 nm. Melatonin suppression was significantly stronger at 460 nm ( p<0.02). An extension to the action spectrum showed that 420 nm light at 16 and 32μW/cm2 significantly suppressed melatonin ( p<0.04 and p<0.002). These studies will help optimize lighting countermeasures to circadian and sleep disruption during spaceflight.

  1. Management of nocturnal enuresis - myths and facts

    PubMed Central

    Sinha, Rajiv; Raut, Sumantra

    2016-01-01

    Nocturnal enuresis often causes considerable distress or functional impairment to patient and their parents necessitating a multidisciplinary approach from paediatrician, paediatric nephrologist, urologists and psychiatrist. Mechanisms of monosymptomatic nocturnal enuresis are mainly nocturnal polyuria, bladder overactivity and failure to awaken from sleep in response to bladder sensations. Goal oriented and etiology wise treatment includes simple behavioral intervention, conditioning alarm regimen and pharmacotherapy with desmopressin, imipramine and anticholinergic drugs. Symptoms often recurs requiring change over or combination of different modes of treatment. PMID:27458562

  2. Melatonin, sleep disturbance and cancer risk.

    PubMed

    Blask, David E

    2009-08-01

    The pineal hormone melatonin is involved in the circadian regulation and facilitation of sleep, the inhibition of cancer development and growth, and the enhancement of immune function. Individuals, such as night shift workers, who are exposed to light at night on a regular basis experience biological rhythm (i.e., circadian) disruption including circadian phase shifts, nocturnal melatonin suppression, and sleep disturbances. Additionally, these individuals are not only immune suppressed, but they are also at an increased risk of developing a number of different types of cancer. There is a reciprocal interaction and regulation between sleep and the immune system quite independent of melatonin. Sleep disturbances can lead to immune suppression and a shift to the predominance in cancer-stimulatory cytokines. Some studies suggest that a shortened duration of nocturnal sleep is associated with a higher risk of breast cancer development. The relative individual contributions of sleep disturbance, circadian disruption due to light at night exposure, and related impairments of melatonin production and immune function to the initiation and promotion of cancer in high-risk individuals such as night shift workers are unknown. The mutual reinforcement of interacting circadian rhythms of melatonin production, the sleep/wake cycle and immune function may indicate a new role for undisturbed, high quality sleep, and perhaps even more importantly, uninterrupted darkness, as a previously unappreciated endogenous mechanism of cancer prevention.

  3. Nocturnal Wakefulness is Associated with Next-Day Suicidal Ideation in Major Depression and Bipolar Disorder

    PubMed Central

    Ballard, Elizabeth D.; Vande Voort, Jennifer L.; Bernert, Rebecca A.; Luckenbaugh, David A.; Richards, Erica M.; Niciu, Mark J.; Furey, Maura L.; Duncan, Wallace C.; Zarate, Carlos A.

    2016-01-01

    Objective Self-reported sleep disturbances may confer elevated risk for suicidal ideation, suicide attempts, and death. However, limited research has evaluated polysomnography (PSG)-determined sleep disturbance as an acute physiological risk factor for suicidal thoughts. This study sought to investigate the relationship between nocturnal wakefulness in association with next-day suicidal ideation using overnight PSG assessment from data collected between 2006 and 2013. Method Participants with DSM-IV-diagnosed major depressive disorder (MDD) or bipolar depression underwent overnight PSG monitoring in a sleep laboratory. The Hamilton Depression Rating Scale (HAM-D) was administered the morning after PSG recording to assess next-day suicidal ideation, severity of depressive symptoms, and subjective sleep disturbances. Results Using a generalized linear mixed model, a significant time-by-ideation interaction was found indicating greater nocturnal wakefulness at 4:00 AM among participants with suicidal ideation (F(4,136) = 3.65, p = .007). Increased time awake during the 4:00 AM hour (4:00 to 4:59) was significantly associated with elevated suicidal thoughts the next day (standardized β = .31, p = .008). This relationship persisted after controlling for age, gender, diagnosis, and severity of depressive symptoms. Conclusion Greater nocturnal wakefulness, particularly in the early morning hours, was significantly associated with next-day suicidal thoughts. PSG-documented sleep disruption at specific times of night may represent an acute risk factor of suicidal ideation that warrants additional research. Clinical Trials Identifier NCT00024635 PMID:27337418

  4. Nocturnal hemodialysis.

    PubMed

    Ranganathan, D; John, G T

    2012-09-01

    Patients receiving conventional hemodialysis have high hospitalisation rates, poor quality of life and survival compared to the general population. Many centres around the world are providing longer hours of hemodialysis - short daily hemodialysis and nocturnal hemodialysis - with a view to improving patient survival and quality of life. Studies have shown that nocturnal haemodiaysis is more effective than conventional hemodialysis in clearing most small, middle and larger molecule toxins and suggest nocturnal dialysis enhances patient survival and quality of life. Concerns include patient acceptance, vascular access related complications and increased cost. The purpose of this review is to examine the advantages and drawbacks of nocturnal dialysis, with a focus on applicability to India where the renal physician has to face cultural and economic barriers, erratic power supply and poor water quality.

  5. Circadian Regulation Gene Polymorphisms are Associated with Sleep Disruption and Duration, and Circadian Phase and Rhythm in Adults with HIV

    PubMed Central

    Lee, Kathryn A.; Gay, Caryl; Byun, Eeeseung; Lerdal, Anners; Pullinger, Clive R.; Aouizerat, Bradley E.

    2016-01-01

    Genes involved in circadian regulation, such as circadian locomotor output cycles kaput [CLOCK], cryptochrome [CRY1], and period [PER], have been associated with sleep outcomes in prior animal and human research. However, it is unclear whether polymorphisms in these genes are associated with the sleep disturbances commonly experienced by adults living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Thus, the purpose of this study was to describe polymorphisms in selected circadian genes that are associated with sleep duration or disruption as well as the sleep-wake rhythm strength and phase timing among adults living with HIV/AIDS. A convenience sample of 289 adults with HIV/AIDS was recruited from HIV clinics and community sites in the San Francisco Bay Area. A wrist actigraph was worn for 72 hours on weekdays to estimate sleep duration or total sleep time (TST), sleep disruption or percentage of wake after sleep onset (WASO), and several circadian rhythm parameters: mesor, amplitude, the ratio of mesor to amplitude (circadian quotient), and 24-hour autocorrelation. Circadian phase measures included clock time for peak activity (acrophase) from actigraphy movement data, and bed time and final wake time from actigraphy and self-report. Genotyping was conducted for polymorphisms in 5 candidate genes involved in circadian regulation: CLOCK, CRY1, PER1, PER2, and PER3. Demographic and clinical variables were evaluated as potential covariates. Interactions between genotype and HIV variables (i.e., viral load, years since HIV diagnosis) were also evaluated. Controlling for potentially confounding variables (e.g., race, gender, CD4+ T-cell count, waist circumference, medication use, smoking, depressive symptoms), CLOCK was associated with WASO, 24-hour autocorrelation, and objectively-measured bed time; CRY1 was associated with circadian quotient; PER1 was associated with mesor and self-reported habitual wake time; PER2 was associated

  6. Circadian regulation gene polymorphisms are associated with sleep disruption and duration, and circadian phase and rhythm in adults with HIV.

    PubMed

    Lee, Kathryn A; Gay, Caryl; Byun, Eeeseung; Lerdal, Anners; Pullinger, Clive R; Aouizerat, Bradley E

    2015-01-01

    Genes involved in circadian regulation, such as circadian locomotor output cycles kaput [CLOCK], cryptochrome [CRY1] and period [PER], have been associated with sleep outcomes in prior animal and human research. However, it is unclear whether polymorphisms in these genes are associated with the sleep disturbances commonly experienced by adults living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Thus, the purpose of this study was to describe polymorphisms in selected circadian genes that are associated with sleep duration or disruption as well as the sleep-wake rhythm strength and phase timing among adults living with HIV/AIDS. A convenience sample of 289 adults with HIV/AIDS was recruited from HIV clinics and community sites in the San Francisco Bay Area. A wrist actigraph was worn for 72 h on weekdays to estimate sleep duration or total sleep time (TST), sleep disruption or percentage of wake after sleep onset (WASO) and several circadian rhythm parameters: mesor, amplitude, the ratio of mesor to amplitude (circadian quotient), and 24-h autocorrelation. Circadian phase measures included clock time for peak activity (acrophase) from actigraphy movement data, and bed time and final wake time from actigraphy and self-report. Genotyping was conducted for polymorphisms in five candidate genes involved in circadian regulation: CLOCK, CRY1, PER1, PER2 and PER3. Demographic and clinical variables were evaluated as potential covariates. Interactions between genotype and HIV variables (i.e. viral load, years since HIV diagnosis) were also evaluated. Controlling for potentially confounding variables (e.g. race, gender, CD4+ T-cell count, waist circumference, medication use, smoking and depressive symptoms), CLOCK was associated with WASO, 24-h autocorrelation and objectively-measured bed time; CRY1 was associated with circadian quotient; PER1 was associated with mesor and self-reported habitual wake time; PER2 was associated with TST

  7. The effect of nap frequency on daytime sleep architecture.

    PubMed

    McDevitt, Elizabeth A; Alaynick, William A; Mednick, Sara C

    2012-08-20

    It is well documented that the quality and quantity of prior sleep influence future sleep. For instance, nocturnal sleep restriction leads to an increase in slow wave sleep (SWS) (i.e. SWS rebound) during a subsequent sleep period. However, few studies have examined how prior napping affects daytime sleep architecture. Because daytime naps are recommended for management of disrupted sleep, understanding the impact of napping on subsequent sleep may be important. We monitored sleep-wake patterns for one week with actigraphy followed by a 75-minute polysomnographically-recorded nap. We found that greater nap frequency was correlated with increased Stage 1 and decreased SWS. We categorized subjects based on nap frequency during the prior week (0 nap, 1 to 2 naps, and 3 to 4 naps) and found differences in Stage 1, Stage 2, and SWS between groups. Subjects who took no naps had the greatest amount of SWS, those who took 1 to 2 naps had the most Stage 2 sleep, and those who took 3 to 4 naps had the most Stage 1. While correlations were not found between nap frequency and nocturnal sleep measures, frequent napping was associated with increased subjective sleepiness. Therefore, frequent napping appears to be associated with lighter daytime sleep and increased sleepiness during the day. Speculatively, low levels of daytime sleepiness and increased SWS in non-nappers may help explain why these individuals choose not to nap.

  8. Sleep and vascular disorders.

    PubMed

    Plante, Gérard E

    2006-10-01

    It is not surprising that cardiovascular diseases such as congestive heart failure and coronary insufficiency can give rise to varying degrees of sleep impairment; it is less readily appreciated that certain physiologic events occurring during sleep-as well as long-term unsatisfactory sleep-may cause or increase the risk of cardiovascular conditions such as hypertension, atherosclerosis, stroke, and cardiac arrythmias. Heart rate abnormalities during sleep in normotensive subjects predict later cardiovascular disease, and their early identification alerts the physician to undertake preventive measures. Maneuvers, such as induction of hypoxia, can elicit abnormal blood pressure responses during sleep, and such responses have been used to identify impending cardiovascular problems that could become therapeutic targets. The spontaneously hypertensive rat has been used to examine the effect of sympathetic nervous system (SNS) activity on the heart under a variety of experimental conditions, including quiet and paradoxical sleep. The results have disclosed significant differences between the responses of spontaneously hypertensive rats and normal rats to SNS stimulation. Exploration of other pathophysiologic pathways affected by exposure to light and dark, including those responsive to the cyclic production of melatonin, will improve our understanding of the effect of disruptions of the circadian cycle on cardiovascular function. There is growing evidence that melatonin can influence important processes such as fluid, nitrogen, and acid-base balance. Human subjects whose nocturnal arterial blood pressure fails to show the "normal" decrement during sleep ("nondippers") are also prone to sleep poorly, exhibit increased SNS activity during sleep, and have an increased risk of total and cardiovascular disease mortality. Chronic sleep deficit is now known to be a risk factor for obesity and may contribute to the visceral form of obesity that underlies the metabolic syndrome

  9. Blood-Brain Barrier Disruption Induced by Chronic Sleep Loss: Low-Grade Inflammation May Be the Link

    PubMed Central

    Velázquez-Moctezuma, J.

    2016-01-01

    Sleep is a vital phenomenon related to immunomodulation at the central and peripheral level. Sleep deficient in duration and/or quality is a common problem in the modern society and is considered a risk factor to develop neurodegenerative diseases. Sleep loss in rodents induces blood-brain barrier disruption and the underlying mechanism is still unknown. Several reports indicate that sleep loss induces a systemic low-grade inflammation characterized by the release of several molecules, such as cytokines, chemokines, and acute-phase proteins; all of them may promote changes in cellular components of the blood-brain barrier, particularly on brain endothelial cells. In the present review we discuss the role of inflammatory mediators that increase during sleep loss and their association with general disturbances in peripheral endothelium and epithelium and how those inflammatory mediators may alter the blood-brain barrier. Finally, this manuscript proposes a hypothetical mechanism by which sleep loss may induce blood-brain barrier disruption, emphasizing the regulatory effect of inflammatory molecules on tight junction proteins. PMID:27738642

  10. Blood-Brain Barrier Disruption Induced by Chronic Sleep Loss: Low-Grade Inflammation May Be the Link.

    PubMed

    Hurtado-Alvarado, G; Domínguez-Salazar, E; Pavon, L; Velázquez-Moctezuma, J; Gómez-González, B

    2016-01-01

    Sleep is a vital phenomenon related to immunomodulation at the central and peripheral level. Sleep deficient in duration and/or quality is a common problem in the modern society and is considered a risk factor to develop neurodegenerative diseases. Sleep loss in rodents induces blood-brain barrier disruption and the underlying mechanism is still unknown. Several reports indicate that sleep loss induces a systemic low-grade inflammation characterized by the release of several molecules, such as cytokines, chemokines, and acute-phase proteins; all of them may promote changes in cellular components of the blood-brain barrier, particularly on brain endothelial cells. In the present review we discuss the role of inflammatory mediators that increase during sleep loss and their association with general disturbances in peripheral endothelium and epithelium and how those inflammatory mediators may alter the blood-brain barrier. Finally, this manuscript proposes a hypothetical mechanism by which sleep loss may induce blood-brain barrier disruption, emphasizing the regulatory effect of inflammatory molecules on tight junction proteins.

  11. Effects of Dose-Dependent Sleep Disruption on Fear and Reward Responses

    DTIC Science & Technology

    2014-04-01

    Sleep , fMRI, neuroimaging, sleep deprivation , sleep ... sleep deprivation on psychophysiological and neural responses to threat and reward stimuli in healthy young adults between the ages of 18 and 30...withdrew or were withdraw after randomization because they 1) could not tolerate the sleep deprivation procedures; or 2) screened positive on a urine

  12. Electroencephalographic studies of sleep

    NASA Technical Reports Server (NTRS)

    Webb, W. B.; Agnew, H. W., Jr.

    1975-01-01

    Various experimental studies on sleep are described. The following areas are discussed: (1) effect of altered day length on sleep, (2) effect of a partial loss of sleep on subsequent nocturnal sleep; (3) effect of rigid control over sleep-wake-up times; (4) sleep and wakefulness in a time-free environment; (5) distribution of spindles during a full night of sleep; and (6) effect on sleep and performance of swiftly changing shifts of work.

  13. Poor sleep maintenance and subjective sleep quality are associated with postpartum maternal depression symptom severity.

    PubMed

    Park, Eliza M; Meltzer-Brody, Samantha; Stickgold, Robert

    2013-12-01

    Women are at increased risk of developing mood disorders during the postpartum period, and poor postpartum sleep may be a modifiable risk factor for the development of depression. This longitudinal study investigated the relationship between sleep variables and postpartum depression symptoms using wrist actigraphy and self-report surveys. Twenty-five healthy primiparous women were recruited from their outpatient obstetricians' offices from July 2009 through March 2010. Subjects wore wrist actigraphs for 1 week during the third trimester of pregnancy and again during the 2nd, 6th, 10th, and 14th weeks postpartum while completing sleep logs and sleep surveys. Subjective assessments of mood were collected at the end of each actigraph week. Subjective sleep assessments were strongly predictive of depression severity scores as measured by the Edinburgh Postnatal Depression Scale (EPDS) across all weeks (p < 0.001). Actigraphic measures of sleep maintenance, such as sleep fragmentation, sleep efficiency, and wake time after sleep onset, were also significantly correlated with EPDS scores postpartum. However, there was no relationship between nocturnal sleep duration and EPDS scores. This study provides additional evidence that poor sleep maintenance as measured by wrist actigraphy, rather than lesser amounts of sleep, is associated with EPDS scores during the postpartum period and that subjective assessments of sleep may be more accurate predictors of postpartum depression symptoms than wrist actigraphy. It also supports the hypothesis that disrupted sleep may contribute to the development and extent of postpartum depression symptoms.

  14. H1N1 influenza virus induces narcolepsy-like sleep disruption and targets sleep-wake regulatory neurons in mice.

    PubMed

    Tesoriero, Chiara; Codita, Alina; Zhang, Ming-Dong; Cherninsky, Andrij; Karlsson, Håkan; Grassi-Zucconi, Gigliola; Bertini, Giuseppe; Harkany, Tibor; Ljungberg, Karl; Liljeström, Peter; Hökfelt, Tomas G M; Bentivoglio, Marina; Kristensson, Krister

    2016-01-19

    An increased incidence in the sleep-disorder narcolepsy has been associated with the 2009-2010 pandemic of H1N1 influenza virus in China and with mass vaccination campaigns against influenza during the pandemic in Finland and Sweden. Pathogenetic mechanisms of narcolepsy have so far mainly focused on autoimmunity. We here tested an alternative working hypothesis involving a direct role of influenza virus infection in the pathogenesis of narcolepsy in susceptible subjects. We show that infection with H1N1 influenza virus in mice that lack B and T cells (Recombinant activating gene 1-deficient mice) can lead to narcoleptic-like sleep-wake fragmentation and sleep structure alterations. Interestingly, the infection targeted brainstem and hypothalamic neurons, including orexin/hypocretin-producing neurons that regulate sleep-wake stability and are affected in narcolepsy. Because changes occurred in the absence of adaptive autoimmune responses, the findings show that brain infections with H1N1 virus have the potential to cause per se narcoleptic-like sleep disruption.

  15. [Nocturnal enuresis in children].

    PubMed

    Hjälmås, K

    1998-01-01

    After allergic disorders, nocturnal enuresis is the most common chronic childhood condition. Recent research has yielded abundant new knowledge about the condition, especially about its aetiology and pathophysiology, and the psychological consequences. A hereditary background has been substantiated by the identification in genetic linkage studies of areas in chromosomes 12 and 13 that are manifestly associated with bedwetting, though genotype expression in the phenotype appears to be complex and heterogeneous. Pathophysiologically, findings in current intensive research suggest three interactive factors to be involved: (i) relative nocturnal polyuria, due to insufficient antidiuretic hormone release during sleep in pre-teenagers, and due to renal tubular dysfunction in adolescents and adults; (ii) reduced nocturnal bladder capacity, especially in the 33 per cent of cases which do not respond to desmopressin treatment; and (iii) the patient's inability to waken in response to signals from a full bladder. Recent findings have also confirmed previous reports that with very few exceptions bedwetting is not caused by psychological factors. On the contrary, the condition causes psychological problems manifested in reduced self-esteem, shame and guilt, though self-esteem is restored by successful treatment. Active treatment should be started as soon as the child is ready to receive it, the main options being an enuresis alarm, desmopressin, or a combination of the two. If reduced bladder capacity is suspected, treatment with a detrusor relaxant should be included.

  16. Sleep Disruption in Young Children. The Influence of Temperament on the Sleep Patterns of Pre-school Children.

    ERIC Educational Resources Information Center

    Atkinson, E.; And Others

    1995-01-01

    Investigates the importance of temperament as a predictor of children's sleep problems. Subjects were 57 toddlers ranging from 12 to 36 months. Discusses case studies to further illuminate other possible factors such as parental handling. Results indicated that children with reported sleep problems were more likely to obtain an intermediate high…

  17. Sleep deprivation disrupts prepulse inhibition of the startle reflex: reversal by antipsychotic drugs.

    PubMed

    Frau, Roberto; Orrù, Marco; Puligheddu, Monica; Gessa, Gian Luigi; Mereu, Giampaolo; Marrosu, Francesco; Bortolato, Marco

    2008-11-01

    Sleep deprivation (SD) is known to induce perceptual impairments, ranging from perceptual distortion to hallucinatory states. Although this phenomenon has been extensively described in the literature, its neurobiological underpinnings remain elusive. In rodents, SD induces a series of behavioural patterns that might be reflective of psychosis and mania, such as hyperlocomotion and sensitization to psychotogenic drugs. Notably, such changes are accompanied by transitory alterations of dopaminergic signalling. Based on the hypothesis that both psychotic and manic disorders reflect gating impairments, the present study was aimed at the assessment of the impact of SD on the behavioural model of prepulse inhibition (PPI) of the startle reflex, a reliable paradigm for the study of informational filtering. Rats subjected to SD (24 h, 48 h, 72 h) exhibited a time-dependent increase in startle reflex and a dramatic deficit in PPI. Both alterations were reversed 24 h after termination of the SD period. Interestingly, PPI disruption was efficiently prevented by haloperidol (0.1 mg/kg i.p.) clozapine (5 mg/kg i.p.) and risperidone (1 mg/kg i.p.). Conversely, neither the anxiolytic diazepam (5 mg/kg i.p.) nor the antidepressant citalopram (5 mg/kg i.p) affected the PPI disruption mediated by SD, although diazepam reversed the enhancement in startle reflex magnitude induced by this manipulation. Our data suggest that SD induces gating deficits that might be relevant to the hallucinatory phenomena observed in humans, and provide a novel reliable animal model where such relationship can be studied.

  18. Sleep-like behavior and 24-h rhythm disruption in the Tc1 mouse model of Down syndrome.

    PubMed

    Heise, I; Fisher, S P; Banks, G T; Wells, S; Peirson, S N; Foster, R G; Nolan, P M

    2015-02-01

    Down syndrome is a common disorder associated with intellectual disability in humans. Among a variety of severe health problems, patients with Down syndrome exhibit disrupted sleep and abnormal 24-h rest/activity patterns. The transchromosomic mouse model of Down syndrome, Tc1, is a trans-species mouse model for Down syndrome, carrying most of human chromosome 21 in addition to the normal complement of mouse chromosomes and expresses many of the phenotypes characteristic of Down syndrome. To date, however, sleep and circadian rhythms have not been characterized in Tc1 mice. Using both circadian wheel-running analysis and video-based sleep scoring, we showed that these mice exhibited fragmented patterns of sleep-like behaviour during the light phase of a 12:12-h light/dark (LD) cycle with an extended period of continuous wakefulness at the beginning of the dark phase. Moreover, an acute light pulse during night-time was less effective in inducing sleep-like behaviour in Tc1 animals than in wild-type controls. In wheel-running analysis, free running in constant light (LL) or constant darkness (DD) showed no changes in the circadian period of Tc1 animals although they did express subtle behavioural differences including a reduction in total distance travelled on the wheel and differences in the acrophase of activity in LD and in DD. Our data confirm that Tc1 mice express sleep-related phenotypes that are comparable with those seen in Down syndrome patients with moderate disruptions in rest/activity patterns and hyperactive episodes, while circadian period under constant lighting conditions is essentially unaffected.

  19. The effects of light therapy on depression and sleep disruption in older adults in a long-term care facility.

    PubMed

    Wu, Mann-Chian; Sung, Huei-Chuan; Lee, Wen-Li; Smith, Graeme D

    2015-10-01

    This study aims to evaluate the effect of light therapy on depression and sleep disruption in older adults residing in a long-term care facility. Psychological morbidity is a problem commonly seen in older adults residing in long-term care facilities. Limited research has addressed the effect of light therapy on depression in this population. A quasi-experimental pretest and posttest design was used. Thirty-four participants in the experimental group received light therapy by sitting in front of a 10000-lux light box 30 min in the morning, three times a week for 4 weeks. Thirty-one participants in the control group received routine care without light therapy. Depression was measured by Geriatric Depression Scale-Short Form at baseline and week 4. After receiving 4 weeks of light therapy, the mean depression score in the experimental group decreased from 7.24 (SD3.42) at pretest to 5.91 (SD 3.40) at posttest, and had a significant reduction (t = 2.22, P = 0.03). However, there was no significant difference in depression score and sleep disruption between the experimental group and control group. Light therapy might have the potential to reduce depressive symptoms and sleep disruption and may be a viable intervention to improve mental health of older adults in the long-term care facilities.

  20. The Impact of Sleep Disruption on Executive Function in Down Syndrome

    ERIC Educational Resources Information Center

    Chen, C.-C.; Spano, G.; Edgin, J. O.

    2013-01-01

    The high prevalence of sleep disorders, particularly obstructive sleep apnea, is well established in children with Down syndrome. However, only a few studies have focused on older children and young adults in this population. Given the presence of sleep disorders and the early emergence of Alzheimer's disease, more work is needed to examine the…

  1. Sleep abnormality in neuromyelitis optica spectrum disorder

    PubMed Central

    Song, Yijun; Pan, Liping; Fu, Ying; Sun, Na; Li, Yu-Jing; Cai, Hao; Su, Lei; Shen, Yi; Cui, Linyang

    2015-01-01

    Objectives: We investigated the sleep structure of patients with neuromyelitis optica spectrum disorder (NMOSD) and the association of abnormalities with brain lesions. Methods: This was a prospective cross-sectional study. Thirty-three patients with NMOSD and 20 matched healthy individuals were enrolled. Demographic and clinical characteristics of patients were collected. Questionnaires were used to assess quality of sleep, daytime sleepiness, fatigue, and depression. Nocturnal polysomnography was performed. Results: Compared with healthy controls, patients with NMOSD had decreases in sleep efficiency (7%; p = 0.0341), non-REM sleep N3 (12%; p < 0.0001), and arousal index (6; p = 0.0138). REM sleep increased by 4% (p = 0.0423). There were correlations between arousal index and REM% or Epworth Sleepiness Scale (r = −0.0145; p = 0.0386, respectively). Six patients with NMOSD (18%, 5 without infratentorial lesions and 1 with infratentorial lesions) had a hypopnea index >5, and all of those with sleep apnea had predominantly the peripheral type. The periodic leg movement (PLM) index was higher in patients with NMOSD than in healthy controls (20 vs 2, p = 0.0457). Surprisingly, 77% of the patients with PLM manifested infratentorial lesions. Conclusions: Sleep architecture was markedly disrupted in patients with NMOSD. Surveillance of nocturnal symptoms and adequate symptomatic control are expected to improve the quality of life of patients with NMOSD. PMID:25918736

  2. Sleep Disturbances in Posttraumatic Stress Disorder: Updated Review and Implications for Treatment

    PubMed Central

    Koffel, Erin; Khawaja, Imran S.; Germain, Anne

    2016-01-01

    Sleep disturbances are common in adults with PTSD and range from insomnia and nightmares to periodic leg movements and disruptive nocturnal behaviors. Together these findings suggest profound disturbances in rapid eye movement (REM) and non-REM (NREM) sleep, although there is a lack of consensus regarding a distinct profile of objective sleep disturbances associated with PTSD. Prospective, longitudinal studies have established that sleep disturbances represent a risk factor for the development and course of PTSD, suggesting that sleep is an important neurobiological mechanism in the etiology and maintenance of this disorder. This research highlights the importance of early identification and treatment of sleep disturbances in at-risk and trauma exposed populations. A number of psychological and pharmacological treatments are effective at treating sleep disturbances in PTSD. Additional research is needed to further develop clinical guidelines informing when and how to integrate sleep-specific treatment with PTSD focused clinical care. PMID:27773950

  3. Association between light at night, melatonin secretion, sleep deprivation, and the internal clock: Health impacts and mechanisms of circadian disruption.

    PubMed

    Touitou, Yvan; Reinberg, Alain; Touitou, David

    2017-03-15

    Exposure to Artificial Light At Night (ALAN) results in a disruption of the circadian system, which is deleterious to health. In industrialized countries, 75% of the total workforce is estimated to have been involved in shift work and night work. Epidemiologic studies, mainly of nurses, have revealed an association between sustained night work and a 50-100% higher incidence of breast cancer. The potential and multifactorial mechanisms of the effects include the suppression of melatonin secretion by ALAN, sleep deprivation, and circadian disruption. Shift and/or night work generally decreases the time spent sleeping, and it disrupts the circadian time structure. In the long run, this desynchronization is detrimental to health, as underscored by a large number of epidemiological studies that have uncovered elevated rates of several diseases, including cancer, diabetes, cardiovascular risks, obesity, mood disorders and age-related macular degeneration. It amounts to a public health issue in the light of the very substantial number of individuals involved. The IARC has classified shift work in group 2A of "probable carcinogens to humans" since "they involve a circadian disorganization". Countermeasures to the effects of ALAN, such as melatonin, bright light, or psychotropic drugs, have been proposed as a means to combat circadian clock disruption and improve adaptation to shift and night work. We review the evidence for the ALAN impacts on health. Furthermore, we highlight the importance of an in-depth mechanistic understanding to combat the detrimental properties of exposure to ALAN and develop strategies of prevention.

  4. Relationships between sleep, physical activity and human health

    PubMed Central

    Atkinson, Greg; Davenne, Damien

    2009-01-01

    Although sleep and exercise may seem to be mediated by completely different physiological mechanisms, there is growing evidence for clinically important relationships between these two behaviors. It is known that passive body heating facilitates the nocturnal sleep of healthy elderly people with insomnia. This finding supports the hypothesis that changes in body temperature trigger somnogenic brain areas to initiate sleep. Nevertheless, little is known about how the core and distal thermoregulatory responses to exercise fit into this hypothesis. Such knowledge could also help in reducing sleep problems associated with nocturnal shiftwork. It is difficult to incorporate physical activity into a shiftworker's lifestyle, since it is already disrupted in terms of family commitments and eating habits. A multi-research strategy is needed to identify what the optimal amounts and timing of physical activity are for reducing shiftwork-related sleep problems. The relationships between sleep, exercise and diet are also important, given the recently reported associations between short sleep length and obesity. The cardiovascular safety of exercise timing should also be considered, since recent data suggest that the reactivity of blood pressure to a change in general physical activity is highest during the morning. This time is associated with an increased risk in general of a sudden cardiac event, but more research work is needed to separate the influences of light, posture and exercise per se on the haemodynamic responses to sleep and physical activity following sleep taken at night and during the day as a nap. PMID:17067643

  5. Nocturnal Hypoxia and Loss of Kidney Function

    PubMed Central

    Ahmed, Sofia B.; Ronksley, Paul E.; Hemmelgarn, Brenda R.; Tsai, Willis H.; Manns, Braden J.; Tonelli, Marcello; Klarenbach, Scott W.; Chin, Rick; Clement, Fiona M.; Hanly, Patrick J.

    2011-01-01

    Background Although obstructive sleep apnea (OSA) is more common in patients with kidney disease, whether nocturnal hypoxia affects kidney function is unknown. Methods We studied all adult subjects referred for diagnostic testing of sleep apnea between July 2005 and December 31 2007 who had serial measurement of their kidney function. Nocturnal hypoxia was defined as oxygen saturation (SaO2) below 90% for ≥12% of the nocturnal monitoring time. The primary outcome, accelerated loss of kidney function, was defined as a decline in estimated glomerular filtration rate (eGFR) ≥4 ml/min/1.73 m2 per year. Results 858 participants were included and followed for a mean study period of 2.1 years. Overall 374 (44%) had nocturnal hypoxia, and 49 (5.7%) had accelerated loss of kidney function. Compared to controls without hypoxia, patients with nocturnal hypoxia had a significant increase in the adjusted risk of accelerated kidney function loss (odds ratio (OR) 2.89, 95% confidence interval [CI] 1.25, 6.67). Conclusion Nocturnal hypoxia was independently associated with an increased risk of accelerated kidney function loss. Further studies are required to determine whether treatment and correction of nocturnal hypoxia reduces loss of kidney function. PMID:21559506

  6. Rapid eye movement sleep deprivation disrupts consolidation but not reconsolidation of novel object recognition memory in rats.

    PubMed

    Chen, Lin; Tian, Shaowen; Ke, Jie

    2014-03-20

    There is increasing evidence that sleep plays a critical role in memory consolidation. However, there are comparatively few studies that have assessed the relationship between sleep and memory reconsolidation. In the present study, we explored the effects of rapid eye movement sleep deprivation (RSD) on the consolidation (experiment 1) and reconsolidation (experiment 2) of novel object recognition memory in rats. In experiment 1 behavioral procedure involved two training phases: sample and test. Rats were subjected to 6h RSD starting either immediately after sample (exposed to 2 objects) or 6h later. In experiment 2 behavioral procedure involved three training phases: sample, reactivation and test. Rats were subjected to 6h RSD starting either immediately after reactivation (exposed to the same 2 sample objects to reactivate the memory trace) or 6h later. Results from experiment 1 showed that post-sample RSD from 0 to 6h but not 6 to 12h disrupted novel object recognition memory consolidation. However, we found that post-reactivation RSD whether from 0 to 6h or 6 to 12h had no effect on novel object recognition memory reconsolidation in experiment 2. The results indicated that RSD selectively disrupted consolidation of novel object recognition memory, suggesting a dissociation effect of RSD on consolidation and reconsolidation.

  7. Rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia in narcolepsy.

    PubMed

    Dauvilliers, Yves; Jennum, Poul; Plazzi, Giuseppe

    2013-08-01

    Narcolepsy is a rare disabling hypersomnia disorder that may include cataplexy, sleep paralysis, hypnagogic hallucinations, and sleep-onset rapid eye movement (REM) periods, but also disrupted nighttime sleep by nocturnal awakenings, and REM sleep behavior disorder (RBD). RBD is characterized by dream-enacting behavior and impaired motor inhibition during REM sleep (REM sleep without atonia, RSWA). RBD is commonly associated with neurodegenerative disorders including Parkinsonisms, but is also reported in narcolepsy in up to 60% of patients. RBD in patients with narcolepsy is, however, a distinct phenotype with respect to other RBD patients and characterized also by absence of gender predominance, elementary rather than complex movements, less violent behavior and earlier age at onset of motor events, and strong association to narcolepsy with cataplexy/hypocretin deficiency. Patients with narcolepsy often present dissociated sleep features including RSWA, increased density of phasic chin EMG and frequent shift from REM to NREM sleep, with or without associated clinical RBD. Most patients with narcolepsy with cataplexy lack the hypocretin neurons in the lateral hypothalamus. Tonic and phasic motor activities in REM sleep and dream-enacting behavior are mostly reported in presence of cataplexy. Narcolepsy without cataplexy is a condition rarely associated with hypocretin deficiency. We proposed that hypocretin neurons are centrally involved in motor control during wakefulness and sleep in humans, and that hypocretin deficiency causes a functional defect in the motor control involved in the development of cataplexy during wakefulness and RBD/RSWA/phasic motor activity during REM sleep.

  8. Sleep deprivation selectively disrupts top-down adaptation to cognitive conflict in the Stroop test.

    PubMed

    Gevers, Wim; Deliens, Gaetane; Hoffmann, Sophie; Notebaert, Wim; Peigneux, Philippe

    2015-12-01

    Sleep deprivation is known to exert detrimental effects on various cognitive domains, including attention, vigilance and working memory. Seemingly at odds with these findings, prior studies repeatedly failed to evidence an impact of prior sleep deprivation on cognitive interference in the Stroop test, a hallmark paradigm in the study of cognitive control abilities. The present study investigated further the effect of sleep deprivation on cognitive control using an adapted version of the Stroop test that allows to segregate top-down (attentional reconfiguration on incongruent items) and bottom-up (facilitated processing after repetitions in responses and/or features of stimuli) components of performance. Participants underwent a regular night of sleep or a night of total sleep deprivation before cognitive testing. Results disclosed that sleep deprivation selectively impairs top-down adaptation mechanisms: cognitive control no longer increased upon detection of response conflict at the preceding trial. In parallel, bottom-up abilities were found unaffected by sleep deprivation: beneficial effects of stimulus and response repetitions persisted. Changes in vigilance states due to sleep deprivation selectively impact on cognitive control in the Stroop test by affecting top-down, but not bottom-up, mechanisms that guide adaptive behaviours.

  9. Sleep Disruption as a Correlate to Cognitive and Adaptive Behavior Problems in Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Taylor, Matthew A.; Schreck, Kimberly A.; Mulick, James A.

    2012-01-01

    Sleep problems associated with autism spectrum disorders (ASD) have been well documented, but less is known about the effects of sleep problems on day-time cognitive and adaptive performance in this population. Children diagnosed with autism or pervasive developmental disorder-not otherwise specified (PDD-NOS) (N = 335) from 1 to 10 years of age…

  10. Pain Disrupts Sleep in Children and Youth with Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Breau, Lynn M.; Camfield, Carol S.

    2011-01-01

    Both chronic pain and sleep problems are common for children with intellectual and developmental disabilities (IDD). Although one study has revealed a relationship between having a medical condition and sleep problems in this population, the role of pain was not examined independently. Thus, the goal of this study was to clarify the specific role…

  11. The Treatment of Sleep Disorders in Parkinson’s Disease: From Research to Clinical Practice

    PubMed Central

    Loddo, Giuseppe; Calandra-Buonaura, Giovanna; Sambati, Luisa; Giannini, Giulia; Cecere, Annagrazia; Cortelli, Pietro; Provini, Federica

    2017-01-01

    Sleep disorders (SDs) are one of the most frequent non-motor symptoms of Parkinson’s disease (PD), usually increasing in frequency over the course of the disease and disability progression. SDs include nocturnal and diurnal manifestations such as insomnia, REM sleep behavior disorder, and excessive daytime sleepiness. The causes of SDs in PD are numerous, including the neurodegeneration process itself, which can disrupt the networks regulating the sleep–wake cycle and deplete a large number of cerebral amines possibly playing a role in the initiation and maintenance of sleep. Despite the significant prevalence of SDs in PD patients, few clinical trials on SDs treatment have been conducted. Our aim is to critically review the principal therapeutic options for the most common SDs in PD. The appropriate diagnosis and treatment of SDs in PD can lead to the consolidation of nocturnal sleep, the enhancement of daytime alertness, and the amelioration of the quality of life of the patients. PMID:28261151

  12. Sleep complaints in periodic paralyses: a web survey.

    PubMed

    Buzzi, G; Mostacci, B; Sancisi, E; Cirignotta, F

    2001-01-01

    Neuronal potassium conductance has been shown to influence the sleep-wake cycle and REM sleep homeostasis. The periodic paralyses (PP) are characterized by episodes of muscular weakness associated with changes in serum potassium levels and, therefore, with possible alterations in extracellular neuronal potassium conductance. We submitted a sleep questionnaire to the members of Periodic Paralysis International Listserv, an on-line support and information group for subjects with PP. Three control groups were made up of patients with untreated depression, patients with depression under treatment and healthy subjects. Both subjects with PP and those with untreated depression had a higher frequency of self-reported insufficient sleep quality and a higher number of nocturnal awakenings than patients with depression under treatment and healthy controls. PP subjects had more self-reported daytime sleepiness, sleep-related hallucinations and nightmares/abnormal dreams than the other three groups. Patients affected by PP may have disrupted sleep architecture and homeostasis. In particular, we suggest that the stereotypical abnormal dreams reported by several patients may reflect oneiric elaboration of nocturnal episodes of flaccid paralysis, while the increased frequency of sleep-related hallucinations may be due to enhanced REM sleep expression associated with alterations of neuronal potassium conductance.

  13. Nocturnal frontal lobe epilepsy in mucopolysaccharidosis.

    PubMed

    Bonanni, Paolo; Volzone, Anna; Randazzo, Giovanna; Antoniazzi, Lisa; Rampazzo, Angelica; Scarpa, Maurizio; Nobili, Lino

    2014-10-01

    Nocturnal frontal lobe epilepsy (NFLE) is an epileptic syndrome that is primarily characterized by seizures with motor signs occurring almost exclusively during sleep. We describe 2 children with mucopolysaccharidosis (MPS) who were referred for significant sleep disturbance. Long term video-EEG monitoring (LT-VEEGM) demonstrated sleep-related hypermotor seizures consistent with NFLE. No case of sleep-related hypermotor seizures has ever been reported to date in MPS. However, differential diagnosis with parasomnias has been previously discussed. The high frequency of frontal lobe seizures causes sleep fragmentation, which may result in sleep disturbances observed in at least a small percentage of MPS patients. We suggest monitoring individuals with MPS using periodic LT-VEEGM, particularly when sleep disorder is present. Moreover, our cases confirm that NFLE in lysosomal storage diseases may occur, and this finding extends the etiologic spectrum of NFLE.

  14. Disrupted sleep-wake regulation in type 1 equilibrative nucleoside transporter knockout mice.

    PubMed

    Kim, T; Ramesh, V; Dworak, M; Choi, D-S; McCarley, R W; Kalinchuk, A V; Basheer, R

    2015-09-10

    The type 1 equilibrative nucleoside transporter (ENT1) is implicated in regulating levels of extracellular adenosine ([AD]ex). In the basal forebrain (BF) levels of [AD]ex increase during wakefulness and closely correspond to the increases in the electroencephalogram (EEG) delta (0.75-4.5Hz) activity (NRδ) during subsequent non-rapid eye movement sleep (NREMS). Thus in the BF, [AD]ex serves as a biochemical marker of sleep homeostasis. Waking EEG activity in theta range (5-9Hz, Wθ) is also described as a marker of sleep homeostasis. An hour-by-hour temporal relationship between the Wθ and NRδ is unclear. In this study we examined the relationship between these EEG markers of sleep homeostasis during spontaneous sleep-wakefulness and during sleep deprivation (SD) and recovery sleep in the ENT1 gene knockout (ENT1KO) mouse. We observed that baseline NREMS amount was decreased during the light period in ENT1KO mice, accompanied by a weak correlation between Wθ of each hour and NRδ of its subsequent hour when compared to their wild-type (WT) littermates. Perfusion of low dose of adenosine into BF not only strengthened the Wθ-NRδ relationship, but also increased NREMS to match with the WT littermates suggesting decreased [AD]ex in ENT1KO mice. However, the SD-induced [AD]ex increase in the BF and the linear correlation between the EEG markers of sleep homeostasis were unaffected in ENT1KO mice suggesting that during SD, sources other than ENT1 contribute to increase in [AD]ex. Our data provide evidence for a differential regulation of wakefulness-associated [AD]ex during spontaneous vs prolonged waking.

  15. Effects of nocturnal railway noise on sleep fragmentation in young and middle-aged subjects as a function of type of train and sound level.

    PubMed

    Saremi, Mahnaz; Grenèche, Jérôme; Bonnefond, Anne; Rohmer, Odile; Eschenlauer, Arnaud; Tassi, Patricia

    2008-12-01

    Due to undisputable effects of noise on sleep structure, especially in terms of sleep fragmentation, the expected development of railway transportation in the next few years might represent a potential risk factor for people living alongside the rail tracks. The aim of this study was to compare the effects of different types of train (freight, automotive, passenger) on arousal from sleep and to determine any differential impact as a function of sound level and age. Twenty young (16 women, 4 men; 25.8 years+/-2.6) and 18 middle-aged (15 women, 3 men; 52.2 years+/-2.5) healthy subjects participated in three whole-night polysomnographic recordings including one control night (35 dBA), and two noisy nights with equivalent noise levels of 40 or 50 dB(A), respectively. Arousal responsiveness increased with sound level. It was the highest in S2 and the lowest in REM sleep. Micro-arousals (3-10 s) occurred at a rate of 25-30%, irrespective of the type of train. Awakenings (>10 s) were produced more frequently by freight train than by automotive and passenger trains. Normal age-related changes in sleep were observed, but they were not aggravated by railway noise, thus questioning whether older persons are less sensitive to noise during sleep. These evidences led to the conclusion that microscopic detection of sleep fragmentation may provide advantageous information on sleep disturbances caused by environmental noises.

  16. Can nocturnal hypertension predict cardiovascular risk?

    PubMed Central

    Friedman, Oded; Logan, Alexander G

    2009-01-01

    Nocturnal hypertension and non-dipping of blood pressure during sleep are distinct entities that often occur together and are regarded as important harbingers of poor cardiovascular prognosis. This review addresses several aspects related to these blood pressure abnormalities including definitions, diagnostic limitations, pathogenesis and associated patient profiles, prognostic significance, and therapeutic strategies. Taken together, persistent nocturnal hypertension and non-dipping blood pressure pattern, perhaps secondary to abnormal renal sodium handling and/or altered nocturnal sympathovagal balance, are strongly associated with deaths, cardiovascular events, and progressive loss of renal function, independent of daytime and 24-hour blood pressure. Several pharmacological and non-pharmacological approaches may restore nocturnal blood pressure and circadian blood pressure rhythm to normal; however, whether this translates to a clinically meaningful reduction in unfavorable cardiovascular and renal consequences remains to be seen. PMID:21949613

  17. Effects of Blast Exposure on Subjective and Objective Sleep Measures in Combat Veterans with and without PTSD

    PubMed Central

    Stocker, Ryan P.J.; Paul, Benjamin T.E.; Mammen, Oommen; Khan, Hassen; Cieply, Marissa A.; Germain, Anne

    2016-01-01

    Study Objectives: This study examined the extent to which self-reported exposure to blast during deployment to Iraq and Afghanistan affects subjective and objective sleep measures in service members and veterans with and without posttraumatic stress disorder (PTSD). Methods: Seventy-one medication-free service members and veterans (mean age = 29.47 ± 5.76 years old; 85% men) completed self-report sleep measures and overnight polysomnographic studies. Four multivariate analyses of variance (MANOVAs) were conducted to examine the impact of blast exposure and PTSD on subjective sleep measures, measures of sleep continuity, non-rapid eye movement (NREM) sleep parameters, and rapid eye movement (REM) sleep parameters. Results: There was no significant Blast × PTSD interaction on subjective sleep measures. Rather, PTSD had a main effect on insomnia severity, sleep quality, and disruptive nocturnal behaviors. There was no significant Blast × PTSD interaction, nor were there main effects of PTSD or Blast on measures of sleep continuity and NREM sleep. A significant PTSD × Blast interaction effect was found for REM fragmentation. Conclusions: The results suggest that, although persistent concussive symptoms following blast exposure are associated with sleep disturbances, self-reported blast exposure without concurrent symptoms does not appear to contribute to poor sleep quality, insomnia, and disruptive nocturnal disturbances beyond the effects of PTSD. Reduced REM sleep fragmentation may be a sensitive index of the synergetic effects of both psychological and physical insults. Citation: Stocker RP, Paul BT, Mammen O, Khan H, Cieply MA, Germain A. Effects of blast exposure on subjective and objective sleep measures in combat veterans with and without PTSD. J Clin Sleep Med 2016;12(1):49–56. PMID:26414975

  18. Sleep deprivation disrupts the contribution of the hippocampus to the formation of novel lexical associations.

    PubMed

    Sterpenich, Virginie; Ceravolo, Leonardo; Schwartz, Sophie

    2017-04-01

    Sleep is involved in the mechanisms underlying memory consolidation and brain plasticity. Consolidation refers to a process through which labile memories are reorganized into more stable ones. An intriguing but often neglected question concerns how pre-existing knowledge is modified when new information enters memory, and whether sleep can influence this process. We investigated how nonword learning may modify the neural representations of closely-related existing words. We also tested whether sleep contributes to any such effect by comparing a group of participants who slept during the night following a first encoding session to a sleep deprived group. Thirty participants were first intensively trained at writing nonwords on Day 1 (remote nonwords) and Day 4 (recent nonwords), following which they underwent functional MRI. This session consisted of a word lexical decision task including words orthographically-close to the trained nonwords, followed by an incidental memory task on the nonwords. Participants who slept detected real words related to remote nonwords faster than those related to recent nonwords, and showed better explicit memory for the remote nonwords. Although the full interaction comparing both groups for these effects was not significant, we found that participants from the sleep-deprivation group did not display such differences between remote and recent conditions. Imaging results revealed that the functional interplay between hippocampus and frontal regions critically mediated these behavioral effects. This study demonstrates that sleep may not only strengthen memory for recently learned items but also promotes a constant reorganization of existing networks of word representations, allowing facilitated access to orthographically-close words.

  19. [Substance-induced sleep disorders and abuse of hypnotics].

    PubMed

    Riemann, D; Nissen, C

    2011-12-01

    The intake of a large variety of substances has a negative impact on sleep. Widely used, readily available substances like alcohol, nicotine, or caffeine need to be mentioned here. Illicit drugs (e.g., heroin or ecstasy) have different mechanisms of action with a high sleep-disrupting potential. Prescription drugs, i.e., corticosteroids or β-blockers, may also negatively affect sleep. An important question is whether the intake of hypnotics, especially benzodiazepines, may have a negative long-term effect on sleep. Classical benzodiazepines (BZ) initially lead to a reduction of nocturnal wake time and prolong total sleep time as a desired effect. Regarding the microstructure of sleep, BZ lead to a reduction of slow frequencies and an increase of fast frequencies in the EEG. With many BZ, tolerance may occur, thus, leading to unwanted dose increases. Further problems include rebound effects that occur upon discontinuation of BZ, including a drastic deterioration of sleep upon drug withdrawal. This phenomenon may pave the way for the development of drug dependency. Further unwanted side-effects (e.g., nocturnal falls) and the question of BZ abuse and dependency will be discussed.

  20. REM sleep deprivation generates cognitive and neurochemical disruptions in the intranigral rotenone model of Parkinson's disease.

    PubMed

    Dos Santos, Ana Carolina D; Castro, Marcela Alexandra V; Jose, Elis Angela K; Delattre, Ana Márcia; Dombrowski, Patrícia A; Da Cunha, Claudio; Ferraz, Anete C; Lima, Marcelo M S

    2013-11-01

    The recently described intranigral rotenone model of Parkinson's disease (PD) in rodents provides an interesting model for studying mechanisms of toxin-induced dopaminergic neuronal injury. The relevance of this model remains unexplored with regard to sleep disorders that occur in PD. On this basis, the construction of a PD model depicting several behavioral and neurochemical alterations related to sleep would be helpful in understanding the association between PD and sleep regulation. We performed bilateral intranigral injections of rotenone (12 μg) on day 0 and the open-field test initially on day 20 after rotenone. Acquisition phase of the object-recognition test, executed also during day 20, was followed by an exact period of 24 hr of rapid eye movement (REM) sleep deprivation (REMSD; day 21). In the subsequent day (22), the rats were re-exposed to the open-field test and to the object-recognition test (choice phase). After the last session of behavioral tests, the rat brains were immediately dissected, and their striata were collected for neurochemical purposes. We observed that a brief exposure to REMSD was able to impair drastically the object-recognition test, similarly to a nigrostriatal lesion promoted by intranigral rotenone. However, the combination of REMSD and rotenone surprisingly did not inflict memory impairment, concomitant with a moderate compensatory mechanism mediated by striatal dopamine release. In addition, we demonstrated the existence of changes in serotonin and noradrenaline neurotransmissions within the striatum mostly as a function of REMSD and REMSD plus rotenone, respectively.

  1. Dual-Tasking Alleviated Sleep Deprivation Disruption in Visuomotor Tracking: An fMRI Study

    ERIC Educational Resources Information Center

    Gazes, Yunglin; Rakitin, Brian C.; Steffener, Jason; Habeck, Christian; Butterfield, Brady; Basner, Robert C.; Ghez, Claude; Stern, Yaakov

    2012-01-01

    Effects of dual-responding on tracking performance after 49-h of sleep deprivation (SD) were evaluated behaviorally and with functional magnetic resonance imaging (fMRI). Continuous visuomotor tracking was performed simultaneously with an intermittent color-matching visual detection task in which a pair of color-matched stimuli constituted a…

  2. Sleep disorders in children with neurologic diseases.

    PubMed

    Zucconi, M; Bruni, O

    2001-12-01

    Pediatric neurologic diseases are often associated with different kinds of sleep disruption (mainly insomnia, less frequently hypersomnia or parasomnias). Due to the key-role of sleep for development, the effort to ameliorate sleep patterns in these children could have important prognostic benefits. Study of sleep architecture and organization in neurologic disorders could lead to a better comprehension of the pathogenesis and a better treatment of the disorders. This article focuses on the following specific neurologic diseases: nocturnal frontal lobe epilepsy and abnormal motor behaviors of epileptic origin, evaluating differential diagnosis with parasomnias; achondroplasia, confirming the crucial role of craniofacial deformity in determining sleep-disordered breathing; neuromuscular diseases, mainly Duchenne's muscular dystrophy and myotonic dystrophy; cerebral palsy, evaluating either the features of sleep architecture and the importance of the respiratory problems associated; headaches, confirming the strict relationships with sleep in terms of neurochemical and neurobehavioral substrates; and finally a review on the effectiveness of melatonin for sleep problems in children with neurologic syndromes and mental retardation, blindness, and epilepsy.

  3. Chronic Sleep Disruption Alters Gut Microbiota, Induces Systemic and Adipose Tissue Inflammation and Insulin Resistance in Mice

    PubMed Central

    Poroyko, Valeriy A.; Carreras, Alba; Khalyfa, Abdelnaby; Khalyfa, Ahamed A.; Leone, Vanessa; Peris, Eduard; Almendros, Isaac; Gileles-Hillel, Alex; Qiao, Zhuanhong; Hubert, Nathaniel; Farré, Ramon; Chang, Eugene B.; Gozal, David

    2016-01-01

    Chronic sleep fragmentation (SF) commonly occurs in human populations, and although it does not involve circadian shifts or sleep deprivation, it markedly alters feeding behaviors ultimately promoting obesity and insulin resistance. These symptoms are known to be related to the host gut microbiota. Mice were exposed to SF for 4 weeks and then allowed to recover for 2 weeks. Taxonomic profiles of fecal microbiota were obtained prospectively, and conventionalization experiments were performed in germ-free mice. Adipose tissue insulin sensitivity and inflammation, as well as circulating measures of inflammation, were assayed. Effect of fecal water on colonic epithelial permeability was also examined. Chronic SF-induced increased food intake and reversible gut microbiota changes characterized by the preferential growth of highly fermentative members of Lachnospiraceae and Ruminococcaceae and a decrease of Lactobacillaceae families. These lead to systemic and visceral white adipose tissue inflammation in addition to altered insulin sensitivity in mice, most likely via enhanced colonic epithelium barrier disruption. Conventionalization of germ-free mice with SF-derived microbiota confirmed these findings. Thus, SF-induced metabolic alterations may be mediated, in part, by concurrent changes in gut microbiota, thereby opening the way for gut microbiome-targeted therapeutics aimed at reducing the major end-organ morbidities of chronic SF. PMID:27739530

  4. How Postpartum Women With Depressive Symptoms Manage Sleep Disruption and Fatigue.

    PubMed

    Doering, Jennifer J; Sims, Dauphne A; Miller, Donald D

    2017-04-01

    Postpartum sleep and fatigue have bidirectional relationships with depressive symptoms and challenge women's everyday functioning. The everyday process of managing postpartum sleep and fatigue in the context of depressive symptoms remains unexplored. We conducted a grounded theory study with a sample of 19 women who screened positive on the Postpartum Depression Screening Scale (PDSS™) Short Form at 3 weeks postpartum. Women completed semi-structured in-home interviews and the full PDSS and Modified Fatigue Symptoms Checklist at 1, 3, and 6 months postpartum. The sample was on average 27 years old, with 2.8 children, and 63% were African-American. They described a basic social process of Finding a Routine Together, during which women's experiences with their infants progressed from Retreating at month 1 toward Finding a New Normal at month 6. In their work to Find a Routine Together, mothers' patterns of change over time were continuous, gradual, or prolonged. Their progress was influenced by depressive symptoms, social support, work and daycare, stability in social circumstances, and underlying stressors. This study's findings suggest the need to allocate resources and tailor interventions to meet the needs of women who are most vulnerable to the health effects of ongoing persistent severe fatigue, disordered sleep, and sub-clinical and clinical levels of depressive symptoms. © 2017 Wiley Periodicals, Inc.

  5. Sleep and the endocrine system.

    PubMed

    Morgan, Dionne; Tsai, Sheila C

    2015-07-01

    In this article, the effect of sleep and sleep disorders on endocrine function and the influence of endocrine abnormalities on sleep are discussed. Sleep disruption and its associated endocrine consequences in the critically ill patient are also reviewed.

  6. Sleep and the Endocrine System.

    PubMed

    Morgan, Dionne; Tsai, Sheila C

    2016-03-01

    In this article, the effect of sleep and sleep disorders on endocrine function and the influence of endocrine abnormalities on sleep are discussed. Sleep disruption and its associated endocrine consequences in the critically ill patient are also reviewed.

  7. Shift work and cancer risk: potential mechanistic roles of circadian disruption, light at night, and sleep deprivation.

    PubMed

    Haus, Erhard L; Smolensky, Michael H

    2013-08-01

    Shift work that includes a nighttime rotation has become an unavoidable attribute of today's 24-h society. The related disruption of the human circadian time organization leads in the short-term to an array of jet-lag-like symptoms, and in the long-run it may contribute to weight gain/obesity, metabolic syndrome/type II diabetes, and cardiovascular disease. Epidemiologic studies also suggest increased cancer risk, especially for breast cancer, in night and rotating female shift workers. If confirmed in more controlled and detailed studies, the carcinogenic effect of night and shift work will constitute additional serious medical, economic, and social problems for a substantial proportion of the working population. Here, we examine the possible multiple and interconnected cancer-promoting mechanisms as a consequence of shift work, i.e., repeated disruption of the circadian system, pineal hormone melatonin suppression by exposure to light at night, sleep-deprivation-caused impairment of the immune system, plus metabolic changes favoring obesity and generation of proinflammatory reactive oxygen species.

  8. Is Isolated Nocturnal Hypertension A Reproducible Phenotype?

    PubMed Central

    Goldsmith, Jeff; Muntner, Paul; Diaz, Keith M.; Reynolds, Kristi; Schwartz, Joseph E.; Shimbo, Daichi

    2016-01-01

    BACKGROUND Isolated nocturnal hypertension (INH), defined as nocturnal without daytime hypertension on ambulatory blood pressure (BP) monitoring (ABPM), has been observed to be associated with an increased risk of cardiovascular disease (CVD) events and mortality. The aim of this study was to determine the short-term reproducibility of INH. METHODS The Improving the Detection of Hypertension Study enrolled a community-based sample of adults (N = 282) in upper Manhattan without CVD, renal failure, or treated hypertension. Each participant completed two 24-hour ABPM recordings (ABPM1: first recording and ABPM2: second recording) with a mean ± SD time interval of 33±17 days between recordings. Daytime hypertension was defined as mean awake systolic/diastolic BP ≥ 135/85mm Hg; nocturnal hypertension as mean sleep systolic/diastolic BP ≥ 120/70mm Hg; INH as nocturnal without daytime hypertension; isolated daytime hypertension (IDH) as daytime without nocturnal hypertension; day and night hypertension (DNH) as daytime and nocturnal hypertension, and any ambulatory hypertension as having daytime and/or nocturnal hypertension. RESULTS On ABPM1, 26 (9.2%), 21 (7.4%), and 50 (17.7%) participants had INH, IDH, and DNH, respectively. On ABPM2, 24 (8.5%), 19 (6.7%), and 54 (19.1%) had INH, IDH, and DNH, respectively. The kappa statistics were 0.21 (95% confidence interval (CI) 0.04–0.38), 0.25 (95% CI 0.06–0.44), and 0.65 (95% CI 0.53–0.77) for INH, IDH, and DNH respectively; and 0.72 (95% CI 0.63–0.81) for having any ambulatory hypertension. CONCLUSIONS Our results suggest that INH and IDH are poorly reproducible phenotypes, and that ABPM should be primarily used to identify individuals with daytime hypertension and/or nocturnal hypertension. PMID:25904648

  9. Airway-parenchyma uncoupling in nocturnal asthma.

    PubMed

    Irvin, C G; Pak, J; Martin, R J

    2000-01-01

    Airway flow resistance is well known to be dependent upon lung volume. The rise in lung volume that occurs in asthma is therefore thought to be an important mechanism that defends airway patency. The purpose of the current study was to investigate the interdependence or mechanical coupling between airways and lung parenchyma during the inflammatory processes that occur in the patient with nocturnal asthma. Five patients with documented nocturnal asthma were studied in both a vertical and a horizontal body plethysmograph. Lung volume was altered with continuous negative pressure as applied to the chest wall with a poncho cuirass in different postures and during sleep. We found during the awake phase that an increase in lung volume decreased lower pulmonary resistance (Rlp); however, within 30 min of sleep onset, functional residual capacity (FRC) fell and Rlp rose more than would be expected for the fall in FRC. Restoring FRC to presleep values either at an early (half-hour) or a late (3-h) time point did not cause Rlp to significantly fall. A second phase of the study showed that the loss of Rlp dependence on lung volume was not due to the assumption of the supine posture. Indirect measurements of lung compliance were consistent with a stiffening of the lung. We conclude that with sleep there is an immediate uncoupling of the parenchyma to the airway, resulting in a loss of interdependence that persists throughout sleep and may contribute to the morbidity and mortality associated with nocturnal asthma.

  10. Sleep benefit in Parkinson's disease is associated with short sleep times.

    PubMed

    Sherif, Eskender; Valko, Philipp O; Overeem, Sebastiaan; Baumann, Christian R

    2014-01-01

    Sleep benefit in Parkinson's disease is characterized by restoration of mobility upon awakening from sleep and prior to drug intake. With this study, we aimed at assessing clinical and nocturnal sleep correlates of this phenomenon. We recorded motor and non-motor symptoms in 131 Parkinson patients with and without sleep benefit, as assessed by questionnaires. Polysomnography recordings were performed in 60 of these patients. Thirty-nine Parkinson patients (30%) reported sleep benefit. Motor symptoms, measures of sleepiness, fatigue, depression, anxiety, sleep-wake disorders, and dopaminergic treatment were not associated with sleep benefit, and most polysomnography measures were similar between both groups. However, Parkinson patients with sleep benefit had shorter total sleep times and longer sleep latencies at nocturnal polysomnography. The link between the occurrence of sleep benefit and shorter nocturnal sleep in Parkinson's disease remains unclear.

  11. Nocturnal cortisol and melatonin secretion in primary insomnia.

    PubMed

    Riemann, Dieter; Klein, Torsten; Rodenbeck, Andrea; Feige, Bernd; Horny, Andrea; Hummel, Ruth; Weske, Gesa; Al-Shajlawi, Anam; Voderholzer, Ulrich

    2002-12-15

    The present study investigated evening and nocturnal serum cortisol and melatonin concentrations in patients with primary insomnia to test if this clinical condition is accompanied by an increase of cortisol secretion and a simultaneous decrease of nocturnal melatonin production. Ten drug-free patients (4 males, 6 females) with primary insomnia (mean age+/-S.D.: 39.2+/-9.1 years) and 10 age- and gender-matched healthy controls participated in the study. All subjects spent three consecutive nights in the sleep laboratory with polysomnography. Measurement of cortisol and melatonin (from 19:00 h to 09:00 h) was performed prior to and during the last laboratory night. Contrary to expectation, cortisol secretion did not differ between healthy controls and insomniac patients. On the other hand, nocturnal melatonin production was significantly diminished in insomniac patients. Polysomnographically determined sleep patterns, in contrast to subjective ratings of sleep, demonstrated only minor alterations of sleep in the insomniac group. The lack of increased cortisol secretion in the patients with primary insomnia indicates that results from studies on the biological consequences of experimental sleep loss in healthy subjects cannot be applied to primary insomnia in general, especially if there are only minor objective sleep alterations. In spite of the negligible objective sleep disturbances in the present sample, nocturnal melatonin production was reduced, which tentatively suggests a role for this hormone in primary insomniacs. The pathophysiological significance of this finding is, however, still a matter of debate.

  12. The sleep-wake cycle and motor activity, but not temperature, are disrupted over the light-dark cycle in mice genetically depleted of serotonin.

    PubMed

    Solarewicz, Julia Z; Angoa-Perez, Mariana; Kuhn, Donald M; Mateika, Jason H

    2015-01-01

    We examined the role that serotonin has in the modulation of sleep and wakefulness across a 12-h:12-h light-dark cycle and determined whether temperature and motor activity are directly responsible for potential disruptions to arousal state. Telemetry transmitters were implanted in 24 wild-type mice (Tph2(+/+)) and 24 mice with a null mutation for tryptophan hydroxylase 2 (Tph2(-/-)). After surgery, electroencephalography, core body temperature, and motor activity were recorded for 24 h. Temperature for a given arousal state (quiet and active wake, non-rapid eye movement, and paradoxical sleep) was similar in the Tph2(+/+) and Tph2(-/-) mice across the light-dark cycle. The percentage of time spent in active wakefulness, along with motor activity, was decreased in the Tph2(+/+) compared with the Tph2(-/-) mice at the start and end of the dark cycle. This difference persisted into the light cycle. In contrast, the time spent in a given arousal state was similar at the remaining time points. Despite this similarity, periods of non-rapid-eye-movement sleep and wakefulness were less consolidated in the Tph2(+/+) compared with the Tph2(-/-) mice throughout the light-dark cycle. We conclude that the depletion of serotonin does not disrupt the diurnal variation in the sleep-wake cycle, motor activity, and temperature. However, serotonin may suppress photic and nonphotic inputs that manifest at light-dark transitions and serve to shorten the ultraradian duration of wakefulness and non-rapid-eye-movement sleep. Finally, alterations in the sleep-wake cycle following depletion of serotonin are unrelated to disruptions in the modulation of temperature.

  13. Review of disrupted sleep patterns in Smith-Magenis syndrome and normal melatonin secretion in a patient with an atypical interstitial 17p11.2 deletion.

    PubMed

    Boudreau, Eilis A; Johnson, Kyle P; Jackman, Angela R; Blancato, Jan; Huizing, Marjan; Bendavid, Claude; Jones, Marypat; Chandrasekharappa, Settara C; Lewy, Alfred J; Smith, Ann C M; Magenis, R Ellen

    2009-07-01

    Smith-Magenis syndrome (SMS) is a disorder characterized by multiple congenital anomalies and behavior problems, including abnormal sleep patterns. It is most commonly due to a 3.5 Mb interstitial deletion of chromosome 17 band p11.2. Secretion of melatonin, a hormone produced by the pineal gland, is the body's signal for nighttime darkness. Published reports of 24-hr melatonin secretion patterns in two independent SMS cohorts (US and France) document an inverted endogenous melatonin pattern in virtually all cases (96%), suggesting that this finding is pathognomic for the syndrome. We report on a woman with SMS due to an atypical large proximal deletion ( approximately 6Mb; cen<->TNFRSFproteinB) of chromosome band (17)(p11.2p11.2) who presents with typical sleep disturbances but a normal pattern of melatonin secretion. We further describe a melatonin light suppression test in this patient. This is the second reported patient with a normal endogenous melatonin rhythm in SMS associated with an atypical large deletion. These two patients are significant because they suggest that the sleep disturbances in SMS cannot be solely attributed to the abnormal diurnal melatonin secretion versus the normal nocturnal pattern.

  14. Post-infarct sleep disruption and its relation to cardiac remodeling in a rat model of myocardial infarction.

    PubMed

    Aghajani, Marjan; Faghihi, Mahdieh; Imani, Alireza; Vaez Mahdavi, Mohammad Reza; Shakoori, Abbas; Rastegar, Tayebeh; Parsa, Hoda; Mehrabi, Saman; Moradi, Fatemeh; Kazemi Moghaddam, Ehsan

    2017-02-03

    Sleep disruption after myocardial infarction (MI) by affecting ubiquitin-proteasome system (UPS) is thought to contribute to myocardial remodeling and progressive worsening of cardiac function. The aim of current study was to test the hypothesis about the increased risk of developing heart failure due to experience of sleep restriction (SR) after MI. Male Wistar rats (n = 40) were randomly assigned to four experimental groups: (1) Sham, (2) MI, (3) MI and SR (MI + SR) (4) Sham and SR (Sham + SR). MI was induced by permanent ligation of left anterior descending coronary artery. Twenty-four hours after surgery, animals were subjected to chronic SR paradigm. Blood sampling was performed at days 1, 8 and 21 after MI for determination of serum levels of creatine kinase-MB (CK-MB), corticosterone, malondialdehyde (MDA) and nitric oxide (NO). Finally, at 21 days after MI, echocardiographic parameters and expression of MuRF1, MaFBx, A20, eNOS, iNOS and NF-kB in the heart were evaluated. We used H&E staining to detect myocardial hypertrophy. We found out that post infarct SR increased corticosterone levels. Our results highlighted deteriorating effects of post-MI SR on NO production, oxidative stress, and echocardiographic indexes (p < 0.05). Moreover, its detrimental effects on myocardial damage were confirmed by overexpression of MuRF1, MaFBx, iNOS and NF-kB (p < 0.001) in left ventricle and downregulation of A20 and eNOS (p < 0.05). Furthermore, histological examination revealed that experience of SR after MI increased myocardial diameter as compared to Sham subjects (p < 0.05). Our data suggest that SR after MI leads to an enlargement of the heart within 21 days, marked by an increase in oxidative stress and NO production as well as an imbalance in UPS that ultimately results in cardiac dysfunction and heart failure.

  15. Relationship between Food Intake and Sleep Pattern in Healthy Individuals

    PubMed Central

    Crispim, Cibele Aparecida; Zimberg, Ioná Zalcman; dos Reis, Bruno Gomes; Diniz, Rafael Marques; Tufik, Sérgio; de Mello, Marco Túlio

    2011-01-01

    Study Objectives: The purpose of this study was to analyze the relationship between food intake and sleep patterns in healthy individuals. Methods: Fifty-two healthy volunteers (27 women and 25 men) were recruited to participate in the study. Volunteers underwent sleep evaluation through nocturnal polysomnography and completed a 3-day food diary to evaluate food intake. Results: No differences in sleep patterns were observed in either gender, except in the percentage of stage 1 sleep, which was greater in men. Different correlations were observed between sleep and dietary variables according to gender. The correlation between dietary and sleep variables in men indicated a negative relationship between nocturnal fat intake and the sleep latency, including REM sleep. The percentage of nocturnal fat intake correlated with sleep efficiency, sleep latency, REM latency, stage 2 sleep, REM sleep, and wake after sleep onset (WASO) in women. The percentage of nocturnal caloric intake correlated with sleep latency and efficiency in women. Conclusions: We conclude that food intake during the nocturnal period is correlated with negative effects on the sleep quality of healthy individuals. Indeed, food intake near the sleeping period (dinner and late night snack) was negatively associated with sleep quality variables. More studies are necessary to elucidate the real effect of food intake on sleep. Citation: Crispim CA; Zimberg IZ; dos Reis BG; Diniz RM; Tufik S; de Mello MT. Relationship between food intake and sleep pattern in healthy individuals. J Clin Sleep Med 2011;7(6):659-664. PMID:22171206

  16. Nocturnal Hypermotor Activity during Apnea-Related Arousals

    PubMed Central

    Hoque, Romy; DelRosso, Lourdes M.

    2016-01-01

    We present a case of a 50-year-old patient who exhibits nocturnal hypermotor activity occurring exclusively during apnea-related arousals consisting of repetitive lower extremity hip-flapping. This movement is unusual and reflects a new form of lower extremity movement associated with apnea-related arousals. Citation: Hoque R, DelRosso LM. Nocturnal hypermotor activity during apnea-related arousals. J Clin Sleep Med 2016;12(9):1305–1307. PMID:27092691

  17. Effects of a Serotonin 2C Agonist and a 2A Antagonist on Actigraphy-Based Sleep Parameters Disrupted by Methamphetamine Self-Administration in Rhesus Monkeys.

    PubMed

    Perez Diaz, Maylen; Andersen, Monica L; Rice, Kenner C; Howell, Leonard L

    2017-01-18

    Sleep disorders and substance abuse are highly comorbid and we have previously shown that methamphetamine self-administration significantly disrupts activity-based sleep parameters in rhesus monkeys. To the best of our knowledge, no study has evaluated the effectiveness of any pharmacological intervention to attenuate the effects of methamphetamine on nighttime activity under well-controlled conditions in laboratory animals. Thus, we examined the effects of a 5-HT2C receptor agonist, WAY163909, and a 5-HT2A receptor antagonist, M100907, given alone and in combination, on actigraphy-based sleep parameters disrupted by methamphetamine self-administration in non-human primates. Adult male/female rhesus monkeys self-administered methamphetamine (0.03 mg/kg/injection, i.v.) under a fixed-ratio 20 schedule of reinforcement (60-min sessions once a day, 5 days per week). Nighttime activity was evaluated using Actiwatch monitors. WAY163909 (0.1, 0.3, and 1.0 mg/kg), M100907 (0.03, 0.1, and 0.3 mg/kg), and a combination (0.1 mg/kg M100+0.3 mg/kg WAY) were administered i.m. before lights-out. Each dose was given for five consecutive days during which self-administration took place in the morning. Both drugs improved activity-based sleep measures disrupted by methamphetamine by decreasing sleep latency and increasing sleep efficiency compared with vehicle. By combining these drugs, their individual effects were significantly enhanced. Agonists at the 5-HT2C receptor and antagonists at the 5-HT2A receptor show promise as potential treatments for the sleep-disrupting effects of stimulants when used alone and in combination. Combining subthreshold doses of WAY and M100 produced significant improvements in nighttime activity measures while avoiding the general motor-decreasing effects of the high dose of WAY.Neuropsychopharmacology advance online publication, 18 January 2017; doi:10.1038/npp.2016.280.

  18. Dual-tasking alleviated sleep deprivation disruption in visuomotor tracking: An fMRI study

    PubMed Central

    Gazes, Yunglin; Rakitin, Brian C.; Steffener, Jason; Habeck, Christian; Butterfield, Brady; Basner, Robert C.; Ghez, Claude; Stern, Yaakov

    2012-01-01

    Effects of dual-responding on tracking performance after 49-hr of sleep deprivation (SD) were evaluated behaviorally and with functional magnetic resonance imaging (fMRI). Continuous visuomotor tracking was performed simultaneously with an intermittent color-matching visual detection task in which a pair of color-matched stimuli constituted a target and non-matches were non-targets. Tracking error means were binned time-locked to stimulus onset of the detection task in order to observe changes associated with dual-responding by comparing the error during targets and non-targets. Similar comparison was made with fMRI data. Our result showed that despite a significant increase in the overall tracking error post SD, from 20 pixels pre SD to 45 pixels post SD, error decreased to a minimum of about 25 pixels 0 to 6 s after dual-response. Despite an overall reduced activation post SD, greater activation difference between targets and non-targets was found post SD in task-related regions, such as the left cerebellum, the left somatosensory cortex, the left extrastriate cortex, bilateral precuneus, the left middle frontal gyrus, and the left motor cortex. Our results suggest that dual-response helps to alleviate performance impairment usually associated with SD. The duration of the alleviation effect was on the order of seconds after dual-responding. PMID:22305924

  19. Regulation of adult neurogenesis by stress, sleep disruption, exercise and inflammation: Implications for depression and antidepressant action.

    PubMed

    Lucassen, P J; Meerlo, P; Naylor, A S; van Dam, A M; Dayer, A G; Fuchs, E; Oomen, C A; Czéh, B

    2010-01-01

    Adult hippocampal neurogenesis, a once unorthodox concept, has changed into one of the most rapidly growing fields in neuroscience. The present report results from the ECNP targeted expert meeting in 2007 during which cellular plasticity changes were addressed in the adult brain, focusing on neurogenesis and apoptosis in hippocampus and frontal cortex. We discuss recent studies investigating factors that regulate neurogenesis with special emphasis on effects of stress, sleep disruption, exercise and inflammation, a group of seemingly unrelated factors that share at least two unifying properties, namely that they all regulate adult hippocampal neurogenesis and have all been implicated in the pathophysiology of mood disorders. We conclude that although neurogenesis has been implicated in cognitive function and is stimulated by antidepressant drugs, its functional impact and contribution to the etiology of depression remains unclear. A lasting reduction in neurogenesis following severe or chronic stress exposure, either in adult or early life, may represent impaired hippocampal plasticity and can contribute to the cognitive symptoms of depression, but is, by itself, unlikely to produce the full mood disorder. Normalization of reductions in neurogenesis appears at least partly, implicated in antidepressant action.

  20. The effect of histidine on mental fatigue and cognitive performance in subjects with high fatigue and sleep disruption scores.

    PubMed

    Sasahara, Ikuko; Fujimura, Naoko; Nozawa, Yoshizu; Furuhata, Yasufumi; Sato, Hitoshi

    2015-08-01

    Our previous study reported that a dried bonito broth known in Japan as 'dashi' improved or ameliorated mood states, including fatigue, during the daily lives of human subjects. Histidine is an amino acid that is present in dried bonito broth, and we sought to evaluate whether histidine would affect feelings of fatigue in humans. We investigated the effects of histidine intake on the feeling of fatigue, mood states and mental task performance by performing a placebo-controlled, double-blind crossover trial. Twenty subjects with high fatigue and sleep disruption scores were asked to ingest histidine or a placebo every day for two weeks. The subjects' mood states were evaluated using the Profile of Mood States (POMS) scale and a visual analog scale (VAS) for eight feelings (fatigue, depression, carelessness, drowsiness, clear thinking, motivation, attentiveness and concentration). We also measured subjects' cognitive performance using the CogHealth test battery. The fatigue T-scores on the POMS test decreased significantly following histidine ingestion compared to placebo ingestion (p<0.05). After two weeks of histidine ingestion, the reaction time for the working memory task in the CogHealth test battery was significantly shorten compared to placebo ingestion. The VAS scores for clear thinking and for attentiveness were increased significantly following histidine ingestion compared to placebo ingestion (p<0.05). These results suggest that daily ingestion of histidine may ameliorate feelings of fatigue, increase performance during working memory tasks, and improve the clear thinking and attentiveness.

  1. NREM parasomnias: arousal disorders and differentiation from nocturnal frontal lobe epilepsy.

    PubMed

    Zucconi, M; Ferini-Strambi, L

    2000-09-01

    Parasomnias emerging from NREM sleep such as sleep walking, sleep terrors and confusional arousals are considered arousal disorders. Nocturnal video-polysomnography is the gold standard to diagnosing and differentiating parasomnias from other arousals with atypical motor behaviors such as nocturnal frontal lobe epilepsy (NFLE). This form of nocturnal seizures with prominent dystonic-dyskinetic components, in some cases genetic, has been recently identified by means of detailed video-analysis of movements during sleep. The clinical picture of parasomnias (with onset in early childhood, rare episodes of long duration, absence of stereotypy, general disappearance after puberty) is different from that of NFLE (which first occurs between the age of 10 and 20, manifests frequent complex and repetitive behaviors of short duration excluding rare prolonged seizures, nocturnal agitation, some daytime complaints such as fatigue or sleepiness, persistence into adulthood). Patients show no difference from classical sleep parameters whilst microstructure analysis shows sleep instability and arousal fluctuations in parasomnias and NFLE. In children as well, at least in our experience, the differential diagnosis between the two disorders is difficult and requires one or more complete nocturnal video-polygraphic recording. In any case the diagnosis of NFLE should be considered in children with nocturnal motor episodes or nocturnal motor agitation, when the attacks persist; this diagnosis is probably more frequent than expected.

  2. Assessment and treatment of nocturnal panic attacks.

    PubMed

    Craske, Michelle G; Tsao, Jennie C I

    2005-06-01

    Nocturnal panic (NP), waking from sleep in a state of panic, is a common occurrence among patients with panic disorder, with 44-71% reporting at least one such attack. NP is a non-REM event that is distinct from sleep terrors, sleep apnea, nightmares or dream-induced arousals. This review outlines recent advances in the characterization of NP, as well as current approaches to the assessment and treatment of NP. In contrast to earlier work, more recent studies suggest that patients with NP do not differ from patients without NP on sleep architecture, sleep physiology, self-reported sleep quality and severity of panic disorder. However, more precise measurement of physiological precipitants and features is warranted. Assessment of NP focuses on ruling out other explanations for NP, with differential diagnosis based on interviews, sleep polysomnography and ambulatory recording of sleep. Psychological treatment (cognitive-behavioral therapy) targets misappraisals of anxiety sensations, hyperventilatory response, and conditioned reactions to internal, physical cues. Recent evidence supports the efficacy of this approach, however, controlled studies on pharmacological agents in the treatment of NP are lacking. Research is needed to examine the effects of combined cognitive-behavioral therapy and medications, compared to medication alone in the treatment of NP.

  3. Influences of twilight on diurnal variation of core temperature, its nadir, and urinary 6-hydroxymelatonin sulfate during nocturnal sleep and morning drowsiness.

    PubMed

    Kondo, Masayuki; Tokura, Hiromi; Wakamura, Tomoko; Hyun, Ki-Ja; Tamotsu, Satoshi; Morita, Takeshi; Oishi, Tadashi

    2009-03-01

    This study aimed at elucidating the physiological significance of dusk and dawn in the circadian rhythm of core temperature (T(core)) and urinary 6-hydroxymelatonin sulfate in humans during sleep and the waking sensation just after rising. Seven female and four male students served as participants. Participants retired at 2300 h and rose at 0700 h. They were requested to sit on a chair and spend time as quietly as possible during wakefulness, reading a book or listening to recorded light music. Two lighting conditions were provided for each participant: 1) Light-Dark (LD)-rectangular light change with abrupt decrease from 3,000 lx to 100 lx at 1800 h, abrupt increase from 0 lx to 3,000 lx at 0700 h. 2) LD-twilight light change with gradual decrease from 3,000 lx to 100 lx starting at 1700 h (twilight period about 2 h), with gradual increase from 0 lx to 3,000 lx starting at 0500 h (twilight period about 2 h). The periods of 0 lx at night were from 2300 h to 0700 h on the first day and from 2300 to 0500 h on the second day. Nadir time advanced significantly under the influence of the LD-twilight condition. The amount of 6-hydroxymelatonin sulfate in urine collected at 0200 h was significantly higher under LD-twilight in comparison with LD-rectangular light. Morning drowsiness tended to be lower under LD-twilight. Our results suggest that in architectural design of indoor illumination it is important to provide LD-twilight in the evening and early morning for sleep promotion in healthy normal people and/or light treatment in elderly patients with advanced dementia.

  4. A pilot study to compare the cerebral hemodynamics between patients with obstructive sleep apnea syndrome (OSA) and periodic limb movement syndrome (PLMS) during nocturnal sleep with near-infrared spectroscopy (NIRS)

    NASA Astrophysics Data System (ADS)

    Zhang, Zhongxing; Schneider, Maja; Laures, Marco; Fritschi, Ursula; Hügli, Gordana; Lehner, Isabella; Qi, Ming; Khatami, Ramin

    2014-03-01

    Obstructive sleep apnea syndrome (OSA) and periodic limb movement in sleep syndrome (PLMS) are two common sleep disorders. Previous studies showed that OSA and PLMS share common features, such as increased cardio-vascular risk, both apnea events and limb movements occur periodically, they are usually associated with cortical arousals, and both of them can induce declines in peripheral oxygen saturation measured with pulse oximetry. However, the question whether apnea events and limb movements also show similar characteristics in cerebral hemodynamic and oxygenation has never been addressed. In this pilot study, we will first time compare the cerebral hemodynamic changes induced by apnea events and limb movements in patients with OSA (n=4) and PLMS (n=4) with NIRS. In patients with OSA, we found periodic oscillations in HbO2, HHb, and blood volume induced by apnea/hypopnea events, HbO2 and HHb showed reverse changing trends. By contrast, the periodic oscillations linked to limb movements were only found in HbO2 and blood volume in patients with PLMS. These findings of different cerebral hemodynamics patterns between apnea events and limb movements may indicate different regulations of nervous system between these two sleep disorders.

  5. Isolated sleep paralysis elicited by sleep interruption.

    PubMed

    Takeuchi, T; Miyasita, A; Sasaki, Y; Inugami, M; Fukuda, K

    1992-06-01

    We elicited isolated sleep paralysis (ISP) from normal subjects by a nocturnal sleep interruption schedule. On four experimental nights, 16 subjects had their sleep interrupted for 60 minutes by forced awakening at the time when 40 minutes of nonrapid eye movement (NREM) sleep had elapsed from the termination of rapid eye movement (REM) sleep in the first or third sleep cycle. This schedule produced a sleep onset REM period (SOREMP) after the interruption at a high rate of 71.9%. We succeeded in eliciting six episodes of ISP in the sleep interruptions performed (9.4%). All episodes of ISP except one occurred from SOREMP, indicating a close correlation between ISP and SOREMP. We recorded verbal reports about ISP experiences and recorded the polysomnogram (PSG) during ISP. All of the subjects with ISP experienced inability to move and were simultaneously aware of lying in the laboratory. All but one reported auditory/visual hallucinations and unpleasant emotions. PSG recordings during ISP were characterized by a REM/W stage dissociated state, i.e. abundant alpha electroencephalographs and persistence of muscle atonia shown by the tonic electromyogram. Judging from the PSG recordings, ISP differs from other dissociated states such as lucid dreaming, nocturnal panic attacks and REM sleep behavior disorders. We compare some of the sleep variables between ISP and non-ISP nights. We also discuss the similarities and differences between ISP and sleep paralysis in narcolepsy.

  6. Research on sleep, circadian rhythms and aging - Applications to manned spaceflight

    NASA Technical Reports Server (NTRS)

    Czeisler, Charles A.; Chiasera, August J.; Duffy, Jeanne F.

    1991-01-01

    Disorders of sleep and circadian rhythmicity are characteristic of both advancing age and manned spaceflight. Sleep fragmentation, reduced nocturnal sleep tendency and sleep efficiency, reduced daytime alertness, and increased daytime napping are common to both of these conditions. Recent research on the pathophysiology and treatment of disrupted sleep in older people has led to a better understanding of how the human circadian pacemaker regulates the timing of the daily sleep-wake cycle and how it responds to the periodic changes in the light-dark cycle to which we are ordinarily exposed. These findings have led to new treatments for some of the sleep disorders common to older individuals, using carefully timed exposure to bright light and darkness to manipulate the phase and/or amplitude of the circadian timing system. These insights and treatment approaches have direct applications in the design of countermeasures allowing astronauts to overcome some of the challenges which manned spaceflight poses for the human circadian timing system. We have conducted an operational feasibility study on the use of scheduled exposure to bright light and darkness prior to launch in order to facilitate adaptation of the circadian system of a NASA Space Shuttle crew to the altered sleep-wake schedule required for their mission. The results of this study illustrate how an understanding of the properties of the human circadian timing system and the consequences of circadian disruption can be applied to manned spaceflight.

  7. Nocturnal manifestations of atypical parkinsonian disorders.

    PubMed

    Bhidayasiri, Roongroj; Jitkritsadakul, Onanong; Colosimo, Carlo

    2014-01-01

    Although nocturnal disturbances are increasingly recognized as an integral part of the continuum of daytime manifestations of Parkinson's disease (PD), there is still little evidence in the medical literature to support the occurrence of these complex phenomena in patients with atypical parkinsonian disorders (APDs). Based on the anatomical substrates in APDs, which are considered to be more extensive outside the basal ganglia than in PD, we might expect that patients with APDs encounter the whole range of nocturnal disturbances, including motor, sleep disorders, autonomic dysfunctions, and neuropsychiatric manifestations at a similar, or even greater, frequency than in PD. This article is a review of the current literature on the problems at nighttime of patients with progressive supranuclear palsy, multiple system atrophy, corticobasal degeneration, and dementia with Lewy bodies. MEDLINE, life science journals and online books were searched by querying appropriate key words. Reports were included if the studies were related to nocturnal manifestations in APDs. Forty articles fulfilled the selection criteria. Differences between these symptoms in APDs and PD are highlighted, given the evidence available about each manifestation. This analysis of nocturnal manifestations of APDs suggests the need for future studies to address these issues to improve the quality of life not only of patients with APDs but the caregivers who encounter the challenges of supporting these patients on a daily basis.

  8. Nocturnal enuresis: an approach to assessment and treatment.

    PubMed

    Bayne, Aaron P; Skoog, Steven J

    2014-08-01

    On the basis of strong evidence, although primary monosymptomatic nocturnal enuresis (PMNE) is common and most children will outgrow the condition spontaneously, the psychological effect to the child can be significant and represents the main reason for treatment of these children. On the basis of international consensus panels, treatment of PMNE should be targeted toward the specific type of bedwetting patterns the child has, using bladder diary, sleep history, and daytime elimination concerns as a guide (Table 3). On the basis of international consensus panels, it is important for the primary care physician to be able to differentiate children with PMNE from children with nonmonosymptomatic nocturnal enuresis (NMNE) and secondary nocturnal enuresis. On the basis of international consensus panels, children with NMNE should have their underlying voiding or stool problem addressed before initiation of therapy for the nocturnal enuresis. On the basis of strong evidence, both the bedwetting alarm and desmopressin are considered first-line therapy for children with PMNE.

  9. Sleep quality and daytime function in adults with cystic fibrosis and severe lung disease.

    PubMed

    Dancey, D R; Tullis, E D; Heslegrave, R; Thornley, K; Hanly, P J

    2002-03-01

    It was hypothesized that adult cystic fibrosis (CF) patients with severe lung disease have impaired daytime function related to nocturnal hypoxaemia and sleep disruption. Nineteen CF patients (forced expiratory volume in one second 28+/-7% predicted) and 10 healthy subjects completed sleep diaries, overnight polysomnography (PSG), and assessment of daytime sleepiness and neurocognitive function. CF patients tended to report more awakenings (0.7+/-0.5 versus 0.3+/-0.2 x h(-1), p=0.08), and PSG revealed reduced sleep efficiency (71+/-25 versus 93+/-4%, p=0.004) and a higher frequency of awakenings (4.2+/-2.7 versus 2.4+/-1.4 x h(-1), p=0.06). Mean arterial oxygen saturation during sleep was lower in CF patients (84.4+/-6.8 versus 94.3+/-1.5%, p<0.0001) and was associated with reduced sleep efficiency (regression coefficient (r)=0.57, p=0.014). CF patients had short sleep latency on the multiple sleep latency test (6.7+/-3 min). The CF group reported lower levels of activation and happiness and greater levels of fatigue (p<0.01), which correlated with indices of sleep loss, such as sleep efficiency (r=0.47, p=10.05). Objective neurocognitive performance was also impaired in CF patients, reflected by lower throughput for simple addition/subtraction, serial reaction and colour-word conflict. The authors concluded that adult cystic fibrosis patients with severe lung disease have impaired neurocognitive function and daytime sleepiness, which is partly related to chronic sleep loss and nocturnal hypoxaemia.

  10. Nocturnal hypoxemia in children and adolescents with cystic fibrosis*

    PubMed Central

    Ramos, Regina Terse Trindade; Santana, Maria Angélica Pinheiro; Almeida, Priscila de Carvalho; Machado, Almério de Souza; Araújo-Filho, José Bouzas; Salles, Cristina

    2013-01-01

    OBJECTIVE: To determine the prevalence of nocturnal hypoxemia and its association with pulmonary function, nutritional status, sleep macrostructure, and obstructive respiratory events during sleep in a population of clinically stable children and adolescents with cystic fibrosis (CF). METHODS: This was a cross-sectional study involving 67 children and adolescents with CF between 2 and 14 years of age. All of the participants underwent polysomnography, and SpO2 was measured by pulse oximetry. We also evaluated the Shwachman-Kulczycki (S-K) scores, spirometry findings, and nutritional status of the patients. RESULTS: The study involved 67 patients. The mean age of the patients was 8 years. The S-K scores differed significantly between the patients with and without nocturnal hypoxemia, which was defined as an SpO2 < 90% for more than 5% of the total sleep time (73.75 ± 6.29 vs. 86.38 ± 8.70; p < 0.01). Nocturnal hypoxemia correlated with the severity of lung disease, FEV1 (rs = −0.42; p = 0.01), FVC (rs = −0.46; p = 0.01), microarousal index (rs = 0.32; p = 0.01), and apnea-hypopnea index (rs = 0.56; p = 0.01). CONCLUSIONS: In this sample of patients with CF and mild-to-moderate lung disease, nocturnal oxygenation correlated with the S-K score, spirometry variables, sleep macrostructure variables, and the apnea-hypopnea index. PMID:24473760

  11. Sleep in the Intensive Care Unit: A Review.

    PubMed

    Pulak, Lisa M; Jensen, Louise

    2016-01-01

    Patients in the intensive care unit (ICU) are susceptible to sleep deprivation. Disrupted sleep is associated with increased morbidity and mortality in the critically ill patients. The etiology of sleep disruption is multifactorial. The article reviews the literature on sleep in the ICU, the effects of sleep deprivation, and strategies to promote sleep in the ICU. Until the impact of disrupted sleep is better explained, it is appropriate to provide critically ill patients with consolidated, restorative sleep.

  12. Supplemental oxygen needs during sleep. Who benefits?

    PubMed

    Owens, Robert L

    2013-01-01

    The physiologic changes that occur in ventilation during sleep contribute to nocturnal oxygen desaturation in those with lung disease. Nocturnal supplemental oxygen is often used as therapy, although convincing data exist only for those who are hypoxemic both during sleep and wake. Ongoing trials may help address whether oxygen should be used in those with only desaturation during sleep. If used, oxygen should be dosed as needed, and patients should be monitored for hypercapnia. Because of its prevalence, obstructive sleep apnea may commonly overlap with lung disease in many patients and have important consequences. Patients with overlap syndromes may be good candidates for noninvasive ventilation during sleep.

  13. H1N1 influenza virus induces narcolepsy-like sleep disruption and targets sleep–wake regulatory neurons in mice

    PubMed Central

    Tesoriero, Chiara; Codita, Alina; Zhang, Ming-Dong; Cherninsky, Andrij; Karlsson, Håkan; Grassi-Zucconi, Gigliola; Bertini, Giuseppe; Harkany, Tibor; Ljungberg, Karl; Liljeström, Peter; Hökfelt, Tomas G. M.; Bentivoglio, Marina; Kristensson, Krister

    2016-01-01

    An increased incidence in the sleep-disorder narcolepsy has been associated with the 2009–2010 pandemic of H1N1 influenza virus in China and with mass vaccination campaigns against influenza during the pandemic in Finland and Sweden. Pathogenetic mechanisms of narcolepsy have so far mainly focused on autoimmunity. We here tested an alternative working hypothesis involving a direct role of influenza virus infection in the pathogenesis of narcolepsy in susceptible subjects. We show that infection with H1N1 influenza virus in mice that lack B and T cells (Recombinant activating gene 1-deficient mice) can lead to narcoleptic-like sleep–wake fragmentation and sleep structure alterations. Interestingly, the infection targeted brainstem and hypothalamic neurons, including orexin/hypocretin-producing neurons that regulate sleep–wake stability and are affected in narcolepsy. Because changes occurred in the absence of adaptive autoimmune responses, the findings show that brain infections with H1N1 virus have the potential to cause per se narcoleptic-like sleep disruption. PMID:26668381

  14. Hypnotic treatment of Sleep Terror Disorder: a case report.

    PubMed

    Koe, G G

    1989-07-01

    This case report describes the hypnotic treatment of Sleep Terror Disorder in a 16-year-old male who was resistant to other forms of treatment. In this patient, night terrors seemed to be precipitated by nocturnal noises wakening him from deep sleep. Posthypnotic suggestions reducing awareness of nocturnal sensory stimulation successfully eliminated his night terrors.

  15. Positional abnormalities during sleep in children affected by obstructive sleep apnea syndrome: the putative role of kinetic muscular chains.

    PubMed

    Carotenuto, Marco; Gimigliano, Francesca; Fiordelisi, Giovanni; Ruberto, Maria; Esposito, Maria

    2013-08-01

    Sleep-related breathing disorders (SRBD) are disorders of breathing during sleep characterized by prolonged partial upper airway obstruction, intermittent complete or partial obstruction (obstructive apnea or hypopnea), or both prolonged and intermittent obstruction that disrupts normal ventilation during sleep, normal sleep patterns, or both. Children with OSAS may sleep in unusual positions, such as seated or with neck hyperextended, even if the neck position is not the only unusual posture or the special sleeping positions that is possible to detect in children with SRBD. We have hypothesized that the assumption of unusual posture during sleep, in particular legs retracting or crossing during sleep, could be a way to enlarge the diaphragmatic excursion and promoting the alveolar gas exchanges avoiding the stress of the antero-lumbar and prevertebral muscular chains in SRBD subjects. We have hypothesized that the assumption of unusual posture during sleep, in particular legs retracting or crossing during sleep, could be a way to enlarge the diaphragmatic excursion and promoting the alveolar gas exchanges avoiding the stress of the antero-lumbar and prevertebral muscular chains in SRBD subjects. We can postulate that the prevertebral and antero-lumbar muscular chains could be oversolicited during the apnoic events, and the assumption of abnormal posture could be interpreted as a way to relax or diminish the strain or muscular stress caused by the apneas. The consequence of this hypothesis could be summarized in the concept that a specific rehabilitation or muscular program to improve the tone of this kinetic chain, could be useful to limit the effect nocturnal or diurnal of this so impacting syndrome.

  16. Analysis of video-polysomnographic sleep findings in dementia with Lewy bodies.

    PubMed

    Terzaghi, Michele; Arnaldi, Dario; Rizzetti, Maria Cristina; Minafra, Brigida; Cremascoli, Riccardo; Rustioni, Valter; Zangaglia, Roberta; Pasotti, Chiara; Sinforiani, Elena; Pacchetti, Claudio; Manni, Raffaele

    2013-09-01

    Knowledge of sleep architecture and disorders of nocturnal sleep in dementia with Lewy bodies (DLB) is limited by a lack of systematic video-polysomnographic (video-PSG) investigations. We describe video-PSG findings in 29 consecutive subjects diagnosed with DLB. All the patients underwent a clinical interview and overnight video-PSG monitoring. Twenty-nine nondemented patients with Parkinson's disease (PD) matched for age and sex with the DLB cases were selected for comparison. The DLB subjects showed less 1NREM sleep (P = .000) and more 2NREM sleep (P = .000) than the PD subjects. Sleep apnea (30.7% vs. 34.8%) and periodic limb movements (60.9% versus 50.0%) were frequent in both groups. Disruptive motor behavioral manifestations were more frequent in subjects with DLB (69.6% vs. 26.9%, P = .008) and consisted of not only REM sleep behavior disorder (RBD) but also confusional events (30.3% vs. 3.8%, P = .020) and arousal-related episodes mimicking RBD. Subjects with DLB in whom a sleep disturbance had been the presenting symptom performed better than those with other onset symptoms on both the Mini-Mental State Examination (22.2 ± 4.1 vs. 18.1 ± 4.6, P = .019) and the Frontal Assessment Battery (15.8 vs. 10.3, P = .010). Polysomnographic findings in DLB show a complex mix of overlapping sleep alterations: impaired sleep structure, sleep comorbidities, and various motor-behavioral events (not restricted to RBD). Clinicians should be aware of the possibility of misleading symptoms and of the risk of overlooking sleep comorbidities, and consider performing polysomnographic sleep investigations in selected cases. We found evidence that a sleep disturbance as the presenting symptom might indicate a different phenotype of the disease, characterized by milder cognitive impairment.

  17. Nocturnal Sleep Disturbances: Risk Factors for Suicide

    MedlinePlus

    ... and consequent feelings of hopelessness and helplessness (Ribeiro et al., 2012). Insomnia is associated with depression, anxiety, ... by suicide victims immediately prior to death (Ribeiro et al., 2012; Rebeiro et al., 2013). A review ...

  18. Sleep and Stroke.

    PubMed

    Mims, Kimberly Nicole; Kirsch, Douglas

    2016-03-01

    Evidence increasingly suggests sleep disorders are associated with higher risk of cardiovascular events, including stroke. Strong data correlate untreated sleep apnea with poorer stroke outcomes and more recent evidence implicates sleep disruption as a possible etiology for increased cerebrovascular events. Also, sleep duration may affect incidence of cardiovascular events. In addition, sleep-disordered breathing, insomnia, restless legs syndrome, and parasomnias can occur as a result of cerebrovascular events. Treatment of sleep disorders improve sleep-related symptoms and may also improve stroke recovery and risk of future events.

  19. Sleep disorders in pregnancy.

    PubMed

    Oyiengo, Dennis; Louis, Mariam; Hott, Beth; Bourjeily, Ghada

    2014-09-01

    Sleep disturbances are common in pregnancy and may be influenced by a multitude of factors. Pregnancy physiology may predispose to sleep disruption but may also result in worsening of some underlying sleep disorders, and the de novo development of others. Apart from sleep disordered breathing, the impact of sleep disorders on pregnancy, fetal, and neonatal outcomes is poorly understood. In this article, we review the literature and discuss available data pertaining to the most common sleep disorders in perinatal women. These include restless legs syndrome, insomnia, circadian pattern disturbances, narcolepsy, and sleep-disordered breathing.

  20. Treating nocturnal enuresis.

    PubMed

    Hamburger, B

    1993-04-01

    Nocturnal enuresis, commonly known as bedwetting, is described in documents dating from 1550 BC. Derived from the Greek word enourein, meaning "in urine" or "inability to control urination," it occurs in 15 to 20 per cent of five year olds and is twice as common in boys as girls. Indeed, no cure has yet been found and thousands of children and their families live with the distress the condition causes. Among affected children, this often includes behavioral problems and low self-esteem.

  1. Madopar HBS in Parkinson patients with nocturnal akinesia.

    PubMed

    Jansen, E N; Meerwaldt, J D

    1988-01-01

    Madopar Hydrodynamically Balanced System (HBS), a new sustained-release levodopa preparation, was used to control severe nightly disabilities in 15 outpatients suffering from Parkinson's disease in an advanced state and with long-term levodopa therapy. This medication was given ante noctem in addition to an otherwise unchanged daily regimen of levodopa administration. In 13 patients a considerable diminution in nocturnal akinesia and in the frequency of waking up was reached with a mean dosage of 308 mg of Madopar HBS. Early morning akinesia was only slightly alleviated in four patients. The nocturnal off-period pain disappeared in one patient. Adverse effects consisted of nocturnal dyskinesia in two patients and early morning dystonia in another two patients. The regular use of sleeping pills was clearly reduced after Madopar HBS therapy.

  2. Type 1 Diabetes and Sleep.

    PubMed

    Farabi, Sarah S

    2016-02-01

    IN BRIEF In people with type 1 diabetes, sleep may be disrupted as a result of both behavioral and physiological aspects of diabetes and its management. This sleep disruption may negatively affect disease progression and development of complications. This review highlights key research findings regarding sleep in people with type 1 diabetes.

  3. Treatments for Sleep Changes

    MedlinePlus

    ... use the bed only for sleep Discourage watching television during periods of wakefulness Medications for sleep changes In some cases, non-drug approaches fail to work or the sleep changes are accompanied by disruptive nighttime behaviors. For those individuals who do require medication, experts ...

  4. Troubled sleep

    PubMed Central

    Haig, David

    2014-01-01

    Disrupted sleep is probably the most common complaint of parents with a new baby. Night waking increases in the second half of the first year of infant life and is more pronounced for breastfed infants. Sleep-related phenotypes of infants with Prader-Willi and Angelman syndromes suggest that imprinted genes of paternal origin promote greater wakefulness whereas imprinted genes of maternal origin favor more consolidated sleep. All these observations are consistent with a hypothesis that waking at night to suckle is an adaptation of infants to extend their mothers’ lactational amenorrhea, thus delaying the birth of a younger sib and enhancing infant survival. PMID:24610432

  5. Violence in sleep.

    PubMed

    Siclari, Francesca; Khatami, Ramin; Urbaniok, Frank; Nobili, Lino; Mahowald, Mark W; Schenck, Carlos H; Cramer Bornemann, Michel A; Bassetti, Claudio L

    2010-12-01

    Although generally considered as mutually exclusive, violence and sleep can coexist. Violence related to the sleep period is probably more frequent than generally assumed and can be observed in various conditions including parasomnias (such as arousal disorders and rapid eye movement sleep behaviour disorder), epilepsy (in particular nocturnal frontal lobe epilepsy) and psychiatric diseases (including delirium and dissociative states). Important advances in the fields of genetics, neuroimaging and behavioural neurology have expanded the understanding of the mechanisms underlying violence and its particular relation to sleep. The present review outlines the different sleep disorders associated with violence and aims at providing information on diagnosis, therapy and forensic issues. It also discusses current pathophysiological models, establishing a link between sleep-related violence and violence observed in other settings.

  6. Neuroimmunologic aspects of sleep and sleep loss

    NASA Technical Reports Server (NTRS)

    Rogers, N. L.; Szuba, M. P.; Staab, J. P.; Evans, D. L.; Dinges, D. F.

    2001-01-01

    The complex and intimate interactions between the sleep and immune systems have been the focus of study for several years. Immune factors, particularly the interleukins, regulate sleep and in turn are altered by sleep and sleep deprivation. The sleep-wake cycle likewise regulates normal functioning of the immune system. Although a large number of studies have focused on the relationship between the immune system and sleep, relatively few studies have examined the effects of sleep deprivation on immune parameters. Studies of sleep deprivation's effects are important for several reasons. First, in the 21st century, various societal pressures require humans to work longer and sleep less. Sleep deprivation is becoming an occupational hazard in many industries. Second, to garner a greater understanding of the regulatory effects of sleep on the immune system, one must understand the consequences of sleep deprivation on the immune system. Significant detrimental effects on immune functioning can be seen after a few days of total sleep deprivation or even several days of partial sleep deprivation. Interestingly, not all of the changes in immune physiology that occur as a result of sleep deprivation appear to be negative. Numerous medical disorders involving the immune system are associated with changes in the sleep-wake physiology--either being caused by sleep dysfunction or being exacerbated by sleep disruption. These disorders include infectious diseases, fibromyalgia, cancers, and major depressive disorder. In this article, we will describe the relationships between sleep physiology and the immune system, in states of health and disease. Interspersed will be proposals for future research that may illuminate the clinical relevance of the relationships between sleeping, sleep loss and immune function in humans. Copyright 2001 by W.B. Saunders Company.

  7. Relationships between sleep quality and brain volume, metabolism, and amyloid deposition in late adulthood.

    PubMed

    Branger, Pierre; Arenaza-Urquijo, Eider M; Tomadesso, Clémence; Mézenge, Florence; André, Claire; de Flores, Robin; Mutlu, Justine; de La Sayette, Vincent; Eustache, Francis; Chételat, Gaël; Rauchs, Géraldine

    2016-05-01

    Recent studies in mouse models of Alzheimer's disease (AD) and in humans suggest that sleep disruption and amyloid-beta (Aβ) accumulation are interrelated, and may, thus, exacerbate each other. We investigated the association between self-reported sleep variables and neuroimaging data in 51 healthy older adults. Participants completed a questionnaire assessing sleep quality and quantity and underwent positron emission tomography scans using [18F]florbetapir and [18F]fluorodeoxyglucose and an magnetic resonance imaging scan to measure Aβ burden, hypometabolism, and atrophy, respectively. Longer sleep latency was associated with greater Aβ burden in prefrontal areas. Moreover, the number of nocturnal awakenings was negatively correlated with gray matter volume in the insular region. In asymptomatic middle-aged and older adults, lower self-reported sleep quality was associated with greater Aβ burden and lower volume in brain areas relevant in aging and AD, but not with glucose metabolism. These results highlight the potential relevance of preserving sleep quality in older adults and suggest that sleep may be a factor to screen for in individuals at risk for AD.

  8. Parasomnia with rhythmic movements manifesting as nocturnal tongue biting.

    PubMed

    Tuxhorn, I; Hoppe, M

    1993-06-01

    The case of a healthy 2-year-old girl with repeated nocturnal tongue biting as a result of rhythmic movements of the jaw associated with body rocking in non-REM sleep is described. Parasomnias manifesting with rhythmic, stereotyped movements of the head, trunk and extremities are well described in healthy children. The term rhythmic movement disorders (RMD) was introduced for these repetive movements in sleep which may appear as head banging (jactatio capitis), body rocking or leg rolling. Severe injuries including fractures, subdural effusions and eye injures are reported. Repeated tongue injuries have not been described as a consequence of RMD. The differential diagnosis from nocturnal seizures is crucial to avoid overtreatment of this benign albeit dramatically presenting condition.

  9. Abnormal Nocturnal Behavior due to Hypoglycemia in a Patient with Type 2 Diabetes.

    PubMed

    Yang, Kwang Ik; Kim, Hyung Ki; Baek, Jeehun; Kim, Doh-Eui; Park, Hyung Kook

    2016-04-15

    Abnormal nocturnal behavior can have many causes, including primary sleep disorder, nocturnal seizures, and underlying medical or neurological disorders. A 79-year-old woman with type 2 diabetes was admitted for evaluation of abnormal nocturnal behavior. Every night at around 04:30 she was observed displaying abnormal behavior including leg shaking, fumbling with bedclothes, crawling around the room with her eyes closed, and non-responsiveness to verbal communication. Polysomnography with 20-channel electroencephalography (EEG) was performed. EEG showed that the posterior dominant rhythm was slower than that observed in the initial EEG, with diffuse theta and delta activities intermixed, and no epileptiform activity. The serum glucose level was 35 mg/dL at that time, and both the EEG findings and clinical symptoms were resolved after an intravenous injection of 50 mL of 50% glucose. These results indicate that nocturnal hypoglycemia should be considered as one of the possible etiologies in patients presenting with abnormal nocturnal behavior.

  10. Sodium cromoglycate in nocturnal asthma.

    PubMed Central

    Morgan, A D; Connaughton, J J; Catterall, J R; Shapiro, C M; Douglas, N J; Flenley, D C

    1986-01-01

    To investigate whether mast cell degranulation was important in producing nocturnal asthma, the effect of a single high dose of nebulised sodium cromoglycate on overnight bronchoconstriction, oxygen saturation, and breathing patterns in eight patients with nocturnal wheeze was examined. The study took the form of a double blind placebo controlled crossover comparison. Treatment with cromoglycate did not reduce the overnight fall in FEV1 or FVC, although it was associated with improved nocturnal oxygenation. This study suggests that mast cell degranulation may not be important in the pathogenesis of nocturnal asthma. PMID:3085257

  11. Primary Nocturnal Enuresis: A Review

    PubMed Central

    Arda, Ersan; Cakiroglu, Basri; Thomas, David T.

    2016-01-01

    Context Nocturnal enuresis or bedwetting is the most common type of urinary incontinence in children. It has significant psychological effects on both the child and the family. Enuresis nocturna is defined as the inability to hold urine during the night in children who have completed toilet training. It is termed as being “primary” if no continence has ever been achieved or “secondary if it follows at least 6 months of dry nights. The aim of this review was to assemble the pathophysiological background and general information about nocturnal enuresis. Evidence Acquisition This review was performed by evaluating the literature on nocturnal enuresis published between 1970 and 2015, available via PubMed and using the keywords “nocturnal enuresis,” “incontinence,” “pediatric,” “review,” and “treatment.” Results Children with nocturnal enuresis produce urine at higher rates during the night, and may have lower bladder capacities. Some children with nocturnal enuresis may also have daytime urgency, frequency, and urinary incontinence. Treatment includes aggressive treatment of accompanying constipation or urinary tract infections, behavioral changes, and medical therapy. Alarm therapy remains the first-line treatment modality for primary nocturnal enuresis. High rates of patient compliance and relapse mean that alternative treatments remain on the agenda. Conclusions Nocturnal enuresis is a common problem that has multifaceted effects on both the child and the family. Due to multiple etiologic factors, nocturnal enuresis is still not clearly defined. PMID:27703953

  12. Accumulated Deep Sleep Is a Powerful Predictor of LH Pulse Onset in Pubertal Children

    PubMed Central

    Butler, J. P.; Nemati, S.; Kangarloo, T.; Ghassemi, M.; Malhotra, A.; Hall, J. E.

    2015-01-01

    Context: During puberty, reactivation of the reproductive axis occurs during sleep, with LH pulses specifically tied to deep sleep. This association suggests that deep sleep may stimulate LH secretion, but there have been no interventional studies to determine the characteristics of deep sleep required for LH pulse initiation. Objective: The objective of this study was to determine the effect of deep sleep fragmentation on LH secretion in pubertal children. Design and Setting: Studies were performed in a clinical research center. Subjects: Fourteen healthy pubertal children (11.3–14.1 y) participated in the study. Interventions: Subjects were randomized to two overnight studies with polysomnography and frequent blood sampling, with or without deep sleep disruption via auditory stimuli. Results: An average of 68.1 ±10.7 (± SE) auditory stimuli were delivered to interrupt deep sleep during the disruption night, limiting deep sleep to only brief episodes (average length disrupted 1.3 ± 0.2 min vs normal 7.1 ± 0.8 min, P < .001), and increasing the number of transitions between non-rapid eye movement (NREM), REM, and wake (disrupted 274.5 ± 33.4 vs normal 131.2 ± 8.1, P = .001). There were no differences in mean LH (normal: 3.2 ± 0.4 vs disrupted: 3.2 ± 0.5 IU/L), LH pulse frequency (0.6 ± 0.06 vs 0.6 ± 0.07 pulses/h), or LH pulse amplitude (2.8 ± 0.4 vs 2.8 ± 0.4 IU/L) between the two nights. Poisson process modeling demonstrated that the accumulation of deep sleep in the 20 minutes before an LH pulse, whether consolidated or fragmented, was a significant predictor of LH pulse onset (P < .001). Conclusion: In pubertal children, nocturnal LH augmentation and pulse patterning are resistant to deep sleep fragmentation. These data suggest that, even when fragmented, deep sleep is strongly related to activation of the GnRH pulse generator. PMID:25490277

  13. Age-related changes in sleep spindles characteristics during daytime recovery following a 25-hour sleep deprivation

    PubMed Central

    Rosinvil, T.; Lafortune, M.; Sekerovic, Z.; Bouchard, M.; Dubé, J.; Latulipe-Loiselle, A.; Martin, N.; Lina, J. M.; Carrier, J.

    2015-01-01

    Objectives: The mechanisms underlying sleep spindles (~11–15 Hz; >0.5 s) help to protect sleep. With age, it becomes increasingly difficult to maintain sleep at a challenging time (e.g., daytime), even after sleep loss. This study compared spindle characteristics during daytime recovery and nocturnal sleep in young and middle-aged adults. In addition, we explored whether spindles characteristics in baseline nocturnal sleep were associated with the ability to maintain sleep during daytime recovery periods in both age groups. Methods: Twenty-nine young (15 women and 14 men; 27.3 y ± 5.0) and 31 middle-aged (19 women and 13 men; 51.6 y ± 5.1) healthy subjects participated in a baseline nocturnal sleep and a daytime recovery sleep after 25 hours of sleep deprivation. Spindles were detected on artifact-free Non-rapid eye movement (NREM) sleep epochs. Spindle density (nb/min), amplitude (μV), frequency (Hz), and duration (s) were analyzed on parasagittal (linked-ears) derivations. Results: In young subjects, spindle frequency increased during daytime recovery sleep as compared to baseline nocturnal sleep in all derivations, whereas middle-aged subjects showed spindle frequency enhancement only in the prefrontal derivation. No other significant interaction between age group and sleep condition was observed. Spindle density for all derivations and centro-occipital spindle amplitude decreased whereas prefrontal spindle amplitude increased from baseline to daytime recovery sleep in both age groups. Finally, no significant correlation was found between spindle characteristics during baseline nocturnal sleep and the marked reduction in sleep efficiency during daytime recovery sleep in both young and middle-aged subjects. Conclusion: These results suggest that the interaction between homeostatic and circadian pressure modulates spindle frequency differently in aging. Spindle characteristics do not seem to be linked with the ability to maintain daytime recovery sleep. PMID

  14. Mood, alertness, and performance in response to sleep deprivation and recovery sleep in experienced shiftworkers versus non-shiftworkers.

    PubMed

    Wehrens, Sophie M T; Hampton, Shelagh M; Kerkhofs, Myriam; Skene, Debra J

    2012-06-01

    Previous studies have shown increased sleepiness and mood changes in shiftworkers, which may be due to sleep deprivation or circadian disruption. Few studies, however, have compared responses of experienced shiftworkers and non-shiftworkers to sleep deprivation in an identical laboratory setting. The aim of this laboratory study, therefore, was to compare long-term shiftworkers and non-shiftworkers and to investigate the effects of one night of total sleep deprivation (30.5 h of continuous wakefulness) and recovery sleep on psychomotor vigilance, self-rated alertness, and mood. Eleven experienced male shiftworkers (shiftwork ≥5 yrs) were matched with 14 non-shiftworkers for age (mean ± SD: 35.7 ± 7.2 and 32.5 ± 6.2 yrs, respectively) and body mass index (BMI) (28.7 ± 3.8 and 26.6 ± 3.4 kg/m(2), respectively). After keeping a 7-d self-selected sleep/wake cycle (7.5/8 h nocturnal sleep), both groups entered a laboratory session consisting of a night of adaptation sleep and a baseline sleep (each 7.5/8 h), a sleep deprivation night, and recovery sleep (4-h nap plus 7.5/8 h nighttime sleep). Subjective alertness and mood were assessed with the Karolinska Sleepiness Scale (KSS) and 9-digit rating scales, and vigilance was measured by the visual psychomotor vigilance test (PVT). A mixed-model regression analysis was carried out on data collected every hour during the sleep deprivation night and on all days (except for the adaptation day), at .25, 4.25, 5.25, 11.5, 12.5, and 13.5 h after habitual wake-up time. Despite similar circadian phase (melatonin onset), demographics, food intake, body posture, and environmental light, shiftworkers felt significantly more alert, more cheerful, more elated, and calmer than non-shiftworkers throughout the laboratory study. In addition, shiftworkers showed a faster median reaction time (RT) compared to non-shiftworkers, although four other PVT parameters did not differ between the groups. As expected, both groups showed a

  15. Sleep and Human Aging.

    PubMed

    Mander, Bryce A; Winer, Joseph R; Walker, Matthew P

    2017-04-05

    Older adults do not sleep as well as younger adults. Why? What alterations in sleep quantity and quality occur as we age, and are there functional consequences? What are the underlying neural mechanisms that explain age-related sleep disruption? This review tackles these questions. First, we describe canonical changes in human sleep quantity and quality in cognitively normal older adults. Second, we explore the underlying neurobiological mechanisms that may account for these human sleep alterations. Third, we consider the functional consequences of age-related sleep disruption, focusing on memory impairment as an exemplar. We conclude with a discussion of a still-debated question: do older adults simply need less sleep, or rather, are they unable to generate the sleep that they still need?

  16. Patient room lighting influences on sleep, appraisal and mood in hospitalized people.

    PubMed

    Giménez, Marina C; Geerdinck, Leonie M; Versteylen, Mathijs; Leffers, Pieter; Meekes, Gaby J B M; Herremans, Hannelore; de Ruyter, Boris; Bikker, Jan Willem; Kuijpers, Petra M J C; Schlangen, Luc J M

    2017-04-01

    Irregular 24 h light/dark cycles with night-time light exposure and a low amplitude are disruptive for sleep, mood and circadian rhythms. Nevertheless such lighting conditions are quite common in medical care facilities. A controlled clinical trial among 196 cardiology ward patients (mean age 66.5 ± 13.1 years SD) investigated how a patient room lighting intervention affects sleep, appraisal and mood across hospitalization. Patients were either assigned to a standardly-lit room or to a room with an interventional lighting system offering a dynamic 24 h light/dark cycle with low nocturnal light exposure and 2 h of bright light (1750 lux) during daytime. Measures included wrist actigraphy and questionnaires assessing alertness, sleep quality, anxiety, depression and lighting appraisal. The median length of hospitalization was 5 days in both study arms. Subjective scores on sleep, alertness, anxiety and depression did not differ between arms. Lighting appraisal in intervention rooms was better as compared to standardly-lit rooms, both in patients (P < 0.001) and staff (P < 0.005). Actigraphic sleep duration of patients improved by 5.9 min (95% CI: 0.6-11.2; P = 0.03 intervention × time effect) per hospitalization day with interventional lighting instead of standard lighting. After 5 days of hospitalization, sleep duration in the lighting intervention rooms increased by 29 min, or a relative 7.3%, as compared to standardly-lit rooms. A 24 h lighting system with enhanced daytime brightness and restricted nocturnal light exposure can improve some aspects of appraisal and objective sleep in hospital patients. More clinical research is needed to establish the best lighting strategy to promote healing and wellbeing within healthcare settings.

  17. Sleep Disorders in Postmenopausal Women

    PubMed Central

    Jehan, Shazia; Masters-Isarilov, Alina; Salifu, Idoko; Zizi, Ferdinand; Jean-Louis, Girardin; Pandi-Perumal, Seithikurippu R; Gupta, Ravi; Brzezinski, Amnon; McFarlane, Samy I

    2015-01-01

    One of the core symptoms of the menopausal transition is sleep disturbance. Peri-menopausal women often complain of difficulties initiating and/or maintaining sleep with frequent nocturnal and early morning awakenings. Factors that may play a role in this type of insomnia include vasomotor symptoms, changing reproductive hormone levels, circadian rhythm abnormalities, mood disorders, coexistent medical conditions, and lifestyle. Other common sleep problems in this age group, such as obstructive sleep apnea and restless leg syndrome, can also worsen the sleep quality. Exogenous melatonin use reportedly induces drowsiness and sleep and may ameliorate sleep disturbances, including the nocturnal awakenings associated with old age and the menopausal transition. Recently, more potent melatonin analogs (selective melatonin-1 (MT1) and melatonin-2 (MT2) receptor agonists) with prolonged effects and slow-release melatonin preparations have been developed. They were found effective in increasing total sleep time and sleep efficiency as well as in reducing sleep latency in insomnia patients. The purpose of this review is to give an overview on the changes in hormonal status to sleep problems among menopausal and postmenopausal women. PMID:26512337

  18. Parasomnias and nocturnal frontal lobe epilepsy (NFLE): lights and shadows--controversial points in the differential diagnosis.

    PubMed

    Bisulli, Francesca; Vignatelli, Luca; Provini, Federica; Leta, Chiara; Lugaresi, Elio; Tinuper, Paolo

    2011-12-01

    Nocturnal frontal lobe epilepsy (NFLE) is characterized by seizures with complex, often bizarre, violent behaviour arising only or mainly during sleep. These unusual seizures and their occurrence during sleep are often accompanied by normal EEG tracings and neuroradiological findings, making it difficult to distinguish NFLE seizures from other non-epileptic nocturnal paroxysmal events, namely parasomnias. NFLE was described for the first time in 1981, but, as its epileptic origin was controversial, the condition was called nocturnal paroxysmal dystonia. Even though many aspects of parasomnias and NFLE have been clarified in the last two decades, the problem of differential diagnosis remains a challenge for clinicians. This paper discusses some controversial points still under debate. The difficulties in distinguishing nocturnal epileptic seizures from parasomnias reflect just one aspect of the intriguing issue of the pathophysiological relationships between all types of paroxysmal motor behaviours during sleep.

  19. Sleep Disorders in Atypical Parkinsonism

    PubMed Central

    Abbott, Sabra M.; Videnovic, Aleksandar

    2014-01-01

    Sleep disorders are commonly seen in atypical parkinsonism, with particular disorders occurring more frequently in specific parkinsonian disorders. Multiple systems atrophy (MSA) is a synucleinopathy often associated with nocturnal stridor which is a serious, but treatable condition highly specific to MSA. In addition, this disorder is strongly associated with rapid eye movement (REM) sleep behavior disorder (RBD), which is also seen in dementia with Lewy bodies (DLB). RBD is far less prevalent in progressive supranuclear palsy (PSP), which is a tauopathy. Insomnia and impaired sleep architecture are the most common sleep abnormalities seen in PSP. Corticobasilar degeneration (CBD) is also a tauopathy, but has far fewer sleep complaints associated with it than PSP. In this manuscript we review the spectrum of sleep dysfunction across the atypical parkinsonian disorders, emphasize the importance of evaluating for sleep disorders in patients with parkinsonian symptoms, and point to sleep characteristics that can provide diagnostic clues to the underlying parkinsonian disorder. PMID:24955381

  20. [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.

  1. Behavioral Treatment for Nocturnal Enuresis

    ERIC Educational Resources Information Center

    Friman, Patrick C.; Jones, Kevin M.

    2005-01-01

    Nocturnal enuresis is one of the most prevalent and distressing of all childhood problems. The treatment of nocturnal enuresis has shifted in the past few decades from a strictly psychopathological perspective to a biobehavioral perspective. Although the primary clinical features of this disorder are medical/organic, there is currently strong…

  2. Response Surface Mapping of Neurobehavioral Performance: Testing the Feasibility of Split Sleep Schedules for Space Operations.

    PubMed

    Mollicone, Daniel J; Van Dongen, Hans P A; Rogers, Naomi L; Dinges, David F

    2008-01-01

    The demands of sustaining high levels of neurobehavioral performance during space operations necessitate precise scheduling of sleep opportunities in order to best preserve optimal performance. We report here the results of the first split-sleep, dose-response experiment involving a range of sleep/wake scenarios with chronically reduced nocturnal sleep, augmented with a diurnal nap. To characterize performance over all combinations of split sleep in the range studied, we used response surface mapping methodology. Waking neurobehavioral performance was studied in N=90 subjects each assigned to one of 18 sleep regimens consisting of a restricted nocturnal anchor sleep period and a diurnal nap. Psychomotor vigilance task performance and subjective assessments of sleepiness were found to be primarily a function of total time in bed per 24 h regardless of how sleep was divided among nocturnal anchor sleep and diurnal nap periods. Digit symbol substitution task performance was also found to be primarily a function of total time in bed per 24 h; however, accounting for nocturnal sleep duration and nap duration separately provided a small but significant enhancement in the variance explained. The results suggest that reductions in total daily sleep result in a near-linear accumulation of impairment regardless of whether sleep is scheduled as a consolidated nocturnal sleep period or split into a nocturnal anchor sleep period and a diurnal nap. Thus, split sleep schedules are feasible and can be used to enhance the flexibility of sleep/work schedules for space operations involving restricted nocturnal sleep due to mission-critical task scheduling. These results are generally applicable to any continuous industrial operation that involves sleep restriction, night operations, and shift work.

  3. Response Surface Mapping of Neurobehavioral Performance: Testing the Feasibility of Split Sleep Schedules for Space Operations

    PubMed Central

    Mollicone, Daniel J.; Van Dongen, Hans P.A.; Rogers, Naomi L.; Dinges, David F.

    2008-01-01

    The demands of sustaining high levels of neurobehavioral performance during space operations necessitate precise scheduling of sleep opportunities in order to best preserve optimal performance. We report here the results of the first split-sleep, dose-response experiment involving a range of sleep/wake scenarios with chronically reduced nocturnal sleep, augmented with a diurnal nap. To characterize performance over all combinations of split sleep in the range studied, we used response surface mapping methodology. Waking neurobehavioral performance was studied in N=90 subjects each assigned to one of 18 sleep regimens consisting of a restricted nocturnal anchor sleep period and a diurnal nap. Psychomotor vigilance task performance and subjective assessments of sleepiness were found to be primarily a function of total time in bed per 24 h regardless of how sleep was divided among nocturnal anchor sleep and diurnal nap periods. Digit symbol substitution task performance was also found to be primarily a function of total time in bed per 24 h; however, accounting for nocturnal sleep duration and nap duration separately provided a small but significant enhancement in the variance explained. The results suggest that reductions in total daily sleep result in a near-linear accumulation of impairment regardless of whether sleep is scheduled as a consolidated nocturnal sleep period or split into a nocturnal anchor sleep period and a diurnal nap. Thus, split sleep schedules are feasible and can be used to enhance the flexibility of sleep/work schedules for space operations involving restricted nocturnal sleep due to mission-critical task scheduling. These results are generally applicable to any continuous industrial operation that involves sleep restriction, night operations, and shift work. PMID:19194521

  4. Response surface mapping of neurobehavioral performance: Testing the feasibility of split sleep schedules for space operations

    NASA Astrophysics Data System (ADS)

    Mollicone, Daniel J.; Van Dongen, Hans P. A.; Rogers, Naomi L.; Dinges, David F.

    The demands of sustaining high levels of neurobehavioral performance during space operations necessitate precise scheduling of sleep opportunities in order to best preserve optimal performance. We report here the results of the first split sleep, dose-response experiment involving a range of sleep/wake scenarios with chronically reduced nocturnal sleep, augmented with a diurnal nap. To characterize performance over all combinations of split sleep in the range studied, we used response surface mapping methodology. Waking neurobehavioral performance was studied in N=90 subjects each assigned to one of 18 sleep regimens consisting of a restricted nocturnal anchor sleep period and a diurnal nap. Psychomotor vigilance task performance and subjective assessments of sleepiness were found to be primarily a function of total time in bed per 24 h regardless of how sleep was divided among nocturnal anchor sleep and diurnal nap periods. Digit symbol substitution task performance was also found to be primarily a function of total time in bed per 24 h; however, accounting for nocturnal sleep duration and nap duration separately provided a small but significant enhancement in the variance explained. The results suggest that reductions in total daily sleep result in a near-linear accumulation of impairment regardless of whether sleep is scheduled as a consolidated nocturnal sleep period or split into a nocturnal anchor sleep period and a diurnal nap. Thus, split sleep schedules are feasible and can be used to enhance the flexibility of sleep/work schedules for space operations involving restricted nocturnal sleep due to mission-critical task scheduling. These results are generally applicable to any continuous industrial operation that involves sleep restriction, night operations, and shift work.

  5. Sleep, Fatigue, Depression and Circadian Activity Rhythms in Women with Breast Cancer Before and After Treatment: A 1-year longitudinal study

    PubMed Central

    Ancoli-Israel, Sonia; Liu, Lianqi; Rissling, Michelle; Natarajan, Loki; Neikrug, Ariel B; Palmer, Barton W; Mills, Paul J; Parker, Barbara A; Sadler, Georgia Robins; Maglione, Jeanne

    2014-01-01

    Purpose Sleep disturbance, fatigue and depression are common complaints in patients with cancer, and often contribute to worse quality of life (QoL). Circadian activity rhythms (CARs) are often disrupted in cancer patients. These symptoms worsen during treatment, but less is known about their long-term trajectory. Methods Sixty-eight women with stage I-III breast cancer (BC) scheduled to receive ≥4 cycles of chemotherapy, and age-, ethnicity- and education-matched normal, cancer-free controls (NC) participated. Sleep was measured with actigraphy (nocturnal total sleep time [nocturnal TST] and daytime total nap time [NAPTIME]) and with the Pittsburgh Sleep Quality Index (PSQI); fatigue with the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF); depression with the Center of Epidemiological Studies-Depression (CES-D). CARs were derived from actigraphy. Several measures of QoL were administered. Data were collected at three time points: before (Baseline), end of cycle 4 (Cycle-4), and one year post-chemotherapy (1-Year). Results Compared to NC, BC had longer NAPTIME, worse sleep quality, more fatigue, more depressive symptoms, more disrupted CARs and worse QoL at Baseline (all p’s<0.05). At Cycle-4, BC showed worse sleep, increased fatigue, more depressive symptoms, and more disrupted CARs compared to their own Baseline levels and to NC (all p’s<0.05). By 1-year, BC’s fatigue, depressive symptoms and QoL returned to Baseline levels but were still worse than those of NC, while NAPTIME and CARs did not differ from NC’s. Conclusion Additional research is needed to determine if beginning treatment of these symptoms before the start of chemotherapy will minimize symptom severity over time. PMID:24733634

  6. Sleep and protein synthesis-dependent synaptic plasticity: impacts of sleep loss and stress

    PubMed Central

    Grønli, Janne; Soulé, Jonathan; Bramham, Clive R.

    2014-01-01

    Sleep has been ascribed a critical role in cognitive functioning. Several lines of evidence implicate sleep in the consolidation of synaptic plasticity and long-term memory. Stress disrupts sleep while impairing synaptic plasticity and cognitive performance. Here, we discuss evidence linking sleep to mechanisms of protein synthesis-dependent synaptic plasticity and synaptic scaling. We then consider how disruption of sleep by acute and chronic stress may impair these mechanisms and degrade sleep function. PMID:24478645

  7. Ambient Light Intensity, Actigraphy, Sleep and Respiration, Circadian Temperature and Melatonin Rhythms and Daytime Performance of Crew Members During Space Flight on STS-90 and STS-95 Missions

    NASA Technical Reports Server (NTRS)

    Czeisler, Charles A.; Dijk, D.-J.; Neri, D. F.; Hughes, R. J.; Ronda, J. M.; Wyatt, J. K.; West, J. B.; Prisk, G. K.; Elliott, A. R.; Young, L. R.

    1999-01-01

    Sleep disruption and associated waking sleepiness and fatigue are common during space flight. A survey of 58 crew members from nine space shuttle missions revealed that most suffered from sleep disruption, and reportedly slept an average of only 6.1 hours per day of flight as compared to an average of 7.9 hours per day on the ground. Nineteen percent of crewmembers on single shift missions and 50 percent of the crewmembers in dual shift operations reported sleeping pill usage (benzodiazepines) during their missions. Benzodiazepines are effective as hypnotics, however, not without adverse side effects including carryover sedation and performance impairment, anterograde amnesia, and alterations in sleep EEG. Our preliminary ground-based data suggest that pre-sleep administration of 0.3 mg of the pineal hormone melatonin may have the acute hypnotic properties needed for treating the sleep disruption of space flight without producing the adverse side effects associated with benzodiazepines. We hypothesize that pre-sleep administration of melatonin will result in decreased sleep latency, reduced nocturnal sleep disruption, improved sleep efficiency, and enhanced next-day alertness and cognitive performance both in ground-based simulations and during the space shuttle missions. Specifically, we have carried out experiments in which: (1) ambient light intensity aboard the space shuttle is assessed during flight; (2) the impact of space flight on sleep (assessed polysomnographically and actigraphically), respiration during sleep, circadian temperature and melatonin rhythms, waking neurobehavioral alertness and performance is assessed in crew members of the Neurolab and STS-95 missions; (3) the effectiveness of melatonin as a hypnotic is assessed independently of its effects on the phase of the endogenous circadian pacemaker in ground-based studies, using a powerful experimental model of the dyssomnia of space flight; (4) the effectiveness of melatonin as a hypnotic is

  8. The Superior Sleep of Healthy Elderly Nuns.

    ERIC Educational Resources Information Center

    Hoch, Carolyn C.; And Others

    1987-01-01

    Compared nocturnal sleep structure of 10 healthy elderly nuns to that of 10 healthy age-matched female controls. The nuns fell asleep more quickly and had less early morning awakening, as well as greater rapid eye movement sleep time. These differences may reflect the more highly entrained life style of the nuns, including modest habitual sleep…

  9. The influence of acute exercise on sleep following high caffeine intake.

    PubMed

    Youngstedt, S D; O'Connor, P J; Crabbe, J B; Dishman, R K

    2000-02-01

    The purpose of this study was to examine the influence of vigorous acute exercise on nocturnal sleep that had been disrupted by high doses (1200 mg) of caffeine throughout the daytime. Eight moderately fit, young males with a history of moderate caffeine use completed four conditions in a within-subjects, counterbalanced design: 60 min of (i) cycling at 60% VO(2peak) or (ii) quiet rest following placebo consumption, (iii) cycling, or (iv) quiet rest following the consumption of a high dose of caffeine. Each condition was performed twice from 1615-1715 h and followed by all-night polysomnographic recording. Subjects consumed two blinded 200-mg capsules of either lactose placebo or caffeine upon awakening, at 1600 h, and 2 h before bedtime. State anxiety was assessed at bedtime. Criterion scores consisted of the mean data across the two days in each condition. Sleep data were analyzed using a condition (exercise versus quiet rest) by drug (caffeine versus placebo) repeated-measures ANOVA. Caffeine-elicited sleep disturbance that was less than previously reported. Exercise attenuated selected sleep disturbances to a small degree. In general, the effects of exercise on sleep were not greater following caffeine compared to placebo. Indeed, increases in slow-wave sleep after exercise were approximately 1/3 smaller following caffeine treatment compared to placebo.

  10. Sleep Problems, Sleepiness and Daytime Behavior in Preschool-Age Children

    ERIC Educational Resources Information Center

    Goodlin-Jones, Beth; Tang, Karen; Liu, Jingyi; Anders, Thomas F.

    2009-01-01

    Background: Sleep problems are a common complaint of parents of preschool children. Children with neurodevelopmental disorders have even more disrupted sleep than typically developing children. Although disrupted nighttime sleep has been reported to affect daytime behavior, the pathway from sleep disruption to sleep problems, to impairments in…

  11. Metabolic consequences of sleep and circadian disorders

    PubMed Central

    Depner, Christopher M.; Stothard, Ellen R.; Wright, Kenneth P.

    2014-01-01

    Sleep and circadian rhythms modulate or control daily physiological patterns with importance for normal metabolic health. Sleep deficiencies associated with insufficient sleep schedules, insomnia with short-sleep duration, sleep apnea, narcolepsy, circadian misalignment, shift work, night eating syndrome and sleep-related eating disorder may all contribute to metabolic dysregulation. Sleep deficiencies and circadian disruption associated with metabolic dysregulation may contribute to weight gain, obesity, and type 2 diabetes potentially by altering timing and amount of food intake, disrupting energy balance, inflammation, impairing glucose tolerance and insulin sensitivity. Given the rapidly increasing prevalence of metabolic diseases, it is important to recognize the role of sleep and circadian disruption in the development, progression, and morbidity of metabolic disease. Some findings indicate sleep treatments and countermeasures improve metabolic health, but future clinical research investigating prevention and treatment of chronic metabolic disorders through treatment of sleep and circadian disruption is needed. PMID:24816752

  12. Sleep benefits subsequent hippocampal functioning.

    PubMed

    Van Der Werf, Ysbrand D; Altena, Ellemarije; Schoonheim, Menno M; Sanz-Arigita, Ernesto J; Vis, José C; De Rijke, Wim; Van Someren, Eus J W

    2009-02-01

    Sleep before learning benefits memory encoding through unknown mechanisms. We found that even a mild sleep disruption that suppressed slow-wave activity and induced shallow sleep, but did not reduce total sleep time, was sufficient to affect subsequent successful encoding-related hippocampal activation and memory performance in healthy human subjects. Implicit learning was not affected. Our results suggest that the hippocampus is particularly sensitive to shallow, but intact, sleep.

  13. Genetic Dissociation of Daily Sleep and Sleep Following Thermogenetic Sleep Deprivation in Drosophila

    PubMed Central

    Dubowy, Christine; Moravcevic, Katarina; Yue, Zhifeng; Wan, Joy Y.; Van Dongen, Hans P.A.; Sehgal, Amita

    2016-01-01

    Study Objectives: Sleep rebound—the increase in sleep that follows sleep deprivation—is a hallmark of homeostatic sleep regulation that is conserved across the animal kingdom. However, both the mechanisms that underlie sleep rebound and its relationship to habitual daily sleep remain unclear. To address this, we developed an efficient thermogenetic method of inducing sleep deprivation in Drosophila that produces a substantial rebound, and applied the newly developed method to assess sleep rebound in a screen of 1,741 mutated lines. We used data generated by this screen to identify lines with reduced sleep rebound following thermogenetic sleep deprivation, and to probe the relationship between habitual sleep amount and sleep following thermogenetic sleep deprivation in Drosophila. Methods: To develop a thermogenetic method of sleep deprivation suitable for screening, we thermogenetically stimulated different populations of wake-promoting neurons labeled by Gal4 drivers. Sleep rebound following thermogenetically-induced wakefulness varies across the different sets of wake-promoting neurons that were stimulated, from very little to quite substantial. Thermogenetic activation of neurons marked by the c584-Gal4 driver produces both strong sleep loss and a substantial rebound that is more consistent within genotypes than rebound following mechanical or caffeine-induced sleep deprivation. We therefore used this driver to induce sleep deprivation in a screen of 1,741 mutagenized lines generated by the Drosophila Gene Disruption Project. Flies were subjected to 9 h of sleep deprivation during the dark period and released from sleep deprivation 3 h before lights-on. Recovery was measured over the 15 h following sleep deprivation. Following identification of lines with reduced sleep rebound, we characterized baseline sleep and sleep depth before and after sleep deprivation for these hits. Results: We identified two lines that consistently exhibit a blunted increase in the

  14. Assessment Of Noise-induced Sleep Fragility In Two Age Ranges By Means Of Polysomnographic Microstructure

    NASA Astrophysics Data System (ADS)

    Terzano, M. G.; Parrino, L.; Spaggiari, M. C.; Buccino, G. P.; Fioriti, G.; Depoortere, H.

    1993-04-01

    The microstructure of sleep, which translates the short-lived fluctuations of the arousal level, is a commonly neglected feature in polysomnographic studies. Specifically arranged microstructural EEG events may provide important information on the dynamic characteristics of the sleep process. CAP (cyclic alternating pattern) and non-CAP are complementary modalities in which arousal-related "phasic" EEG phenomena are organized in non-REM sleep, and they correspond to opposite conditions of unstable and stable sleep depth, respectively. Thus, arousal instability can be measured by the CAP rate, the percentage ratio of total CAP time to total non-REM sleep time. The CAP rate, an age-related physiological variable that increases in several pathological conditions, is highly sensitive to acoustic perturbation. In the present study, two groups of healthy subjects without complaints about sleep, belonging to different age ranges (six young adults, three males and three females, between 20 and 30 years, and six middle-aged individuals, three males and three females, between 40 and 55 years) slept, after adaptation to the sleep laboratory, in a random sequence for two non-consecutive nights either under silent baseline (27·3 dB(A) Lcq) or noise-disturbed (continuous 55 dB(A) white noise) conditions. Age-related and noise-related effects on traditional sleep parameters and on the CAP rate were statistically evaluated by a split-plot test. Compared to young adults, the middle-aged individuals showed a significant reduction of total sleep time, stage 2 and REM sleep and significantly higher values of nocturnal awakenings and the CAP rate. The noisy nights were characterized by similar alterations. The disruptive effects of acoustic perturbation were greater on the more fragile sleep architecture of the older group. The increased fragility of sleep associated with aging probably reflects the decreased capacity of the sleeping brain to maintain steady states of vigilance. Total

  15. Abnormal Nocturnal Behavior due to Hypoglycemia in a Patient with Type 2 Diabetes

    PubMed Central

    Yang, Kwang Ik; Kim, Hyung Ki; Baek, Jeehun; Kim, Doh-Eui; Park, Hyung Kook

    2016-01-01

    Abnormal nocturnal behavior can have many causes, including primary sleep disorder, nocturnal seizures, and underlying medical or neurological disorders. A 79-year-old woman with type 2 diabetes was admitted for evaluation of abnormal nocturnal behavior. Every night at around 04:30 she was observed displaying abnormal behavior including leg shaking, fumbling with bedclothes, crawling around the room with her eyes closed, and non-responsiveness to verbal communication. Polysomnography with 20-channel electroencephalography (EEG) was performed. EEG showed that the posterior dominant rhythm was slower than that observed in the initial EEG, with diffuse theta and delta activities intermixed, and no epileptiform activity. The serum glucose level was 35 mg/dL at that time, and both the EEG findings and clinical symptoms were resolved after an intravenous injection of 50 mL of 50% glucose. These results indicate that nocturnal hypoglycemia should be considered as one of the possible etiologies in patients presenting with abnormal nocturnal behavior. Citation: Yang KI, Kim HK, Baek J, Kim DE, Park HK. Abnormal nocturnal behavior due to hypoglycemia in a patient with type 2 diabetes. J Clin Sleep Med 2016;12(4):627–629. PMID:26943712

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

    PubMed

    Naismith, S; Winter, V; Gotsopoulos, H; Hickie, I; Cistulli, P

    2004-02-01

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

  17. Effects of Night-Time Use of Rotigotine on Nocturnal Symptoms in Parkinson's Disease.

    PubMed

    Vallderiola, Francesc; Compta, Yaroslau; Aparicio, Javier; Tarradellas, Jaume; Salazar, Gabriel; Oliver, Josep María; Callén, Antonio; Delgado, Tania; Nobbe, Fritz

    2015-01-01

    Objectives. This open-label study assessed the efficacy and safety of exclusive night-time administration of transdermal rotigotine in patients with nocturnal and early morning PD symptoms. Methods. Patients with PD and nocturnal and early morning symptoms received transdermal rotigotine patches (2-16 mg/24 h) applied in the evening and removed in the morning for 3 months. Sleep disturbance was assessed with modified Parkinson's Disease Sleep Scale (PDSS-2). Other outcomes included a pain visual analogue scale (VAS) and short-form Parkinson's Disease Questionnaire (PDQ-8) for quality of life. Results. 74 patients completed treatment in this study. At the end of treatment, PDSS-2 total score had improved by mean 10.9 points from baseline (p < 0.001). All three PDSS-2 domain scores (sleep disturbances, nocturnal motor symptoms, and nocturnal symptoms) were also significantly improved by 41%, 56%, and 48%, respectively (p < 0.001). VAS-pain score decreased from 3.2 to 2.3 (p < 0.001). PDQ-8 score decreased from 23.8 to 18.1 (p < 0.001). The most frequently reported adverse events included nausea (9%), anxiety (4%), and dizziness (4%). Conclusions. Night-time administration of transdermal rotigotine is an effective and well tolerated treatment for nocturnal symptoms in patients with PD.

  18. Effects of Night-Time Use of Rotigotine on Nocturnal Symptoms in Parkinson's Disease

    PubMed Central

    Vallderiola, Francesc; Compta, Yaroslau; Aparicio, Javier; Tarradellas, Jaume; Salazar, Gabriel; Oliver, Josep María; Callén, Antonio; Delgado, Tania; Nobbe, Fritz

    2015-01-01

    Objectives. This open-label study assessed the efficacy and safety of exclusive night-time administration of transdermal rotigotine in patients with nocturnal and early morning PD symptoms. Methods. Patients with PD and nocturnal and early morning symptoms received transdermal rotigotine patches (2–16 mg/24 h) applied in the evening and removed in the morning for 3 months. Sleep disturbance was assessed with modified Parkinson's Disease Sleep Scale (PDSS-2). Other outcomes included a pain visual analogue scale (VAS) and short-form Parkinson's Disease Questionnaire (PDQ-8) for quality of life. Results. 74 patients completed treatment in this study. At the end of treatment, PDSS-2 total score had improved by mean 10.9 points from baseline (p < 0.001). All three PDSS-2 domain scores (sleep disturbances, nocturnal motor symptoms, and nocturnal symptoms) were also significantly improved by 41%, 56%, and 48%, respectively (p < 0.001). VAS-pain score decreased from 3.2 to 2.3 (p < 0.001). PDQ-8 score decreased from 23.8 to 18.1 (p < 0.001). The most frequently reported adverse events included nausea (9%), anxiety (4%), and dizziness (4%). Conclusions. Night-time administration of transdermal rotigotine is an effective and well tolerated treatment for nocturnal symptoms in patients with PD. PMID:26576319

  19. Sleep Health: Reciprocal Regulation of Sleep and Innate Immunity.

    PubMed

    Irwin, Michael R; Opp, Mark R

    2017-01-01

    Sleep disturbances including insomnia independently contribute to risk of inflammatory disorders and major depressive disorder. This review and overview provides an integrated understanding of the reciprocal relationships between sleep and the innate immune system and considers the role of sleep in the nocturnal regulation of the inflammatory biology dynamics; the impact of insomnia complaints, extremes of sleep duration, and experimental sleep deprivation on genomic, cellular, and systemic markers of inflammation; and the influence of sleep complaints and insomnia on inflammaging and molecular processes of cellular aging. Clinical implications of this research include discussion of the contribution of sleep disturbance to depression and especially inflammation-related depressive symptoms. Reciprocal action of inflammatory mediators on the homeostatic regulation of sleep continuity and sleep macrostructure, and the potential of interventions that target insomnia to reverse inflammation, are also reviewed. Together, interactions between sleep and inflammatory biology mechanisms underscore the implications of sleep disturbance for inflammatory disease risk, and provide a map to guide the development of treatments that modulate inflammation, improve sleep, and promote sleep health.

  20. Evaluation of nocturnal bronchoconstriction by all night tracheal sound monitoring.

    PubMed Central

    Lenclud, C.; Cuttitta, G.; Van Gansbeke, D.; Visconti, A.; Van Muylem, A.; Bellia, V.; Yernault, J. C.

    1996-01-01

    BACKGROUND: A study was undertaken to evaluate the reliability of a digital tracheal sound analyser (ELENS-DSA) in predicting nocturnal changes in airways resistance in asthmatic patients. This device allows continuous measurement of the proportion of the time occupied by wheezing (Wh%). METHODS: Nocturnal polygraphic studies with simultaneous continuous monitoring of tracheal sounds and airways resistance were performed in seven patients with nocturnal asthma. In order to evaluate the possible bias in wheezing estimation, each tracheal sound recording was passed through the automatic analyser and simultaneously monitored with earphones by an experienced observer. RESULTS: The device detected audible wheezing with an optimal sensitivity and specificity of 70%. Snoring was a minor cause of the relatively poor characteristics of the system. A close correlation (p < 0.001) between Wh% and airways resistance was observed only in those patients with the highest increase in resistance; when the results of all the subjects were pooled the correlation observed was poor. The predictive value of Wh% in detecting changes in airways resistance during 10 minute intervals was lower than 70%. The positive and negative predictive values of Wh% were raised to 79% and 83%, respectively, for 30 minute intervals. CONCLUSIONS: The ELENS-DSA system is a relatively crude means of detecting wheezing and assessing bronchoconstriction quantitatively. However, it is able to detect accurately nocturnal bronchoconstriction for 30 minute intervals. This finding, along with the fact that the monitoring is non-invasive, suggests that it may be a promising tool, especially for patients during sleep. PMID:8882075

  1. Coexistence of Epileptic Nocturnal Wanderings and an Arachnoid Cyst

    PubMed Central

    Jiménez-Genchi, Alejandro; Díaz-Galviz, John L.; García-Reyna, Juan Carlos; Ávila-Ordoñez, Mario U.

    2007-01-01

    Episodic nocturnal wanderings (ENWs) have rarely been associated with gross abnormalities of brain structures. We describe the case of a patient with ENWs in coexistence with an arachnoid cyst (AC). The patient was a 15-year-old boy who presented with nocturnal attacks characterized by complex motor behaviors. An MRI revealed a left temporal cyst and a SPECT Tc99 scan showed left temporal hypoperfusion and bilateral frontal hyperperfusion, more evident on the right side. During an all-night polysomnographic recording with audiovisual monitoring, dystonic posture followed by sleepwalking-like behavior was documented. The sleepwalking-like behavior was preceded by a spike discharge over the left frontocentral region with contralateral projection and secondary generalization during stage 2 sleep. Treatment with levetiracetam produced a striking remission of seizures. This supports a conservative management of an AC, considering that it may be an incidental finding. In epileptic patients, an AC may not necessarily be related to the location of the seizure focus. Citation: Jiménez-Genchi A; Díaz-Galviz JL; García-Reyna JC et al. Coexistence of epileptic nocturnal wanderings and an arachnoid cyst. J Clin Sleep Med 2007;3(4):399-401. PMID:17694730

  2. Nocturnal activity of nesting shrubland and grassland passerines: Chapter 9

    USGS Publications Warehouse

    Slay, Christy M.; Ellison, Kevin S.; Ribic, Christine; Smith, Kimberly G.; Schmitz, Carolyn M.

    2013-01-01

    Nocturnal activity of nesting passerines is largely undocumented in field situations. We used video recordings to quantify sleep patterns of four shrubland and three grassland bird species during the nestling period. All species exhibited “back sleep” (bill tucked under scapular feathers); individuals woke frequently for vigils of their surroundings. Sleep-bout duration varied from 6 minutes (grasshopper sparrow) to 28 minutes (blue-winged warbler, field sparrow). Duration on nest varied from 6.4 hours (field sparrow) to 8.8 hours (indigo bunting). Adults woke 20–30 minutes before sunrise. First morning absence from the nest was short; nestlings were fed within 12 minutes of a parent’s departure. Further research is needed to understand energetic costs of sleep and behavioral adaptations to environmental pressures.

  3. Effect of Ship Noise on Sleep

    NASA Astrophysics Data System (ADS)

    Tamura, Y.; Kawada, T.; Sasazawa, Y.

    1997-08-01

    The effects of a steady sound level of 65 dB(A) from a diesel ship engine on nocturnal sleep were studied using polygraphic and subjective sleep parameters. Three healthy men, aged 29 to 33 years, participated in the experiment. Sleep polygrams and the sound level in a sleep laboratory were recorded for each subject for five exposure nights and five control nights. The following morning, the subjects answered a self-rating sleep questionnaire (called the OSA) and underwent simple reaction time tests. The percentage of S2, SREM latency and the REM interval increased, while %SREM decreased during the noise-exposed nights as compared with corresponding values on the control nights. Other parameters of sleep EEG were unchanged. Five scale scores for OSA, sleepiness, sleep maintenance, worry, integrated sleep feeling and sleep initiation deteriorated significantly on the noise-exposed nights as compared with the control nights. Canonical discriminant analysis was conducted using 19 sleep parameters. The standard partial regression coefficients of %SREM, %S2 and %S1 were somewhat higher than other parameters. It was suggested that exposure to the 65 dB(A) ship noise exerted adverse effects on nocturnal sleep, subjectively and in part polygraphically (REM sleep and shallow sleep).

  4. Sleep and Eating Disorders.

    PubMed

    Allison, Kelly C; Spaeth, Andrea; Hopkins, Christina M

    2016-10-01

    Insomnia is related to an increased risk of eating disorders, while eating disorders are related to more disrupted sleep. Insomnia is also linked to poorer treatment outcomes for eating disorders. However, over the last decade, studies examining sleep and eating disorders have relied on surveys, with no objective measures of sleep for anorexia nervosa or bulimia nervosa, and only actigraphy data for binge eating disorder. Sleep disturbance is better defined for night eating syndrome, where sleep efficiency is reduced and melatonin release is delayed. Studies that include objectively measured sleep and metabolic parameters combined with psychiatric comorbidity data would help identify under what circumstances eating disorders and sleep disturbance produce an additive effect for symptom severity and for whom poor sleep would increase risk for an eating disorder. Cognitive behavior therapy for insomnia may be a helpful addition to treatment of those with both eating disorder and insomnia.

  5. Analyzing nocturnal noise stratification.

    PubMed

    Rey Gozalo, Guillermo; Barrigón Morillas, Juan Miguel; Gómez Escobar, Valentín

    2014-05-01

    Pollution associated to traffic can be considered as one of the most relevant pollution sources in our cities; noise is one of the major components of traffic pollution; thus, efforts are necessary to search adequate noise assessment methods and low pollution city designs. Different methods have been proposed for the evaluation of noise in cities, including the categorization method, which is based on the functionality concept. Until now, this method has only been studied (with encouraging results) for short-term, diurnal measurements, but nocturnal noise presents a behavior clearly different on respect to the diurnal one. In this work 45 continuous measurements of approximately one week each in duration are statistically analyzed to identify differences between the proposed categories. The results show that the five proposed categories highlight the noise stratification of the studied city in each period of the day (day, evening, and night). A comparison of the continuous measurements with previous short-term measurements indicates that the latter can be a good approximation of the former in diurnal period, reducing the resource expenditure for noise evaluation. Annoyance estimated from the measured noise levels was compared with the response of population obtained from a questionnaire with good agreement. The categorization method can yield good information about the distribution of a pollutant associated to traffic in our cities in each period of the day and, therefore, is a powerful tool for town planning and the design of pollution prevention policies.

  6. Nocturnal Orgasm in College Women: Its Relation to Dreams and Anxiety Associated with Sexual Factors

    ERIC Educational Resources Information Center

    Henton, Comradge L.

    1976-01-01

    A total of 774 female undergraduates were administered a structured questionnaire and an anxiety scale. It was found that women do experience nocturnal orgasms during sleep. Differences were found according to year at school as well as a positive correlation between level of anxiety and sexual excitement. (MS)

  7. Sleep and Alertness Management II: Effects on Sleep Pattern and Sleep Quality in Marmosets (slaap- en alertheidsmanagement II: effecten op slaapritme en slaapkwaliteit in marmosetapen)

    DTIC Science & Technology

    2006-10-01

    II: Effects on F +31 15 284 39 91 sleep pattern and sleep quality in marmosets Info-DenV@tno.nf Date October 2006 Author(s) Dr I.l1.C.H.M. Philippens...5126 Summary In this study, the marmoset monkey model was validated using nocturnal electroencephalogram measurements for evaluating effects on sleep...the effects of the short acting hypnotic drugs temazepam, zolpidem and zaleplon on sleep were determined in the marmoset monkey. The results showed

  8. [Sleep in normal aging].

    PubMed

    Goldenberg, F

    1991-10-01

    Sleep in the elderly is characterized by a decrease in the ability to stay asleep resulting in a more fragmented sleep. Spindles are less frequent and less ample, shorter, without an increase during the night contrary young subjects. Delta activity in slow wave sleep is decreased in the 0.5-2 Hz frequency band only. REM sleep occurs earlier the first REM period duration increases. The REM sleep appearance is almost uniform during the night. REMs density does not increase toward the end of the sleeping period. The sleep-wake circadian rhythm is advanced (bedtime and morning awakening occur earlier). The temperature rhythm is also advanced. The rise in temperature after the nadir begins earlier for females and the initial ascent is more rapid. This explains why women wake up earlier and sleep for shorter durations than men. The nocturnal and diurnal mean plasmatic norepinephrine values increase. The rhythm of cortisol secretion is advanced. The GH and melatonin peaks of secretion are decreased. The acrophase of melatonin rhythm is occurring later in the elderly. These results suggest a weakening of circadian structure in the course of aging and an altered relationship between the pacemakers driving melatonin and cortisol circadian rhythms.

  9. Cerebral Activity Associated with Transient Sleep-Facilitated Reduction in Motor Memory Vulnerability to Interference

    PubMed Central

    Albouy, Geneviève; King, Bradley R.; Schmidt, Christina; Desseilles, Martin; Dang-Vu, Thien Thanh; Balteau, Evelyne; Phillips, Christophe; Degueldre, Christian; Orban, Pierre; Benali, Habib; Peigneux, Philippe; Luxen, André; Karni, Avi; Doyon, Julien; Maquet, Pierre; Korman, Maria

    2016-01-01

    Motor memory consolidation is characterized, in part, by a sleep-facilitated decrease in susceptibility to subsequent interfering experiences. Surprisingly, the cerebral substrates supporting this phenomenon have never been examined. We used fMRI to investigate the neural correlates of the influence of sleep on interference to motor memory consolidation. Healthy young adults were trained on a sequential motor task, and subsequently practiced a second competing sequence after an interval including diurnal sleep or wakefulness. Participants were then retested on the initial sequence 8 h and 24 h (including nocturnal sleep) after training. Results demonstrated that a post-training nap significantly protected memory against interference at 8 h and modulated the link between cerebral activity and behavior, such that a smaller post-interference decrease in cortico-striatal activity was associated with better performance. Interestingly, the protective effect of a nap was only transitory, as both groups performed similarly at 24 h. Activity in cortico-striatal areas that was disrupted during the day, presumably due to interference and accentuated in the absence of a nap, was restored overnight. Altogether, our findings offer the first evidence that cortico-striatal areas play a critical role in the transient sleep-facilitated reduction in motor memory vulnerability and in the overnight restoration of previously degraded memories. PMID:27725727

  10. Cerebral Activity Associated with Transient Sleep-Facilitated Reduction in Motor Memory Vulnerability to Interference.

    PubMed

    Albouy, Geneviève; King, Bradley R; Schmidt, Christina; Desseilles, Martin; Dang-Vu, Thien Thanh; Balteau, Evelyne; Phillips, Christophe; Degueldre, Christian; Orban, Pierre; Benali, Habib; Peigneux, Philippe; Luxen, André; Karni, Avi; Doyon, Julien; Maquet, Pierre; Korman, Maria

    2016-10-11

    Motor memory consolidation is characterized, in part, by a sleep-facilitated decrease in susceptibility to subsequent interfering experiences. Surprisingly, the cerebral substrates supporting this phenomenon have never been examined. We used fMRI to investigate the neural correlates of the influence of sleep on interference to motor memory consolidation. Healthy young adults were trained on a sequential motor task, and subsequently practiced a second competing sequence after an interval including diurnal sleep or wakefulness. Participants were then retested on the initial sequence 8 h and 24 h (including nocturnal sleep) after training. Results demonstrated that a post-training nap significantly protected memory against interference at 8 h and modulated the link between cerebral activity and behavior, such that a smaller post-interference decrease in cortico-striatal activity was associated with better performance. Interestingly, the protective effect of a nap was only transitory, as both groups performed similarly at 24 h. Activity in cortico-striatal areas that was disrupted during the day, presumably due to interference and accentuated in the absence of a nap, was restored overnight. Altogether, our findings offer the first evidence that cortico-striatal areas play a critical role in the transient sleep-facilitated reduction in motor memory vulnerability and in the overnight restoration of previously degraded memories.

  11. Sleep and sleep disorders in Don Quixote.

    PubMed

    Iranzo, Alex; Santamaria, Joan; de Riquer, Martín

    2004-01-01

    In Don Quijote de la Mancha, Miguel de Cervantes presents Don Quixote as an amazing character of the 17th century who suffers from delusions and illusions, believing himself to be a medieval knight errant. Besides this neuropsychiatric condition, Cervantes included masterful descriptions of several sleep disorders such as insomnia, sleep deprivation, disruptive loud snoring and rapid eye movement sleep behaviour disorder. In addition, he described the occurrence of physiological, vivid dreams and habitual, post-prandial sleepiness--the siesta. Cervantes' concept of sleep as a passive state where all cerebral activities are almost absent is in conflict with his description of abnormal behaviours during sleep and vivid, fantastic dreams. His concept of sleep was shared by his contemporary, Shakespeare, and could have been influenced by the reading of the classical Spanish book of psychiatry Examen de Ingenios (1575).

  12. Growth hormone and cortisol secretion in relation to sleep and wakefulness.

    PubMed Central

    Davidson, J R; Moldofsky, H; Lue, F A

    1991-01-01

    The study investigated secretory patterns of growth hormone (GH) and cortisol in relation to sleep and wakefulness. Plasma hormone levels were monitored in 10 young men during baseline waking and sleeping, during 40 hours of wakefulness, and during sleep following deprivation. The normal nocturnal GH surge disappeared with sleep deprivation, and was intensified following sleep deprivation. Mean GH levels were higher during slow wave sleep (SWS) compared with other sleep stages. During sleep after deprivation, GH secretion was prolonged, and second GH peaks occurred in three subjects which were not associated with SWS. Average 24-hour cortisol levels were not altered by sleep deprivation or sleep following deprivation, but the nocturnal cortisol rise occurred approximately one hour earlier with sleep deprivation and one hour later with resumed sleep, compared to baseline. This effect on the timing of the rise is consistent with an initial inhibitory influence of sleep on cortisol secretion. The results demonstrate that: the nocturnal growth hormone surge is largely sleep-dependent; temporal associations between GH and SWS are not reliable after sleep deprivation; although the cortisol rhythm is not sleep-dependent, the timing of the cortisol rise may be influenced by sudden changes in the sleep-wake schedule. PMID:1911740

  13. Day-to-Day Dynamics of Associations between Sleep, Napping, Fatigue and the Cortisol Diurnal Rhythm in Women Diagnosed with Breast Cancer

    PubMed Central

    Tell, Dina; Mathews, Herbert L.; Janusek, Linda Witek

    2014-01-01

    OBJECTIVES To examine whether day-to-day variations in sleep behaviors, ongoing sleep disturbance and fatigue predict the cortisol diurnal rhythm in women recently diagnosed with early stage breast cancer. Methods Women (N=130, age=55. 6±9.4 years) collected saliva 5×/day/2 days for cortisol. Diaries were used to assess prior-day nap duration, nocturnal awakenings, sleep latency, and morning restfulness. Ongoing fatigue and sleep disturbance were measured using the Multidimensional Fatigue Symptom Inventory and the Pittsburg Sleep Quality Inventory. Data were analyzed using multilevel growth curve modeling. Results Greater ongoing fatigue (b=0.035, p = .032), or sleep disturbance (b=0.026, p = .006) predicted a slower cortisol decline. Greater ongoing fatigue also predicted higher awakening cortisol (b=0.154, p = .030) and lower cortisol awakening response (CAR) (b=−0.146, p = .005). Longer prior-day naps predicted higher CAR (b=0.042, p=.050), and a steeper cortisol decline (b=−0.035, p = .003). Longer sleep latency predicted both a greater cortisol linear decline (b=−0.013, p < .001), and a greater quadratic slope curvature (b=0.0007, p < .001). Feeling less rested in the morning predicted lower awakening cortisol (b=−0.187, p= .004), higher CAR (b=0.124, p=.016) and a slower cortisol decline (b=0.023, p=.042). CONCLUSIONS Both daily variations in sleep behaviors and ongoing sleep disturbance and fatigue associated with a disrupted cortisol rhythm. In contrast, prior-day napping associated with a more robust cortisol rhythm. These findings are particularly relevant to women with breast cancer who often experience sleep disturbance and fatigue. Additional research is needed to determine causal pathways between sleep disturbance and dysregulation of the hypothalamic-pituitary-adrenal axis in patients with breast cancer. PMID:25186656

  14. Multi-Modal Treatment of Nocturnal Enuresis.

    ERIC Educational Resources Information Center

    Mohr, Caroline; Sharpley, Christopher F.

    1988-01-01

    The article reports a multimodal treatment of nocturnal enuresis and anxious behavior in a mildly mentally retarded woman. Behavioral treatment and removal of caffeine from the subject's diet eliminated both nocturnal enuresis and anxious behavior. (Author/DB)

  15. Obstructive sleep apnea and asthma*

    PubMed Central

    Salles, Cristina; Terse-Ramos, Regina; Souza-Machado, Adelmir; Cruz, Álvaro A

    2013-01-01

    Symptoms of sleep-disordered breathing, especially obstructive sleep apnea syndrome (OSAS), are common in asthma patients and have been associated with asthma severity. It is known that asthma symptoms tend to be more severe at night and that asthma-related deaths are most likely to occur during the night or early morning. Nocturnal symptoms occur in 60-74% of asthma patients and are markers of inadequate control of the disease. Various pathophysiological mechanisms are related to the worsening of asthma symptoms, OSAS being one of the most important factors. In patients with asthma, OSAS should be investigated whenever there is inadequate control of symptoms of nocturnal asthma despite the treatment recommended by guidelines having been administered. There is evidence in the literature that the use of continuous positive airway pressure contributes to asthma control in asthma patients with obstructive sleep apnea and uncontrolled asthma. PMID:24310634

  16. Snoring, sleep disturbance, and behaviour in 4-5 year olds.

    PubMed Central

    Ali, N J; Pitson, D J; Stradling, J R

    1993-01-01

    Parents of 996 children aged 4-5 years identified consecutively from the Oxford health visitor register were asked to complete a questionnaire about breathing disorders during sleep. A total of 782 (78.5%) was returned. Ninety five (12.1%) children were reported to snore on most nights. Habitual snoring was significantly associated with daytime sleepiness, restless sleep, and hyperactivity. The questionnaire responses were used to select two subgroups, one at high risk of a sleep and breathing disorder and a control group. These children (132 in total) were monitored at home with overnight video recording and oximetry, and had formal behavioural assessment using the Conners scale. Seven (7/66) children from the high risk group and none from the control group had obvious sleep disturbance consequent on snoring and upper airway obstruction. Thus our estimate of the prevalence of sleep and breathing disorders in this age group is 7/996 or 0.7%. The high risk group had significantly higher nocturnal movement, oxygen saturation dip rates, and overnight pulse rates than the controls. Maternal but not paternal smoking was associated with the high risk group. Parents and teachers thought those in the high risk group were more hyperactive and inattentive than the controls, but only their parents thought them more aggressive. Significant sleep and breathing disorders occur in about 0.7% of 4-5 year olds. Children whose parents report snoring and sleep disturbance have objective evidence of sleep disruption and show more behaviour problems than controls. PMID:8280201

  17. Outflow from a Nocturnal Thunderstorm.

    DTIC Science & Technology

    1980-11-01

    P AD-A093 796 ILLINOIS STATE WATER SURVEY URBANAF/ .2 OUTFLOW FROM A NOCTURNAL THUNDERSTORM. (U) NOV a0 R W SCOTT NSF-ATHN78-0a865 UNCLASSIFIED SWS...CR-242 ARO-15529.5-6S N I muuuuuuuuuuuu iDA0937 9 6 State Water Survey Division k istitute of METEOROLOGY SECTION 0 uJD AT THE UNIVERSITY OF ILLINOIS...SWS Contract Report 242 / F OUTFLOW FROM A NOCTURNAL THUNDERSTORM Robert W. Scott Meteorology Section Illinois State Water Survey -- DTIC ELECTE CD

  18. Ogun Oru: a traditional explanation for nocturnal neuropsychiatric disturbances among the Yoruba of Southwest Nigeria.

    PubMed

    Aina, O F; Famuyiwa, O O

    2007-03-01

    This article describes three cases of ;ogun oru' (nocturnal warefare), a condition reported in southwest Nigeria involving an acute night-time disturbance that is culturally attributed to demonic infiltration of the body and psyche during dreaming. Ogun oru is characterized by its occurrence, a female preponderance, the perception of an underlying feud between the sufferer's earthly spouse and a ;spiritual' spouse, and the event of bewitchment through eating while dreaming. The condition is believed to be treatable through Christian prayers or elaborate traditional rituals designed to exorcise the imbibed demonic elements. Ogun oru may be a label applied to medical problems. The differential diagnosis includes mainly parasomnias, for example, sleep terror, sleepwalking and sleep paralysis and, to a lesser extent, nocturnal or sleep epilepsy.

  19. Doxorubicin resistance in breast cancer is driven by light at night-induced disruption of the circadian melatonin signal.

    PubMed

    Xiang, Shulin; Dauchy, Robert T; Hauch, Adam; Mao, Lulu; Yuan, Lin; Wren, Melissa A; Belancio, Victoria P; Mondal, Debasis; Frasch, Tripp; Blask, David E; Hill, Steven M

    2015-08-01

    Chemotherapeutic resistance, particularly to doxorubicin (Dox), represents a major impediment to successfully treating breast cancer and is linked to elevated tumor metabolism and tumor over-expression and/or activation of various families of receptor- and non-receptor-associated tyrosine kinases. Disruption of circadian time structure and suppression of nocturnal melatonin production by dim light exposure at night (dLEN), as occurs with shift work, and/or disturbed sleep-wake cycles, is associated with a significantly increased risk of an array of diseases, including breast cancer. Melatonin inhibits human breast cancer growth via mechanisms that include the suppression of tumor metabolism and inhibition of expression or phospho-activation of the receptor kinases AKT and ERK1/2 and various other kinases and transcription factors. We demonstrate in tissue-isolated estrogen receptor alpha-positive (ERα+) MCF-7 human breast cancer xenografts, grown in nude rats maintained on a light/dark cycle of LD 12:12 in which dLEN is present during the dark phase (suppressed endogenous nocturnal melatonin), a significant shortening of tumor latency-to-onset, increased tumor metabolism and growth, and complete intrinsic resistance to Dox therapy. Conversely, a LD 12:12 dLEN environment incorporating nocturnal melatonin replacement resulted in significantly lengthened tumor latency-to-onset, tumor regression, suppression of nighttime tumor metabolism, and kinase and transcription factor phosphorylation, while Dox sensitivity was completely restored. Melatonin acts as both a tumor metabolic inhibitor and circadian-regulated kinase inhibitor to reestablish the sensitivity of breast tumors to Dox and drive tumor regression, indicating that dLEN-induced circadian disruption of nocturnal melatonin production contributes to a complete loss of tumor sensitivity to Dox chemotherapy.

  20. Doxorubicin Resistance in Breast Cancer is Driven by Light at Night Induced Disruption of the Circadian Melatonin Signal

    PubMed Central

    Xiang, Shulin; Dauchy, Robert T.; Hauch, Adam; Mao, Lulu; Yuan, Lin; Wren, Melissa A.; Belancio, Victoria P.; Mondal, Debasis; Frasch, Tripp; Blask, David E.; Hill, Steven M.

    2015-01-01

    Chemotherapeutic resistance, particularly to doxorubicin (Dox), represents a major impediment to successfully treating breast cancer and is linked to elevated tumor metabolism and tumor over-expression and/or activation of various families of receptor- and non-receptor-associated tyrosine kinases. Disruption of circadian time structure and suppression of nocturnal melatonin production by dim light exposure at night (dLEN), as occurs with shift work, and/or disturbed sleep-wake cycles, is associated with a significantly increased risk of an array of diseases, including breast cancer. Melatonin inhibits human breast cancer growth via mechanisms that include the suppression of tumor metabolism and inhibition of expression or phospho-activation of the receptor kinases AKT and ERK1/2 and various other kinases and transcription factors. We demonstrate in tissue-isolated estrogen receptor alpha-positive (ERα+) MCF-7 human breast cancer xenografts, grown in nude rats maintained on a light/dark cycle of LD 12:12 in which dLEN is present during the dark phase (suppressed endogenous nocturnal melatonin), a significant shortening of tumor latency-to-onset, increased tumor metabolism and growth, and complete intrinsic resistance to Dox therapy. Conversely, a LD 12:12dLEN environment incorporating nocturnal melatonin replacement resulted in significantly lengthened tumor latency-to-onset, tumor regression, suppression of nighttime tumor metabolism, and kinase and transcription factor phosphorylation, while Dox sensitivity was completely restored. Melatonin acts as both a tumor metabolic inhibitor and circadian-regulated kinase inhibitor to reestablish the sensitivity of breast tumors to Dox and drive tumor regression indicating that dLEN-induced circadian disruption of nocturnal melatonin production contributes to a complete loss of tumor sensitivity to Dox chemotherapy. PMID:25857269

  1. Sleep in eating disorders.

    PubMed

    Lauer, Christoph J; Krieg, Jürgen-Christian

    2004-04-01

    Sleep research on eating disorders has addressed two major questions: (1) the effects of chronic starvation in anorexia nervosa and of rapidly fluctuating eating patterns in bulimia nervosa on the sleep regulating processes and (2) the search for a significant neurobiological relationship between eating disorders and major depression. At present, the latter question appears to be resolved, since most of the available evidences clearly underline the notion that eating disorders (such as anorexia and bulimia nervosa) and affective disorders are two distinct entities. Regarding the effects of starvation on sleep regulation, recent research in healthy humans and in animals demonstrates that such a condition results in a fragmentation of sleep and a reduction of slow wave sleep. Although several peptides are supposed to be involved in these regulatory processes (i.e. CCK, orexin, leptin), their mode of action is still poorly understood. In opposite to these experimentally induced sleep disturbances are the findings that the sleep patterns in eating disorder patients per se do not markedly differ from those in healthy subjects. However, when focusing on the so-called restricting anorexics, who maintain their chronic underweight by strictly dieting, the expected effects of malnutrition on sleep can be ascertained. Furthermore, at least partial weight restoration results in a 'deepening' of nocturnal sleep in the anorexic patients. However, our knowledge about the neurobiological systems (as well as their circadian pattern of activity) that transmit the effects of starvation and of weight restoration on sleep is still limited and should be extended to metabolic signals mediating sleep.

  2. Craniofacial skeletal architecture and obstructive sleep apnoea syndrome severity.

    PubMed

    Costa E Sousa, Rui Augusto; dos Santos Gil, Nuno Alexandre

    2013-12-01

    Obstructive sleep apnoea syndrome (OSAS) is a sleep related breathing disorder caused by pharynx obstruction that often terminates in abrupt arousals and is capable of disrupting physiological sleep profile. Its' severity has been associated, among others, with craniofacial skeletal morphology. To investigate this relationship and elucidate craniofacial skeleton patterns in individuals without obvious maxillofacial abnormalities, 171 OSAS patients were studied with nocturnal polysomnographic record and cephalometric X-ray (24 variables). Cephalometric variables were compared between three apnoea/hypopnoea index (AHI) groups (AHI ≤ 15; 15 < AHI < 30; AHI ≥ 30) and uni/multivariate analysis between cephalometric variables and AHI were performed. The patients were predominantly men (83%), with a mean age of 48.1 years. Mean BMI and AHI were 28.4 kg/m(2) and 26.2, respectively. Most cephalometric variables differed among the three AHI groups. Fifteen cephalometric variables showed a correlation with AHI. Five cephalometric variables and BMI were independent AHI predictors. Cephalometric variables were better AHI predictors in normal weight patients. Significant evidence of craniofacial skeleton influence was found on OSAS severity, caudalization of the hyoid and lower sagittal facial projection being the most important patterns. From the cephalometric variables analysed, the hypopharynx calibre demonstrated a higher predictive value for AHI, independently of BMI.

  3. Changes in the waking EEG as a consequence of sleep and sleep deprivation.

    PubMed

    Corsi-Cabrera, M; Ramos, J; Arce, C; Guevara, M A; Ponce-de León, M; Lorenzo, I

    1992-12-01

    Electroencephalographic (EEG) activity was monopolarly recorded during resting wakefulness in 10 volunteers under the following conditions: at night before going to sleep, at night before total sleep deprivation, in the morning after waking, in the morning after sleep deprivation and at night after having slept during the day. Absolute and relative power and inter- and intrahemispheric correlation were established. After diurnal and nocturnal sleep as compared to sleep deprivation, we obtained the following significant results: interhemispheric correlations were higher; intrahemispheric correlations were lower; absolute power of alpha 2, beta 1 and beta 2 was lower; and relative power of alpha 2 and beta 2 was lower. EEG changes as a consequence of sleep or lack of sleep are dependent on prior sleep and/or wakefulness and not on circadian phase. EEG activity during wakefulness is a sensitive parameter and a useful tool to assess the consequences of sleep on brain functional organization.

  4. Visual Navigation in Nocturnal Insects.

    PubMed

    Warrant, Eric; Dacke, Marie

    2016-05-01

    Despite their tiny eyes and brains, nocturnal insects have evolved a remarkable capacity to visually navigate at night. Whereas some use moonlight or the stars as celestial compass cues to maintain a straight-line course, others use visual landmarks to navigate to and from their nest. These impressive abilities rely on highly sensitive compound eyes and specialized visual processing strategies in the brain.

  5. Electroencephalographic and behavioral effects of nocturnally occurring jet aircraft sounds.

    NASA Technical Reports Server (NTRS)

    Levere, T. E.; Bartus, R. T.; Hart, F. D.

    1972-01-01

    The present research presents data relative to the objective evaluation of the effects of a specific complex auditory stimulus presented during sleep. The auditory stimulus was a jet aircraft flyover of approximately 20-sec duration and a peak intensity level of approximately 80 dB (A). Our specific interests were in terms of how this stimulus would interact with the frequency pattern of the sleeping EEG and whether there would be any carry-over effects of the nocturnally presented stimuli to the waking state. The results indicated that the physiological effects (changes in electroencephalographic activity) produced by the jet aircraft stimuli outlasted the physical presence of the auditory stimuli by a considerable degree. Further, it was possible to note both behavioral and electroencephalographic changes during waking performances subsequent to nights disturbed by the jet aircraft flyovers which were not apparent during performances subsequent to undisturbed nights.

  6. Cold and hunger induce diurnality in a nocturnal mammal.

    PubMed

    van der Vinne, Vincent; Riede, Sjaak J; Gorter, Jenke A; Eijer, Willem G; Sellix, Michael T; Menaker, Michael; Daan, Serge; Pilorz, Violetta; Hut, Roelof A

    2014-10-21

    The mammalian circadian system synchronizes daily timing of activity and rest with the environmental light-dark cycle. Although the underlying molecular oscillatory mechanism is well studied, factors that influence phenotypic plasticity in daily activity patterns (temporal niche switching, chronotype) are presently unknown. Molecular evidence suggests that metabolism may influence the circadian molecular clock, but evidence at the level of the organism is lacking. Here we show that a metabolic challenge by cold and hunger induces diurnality in otherwise nocturnal mice. Lowering ambient temperature changes the phase of circadian light-dark entrainment in mice by increasing daytime and decreasing nighttime activity. This effect is further enhanced by simulated food shortage, which identifies metabolic balance as the underlying common factor influencing circadian organization. Clock gene expression analysis shows that the underlying neuronal mechanism is downstream from or parallel to the main circadian pacemaker (the hypothalamic suprachiasmatic nucleus) and that the behavioral phenotype is accompanied by phase adjustment of peripheral tissues. These findings indicate that nocturnal mammals can display considerable plasticity in circadian organization and may adopt a diurnal phenotype when energetically challenged. Our previously defined circadian thermoenergetics hypothesis proposes that such circadian plasticity, which naturally occurs in nocturnal mammals, reflects adaptive maintenance of energy balance. Quantification of energy expenditure shows that diurnality under natural conditions reduces thermoregulatory costs in small burrowing mammals like mice. Metabolic feedback on circadian organization thus provides functional benefits by reducing energy expenditure. Our findings may help to clarify relationships between sleep-wake patterns and metabolic phenotypes in humans.

  7. Adaptation to Life in the High Andes: Nocturnal Oxyhemoglobin Saturation in Early Development

    PubMed Central

    Hill, Catherine Mary; Baya, Ana; Gavlak, Johanna; Carroll, Annette; Heathcote, Kate; Dimitriou, Dagmara; L'Esperance, Veline; Webster, Rebecca; Holloway, John; Virues-Ortega, Javier; Kirkham, Fenella Jane; Bucks, Romola Starr; Hogan, Alexandra Marie

    2016-01-01

    Study Objectives: Physiological adaptation to high altitude hypoxia may be impaired in Andeans with significant European ancestry. The respiratory ‘burden’ of sleep may challenge adaptation, leading to relative nocturnal hypoxia. Developmental aspects of sleep-related breathing in high-altitude native children have not previously been reported. We aimed to determine the influence of development on diurnal-nocturnal oxyhemoglobin differences in children living at high altitude. Methods: This was a cross-sectional, observational study. Seventy-five healthy Bolivian children aged 6 mo to 17 y, native to low altitude (500 m), moderate high altitude (2,500 m), and high altitude (3,700 m) were recruited. Daytime resting pulse oximetry was compared to overnight recordings using Masimo radical oximeters. Genetic ancestry was determined from DNA samples. Results: Children had mixed European/Amerindian ancestry, with no significant differences between altitudes. Sixty-two participants had ≥ 5 h of nocturnal, artifact-free data. As predicted, diurnal mean oxyhemoglobin saturation decreased across altitudes (infants and children, both P < 0.001), with lowest diurnal values at high altitude in infants. At high altitude, there was a greater drop in nocturnal mean oxyhemoglobin saturation (infants, P < 0.001; children, P = 0.039) and an increase in variability (all P ≤ 0.001) compared to low altitude. Importantly, diurnal to nocturnal altitude differences diminished (P = 0.036), from infancy to childhood, with no further change during adolescence. Conclusions: Physiological adaptation to high-altitude living in native Andeans is unlikely to compensate for the significant differences we observed between diurnal and nocturnal oxyhemoglobin saturation, most marked in infancy. This vulnerability to sleep-related hypoxia in early childhood has potential lifespan implications. Future studies should characterize the sleep- related respiratory physiology underpinning our

  8. Sleepwalking and other ambulatory behaviours during sleep.

    PubMed

    Plazzi, G; Vetrugno, R; Provini, F; Montagna, P

    2005-12-01

    Different pathological conditions may lead to somnambulic automatisms arising from nocturnal sleep. Video polysomnography represents the diagnostic tool but, due to the difficulty of capturing complex episodes in the sleep laboratory, audio-video recordings at home of the episodes may help in the differential diagnosis also. Sleepwalking is a disorder of arousal in which the subject arises from deep sleep, even displaying long complex behaviour, including leaving the bed and walking, with memory impairment of the event. Disordered arousal mechanisms with an inability of the brain to fully awaken from slow-wave sleep are thought to lead to these motor automatisms. REM sleep behaviour disorders begin during REM sleep and are accompanied by features of REM sleep. The motor behaviour may be violent and injurious to the patient and/or bed partner. In some patients, however, the behaviour may be similar to that observed in sleepwalking and some patients have an overlap syndrome. In nocturnal frontal lobe epilepsy in particular, and in complex partial seizures in general, stereotypic and repetitive motor attacks may recur, at any time, on the same night and on different nights, with a continuum between minimal or minor attacks and major or prolonged episodes up to agitated epileptic nocturnal wanderings.

  9. Sleep can reduce proactive interference.

    PubMed

    Abel, Magdalena; Bäuml, Karl-Heinz T

    2014-01-01

    Sleep has repeatedly been connected to processes of memory consolidation. While extensive research indeed documents beneficial effects of sleep on memory, little is yet known about the role of sleep for interference effects in episodic memory. Although two prior studies reported sleep to reduce retroactive interference, no sleep effect has previously been found for proactive interference. Here we applied a study format differing from that employed by the prior studies to induce a high degree of proactive interference, and asked participants to encode a single list or two interfering lists of paired associates via pure study cycles. Testing occurred after 12 hours of diurnal wakefulness or nocturnal sleep. Consistent with the prior work, we found sleep in comparison to wake did not affect memory for the single list, but reduced retroactive interference. In addition we found sleep reduced proactive interference, and reduced retroactive and proactive interference to the same extent. The finding is consistent with the view that arising benefits of sleep are caused by the reactivation of memory contents during sleep, which has been suggested to strengthen and stabilise memories. Such stabilisation may make memories less susceptible to competition from interfering memories at test and thus reduce interference effects.

  10. Sleep and respiration in microgravity

    NASA Technical Reports Server (NTRS)

    Prisk, G. K.

    1998-01-01

    Sleep studies conducted during the STS-90 Neurolab mission are explored. The relationship between sleep, melatonin, and circadian phase is reviewed. The study contained both sleep and awake components. The objectives of the sleep component were to test five hypotheses: that circadian rhythms of core body temperature and urinary melatonin are synchronized to required sleep-wake schedules, that spaceflight results in substantial disruption of sleep, that the pattern of chest and abdominal wall motion alters during the different sleep stages in microgravity, that arterial oxygen saturation is reduced during some stages of sleep in microgravity, and that pre-sleep administration of melatonin during microgravity results in improved sleep quality. The awake component tested three hypotheses: that ventilatory response to carbon dioxide is increased during exposure to microgravity and that this exacerbates sleep disruption, that ventilatory response to hypoxia is increased by exposure to microgravity, and that the improved sleep resulting from the pre-sleep administration of melatonin enhances next day cognition when compared to placebo.

  11. Artificial light pollution increases nocturnal vigilance in peahens

    PubMed Central

    Chisholm, Sarah; Byerley, Sydney D; Coy, Jeanee R.; Aziz, Aisyah; Wolf, Jamie A.; Gnerlich, Amanda C.

    2015-01-01

    Artificial light pollution is drastically changing the sensory environments of animals. Even though many animals are now living in these changed environments, the effect light pollution has on animal behavior is poorly understood. We investigated the effect of light pollution on nocturnal vigilance in peahens (Pavo cristatus). Captive peahens were exposed to either artificial lighting or natural lighting at night. We employed a novel method to record their vigilance behavior by attaching accelerometers to their heads and continuously monitoring their large head movements. We found that light pollution significantly increases nocturnal vigilance in peahens. Furthermore, the birds faced a trade-off between vigilance and sleep at night: peahens that were more vigilant spent less time sleeping. Given the choice, peahens preferred to roost away from high levels of artificial lighting but showed no preference for roosting without artificial lighting or with low levels of artificial lighting. Our study demonstrates that light pollution can have a substantial impact on animal behavior that can potentially result in fitness consequences. PMID:26339552

  12. Artificial light pollution increases nocturnal vigilance in peahens.

    PubMed

    Yorzinski, Jessica L; Chisholm, Sarah; Byerley, Sydney D; Coy, Jeanee R; Aziz, Aisyah; Wolf, Jamie A; Gnerlich, Amanda C

    2015-01-01

    Artificial light pollution is drastically changing the sensory environments of animals. Even though many animals are now living in these changed environments, the effect light pollution has on animal behavior is poorly understood. We investigated the effect of light pollution on nocturnal vigilance in peahens (Pavo cristatus). Captive peahens were exposed to either artificial lighting or natural lighting at night. We employed a novel method to record their vigilance behavior by attaching accelerometers to their heads and continuously monitoring their large head movements. We found that light pollution significantly increases nocturnal vigilance in peahens. Furthermore, the birds faced a trade-off between vigilance and sleep at night: peahens that were more vigilant spent less time sleeping. Given the choice, peahens preferred to roost away from high levels of artificial lighting but showed no preference for roosting without artificial lighting or with low levels of artificial lighting. Our study demonstrates that light pollution can have a substantial impact on animal behavior that can potentially result in fitness consequences.

  13. 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…

  14. Sleep paralysis and folklore.

    PubMed

    Cox, Ann M

    2015-07-01

    Sleep paralysis is a relatively new term to describe what for hundreds of years many believed to be a visitation by a malevolent creature which attacked its victims as they slept. The first clinical description of sleep paralysis was published in 1664 in a Dutch physician's case histories, where it was referred to as, 'Incubus or the Night-Mare [sic]'. In 1977, it was discovered more than 100 previously healthy people from various South East Asian communities had died mysteriously in their sleep. The individuals affected were dying at a rate of 92/100,000 from Sudden Unexplained Nocturnal Death Syndrome. No underlying cause was ever found, only that subsequent studies revealed a high rate of sleep paralysis and belief in the dab tsog (nightmare spirit) amongst members of the community. The nightmare/succubus is descended from Lilith. The earliest reference to Lilith is found in the Sumerian King list of 2400 BC known as Lilitu or she-demon, she bore children from her nocturnal unions with men. In other derivations, she was Adam's first wife who rather than 'obey' became a demon that preyed on women during childbirth. In modern Middle Eastern maternity wards, some women still wear amulets for protection. Today, clinical cause of these disturbances is sleep paralysis due to the unsuitable timing of REM sleep. During the 'Nightmare' episode, the sleeper becomes partially conscious during REM cycle, leaving the individual in a state between dream and wakefulness. For some, culture and the tradition of the nightmare is explanation enough.

  15. Sleep paralysis and folklore

    PubMed Central

    2015-01-01

    Sleep paralysis is a relatively new term to describe what for hundreds of years many believed to be a visitation by a malevolent creature which attacked its victims as they slept. The first clinical description of sleep paralysis was published in 1664 in a Dutch physician’s case histories, where it was referred to as, ‘Incubus or the Night-Mare [sic]’. In 1977, it was discovered more than 100 previously healthy people from various South East Asian communities had died mysteriously in their sleep. The individuals affected were dying at a rate of 92/100,000 from Sudden Unexplained Nocturnal Death Syndrome. No underlying cause was ever found, only that subsequent studies revealed a high rate of sleep paralysis and belief in the dab tsog (nightmare spirit) amongst members of the community. The nightmare/succubus is descended from Lilith. The earliest reference to Lilith is found in the Sumerian King list of 2400 BC known as Lilitu or she-demon, she bore children from her nocturnal unions with men. In other derivations, she was Adam’s first wife who rather than ‘obey’ became a demon that preyed on women during childbirth. In modern Middle Eastern maternity wards, some women still wear amulets for protection. Today, clinical cause of these disturbances is sleep paralysis due to the unsuitable timing of REM sleep. During the ‘Nightmare’ episode, the sleeper becomes partially conscious during REM cycle, leaving the individual in a state between dream and wakefulness. For some, culture and the tradition of the nightmare is explanation enough. PMID:28008370

  16. Experiences of Sleep and Benzodiazepine Use among Older Women

    PubMed Central

    Rubinstein, Robert L.

    2015-01-01

    Sleep disturbances are common among older women; however, little is known about sleep experiences among chronic benzodiazepine users. The experience of sleep, sleep troubles, and management of sleep problems were explored through semi-structured interviews with 12 women aged 65 to 92 who had used a benzodiazepine for three months or longer to treat a sleep disturbance. Themes that emerged from an interpretive phenomenological analysis included multiple reasons for sleep disruptions (health problems, mental disturbances, and sleeping arrangements); opposing effects of benzodiazepines on sleep (helps or does not work); and several supplemental sleep strategies (modification of the environment, distraction, and consumption). PMID:25581296

  17. Sleep Patterns among South Korean Infants and Toddlers: Global Comparison.

    PubMed

    Ahn, Youngmin; Williamson, Ariel A; Seo, Hyun-Joo; Sadeh, Avi; Mindell, Jodi A

    2016-02-01

    The purpose of this study was to examine sleep patterns in a large sample of infants and toddlers (ages birth to 36 months) in Korea, and to compare sleep patterns, sleep problems, sleep ecology, and parental behaviors to global sleep data on young children in both predominantly Asian (P-A) and predominantly Caucasian (P-C) countries/regions. We additionally examined parent and child demographic information, parental behaviors, and aspects of the sleep ecology as predictors of sleep patterns among infants and toddlers in Korea. Parents/caregivers of 1,036 Korean infants and toddlers completed an expanded, internet-based version of the brief infant sleep questionnaire. Consistent with other studies of sleep in early childhood, sleep/wake patterns became increasingly consolidated with older child age for the Korea sample. Compared to both P-A and P-C infants and toddlers, children in Korea had the latest bedtimes, shortest total sleep and daytime sleep durations, and the least frequent rates of napping. Even though half of parents perceive their children's sleep problematic, parental perceptions of severe child sleep problems were the lowest. Within Korea, breastfeeding and bottle-feeding at sleep resumption were associated with increased nocturnal awakenings. Evening television viewing was associated with later bedtimes, which may have implications for sleep hygiene recommendations in clinical practice. The current study provides important information about sleep/wake patterns, parental behaviors, and aspects of the sleep ecology for infants and toddlers for physicians to support healthy sleep in Korea.

  18. Sleep walking

    MedlinePlus

    ... sleep cycle has stages, from light drowsiness to deep sleep. During the stage called rapid eye movement ( ... REM sleep. Sleepwalking (somnambulism) most often occurs during deep, non-REM sleep (called N3 sleep) early in ...

  19. A visit to Absurdistan: a nightmare of a sleep specialist.

    PubMed

    Rodenstein, Daniel; Duran Cantolla, Joaquin

    2013-12-01

    During a nocturnal dream, the authors discover a strange and unknown country, Absurdistan. Absurdistanis main concern appears to be sleep, whether nocturnal or diurnal, rather than wakefulness. They are fond of sleeping in any form, and devote much time to this activity. The authors follow a guide that shows them all kinds of strange sleep habits and keeps explaining the complex as well as the obvious. As the journey evolves, the explanations turn more and more confusing, becoming also amazingly surrealistic. The dream ends with a welcome wakefulness leaving the authors unsure of which is the waking state and which the dream.

  20. Sexual behavior in sleep, sleepwalking and possible REM behavior disorder: a case report.

    PubMed

    Alves, R; Alóe, F; Tavares, S; Vidrio, S; Yáñez, L; Aguilar-Roblero, R; Rosenthal, L; Villalobos, L; Fernández-Cancino, F; Drucker-Colín, R; Chagoya De Sanchez, V

    1999-01-01

    Seven cases of sexual behavior during sleep (SBS) have been recently reported. The subjects had histories of behavioral parasomnias as well as positive family histories of parasomnia. A 27 year-old man with a history of sexual behavior during sleep was reported. His sleep history disclosed sleepwalking (SW) since 9 years of age. He also developed episodes of highly disruptive and violent nocturnal behavior with dream enactment at age 20 years, which often resulted in physical injuries either to himself or his wife and infant. His wife also reported episodes of amnestic sexual behavior that began 4 years before referral. During the episodes, the patient typically procured his wife, achieving complete sexual intercourse with total amnesia. Physical and neurological diagnostic workups were unremarkable. Family history disclosed sleepwalking in his brother. He was put on 2mg/day of bedtime clonazepam with a remarkable clinical improvement. This case involves either the combination of violent and non-violent sleepwalking with SBS, or the superimposition of presumed REM sleep behavior disorder (RBD) on top of preexisting SW in a man who also developed SBS in adulthood. Thus, this is a case report of probable parasomnia overlap syndrome.

  1. Sleep disturbances in eating disorders: a review.

    PubMed

    Cinosi, E; Di Iorio, G; Acciavatti, T; Cornelio, M; Vellante, F; De Risio, L; Martinotti, G

    2011-01-01

    Psychiatric disorders are frequently associated with disturbances of sleep and circadian rhythms. This review focus on the relationship between sleep disturbances and eating disorders. In the first part are discussed the presence of sleep disorders among patients suffering from anorexia nervosa and bulimia nervosa, the macrostructure and microstructure of theirs sleep, the differences between the various subtypes in ED patients, the dreams of eating disordered patients and their recurrent contents. In the second part, there are treated sleep disturbances in binge eating disorder and other eating disorders not otherwise specified, such as nocturnal (night) eating syndrome and sleep-related eating disorder. In the third part, there are presented data concerning the neurobiological and neuroendocrinological correlates between feeding, metabolism, weight restoration and the processes regulating sleep. In conclusion, possible future investigations are proposed.

  2. Effects of maxillary expansion and placebo effect of appliances on nocturnal enuresis – preliminary results

    PubMed Central

    Oshagh, Morteza; Aminsharifi, Ali Reza; Fallahzadeh, Mohammad Hossein; Ghodrati, Parisa

    2014-01-01

    Introduction Nocturnal enuresis has been found a common symptom among children with breathing problems and sleep apnea. The purpose of this study was to evaluate the therapeutic and placebo effects of slow maxillary expansion on nocturnal enuresis. Material and methods Four children with enuresis aged 7–12 years were selected. Rigid acrylic expansion appliances were fabricated and delivered to them. Frequency of enuresis was recorded by the parents during three stages: 1) before appliance delivery; 2) after appliance insertion without expansion; and 3) during expansion and retention. Results The frequency of wetting decreased significantly during the period of appliance use without expansion. During the expansion and retention phase, two patients became completely dry, and two patients improved significantly. Conclusions Maxillary expansion can have a positive effect on the treatment of nocturnal enuresis. Also, the placebo effect of the expansion appliance has significant effects on enuresis. PMID:24982782

  3. Endocrine Effects of Circadian Disruption.

    PubMed

    Bedrosian, Tracy A; Fonken, Laura K; Nelson, Randy J

    2016-01-01

    Disruption of circadian rhythms, provoked by artificial lighting at night, inconsistent sleep-wake schedules, and transmeridian air travel, is increasingly prevalent in modern society. Desynchrony of biological rhythms from environmental light cycles has dramatic consequences for human health. In particular, disrupting homeostatic oscillations in endocrine tissues and the hormones that these tissues regulate can have cascading effects on physiology and behavior. Accumulating evidence suggests that chronic disruption of circadian organization of endocrine function may lead to metabolic, reproductive, sleep, and mood disorders. This review discusses circadian control of endocrine systems and the consequences of distorting rhythmicity of these systems.

  4. Normal sleep and circadian rhythms: neurobiologic mechanisms underlying sleep and wakefulness.

    PubMed

    Markov, Dimitri; Goldman, Marina

    2006-12-01

    Sleep is a vital, highly organized process regulated by complex systems of neuronal networks and neurotransmitters. Sleep plays an important role in the regulation of central nervous system and body physiologic functions. Sleep architecture changes with age and is easily susceptible to external and internal disruption. Reduction or disruption of sleep can affect numerous functions varying from thermoregulation to learning and memory during the waking state.

  5. Cardio-respiratory function during sleep.

    PubMed

    Bonsignore, G

    1991-01-01

    Respiratory function undergoes sleep-associated changes which in normal subjects leave it unaffected. However in some cases they may be more marked than usual or may be superimposed on a pre-existing disease, thus giving rise to sleep-related ventilation disorders. These include obstructive sleep apnea syndrome (OSAS), nocturnal desaturation events of chronic obstructive pulmonary disease (COPD) and restrictive syndromes, as well as nocturnal asthmatic attacks. OSAS is a condition characterized by the frequent recurrence of interruptions of oronasal flow (greater than 10 s.) due to upper airway occlusion induced by a reduction in pharyngeal muscle tone. This phenomenon, particularly prominent in REM sleep, results in oxyhemoglobin desaturation and marked cardiovascular consequences (arrhythmias, increases in pulmonary and systemic arterial pressure), as well as symptoms (loud intermittent snoring, daytime sleepiness, intellectual deterioration etc.). Obesity is often associated with OSAS or may lead to a sleep-related hypoventilation syndrome. Treatment is based on weight loss, surgery of upper airway abnormalities, if present, and on splinting of the upper airway by the application of nasal continuous positive airway pressure. In COPD and restrictive disorders, nocturnal hypoxemia is mainly due to REM-associated loss of respiratory muscle tone, as well as in the sleep-related exaggeration of functional defects due to COPD (low chemoreceptor sensitivity, high closing volume etc.). Treatment is based on oxygen administration, provided that possible side-effects are carefully monitored. Nocturnal asthma is due to circadian changes in hormonal secretion (catecholamines, cortisol), as well as supine posture, reduced muco-ciliary clearance, gastro-esophageal reflux etc. Sleep itself plays some role through a depressed arousal reaction in slow wave sleep, resulting in more marked and prolonged attacks in this stage. Slow-release theophylline or beta-mimetic medications

  6. Sleep-Disordered Breathing

    PubMed Central

    Markov, Dimitri; Doghramji, Karl

    2006-01-01

    Sleep disorders are becoming more prevalent. There is an overlap of symptoms related to obstructive sleep apnea syndrome (OSAS) and many psychiatric conditions. Complaints of excessive sleepiness, insomnia, cognitive dysfunction, and depressive symptoms can be related to both disease states. Obstructive sleep apnea syndrome is characterized by repetitive disruption of sleep by cessation of breathing and was first described in the 19th century by bedside observation during sleep. Physicians observed this cessation of breathing while the patient slept and postulated that these episodes were responsible for subsequent complaints of sleepiness. OSAS can coexist with major depressive disorder, exacerbate depressive symptoms, or be responsible for a large part of the symptom complex of depression. Additionally, in schizophrenia, sleep apnea may develop as a result of chronic neuroleptic treatment and its effect on gains in body weight, a major risk factor for the development of OSAS. It is important to recognize the signs and symptoms of sleep apnea, namely excessive daytime sleepiness, snoring, and witnessed apneas. Recognition of the existence of sleep apnea, prompt referral to a sleep specialist, and ultimately treatment of an underlying sleep disorder, such as OSAS, can ameliorate symptoms of psychiatric disease. PMID:20975818

  7. Trichotillomania and Non-Epileptic Seizures as Sleep-Related Dissociative Phenomena

    PubMed Central

    Angulo-Franco, Melina; Bush-Martínez, Alejandra; Nenclares-Portocarrero, Alejandro; Jiménez-Genchi, Alejandro

    2015-01-01

    The occurrence of non-epileptic seizures (NES) and trichotillomania during sleep is rare. We describe the case of an adult woman with a personal history of childhood maltreatment and psychiatric morbidity (major depression, trichotillomania, and conversion disorder), who was referred to the sleep unit because of nocturnal hair-pulling and psychomotor agitation during sleep. An all-night PSG recording with audiovisual monitoring documented seven episodes of trichotillomania and one NES, all of which arose from unequivocal wakefulness. Improvement of nocturnal behaviors was observed after long-term psychotherapy. This case illustrates that nocturnal trichotillomania and NES may be symptoms of a sleep-related dissociative disorder. Citation: Angulo-Franco M, Bush-Martínez A, Nenclares-Portocarrero A, Jiménez-Genchi A. Trichotillomania and non-epileptic seizures as sleep-related dissociative phenomena. J Clin Sleep Med 2015;11(3):271–273. PMID:25515284

  8. Current treatments to counter sleep dysfunction as a pathogenic stimulus of fibromyalgia.

    PubMed

    Choy, Ernest H

    2016-05-01

    Fibromyalgia is characterized by chronic widespread pain, fatigue and nonrestorative sleep. Polysomnography showed reduced short-wave sleep and abnormal alpha rhythms during nonrapid eye movement sleep in patients with fibromyalgia. However, sleep dysfunction might be pathogenic in fibromyalgia since myalgia and fatigue could be induced in healthy individuals by disrupting sleep. Poor sleep quality was a major risk factor for the subsequent development of chronic widespread pain in healthy pain-free individuals. Sleep disruption leads to impairment of the descending pain inhibition pathways. Aside from good sleep, hygiene, exercise can promote sleep. Among currently available pharmacological treatments, evidence suggests amitriptyline and pregabalin can improve sleep in fibromyalgia.

  9. Prevalence and risk factors of monosymptomatic nocturnal enuresis in Turkish children

    PubMed Central

    Özkan, Seçil; Durukan, Elif; Iseri, Elvan; Gürocak, Serhat; Maral, Işil; Ali Bumin, M.

    2010-01-01

    Objectives To determine the prevalence of primary monosymptomatic nocturnal enuresis (PMNE) and assess risk factors that can cause this disease. Methods After the determination of 15 primary schools in the provincial center of Ankara, questionnaires were given to 15,150 students to be answered by their parents. Detailed urologic history was obtained and physical examination applied to the students whose parents answered the questionnaire. After excluding children with polysymptomatic NE, 14060 questionnaires of MNE patients were evaluated. Demographic features with social and medical history of students and their parents, general approach of family to the children, school success of the students and general behavioral attitudes, method of toilet training and the presence of nocturnal enuresis were questioned. Results MNE was determined in 9.0% (n: 1266) of the students and nocturnal enuresis frequency was higher in boys than girls (P<0.05). Univariate analysis revealed gender, method of toilet training, sleep problems, school success, and general approach of the family to children and general behavioral attitudes of the children as significant factors. In logistic regression analysis; age, male gender, toilette training with threatening method, deep sleeper, sleep walking, being introverted and shy, significantly increases the risk of nocturnal enuresis. Conclusions The current study suggests that the methods of toilet training are extremely important to prevent bedwetting and behavioral disorders due to enuresis. Parents should be well-informed about the appropriate toilet training method. PMID:20877597

  10. Benign nocturnal alternating hemiplegia of childhood: two cases with positive evolution.

    PubMed

    Villéga, Frédéric; Picard, Fabienne; Espil-Taris, Caroline; Husson, Marie; Michel, Véronique; Pedespan, Jean-Michel

    2011-06-01

    Benign nocturnal alternating hemiplegia (BNAH) of childhood is distinct from the classic form of malignant alternating hemiplegia of childhood [1]. It is characterized by hemiplegic attacks occurring exclusively during sleep [2]. It can be misdiagnosed as migraine, nocturnal frontal lobe epilepsy, benign rolandic epilepsy, Panayiotopoulos syndrome, or sleep-related movement disorder [1-4]. Only nine patients have been described to date, with typically, a normal development [1,5-7]. In order to insist about the benignity of the affection, we report two cases: a new three-year-old boy suffering from BNAH and a patient already published to show positive evolution at fourteen years of age. BNAH is a rare disorder but may be underdiagnosed. Making an early diagnosis can help to describe to the parents the good prognosis without treatment.

  11. Benign nocturnal alternating hemiplegia of childhood: a new case with unusual findings.

    PubMed

    Mangano, Salvatore; Fontana, Antonina; Spitaleri, Chiara; Mangano, Giuseppa Renata

    2014-05-01

    It has been described a neuro developmental disorder labelled "Benign nocturnal alternating hemiplegia of childhood" (BNAHC) characterized by recurrent attacks of nocturnal hemiplegia without progression to neurological or intellectual impairment. We report a female patient who at 11months revealed a motionless left arm, unusual crying without impairment of consciousness and obvious precipitating factors. The attacks occur during sleep in the early morning with lack of ictal and interictal electroencephalographic abnormalities, progressive neurological deficit, and cognitive impairment. Unlike previous reports of BNAHC our patient come from a family with a history of both migraine, hemiplegic migraine, and sleep disorders. Our study remarks on the typical features described in previous studies and stresses the uncommon aspects that could help to identify the disorder which is likely to have been underestimated. Despite some clinical similarities between BNAHC and familiar hemiplegic migraine and alternating hemiplegia of childhood, the genetic analyses of our patient did not reveal genetic mutations found in both disorders.

  12. Relationship between child sleep disturbances and maternal sleep, mood, and parenting stress: a pilot study.

    PubMed

    Meltzer, Lisa J; Mindell, Jodi A

    2007-03-01

    Although sleep disturbances in children are common, little is known about the relationship between children's sleep disruptions and maternal sleep and daytime functioning. Forty-seven mothers completed measures of sleep, depression, parenting stress, fatigue, and sleepiness. Significant differences in maternal mood and parenting stress were found between mothers of children with and without significant sleep disturbances. Regression analyses showed that the quality of the children's sleep significantly predicted the quality of maternal sleep. In addition, maternal sleep quality was a significant predictor of maternal mood, stress, and fatigue. Results from this pilot study support the need for future research examining the relationship between child sleep disturbances and maternal daytime functioning, and they highlight the importance of screening for and treating pediatric sleep disruptions.

  13. Sporadic nocturnal frontal lobe epilepsy: A consecutive series of 8 cases

    PubMed Central

    Yeh, Shih-Bin; Schenck, Carlos H.

    2014-01-01

    Objective To present findings on a series of cases of sporadic nocturnal frontal lobe epilepsy (NFLE), a form of NFLE that is infrequently reported, in contrast to familial (autosomal dominant) NFLE. Both forms of NFLE need to be distinguished from parasomnias, nocturnal temporal lobe epilepsy, and other nocturnal disorders. Methods Eight consecutive cases of sporadic NFLE were evaluated at a sleep clinic in Taiwan. All patients had clinical evaluations, daytime waking and sleeping EEGs, brain MRIs, and overnight video-polysomnography (vPSG) with seizure montage. Results Gender was equal (four males, four females); mean age was 18.4 yrs (range, 7–41 yrs). Age of NFLE onset was by puberty. Premorbid history was negative for any neurologic, medical or psychiatric disorder. NFLE subtypes: nocturnal paroxysmal dystonia, n=6; paroxysmal arousals, n=2. MRI brain scan abnormalities with clinical correlates were found in one patient. Daytime awake EEGs were negative for ictal/interictal activity in all patients, but two patients had daytime sleep EEGs with interictal epileptiform EEG activity. During vPSG studies, three of eight patients with NFLE seizure events had concurrent epileptiform EEG activity, and two patients had interictal epileptiform EEG activity during their vPSG studies. No case had a spontaneous remission. Anticonvulsant therapy was highly effective in all eight cases (>75% reduction in seizure frequency). Discussion These cases confirm that sporadic NFLE closely resembles familial NFLE, and comprises a set of distinct clinical manifestations, with variable intensity, and variable scalp EEG epileptiform abnormalities across sleep and wakefulness, which have previously been identified in Caucasian patients from Europe and North America. PMID:26483923

  14. Agreement rates for sleep/wake judgments obtained via accelerometer and sleep diary: a comparison.

    PubMed

    Kawada, Tomoyuki

    2008-11-01

    Agreement rates for waking and sleeping obtained via sleep diary and accelerometer were evaluated, to compare the two methods. Sleep/wake data for consecutive days and nights were surveyed in 119 healthy university students. Accelerometer sleep/wake judgments obeyed the standard algorithm. Agreement rates for waking and sleeping according to accelerometer versus sleep diary, respectively, were calculated. Sleep diary data were set as a baseline. Seventy-six subjects (63.9%), 22 to 32 years of age, presented perfect data for the analysis. The mean sleep times, in minutes, judged by sleep diary and by accelerometer, were 482.3 and 629.6, respectively. The mean percentages and standard deviations of agreement on wake and sleep were 77.5% (SD = 10.2) and 86.1% (SD = 6.2), respectively. There was a significant negative relationship between the agreement rates for wake and sleep (r = -.482, p < .01). The accelerometer showed some measurement failure during waking, presumably because of the decrease in body movement. Sleep diary data during daytime appear to be more valid for detecting a sleep/wake cycle than are accelerometer data. In contrast, nocturnal sleep diary data might be supplemented by the use of an accelerometer as long as participants do not have insomnia.

  15. Excessive sleep need following traumatic brain injury: a case-control study of 36 patients.

    PubMed

    Sommerauer, Michael; Valko, Philipp O; Werth, Esther; Baumann, Christian R

    2013-12-01

    Increased sleep need following traumatic brain injury, referred to in this study as post-traumatic pleiosomnia, is common, but so far its clinical impact and therapeutic implications have not been characterized. We present a case-control study of 36 patients with post-traumatic pleiosomnia, defined by an increased sleep need of at least 2 h per 24 h after traumatic brain injury, compared to 36 controls. We assessed detailed history, sleep-activity patterns with sleep logs and actigraphy, nocturnal sleep with polysomnography and daytime sleep propensity with multiple sleep latency tests. Actigraphy recordings revealed that traumatic brain injury (TBI) patients had longer estimated sleep durations than controls (10.8 h per 24 h, compared to 7.3 h). When using sleep logs, TBI patients underestimated their sleep need. During nocturnal sleep, patients had higher amounts of slow-wave sleep than controls (20 versus 13.8%). Multiple sleep latency tests revealed excessive daytime sleepiness in 15 patients (42%), and 10 of them had signs of chronic sleep deprivation. We conclude that post-traumatic pleiosomnia may be even more frequent than reported previously, because affected patients often underestimate their actual sleep need. Furthermore, these patients exhibit an increase in slow-wave sleep which may reflect recovery mechanisms, intrinsic consequences of diffuse brain damage or relative sleep deprivation.

  16. Obstructive sleep-disordered breathing, enuresis and combined disorders in children: chance or related association?

    PubMed

    Zaffanello, Marco; Piacentini, Giorgio; Lippi, Giuseppe; Fanos, Vassilios; Gasperi, Emma; Nosetti, Luana

    2017-02-06

    Nocturnal enuresis is usually diagnosed and treated by a primary paediatrician or family practitioner; if there is any doubt, the children may be referred to a paediatric urologist. Obstructive sleep-disordered breathing is a complex, multifactorial disorder. Adenotonsillar hypertrophy is considered an important factor associated with obstructive sleep apnoea syndrome. Enuresis and obstructive sleep-disordered breathing are both frequent problems of sleep in childhood. We conducted an electronic search in Medline, Scopus and the ISI Web of Science to look for published material and identify a putative link between nocturnal enuresis and obstructive sleep-disordered breathing. A total number of 98 documents were found, but 24 of these had to be excluded after an attentive reading of the title, abstract or full text because the information therein was not suitable for the aims of our search. Studies have found that children with obstructive sleep apnoea syndrome frequently also have nocturnal enuresis. Both disorders have an underlying sleep disturbance characterised by an altered arousal response and sleep fragmentation. The pathophysiology of enuretic events is seemingly linked to nocturnal obstructive events, causing increased intra-abdominal pressure and altered systemic blood pressure that induces natriuresis and polyuria by altering levels of antidiuretic hormone, and atrial and brain natriuretic peptides. We found 17 studies regarding the urological outcome of treatment for obstructive sleep-disordered breathing in children with enuresis. Although a vast amount of information is now available regarding the relationship between nocturnal enuresis and obstructive sleep-disordered breathing, many of the published studies were uncontrolled, retrospective or prospective cohort studies (grade C recommendation). Resolution of enuresis after medical or surgical treatment for obstructive sleep-disordered breathing has been emphasised. Consequently, symptoms such as

  17. Sustained Sleep Fragmentation Induces Sleep Homeostasis in Mice

    PubMed Central

    Baud, Maxime O.; Magistretti, Pierre J.; Petit, Jean-Marie

    2015-01-01

    Study Objectives: Sleep fragmentation (SF) is an integral feature of sleep apnea and other prevalent sleep disorders. Although the effect of repetitive arousals on cognitive performance is well documented, the effects of long-term SF on electroencephalography (EEG) and molecular markers of sleep homeostasis remain poorly investigated. To address this question, we developed a mouse model of chronic SF and characterized its effect on EEG spectral frequencies and the expression of genes previously linked to sleep homeostasis including clock genes, heat shock proteins, and plasticity-related genes. Design: N/A. Setting: Animal sleep research laboratory. Participants : Sixty-six C57BL6/J adult mice. Interventions: Instrumental sleep disruption at a rate of 60/h during 14 days Measurements and Results: Locomotor activity and EEG were recorded during 14 days of SF followed by recovery for 2 days. Despite a dramatic number of arousals and decreased sleep bout duration, SF minimally reduced total quantity of sleep and did not significantly alter its circadian distribution. Spectral analysis during SF revealed a homeostatic drive for slow wave activity (SWA; 1–4 Hz) and other frequencies as well (4–40 Hz). Recordings during recovery revealed slow wave sleep consolidation and a transient rebound in SWA, and paradoxical sleep duration. The expression of selected genes was not induced following chronic SF. Conclusions: Chronic sleep fragmentation (SF) increased sleep pressure confirming that altered quality with preserved quantity triggers core sleep homeostasis mechanisms. However, it did not induce the expression of genes induced by sleep loss, suggesting that these molecular pathways are not sustainably activated in chronic diseases involving SF. Citation: Baud MO, Magistretti PJ, Petit JM. Sustained sleep fragmentation induces sleep homeostasis in mice. SLEEP 2015;38(4):567–579. PMID:25325477

  18. Tuned in Parenting and Infant Sleep Patterns

    ERIC Educational Resources Information Center

    Priddis, Lynn E.

    2009-01-01

    This paper focuses on infant sleep behaviour that is of concern to mothers of young infants, and disruptive to families. It reports on the incidence of sleep problems in dyads that self-referred to a specialist clinic, and the relationship between the mother's sensitive responsiveness and infant sleep patterns in a sample of 65 Australian infants.…

  19. MBD5 haploinsufficiency is associated with sleep disturbance and disrupts circadian pathways common to Smith–Magenis and fragile X syndromes

    PubMed Central

    Mullegama, Sureni V; Pugliesi, Loren; Burns, Brooke; Shah, Zalak; Tahir, Raiha; Gu, Yanghong; Nelson, David L; Elsea, Sarah H

    2015-01-01

    Individuals with autism spectrum disorders (ASD) who have an identifiable single-gene neurodevelopmental disorder (NDD), such as fragile X syndrome (FXS, FMR1), Smith–Magenis syndrome (SMS, RAI1), or 2q23.1 deletion syndrome (del 2q23.1, MBD5) share phenotypic features, including a high prevalence of sleep disturbance. We describe the circadian deficits in del 2q23.1 through caregiver surveys in which we identify several frequent sleep anomalies, including night/early awakenings, coughing/snoring loudly, and difficulty falling asleep. We couple these findings with studies on the molecular analysis of the circadian deficits associated with haploinsufficiency of MBD5 in which circadian gene mRNA levels of NR1D2, PER1, PER2, and PER3 were altered in del 2q23.1 lymphoblastoid cell lines (LCLs), signifying that haploinsufficiency of MBD5 can result in dysregulation of circadian rhythm gene expression. These findings were further supported by expression microarrays of MBD5 siRNA knockdown cells that showed significantly altered expression of additional circadian rhythm signaling pathway genes. Based on the common sleep phenotypes observed in del 2q23.1, SMS, and FXS patients, we explored the possibility that MBD5, RAI1, and FMR1 function in overlapping circadian rhythm pathways. Bioinformatic analysis identified conserved putative E boxes in MBD5 and RAI1, and expression levels of NR1D2 and CRY2 were significantly reduced in patient LCLs. Circadian and mTOR signaling pathways, both associated with sleep disturbance, were altered in both MBD5 and RAI1 knockdown microarray data, overlapping with findings associated with FMR1. These data support phenotypic and molecular overlaps across these syndromes that may be exploited to provide therapeutic intervention for multiple disorders. PMID:25271084

  20. MBD5 haploinsufficiency is associated with sleep disturbance and disrupts circadian pathways common to Smith-Magenis and fragile X syndromes.

    PubMed

    Mullegama, Sureni V; Pugliesi, Loren; Burns, Brooke; Shah, Zalak; Tahir, Raiha; Gu, Yanghong; Nelson, David L; Elsea, Sarah H

    2015-06-01

    Individuals with autism spectrum disorders (ASD) who have an identifiable single-gene neurodevelopmental disorder (NDD), such as fragile X syndrome (FXS, FMR1), Smith-Magenis syndrome (SMS, RAI1), or 2q23.1 deletion syndrome (del 2q23.1, MBD5) share phenotypic features, including a high prevalence of sleep disturbance. We describe the circadian deficits in del 2q23.1 through caregiver surveys in which we identify several frequent sleep anomalies, including night/early awakenings, coughing/snoring loudly, and difficulty falling asleep. We couple these findings with studies on the molecular analysis of the circadian deficits associated with haploinsufficiency of MBD5 in which circadian gene mRNA levels of NR1D2, PER1, PER2, and PER3 were altered in del 2q23.1 lymphoblastoid cell lines (LCLs), signifying that haploinsufficiency of MBD5 can result in dysregulation of circadian rhythm gene expression. These findings were further supported by expression microarrays of MBD5 siRNA knockdown cells that showed significantly altered expression of additional circadian rhythm signaling pathway genes. Based on the common sleep phenotypes observed in del 2q23.1, SMS, and FXS patients, we explored the possibility that MBD5, RAI1, and FMR1 function in overlapping circadian rhythm pathways. Bioinformatic analysis identified conserved putative E boxes in MBD5 and RAI1, and expression levels of NR1D2 and CRY2 were significantly reduced in patient LCLs. Circadian and mTOR signaling pathways, both associated with sleep disturbance, were altered in both MBD5 and RAI1 knockdown microarray data, overlapping with findings associated with FMR1. These data support phenotypic and molecular overlaps across these syndromes that may be exploited to provide therapeutic intervention for multiple disorders.

  1. Gender differences in associations of diurnal blood pressure variation, awake physical activity, and sleep quality with negative affect: the work site blood pressure study.

    PubMed

    Kario, K; Schwartz, J E; Davidson, K W; Pickering, T G

    2001-11-01

    This study reports on the associations among depression, anxiety, awake physical activity, sleep quality (assessed by nocturnal physical activity), and diurnal blood pressure (BP) variation in a nonpsychiatric sample (The Work Site Blood Pressure Study). We conducted ambulatory BP (ABP) monitoring and actigraphy in 231 working men and women. Depression and anxiety were measured by the Brief Symptom Inventory. There were gender-specific associations between depression or anxiety and ABP parameters. In men, depression was associated positively with the sleep/awake systolic BP (SBP) ratio (r=0.24, P=0.006). After controlling for age, body mass index, and awake and sleep activity, depression remained significantly associated with the sleep/awake SBP ratio (r=0.25, P=0.005) and was also significantly related to sleep SBP (r=0.21, P=0.02). Anxiety, which was related to depression (r=0.73, P<0.0001), had a similar but slightly weaker pattern of associations with ABP and activity. These associations were not found in women, but there were associations of anxiety with awake SBP (r=0.24, P=0.01) and pulse rate (r=0.27, P=0.006). In conclusion, depression is associated with disrupted diurnal BP variation independent of ambulatory physical activity in working men, whereas anxiety is associated with awake SBP and pulse rate in women.

  2. Percutaneous nocturnal oximetry in amyotrophic lateral sclerosis: periodic desaturation.

    PubMed

    de Carvalho, Mamede; Costa, João; Pinto, Susana; Pinto, Anabela

    2009-06-01

    Percutaneous nocturnal oximetry (PNO) is useful to screen respiratory function in amyotrophic lateral sclerosis (ALS). PNO recordings of some patients disclose a periodical pattern of O(2) desaturation (PP), whose significance is unknown. We aimed to characterize PP pattern, and we used a prospective study enrolling 261 consecutive ALS patients. Clinical, pulmonary and neurophysiological tests performed included: ALS functional rating scale, forced vital capacity (FVC), maximal inspiratory pressure (PImax), mouth occlusion pressure (MOP), phrenic nerve motor response, needle electromyography of the diaphragm, PNO, and sleep study. A total of 837 PNO recordings were analysed (3.2 recordings/patient) and 45 patients showed typical PP (17.2%). Four were excluded, 13 had normal diaphragm (group 1, G1), and in 28 the diaphragm was abnormal (G2). The two groups were comparable, apart from respiratory score, FVC and PImax which were lower in G2. In G1, REM sleep was absent and hypoventilation occurred at slow-wave sleep. Five patients in G1 were very spastic, had low MOP/FVC and a short survival. This study identified a subgroup of ALS patients (G1) with marked signs of upper motor neuron lesion, strong respiratory muscles, PP, low MOP/FVC ratio and poor prognosis. We speculate that they have a central respiratory dysfunction and deserve special care.

  3. Sleep Problems

    MedlinePlus

    ... For Consumers Consumer Information by Audience For Women Sleep Problems Share Tweet Linkedin Pin it More sharing ... PDF 474KB) En Español Medicines to Help You Sleep Tips for Better Sleep Basic Facts about Sleep ...

  4. Sleep Disorders

    MedlinePlus

    ... the day, even if you have had enough sleep? You might have a sleep disorder. The most common kinds are Insomnia - a hard time falling or staying asleep Sleep apnea - breathing interruptions during sleep Restless legs syndrome - ...

  5. [Non-epileptic paroxysmal sleep disorders].

    PubMed

    Malagón-Valdez, Jorge

    2013-09-06

    Non-epileptic paroxysmal disorders during sleep are a great challenge for the clinician. It is important to know the various clinical manifestations for appropriate differential diagnosis, since alterations in sleep, mostly motor, are part of these disorders. Our paper describes the normal sleep stages and electroencephalographic characteristics and polysomnography basic data. The confusions especially with nocturnal frontal lobe epilepsy are frequent and cause unnecessary drugs administered, the emotional burden of the parents or caretakers, which is the diagnosis of epilepsy. We discuss the possible causes of diagnostic errors.

  6. Ripple-Triggered Stimulation of the Locus Coeruleus during Post-Learning Sleep Disrupts Ripple/Spindle Coupling and Impairs Memory Consolidation

    ERIC Educational Resources Information Center

    Novitskaya, Yulia; Sara, Susan J.; Logothetis, Nikos K.; Eschenko, Oxana

    2016-01-01

    Experience-induced replay of neuronal ensembles occurs during hippocampal high-frequency oscillations, or ripples. Post-learning increase in ripple rate is predictive of memory recall, while ripple disruption impairs learning. Ripples may thus present a fundamental component of a neurophysiological mechanism of memory consolidation. In addition to…

  7. Rotigotine Objectively Improves Sleep in Parkinson's Disease: An Open-Label Pilot Study with Actigraphic Recording

    PubMed Central

    Calandra-Buonaura, Giovanna; Guaraldi, Pietro; Doria, Andrea; Zanigni, Stefano; Nassetti, Stefania; Favoni, Valentina; Cevoli, Sabina; Provini, Federica; Cortelli, Pietro

    2016-01-01

    Sleep disturbances represent important predictors of poor quality of life (QoL) in Parkinson's disease (PD). This open-label pilot study aimed to objectively assess, by means of actigraphic recording, effect of rotigotine on sleep in PD patients with self-reported sleep complaints. 15 PD patients underwent one-week actigraphic recording before (T0) and during (T1) rotigotine treatment, which was titrated to the dose subjectively improving motor symptoms (4–8 mg/24 h). Sleep disturbances, daytime sleepiness, cognitive performance, QoL, and depression were also evaluated with questionnaires. Actigraphic recordings showed a significant reduction in nocturnal motor activity and mean duration of wake episodes after sleep onset during rotigotine treatment compared to baseline. In 10 patients presenting objective evidence of poor sleep quality at T0 (sleep efficiency ≤ 85%), rotigotine also significantly improved other sleep parameters and further reduced nocturnal motor activity and mean duration of wake episodes. A significant decrease in number and duration of daytime sleep episodes was also observed at T1. Finally we confirmed that rotigotine significantly improves perceived sleep quality and QoL. Our study showed for the first time that rotigotine is associated with an objective improvement of nocturnal and diurnal sleep disturbances in PD patients with self-reported sleep complaints. This study is registered with AIFA-observational study registry number 12021. PMID:26981312

  8. CONTROL OF SLEEP AND WAKEFULNESS

    PubMed Central

    Brown, Ritchie E.; Basheer, Radhika; McKenna, James T.; Strecker, Robert E.; McCarley, Robert W.

    2013-01-01

    This review summarizes the brain mechanisms controlling sleep and wakefulness. Wakefulness promoting systems cause low-voltage, fast activity in the electroencephalogram (EEG). Multiple interacting neurotransmitter systems in the brain stem, hypothalamus, and basal forebrain converge onto common effector systems in the thalamus and cortex. Sleep results from the inhibition of wake-promoting systems by homeostatic sleep factors such as adenosine and nitric oxide and GABAergic neurons in the preoptic area of the hypothalamus, resulting in large-amplitude, slow EEG oscillations. Local, activity-dependent factors modulate the amplitude and frequency of cortical slow oscillations. Non-rapid-eye-movement (NREM) sleep results in conservation of brain energy and facilitates memory consolidation through the modulation of synaptic weights. Rapid-eye-movement (REM) sleep results from the interaction of brain stem cholinergic, aminergic, and GABAergic neurons which control the activity of glutamatergic reticular formation neurons leading to REM sleep phenomena such as muscle atonia, REMs, dreaming, and cortical activation. Strong activation of limbic regions during REM sleep suggests a role in regulation of emotion. Genetic studies suggest that brain mechanisms controlling waking and NREM sleep are strongly conserved throughout evolution, underscoring their enormous importance for brain function. Sleep disruption interferes with the normal restorative functions of NREM and REM sleep, resulting in disruptions of breathing and cardiovascular function, changes in emotional reactivity, and cognitive impairments in attention, memory, and decision making. PMID:22811426

  9. Control of sleep and wakefulness.

    PubMed

    Brown, Ritchie E; Basheer, Radhika; McKenna, James T; Strecker, Robert E; McCarley, Robert W

    2012-07-01

    This review summarizes the brain mechanisms controlling sleep and wakefulness. Wakefulness promoting systems cause low-voltage, fast activity in the electroencephalogram (EEG). Multiple interacting neurotransmitter systems in the brain stem, hypothalamus, and basal forebrain converge onto common effector systems in the thalamus and cortex. Sleep results from the inhibition of wake-promoting systems by homeostatic sleep factors such as adenosine and nitric oxide and GABAergic neurons in the preoptic area of the hypothalamus, resulting in large-amplitude, slow EEG oscillations. Local, activity-dependent factors modulate the amplitude and frequency of cortical slow oscillations. Non-rapid-eye-movement (NREM) sleep results in conservation of brain energy and facilitates memory consolidation through the modulation of synaptic weights. Rapid-eye-movement (REM) sleep results from the interaction of brain stem cholinergic, aminergic, and GABAergic neurons which control the activity of glutamatergic reticular formation neurons leading to REM sleep phenomena such as muscle atonia, REMs, dreaming, and cortical activation. Strong activation of limbic regions during REM sleep suggests a role in regulation of emotion. Genetic studies suggest that brain mechanisms controlling waking and NREM sleep are strongly conserved throughout evolution, underscoring their enormous importance for brain function. Sleep disruption interferes with the normal restorative functions of NREM and REM sleep, resulting in disruptions of breathing and cardiovascular function, changes in emotional reactivity, and cognitive impairments in attention, memory, and decision making.

  10. The Role of Sleep and Sleep Disorders in the Development, Diagnosis, and Management of Neurocognitive Disorders

    PubMed Central

    Miller, Michelle A.

    2015-01-01

    It is becoming increasingly apparent that sleep plays an important role in the maintenance, disease prevention, repair, and restoration of both mind and body. The sleep and wake cycles are controlled by the pacemaker activity of the superchiasmic nucleus in the hypothalamus but can be disrupted by diseases of the nervous system causing disordered sleep. A lack of sleep has been associated with an increase in all-cause mortality. Likewise, sleep disturbances and sleep disorders may disrupt neuronal pathways and have an impact on neurological diseases. Sleep deprivation studies in normal subjects demonstrate that a lack of sleep can cause attention and working memory impairment. Moreover, untreated sleep disturbances and sleep disorders such as obstructive sleep apnoe (OSA) can also lead to cognitive impairment. Poor sleep and sleep disorders may present a significant risk factor for the development of dementia. In this review, the underlying mechanisms and the role of sleep and sleep disorders in the development of neurocognitive disorders [dementia and mild cognitive impairment (MCI)] and how the presence of sleep disorders could direct the process of diagnosis and management of neurocognitive disorders will be discussed. PMID:26557104

  11. Leg actigraphy to quantify periodic limb movements of sleep: a systematic review and meta-analysis

    PubMed Central

    Plante, David T.

    2014-01-01

    SUMMARY Periodic limb movements of sleep (PLMS) are repetitive, stereotyped movements that can disrupt sleep and result in insomnia, non-restorative sleep, and/or daytime sleepiness. Currently, polysomnography is the gold standard and only clinically acceptable means of quantifying PLMS. Leg-worn actigraphy is an alternative method of measuring PLMS, which may circumvent many of the economic and technical limitations of polysomnography to quantify nocturnal leg movements. However, the use of leg actigraphy as a diagnostic means of assessing PLMS has not been systematically evaluated. In this review, the use of leg-worn actigraphy to measure PLMS is systematically evaluated, using both qualitative and quantitative assessment. Findings demonstrate significant heterogeneity among a limited number of studies in terms of type of actigraph utilized, position of the device on the lower extremity, and methods employed to count PLMS. In general, common accelerometers vary in their sensitivity and specificity to detect PLMS, which is likely related to the technical specifications of a given device. A current limitation in the ability to combine data from actigraphs placed on both legs is also a significant barrier to their use in clinical settings. Further research is required to determine the optimal methods to quantify PLMS using leg actigraphy, as well as specific clinical situations in which these devices may prove most useful. PMID:24726711

  12. Transdermal Rotigotine Improves Sleep Fragmentation in Parkinson's Disease: Results of the Multicenter, Prospective SLEEP-FRAM Study.

    PubMed

    Pagonabarraga, Javier; Piñol, Gerard; Cardozo, Adriana; Sanz, Pilar; Puente, Víctor; Otermín, Pilar; Legarda, Inés; Delgado, Tania; Serrano, Carmen; Balaguer, Ernest; Aguirregomozcorta, María; Álvarez, Ramiro; Kulisevsky, Jaime J

    2015-01-01

    Sleep disturbances occur frequently in patients with Parkinson's disease (PD). The aim of this study was to investigate the effects of rotigotine on sleep fluctuations in a sample of PD patients with self-reported complaints of nocturnal awakenings. This prospective, open-label, observational, and multicenter study enrolled consecutive outpatients with PD and administered rotigotine (mean dose 8.9 mg/day) for 3 months. The primary endpoint was the change from baseline in sleep fragmentation, assessed using the sleep maintenance subscale score of the Parkinson's Disease Sleep Scale (PDSS). The newly designed Parkinson's Disease Sleep Fragmentation Questionnaire (PD-SFQ) was used to measure other sleep parameters. A total of 62 patients were enrolled (mean age 70.2 years; 66% male). At 3 months, rotigotine significantly improved sleep fragmentation from baseline on the PDSS-2 sleep maintenance subscale (from 3.4 ± 0.9 to 1.9 ± 1.4; P < 0.0001). Rotigotine also significantly improved nocturnal motor symptoms (P < 0.0001), restless legs-like symptoms (P < 0.005), and nocturia (P = 0.004). Rotigotine significantly improved self-reported complaints of sleep fragmentation in PD patients and could be a useful treatment to improve this specific sleep problem in PD. However, these results are based on a small and clinically heterogeneous sample so they must be taken cautiously.

  13. Transdermal Rotigotine Improves Sleep Fragmentation in Parkinson's Disease: Results of the Multicenter, Prospective SLEEP-FRAM Study

    PubMed Central

    Pagonabarraga, Javier; Piñol, Gerard; Cardozo, Adriana; Sanz, Pilar; Puente, Víctor; Otermín, Pilar; Legarda, Inés; Delgado, Tania; Serrano, Carmen; Balaguer, Ernest; Aguirregomozcorta, María; Álvarez, Ramiro; Kulisevsky, Jaime J.

    2015-01-01

    Sleep disturbances occur frequently in patients with Parkinson's disease (PD). The aim of this study was to investigate the effects of rotigotine on sleep fluctuations in a sample of PD patients with self-reported complaints of nocturnal awakenings. This prospective, open-label, observational, and multicenter study enrolled consecutive outpatients with PD and administered rotigotine (mean dose 8.9 mg/day) for 3 months. The primary endpoint was the change from baseline in sleep fragmentation, assessed using the sleep maintenance subscale score of the Parkinson's Disease Sleep Scale (PDSS). The newly designed Parkinson's Disease Sleep Fragmentation Questionnaire (PD-SFQ) was used to measure other sleep parameters. A total of 62 patients were enrolled (mean age 70.2 years; 66% male). At 3 months, rotigotine significantly improved sleep fragmentation from baseline on the PDSS-2 sleep maintenance subscale (from 3.4 ± 0.9 to 1.9 ± 1.4; P < 0.0001). Rotigotine also significantly improved nocturnal motor symptoms (P < 0.0001), restless legs-like symptoms (P < 0.005), and nocturia (P = 0.004). Rotigotine significantly improved self-reported complaints of sleep fragmentation in PD patients and could be a useful treatment to improve this specific sleep problem in PD. However, these results are based on a small and clinically heterogeneous sample so they must be taken cautiously. PMID:25793143

  14. Sleep can eliminate list-method directed forgetting.

    PubMed

    Abel, Magdalena; Bäuml, Karl-Heinz T

    2013-05-01

    Recent work suggests a link between sleep and memory consolidation, indicating that sleep in comparison to wakefulness stabilizes memories. However, relatively little is known about how sleep affects forgetting. Here we examined whether sleep influences directed forgetting, the finding that people can intentionally forget obsolete memories when cued to do so. We applied the list-method directed forgetting task and assessed memory performance after 3 delay intervals. Directed forgetting was present after a short 20-min delay and after a 12-hr delay filled with diurnal wakefulness; in contrast, the forgetting was absent after a 12-hr delay that included regular nocturnal sleep. Successful directed forgetting after a delay thus can depend on whether sleep or wakefulness follows upon encoding: When wakefulness follows upon encoding, the forgetting can be successful; when sleep follows upon encoding, no forgetting may arise. Connections of the results to recent studies on the interplay between forgetting and sleep are discussed.

  15. [The effect of memorization processes on the structural organization of natural human sleep].

    PubMed

    Arons, E K

    1990-01-01

    The effect of sleep on learning was investigated, comparing results of memorizing and reproduction of an unknown text before and after subsequent sleep, with a detailed analysis of sleep patterns. Psychological tests excluded the possibility of emotional and stress factors. Presleep learning did not influence mean values of such sleep parameters as total sleep time or duration of different sleep stages. The main finding ot the present experiment was a redistribution of stage REM during nocturnal sleep following learning--its increase in the second sleep cycle with a corresponding decrease toward the end of night. Also, individual difficulties in learning were inversely related to REM latency. Changes in sleep patterns after learning didn't influence the total number of sleep cycles. It is suggested that the REM phase of sleep might be involved in the processing of information acquired during wakefulness.

  16. High levels of nocturnal activity in children with attention-deficit hyperactivity disorder: a video analysis.

    PubMed

    Konofal, E; Lecendreux, M; Bouvard, M P; Mouren-Simeoni, M C

    2001-04-01

    Sleep disturbances can lead to symptoms of attention-deficit hyperactivity disorder (ADHD) in children. In the present study, we compared the sleep patterns of 30 children with ADHD, with those of 19 controls matched for age (5-10 years) and sex. Sleep patterns were recorded during one night, using polysomnography (PSG) and a video system in the sleep laboratory. Both ADHD children and controls were medication free and showed no clinical signs of sleep and alertness problems. An infrared camera was used to record all types of movement, which were scored and analyzed using specific software (Observer(R) 3.0; Noldus International, The Netherlands). No significant differences in sleep variables were found between ADHD children and controls. Polysomnography data showed no significant difference between the two groups. Attention-deficit hyperactivity disorder children moved more often than controls (upper limbs, P < 0.04; lower limbs, P < 0.03; all types, P < 0.003). The duration of movements was significantly longer in ADHD children (upper limbs, P < 0.03; all types, P < 0.02). The results of the video analysis were consistent with previous findings that ADHD children have higher levels of nocturnal activity than controls. This activity concerned mostly upper and lower limb movements. Futher studies are required to determine why noctural activity does not affect sleep continuity in a more significant way and whether it should be treated specifically.

  17. Melatonin and sleep-related problems in children with intractable epilepsy.

    PubMed

    Elkhayat, Hamed A; Hassanein, Sahar M; Tomoum, Hoda Y; Abd-Elhamid, Iman A; Asaad, Tarek; Elwakkad, Amany S

    2010-04-01

    Children with epilepsy have high rates of sleep problems. Melatonin has been advocated in treatment of sleep disorders, and its beneficial effect has been confirmed in insomnia. The aim of this study was to assess melatonin levels in children with intractable epilepsy and its relation to pattern of sleep and characteristics of seizure disorder, as well as the effect of melatonin therapy on those parameters. The study was conducted on 23 children with intractable epilepsy and 14 children with controlled seizures. Patients were evaluated by psychometric sleep assessment and assay of diurnal and nocturnal melatonin levels. Children with intractable epilepsy received oral melatonin before bedtime. They were reassessed after 3 months. Children with intractable epilepsy had higher scores for each category of sleep walking, forcible teeth grinding, and sleep apnea. At the end of therapeutic trial, patients with intractable epilepsy exhibited significant improvement in bedtime resistance, sleep duration, sleep latency, frequent nocturnal arousals, sleep walking, excessive daytime sleepiness, nocturnal enuresis, forcible teeth grinding, sleep apnea, and Epworth sleepiness scores. There was also significant reduction in seizure severity. Thus, use of melatonin in patients with intractable seizures was associated with improvement of both many sleep-related phenomena and the severity of seizures.

  18. Role of Sleep Deprivation in Fear Conditioning and Extinction: Implications for Treatment of PTSD

    DTIC Science & Technology

    2013-10-01

    of the model is the impact on sleep . In animals, fear conditioning disrupts sleep , especially REM sleep . Sleep deprivation, in whole or just of REM ...was tested. We examined the effects of initial learning on REM sleep and whether REM sleep subsequent to learning facilitated memory consolidation of...threat and safety. Results showed increased safety learning was associated with increased consolidation of REM sleep the subsequent night. Increased

  19. Normative longitudinal maternal sleep: the first four postpartum months

    PubMed Central

    MONTGOMERY-DOWNS, Hawley E.; INSANA, Salvatore P.; CLEGG-KRAYNOK, Megan M.; MANCINI, Laura M.

    2010-01-01

    Objective To describe the normative course of maternal sleep during the first four months postpartum. Study Design Sleep was objectively measured using continuous wrist actigraphy. This was a longitudinal, field-based assessment of nocturnal sleep during postpartum weeks two through 16. Fifty mothers participated during postpartum weeks two through 13; 24 participated during postpartum weeks nine through 16. Results Maternal nocturnal sleep time was 7.2 (SD±.95) hours and did not change significantly across postpartum weeks two through 16. Maternal sleep efficiency did improve across weeks two (79.7% [SD±5.5]) through 16 (90.2% [SD±3.5]) as a function of decreased sleep fragmentation across weeks two (21.7 [SD±5.2]) through 16 (12.8 [SD±3.3]). Conclusion Though postpartum mothers’ total sleep time was higher than expected during the initial postpartum months, this sleep was highly fragmented (similar to fragmenting sleep disorders) and inefficient. This profile of disturbed sleep should be considered in intervention designs and family leave policies. PMID:20719289

  20. Sleep apnoea.

    PubMed

    Jun, Jonathan C; Chopra, Swati; Schwartz, Alan R

    2016-03-01

    Sleep apnoea is a disorder characterised by repetitive pauses in breathing during sleep caused by airway occlusion (obstructive sleep apnoea) or altered control of breathing (central sleep apnoea). In this Clinical Year in Review, we summarise high-impact research from the past year pertaining to management, diagnosis and cardio-metabolic consequences of sleep apnoea.

  1. Adult obstructive sleep apnoea

    PubMed Central

    Jordan, Amy S.; McSharry, David G.; Malhotra, Atul

    2013-01-01

    Obstructive sleep apnoea is an increasingly common disorder of repeated upper airway collapse during sleep, which leads to oxygen desaturation and disrupted sleep. Symptoms include snoring, witnessed apnoeas, and sleepiness. Pathogenesis varies; predisposing factors include small upper airway lumen, unstable respiratory control, low arousal threshold, small lung volume, and dysfunctional upper airway dilator muscles. Risk factors include obesity, male sex, age, menopause, fluid retention, adenotonsillar hypertrophy, and smoking. Obstructive sleep apnoea causes sleepiness, road traffic accidents, and probably systemic hypertension. It has also been linked to myocardial infarction, congestive heart failure, stroke, and diabetes mellitus though not definitively. Continuous positive airway pressure is the treatment of choice, with adherence of 60–70%. Bi-level positive airway pressure or adaptive servo-ventilation can be used for patients who are intolerant to continuous positive airway pressure. Other treatments include dental devices, surgery, and weight loss. PMID:23910433

  2. Memory consolidation in sleep disorders.

    PubMed

    Cellini, Nicola

    2016-09-25

    In recent years sleep-related memory consolidation has become a central topic in the sleep research field. Several studies have shown that in healthy individuals sleep promotes memory consolidation. Notwithstanding this, the consequences of sleep disorders on offline memory consolidation remain poorly investigated. Research studies indicate that patients with insomnia, obstructive sleep apnea, and narcolepsy often exhibit sleep-related impairment in the consolidation of declarative and procedural information. On the other hand, patients with parasomnias, such as sleep-walking, night terrors and rapid eye movement (REM) behavior disorder, do not present any memory impairment. These studies suggest that only sleep disorders characterized by increased post-learning arousal and disrupted sleep architecture seem to be associated with offline memory consolidation issues. Such impairments, arising already in childhood, may potentially affect the development and maintenance of an individual's cognitive abilities, reducing their quality of life and increasing the risk of accidents. However, promising findings suggest that successfully treating sleep symptoms can result in the restoration of memory functions and marked reduction of direct and indirect societal costs of sleep disorders.

  3. Repetitive Arm Movements During Sleep: A Polysomnographic Assessment

    PubMed Central

    Torabi-Nami, Mohammad; Mehrabi, Samrad; Derman, Sabri

    2016-01-01

    Sleep-related movement disorders should be differentiated from parasomnias, sleep-associated behavioral disorders, and epilepsy. Polysomnography (PSG) is the gold standard in evaluating such disorders. Periodic leg movement disorder during sleep (PLMS), hypnic jerks, bruxism, rhythmic movement disorder, restless legs syndrome, and nocturnal leg cramps have broadly been discussed in the literature. However, periodic arm movement disorder in sleep (PAMS) is a less-appreciated entity perhaps because arm surface electromyography is not an integral part of the standard polysomnography. Results from our PSG study in a case suspected for PAMS prompted us to herewith discuss this problem. PMID:27563420

  4. The cognitive cost of sleep lost

    PubMed Central

    McCoy, John G.; Strecker, Robert E.

    2013-01-01

    A substantial body of literature supports the intuitive notion that a good night’s sleep can facilitate human cognitive performance the next day. Deficits in attention, learning & memory, emotional reactivity, and higher-order cognitive processes, such as executive function and decision making, have all been documented following sleep disruption in humans. Thus, whilst numerous clinical and experimental studies link human sleep disturbance to cognitive deficits, attempts to develop valid and reliable rodent models of these phenomena are fewer, and relatively more recent. This review focuses primarily on the cognitive impairments produced by sleep disruption in rodent models of several human patterns of sleep loss/sleep disturbance. Though not an exclusive list, this review will focus on four specific types of sleep disturbance: total sleep deprivation, experimental sleep fragmentation, selective REM sleep deprivation, and chronic sleep restriction. The use of rodent models can provide greater opportunities to understand the neurobiological changes underlying sleep loss induced cognitive impairments. Thus, this review concludes with a description of recent neurobiological findings concerning the neuroplastic changes and putative brain mechanisms that may underlie the cognitive deficits produced by sleep disturbances. PMID:21875679

  5. Severe obstructive sleep apnoea syndrome in an adult patient with Laron syndrome.

    PubMed

    Dagan, Y; Abadi, J; Lifschitz, A; Laron, Z

    2001-08-01

    A 68 year old patient with Laron syndrome (primary growth hormone (GH) resistance-insensitivity due to a molecular defect of the GH receptor) and severe obstructive sleep apnoea syndrome is described. Treatment with continuous positive air pressure therapy resulted in improved nocturnal sleep, daytime alertness and cognitive functions.

  6. Central Interleukin-1β Suppresses the Nocturnal Secretion of Melatonin

    PubMed Central

    Herman, A. P.; Bochenek, J.; Król, K.; Krawczyńska, A.; Antushevich, H.; Pawlina, B.; Herman, A.; Romanowicz, K.; Tomaszewska-Zaremba, D.

    2016-01-01

    In vertebrates, numerous processes occur in a rhythmic manner. The hormonal signal reliably reflecting the environmental light conditions is melatonin. Nocturnal melatonin secretion patterns could be disturbed in pathophysiological states, including inflammation, Alzheimer's disease, and depression. All of these states share common elements in their aetiology, including the overexpression of interleukin- (IL-) 1β in the central nervous system. Therefore, the present study was designed to determine the effect of the central injection of exogenous IL-1β on melatonin release and on the expression of the enzymes of the melatonin biosynthetic pathway in the pineal gland of ewe. It was found that intracerebroventricular injections of IL-1β (50 µg/animal) suppressed (P < 0.05) nocturnal melatonin secretion in sheep regardless of the photoperiod. This may have resulted from decreased (P < 0.05) synthesis of the melatonin intermediate serotonin, which may have resulted, at least partially, from a reduced expression of tryptophan hydroxylase. IL-1β also inhibited (P < 0.05) the expression of the melatonin rhythm enzyme arylalkylamine-N-acetyltransferase and hydroxyindole-O-methyltransferase. However, the ability of IL-1β to affect the expression of these enzymes was dependent upon the photoperiod. Our study may shed new light on the role of central IL-1β in the aetiology of disruptions in melatonin secretion. PMID:27212805

  7. Relationship between Sleep Habits and Nighttime Sleep among Healthy Preschool Children in Taiwan.

    PubMed

    Lo, Ming Jae

    2016-12-01

    Introduction: We examined the nighttime sleep habits associated with insufficient sleep quantity and poor sleep quality among healthy preschool-aged Taiwanese children. Materials and Methods: The study population of this cross-sectional survey was a stratified random sample of 3 to 6-year-old preschool children from 19 cities and counties in Taiwan. A caregiver-administered questionnaire was used to collect information on preschooler sleep quantity (sleep duration and sleep latency) and sleep quality (sleep disturbances and disruption) and potentially related sleep habits. Results: Of the 1253 children for whom analysable survey data were collected (children's mean age: 5.03 ± 1.27 years), more than half (53.07%) engaged in bedtime television (TV)-viewing, 88.95% required a sleep reminder, 43.85% exhibited bedtime resistance, 93.6% engaged in co-sleeping (bed-sharing or room-sharing), and only 33.72% slept in a well darkened bedroom. Bedtime TV-viewing, co-sleeping, bedroom light exposure, and bedtime resistance were the primary predictors, without a bedtime TV-viewing habit was the strongest predictor analysed; it explained 15.2% and 19.9% of the variance in adequate sleep quantity and improved sleep quality in preschool children. Conclusion: Sleep loss and poor sleep quality in preschool children could be alleviated, at least partly, by curtailing bedtime TV-viewing, limiting light exposure during sleeping, and reducing bed-sharing habit.

  8. Cytokines in sleep regulation.

    PubMed

    Krueger, J M; Takahashi, S; Kapás, L; Bredow, S; Roky, R; Fang, J; Floyd, R; Renegar, K B; Guha-Thakurta, N; Novitsky, S

    1995-01-01

    The central thesis of this essay is that the cytokine network in brain is a key element in the humoral regulation of sleep responses to infection and in the physiological regulation of sleep. We hypothesize that many cytokines, their cellular receptors, soluble receptors, and endogenous antagonists are involved in physiological sleep regulation. The expressions of some cytokines are greatly amplified by microbial challenge. This excess cytokine production during infection induces sleep responses. The excessive sleep and wakefulness that occur at different times during the course of the infectious process results from dynamic changes in various cytokines that occur during the host's response to infectious challenge. Removal of any one somnogenic cytokine inhibits normal sleep, alters the cytokine network by changing the cytokine mix, but does not completely disrupt sleep due to the redundant nature of the cytokine network. The cytokine network operates in a paracrine/autocrine fashion and is responsive to neuronal use. Finally, cytokines elicit their somnogenic actions via endocrine and neurotransmitter systems as well as having direct effects neurons and glia. Evidence in support of these postulates is reviewed in this essay.

  9. Local awakening: regional reorganizations of brain oscillations after sleep.

    PubMed

    Tsai, Pei-Jung; Chen, Sharon Chia-Ju; Hsu, Chun-Yao; Wu, Changwei W; Wu, Yu-Chin; Hung, Ching-Sui; Yang, Albert C; Liu, Po-Yu; Biswal, Bharat; Lin, Ching-Po

    2014-11-15

    Brain functions express rhythmic fluctuations accompanied by sleep and wakefulness each day, but how sleep regulates brain rhythms remains unclear. Following the dose-dependent local sleep concept, two succeeding questions emerge: (1) is the sleep regulation a network-specific process; and (2) is the awakening state dependent on the previous sleep stages? To answer the questions, we conducted simultaneous EEG and fMRI recordings over 22 healthy male participants, along pre-sleep, nocturnal sleep and awakening. Using paired comparisons between awakening and pre-sleep conditions, three scenarios of the regional specificity were demonstrated on awakening: (1) the default-mode and hippocampal networks maintained similar connectivity and spectral power; (2) the sensorimotor network presented reduced connectivity and spectral power; and (3) the thalamus demonstrated substantially enhanced connectivity to the neo-cortex with decreased spectral power. With regard to the stage effect, the deep sleep group had significant changes in both functional connectivity and spectral power on awakening, whereas the indices of light sleep group remained relatively quiescent after sleep. The phenomena implied that slow-wave sleep could be key to rebooting the BOLD fluctuations after sleep. In conclusion, the regional specificity and the stage effect were verified in support of the local awakening concept, indicating that sleep regulation leads to the reorganization of brain networks upon awakening.

  10. Pathogenesis of paroxysmal nocturnal hemoglobinuria.

    PubMed

    Murakami, Yoshiko

    Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired GPI deficiency caused by somatic mutation of the PIGA gene in one or several hematopoietic stem cells. Recently, PNH caused by somatic mutation of one allele of the PIGT gene in combination with a germline mutation of the other allele was reported, showing that PIGA is not the only gene responsible for PNH, though other causes are rare. These mutant cells become GPI deficient, expand clonally and differentiate into all of the hematopoietic lineages. When GPI deficient erythrocytes increase in proportion, massive hemolysis occurs due to activated complement attack during infection. As the complement regulatory proteins such as CD59 and DAF are GPI anchored proteins, they are defective on GPI deficient erythrocytes and these abnormal erythrocytes are thereby left unprotected from complement attack. Hemolytic anemia, venous thrombosis, and bone marrow failure are thus the resulting triad of symptoms. Clonal expansion does not occur with PIGA deficiency alone. We hypothesize that PIGA deficient cells acquire a proliferative phenotype via additional gene mutations within the associated environment of bone marrow failure. This hypothesis will be explained by introducing recent reports.

  11. Sleep and Plasticity in Schizophrenia

    PubMed Central

    Sprecher, Kate E.; Ferrarelli, Fabio

    2016-01-01

    Schizophrenia is a devastating mental illness with a worldwide prevalence of approximately 1 %. Although the clinical features of the disorder were described over one hundred years ago, its neurobiology is still largely elusive despite several decades of research. Schizophrenia is associated with marked sleep disturbances and memory impairment. Above and beyond altered sleep architecture, sleep rhythms including slow waves and spindles are disrupted in schizophrenia. In the healthy brain, these rhythms reflect and participate in plastic processes during sleep. This chapter discusses evidence that schizophrenia patients exhibit dysfunction of sleep-mediated plasticity on a behavioral, cellular, and molecular level and offers suggestions on how the study of sleeping brain activity can shed light on the pathophysiological mechanisms of the disorder. PMID:25608723

  12. Maternal and infant sleep postpartum.

    PubMed

    McGuire, Elizabeth

    2013-07-01

    New parents should be aware that infants' sleep is unlike that of adults and that meeting their infant's needs is likely to disrupt their own sleep. They will need to adjust their routine to manage their own sleep needs. Parental sleep patterns in the postpartum period are tied to the infant's development of a circadian sleep-wake rhythm, and the infant's feeds. Close contact with the mother and exposure to light/dark cues appear to assist in the development of the infant's circadian rhythm. The composition of breastmilk varies over the course of 24 hours and some components produced at night are likely to contribute to the infant's day/night entrainment. There is no clear evidence that using artificial feeds improves maternal sleep. Most infants need night feeds but requirements for nighttime feeds vary with the individual.

  13. Too hot to sleep? Sleep behaviour and surface body temperature of Wahlberg's Epauletted Fruit Bat.

    PubMed

    Downs, Colleen T; Awuah, Adwoa; Jordaan, Maryna; Magagula, Londiwe; Mkhize, Truth; Paine, Christine; Raymond-Bourret, Esmaella; Hart, Lorinda A

    2015-01-01

    The significance of sleep and factors that affect it have been well documented, however, in light of global climate change the effect of temperature on sleep patterns has only recently gained attention. Unlike many mammals, bats (order: Chiroptera) are nocturnal and little is known about their sleep and the effects of ambient temperature (Ta) on their sleep. Consequently we investigated seasonal temperature effects on sleep behaviour and surface body temperature of free-ranging Wahlberg's epauletted fruit bat, Epomophorus wahlbergi, at a tree roost. Sleep behaviours of E. wahlbergi were recorded, including: sleep duration and sleep incidences (i.e. one eye open and both eyes closed). Sleep differed significantly across all the individuals in terms of sleep duration and sleep incidences. Individuals generally spent more time awake than sleeping. The percentage of each day bats spent asleep was significantly higher during winter (27.6%), compared with summer (15.6%). In summer, 20.7% of the sleeping bats used one eye open sleep, and this is possibly the first evidence of one-eye-sleep in non-marine mammals. Sleep duration decreased with extreme heat as bats spent significantly more time trying to cool by licking their fur, spreading their wings and panting. Skin temperatures of E. wahlbergi were significantly higher when Ta was ≥35°C and no bats slept at these high temperatures. Consequently extremely hot days negatively impact roosting fruit bats, as they were forced to be awake to cool themselves. This has implications for these bats given predicted climate change scenarios.

  14. Memory consolidation during sleep: interactive effects of sleep stages and HPA regulation.

    PubMed

    Wagner, Ullrich; Born, Jan

    2008-01-01

    Sleep is critically involved in the consolidation of previously acquired memory traces. However, nocturnal sleep is not uniform but is subject to distinct changes in electrophysiological and neuroendocrine activity. Specifically, the first half of the night is dominated by slow wave sleep (SWS), whereas rapid eye movement (REM) sleep prevails in the second half. Concomitantly, hypothalamo-pituitary-adrenal (HPA) activity as indicated by cortisol release is suppressed to a minimum during early sleep, while drastically increasing during late sleep. We have shown that the different sleep stages and the concomitant glucocorticoid release are interactively involved in the consolidation of different types of memories. SWS-rich early sleep has been demonstrated to benefit mainly the consolidation of hippocampus-dependent declarative memories (i.e. facts and episodes). In contrast, REM sleep-rich late sleep was shown to improve in particular emotional memories involving amygdalar function, as well as procedural memories (for skills) not depending on hippocampal or amygdalar function. Enhancing plasma glucocorticoid concentrations during SWS-rich early sleep counteracted hippocampus-dependent declarative memory consolidation, but did not affect hippocampus-independent procedural memory. Preventing the increase in cortisol during late REM sleep-rich sleep by administration of metyrapone impaired hippocampus-dependent declarative memory but enhanced amygdala-dependent emotional aspects of memory. The data underscore the importance of pituitary-adrenal inhibition during early SWS-rich sleep for efficient consolidation of declarative memory. The increase in cortisol release during late REM sleep-rich sleep may counteract an overshooting consolidation of emotional memories.

  15. Impact of nocturia on sleep and quality of life: a brief, selected review for the International Consultation on Incontinence Research Society (ICI-RS) nocturia think tank.

    PubMed

    Bliwise, Donald L; Rosen, Raymond C; Baum, Neil

    2014-04-01

    Nocturia, the need to awaken at night to void, is a highly prevalent disorder that negatively affects nocturnal sleep, increases daytime tiredness, and adversely impacts quality of life. In this selective review, we provide the reader an overview of current work in this area. From the perspective of disturbed sleep, two divergent perspectives have emerged from the literature when discussing nocturia. The first is that a patient awakens because of an urge to urinate. The second is that a patient awakens during the night for some reason unrelated to urinary urge (e.g., an awakening from an environmental source or from intrinsic lightening of sleep) and then decides to void while awake. In the few studies that have inquired about nocturia as a cause of awakenings, nocturia often ranks above the traditional psychological or physical factors. Not only is nocturia likely to disrupt sleep, but it may impact waking quality of life as well. A number of generic and nocturia-related questionnaires have been used to quantify the effect of nocturia on quality of life. In this short paper, we introduce the reader to several key studies in these important areas.

  16. Sleep and Respiration in Microgravity

    NASA Technical Reports Server (NTRS)

    West, John B.; Elliott, Ann R.; Prisk, G. Kim; Paiva, Manuel

    2003-01-01

    Sleep is often reported to be of poor quality in microgravity, and studies on the ground have shown a strong relationship between sleep-disordered breathing and sleep disruption. During the 16-day Neurolab mission, we studied the influence of possible changes in respiratory function on sleep by performing comprehensive sleep recordings on the payload crew on four nights during the mission. In addition, we measured the changes in the ventilatory response to low oxygen and high carbon dioxide in the same subjects during the day, hypothesizing that changes in ventilatory control might affect respiration during sleep. Microgravity caused a large reduction in the ventilatory response to reduced oxygen. This is likely the result of an increase in blood pressure at the peripheral chemoreceptors in the neck that occurs when the normally present hydrostatic pressure gradient between the heart and upper body is abolished. This reduction was similar to that seen when the subjects were placed acutely in the supine position in one-G. In sharp contrast to low oxygen, the ventilatory response to elevated carbon dioxide was unaltered by microgravity or the supine position. Because of the similarities of the findings in microgravity and the supine position, it is unlikely that changes in ventilatory control alter respiration during sleep in microgravity. During sleep on the ground, there were a small number of apneas (cessation of breathing) and hypopneas (reduced breathing) in these normal subjects. During sleep in microgravity, there was a reduction in the number of apneas and hypopneas per hour compared to preflight. Obstructive apneas virtually disappeared in microgravity, suggesting that the removal of gravity prevents the collapse of upper airways during sleep. Arousals from sleep were reduced in microgravity compared to preflight, and virtually all of this reduction was as a result of a reduction in the number of arousals from apneas and hypopneas. We conclude that any sleep

  17. Nocturnal electromyographic evaluation of masseter muscle activity in the complete denture patient.

    PubMed

    von Gonten, A S; Palik, J F; Oberlander, B A; Rugh, J D

    1986-11-01

    Nocturnal oral activity was evaluated in 12 complete denture wearers by means of EMG measurements of the masseter muscle. Patients who had worn dentures for at least 6 months were selected. EMG levels were compared when subjects slept with and without the dentures in the mouth. Three subjects appeared to have reduced EMG values when sleeping with the dentures. However, no overall group trends or significant differences were obtained. High variability in nightly EMG values could not be explained by a post hoc analysis of patient oral symptoms or denture characteristics. Efforts should be directed at improved methodology to study the specific mechanism of the effect of denture wearing on nocturnal muscle activity levels. Additional knowledge is needed on the occurrence and effects of parafunctional habits in the edentulous patients.

  18. Benign parasomnias and nocturnal frontal epilepsy: differential diagnosis in a case report.

    PubMed

    Gaggero, R; Devescovi, R; Nobili, L; Baglietto, M G; Zucconi, M; Schinardi, A

    2001-08-01

    We report the case of a 13-year-old boy who complained of complex motor episodes during sleep characterized by sudden arousal followed by deambulation associated with automatic movements and vocalization. His family history included both epileptic and psychiatric disorders. The patient himself presented psychopathologic traits and adaptive difficulties. In support of an epileptic origin of these phenomena were the stereotyped fashion in which they appeared and their responsiveness to carbamazepine. We classified the present case as a nocturnal frontal epilepsy with variable manifestations that can be classified as paroxysmal arousals, paroxysmal dystonia, and epileptic nocturnal wanderings. It was possible to differentiate such events from the most common parasomnias on the basis of videopolysomnographic studies.

  19. Effects of Light Interruption on Sleep and Viability of Drosophila melanogaster

    PubMed Central

    Liu, Zhenxing; Zhao, Zhangwu

    2014-01-01

    Light is a very important regulator of the daily sleep rhythm. Here, we investigate the influence of nocturnal light stimulation on Drosophila sleep. Results showed that total daytime sleep was reduced due to a decrease in daytime sleep episode duration caused by discontinuous light stimulation, but sleep was not strongly impacted at nighttime although the discontinuous light stimulation occurred during the scotophase. During a subsequent recovery period without light interruption, the sleep quality of nighttime sleep was improved and of daytime sleep reduced, indicating flies have a persistent response to nocturnal light stimulation. Further studies showed that the discontinuous light stimulation damped the daily rhythm of a circadian light-sensitive protein cryptochrome both at the mRNA and protein levels, which subsequently caused disappearance of circadian rhythm of the core oscillator timeless and decrease of TIMLESS protein at nighttime. These data indicate that the nocturnal light interruption plays an important role in sleep through core proteins CRYTOCHROME and TIMLESS, Moreover, interruption of sleep further impacted reproduction and viability. PMID:25148297

  20. Slow Wave Sleep and Long Duration Spaceflight

    NASA Technical Reports Server (NTRS)

    Whitmire, Alexandra; Orr, Martin; Arias, Diana; Rueger, Melanie; Johnston, Smith; Leveton, Lauren

    2012-01-01

    While ground research has clearly shown that preserving adequate quantities of sleep is essential for optimal health and performance, changes in the progression, order and /or duration of specific stages of sleep is also associated with deleterious outcomes. As seen in Figure 1, in healthy individuals, REM and Non-REM sleep alternate cyclically, with stages of Non-REM sleep structured chronologically. In the early parts of the night, for instance, Non-REM stages 3 and 4 (Slow Wave Sleep, or SWS) last longer while REM sleep spans shorter; as night progresses, the length of SWS is reduced as REM sleep lengthens. This process allows for SWS to establish precedence , with increases in SWS seen when recovering from sleep deprivation. SWS is indeed regarded as the most restorative portion of sleep. During SWS, physiological activities such as hormone secretion, muscle recovery, and immune responses are underway, while neurological processes required for long term learning and memory consolidation, also occur. The structure and duration of specific sleep stages may vary independent of total sleep duration, and changes in the structure and duration have been shown to be associated with deleterious outcomes. Individuals with narcolepsy enter sleep through REM as opposed to stage 1 of NREM. Disrupting slow wave sleep for several consecutive nights without reducing total sleep duration or sleep efficiency is associated with decreased pain threshold, increased discomfort, fatigue, and the inflammatory flare response in skin. Depression has been shown to be associated with a reduction of slow wave sleep and increased REM sleep. Given research that shows deleterious outcomes are associated with changes in sleep structure, it is essential to characterize and mitigate not only total sleep duration, but also changes in sleep stages.

  1. Retino-hypothalamic regulation of light-induced murine sleep

    PubMed Central

    Muindi, Fanuel; Zeitzer, Jamie M.; Heller, Horace Craig

    2014-01-01

    The temporal organization of sleep is regulated by an interaction between the circadian clock and homeostatic processes. Light indirectly modulates sleep through its ability to phase shift and entrain the circadian clock. Light can also exert a direct, circadian-independent effect on sleep. For example, acute exposure to light promotes sleep in nocturnal animals and wake in diurnal animals. The mechanisms whereby light directly influences sleep and arousal are not well understood. In this review, we discuss the direct effect of light on sleep at the level of the retina and hypothalamus in rodents. We review murine data from recent publications showing the roles of rod-, cone- and melanopsin-based photoreception on the initiation and maintenance of light-induced sleep. We also present hypotheses about hypothalamic mechanisms that have been advanced to explain the acute control of sleep by light. Specifically, we review recent studies assessing the roles of the ventrolateral preoptic area (VLPO) and the suprachiasmatic nucleus (SCN). We also discuss how light might differentially promote sleep and arousal in nocturnal and diurnal animals respectively. Lastly, we suggest new avenues for research on this topic which is still in its early stages. PMID:25140132

  2. Diverting the Pathway to Substance Misuse by Improving Sleep

    DTIC Science & Technology

    2015-05-01

    overall alcohol and drug use in the target population, its relationship with sleep disturbance; include an educational/motivational module...and include a novel component for addressing nocturnal vigilance that incorporates recent cognitive behavioral techniques. Alcohol, drug , and...be assessed. We will assess outcomes related to sleep and alcohol/substance/prescription drug use and the degree to which the effect on the latter

  3. Sleep-disordered breathing as a delayed complication of iatrogenic vocal cord trauma.

    PubMed

    Faiz, Saadia A; Bashoura, Lara; Kodali, Lavanya; Hessel, Amy C; Evans, Scott E; Balachandran, Diwakar D

    2016-06-01

    A case of a 55-year-old woman with iatrogenic vocal cord trauma and sleep-related symptoms is reported. In particular, this case highlights sleep-disordered breathing as a delayed complication after iatrogenic vocal cord trauma. The patient developed acute stridor from a contralateral vocal cord hematoma following vocal fold injection for right vocal cord paralysis. Acute respiratory symptoms resolved with oxygen, steroids, and nebulized therapy, but nocturnal symptoms persisted and polysomnography revealed sleep-related hypoventilation and mild obstructive sleep apnea. Positive pressure therapy was successfully used to ameliorate her symptoms and treat sleep-disordered breathing until her hematoma resolved. In addition to the typically acute respiratory symptoms that may result from vocal cord dysfunction, sleep-disordered breathing may also present as a significant subacute or chronic problem. Management of the acute respiratory symptoms is relatively well established, but clinicians should be alert for more subtle nocturnal symptoms that may require further study with polysomnography.

  4. BDNF in sleep, insomnia, and sleep deprivation.

    PubMed

    Schmitt, Karen; Holsboer-Trachsler, Edith; Eckert, Anne

    2016-01-01

    The protein brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family of growth factors involved in plasticity of neurons in several brain regions. There are numerous evidence that BDNF expression is decreased by experiencing psychological stress and that, accordingly, a lack of neurotrophic support causes major depression. Furthermore, disruption in sleep homeostatic processes results in higher stress vulnerability and is often associated with stress-related mental disorders. Recently, we reported, for the first time, a relationship between BDNF and insomnia and sleep deprivation (SD). Using a biphasic stress model as explanation approach, we discuss here the hypothesis that chronic stress might induce a deregulation of the hypothalamic-pituitary-adrenal system. In the long-term it leads to sleep disturbance and depression as well as decreased BDNF levels, whereas acute stress like SD can be used as therapeutic intervention in some insomniac or depressed patients as compensatory process to normalize BDNF levels. Indeed, partial SD (PSD) induced a fast increase in BDNF serum levels within hours after PSD which is similar to effects seen after ketamine infusion, another fast-acting antidepressant intervention, while traditional antidepressants are characterized by a major delay until treatment response as well as delayed BDNF level increase. Key messages Brain-derived neurotrophic factor (BDNF) plays a key role in the pathophysiology of stress-related mood disorders. The interplay of stress and sleep impacts on BDNF level. Partial sleep deprivation (PSD) shows a fast action on BDNF level increase.

  5. Reversal of the sleep/wake cycle disorder of sleeping sickness after trypanosomicide treatment.

    PubMed

    Buguet, A; Tapie, P; Bert, J

    1999-09-01

    To determine whether the circadian disruption of the sleep/wake cycle observed in sleeping sickness, human African trypanosomiasis (HAT), can be reversed after trypanosomicide treatment, 10 Congolese patients infected by Trypanosoma brucei gambiense underwent 24-h polysomnographic recordings before treatment with melarsoprol and after each of three weekly treatment sessions. Polysomnography consisted of a continuous recording of the electroencephalogram, electromyogram and electro-oculogram on a Minidix Alvar polygraph. Sleep traces were analysed in 20-sec epochs for wakefulness, REM sleep, and NREM sleep [stages 1, 2, 3, 4; stages 3 and 4 representing slow-wave sleep (SWS)]. As previously described (Buguet et al. 1993), the 24-h distribution of the sleep/wake cycle was disturbed proportionally to the severity of the illness. The overall amounts of each sleep/wake stage did not change after treatment. However, the patterns of occurrence of sleep episodes, REM sleep and SWS phases were determinant in the evaluation of treatment efficacy. The trypanosomicide action of melarsoprol led to a reduction in the number of sleep episodes, except in one patient whose health condition worsened during the third treatment session: sleep onset REM sleep phases (SOREMPs) decreased and the number of SWS episodes during a sleep episode increased. We conclude that in HAT, the reversibility of the sleep/wake cycle alteration and that of sleep structure constitute the basis for an evaluation of the healing process.

  6. Sleep Patterns among South Korean Infants and Toddlers: Global Comparison

    PubMed Central

    2016-01-01

    The purpose of this study was to examine sleep patterns in a large sample of infants and toddlers (ages birth to 36 months) in Korea, and to compare sleep patterns, sleep problems, sleep ecology, and parental behaviors to global sleep data on young children in both predominately Asian (P-A) and predominately Caucasian (P-C) countries/regions. We additionally examined parent and child demographic information, parental behaviors, and aspects of the sleep ecology as predictors of sleep patterns among infants and toddlers in Korea. Parents/caregivers of 1,036 Korean infants and toddlers completed an expanded, internet-based version of the brief infant sleep questionnaire. Consistent with other studies of sleep in early childhood, sleep/wake patterns became increasingly consolidated with older child age for the Korea sample. Compared to both P-A and P-C infants and toddlers, children in Korea had the latest bedtimes, shortest total sleep and daytime sleep durations, and the least frequent rates of napping. Even though half of parents perceive their children’s sleep problematic, parental perceptions of severe child sleep problems were the lowest. Within Korea, breastfeeding and bottle-feeding at sleep resumption were associated with increased nocturnal awakenings. Evening television viewing was associated with later bedtimes, which may have implications for sleep hygiene recommendations in clinical practice. The current study provides important information about sleep/wake patterns, parental behaviors, and aspects of the sleep ecology for infants and toddlers for physicians to support healthy sleep in Korea. PMID:26839481

  7. Nocturnal giddiness in relation to nocturia and other symptoms and to medication in the elderly.

    PubMed

    Asplund, Ragnar

    2005-01-01

    The aim of this study was to evaluate the relation of nocturia, somatic diseases, symptoms, and medication to nocturnal giddiness in a group of elderly men and women. A questionnaire survey was undertaken among 10,216 elderly subjects. The mean (+/-S.D.) ages of the men and women were 73.0 +/- 6.0 and 72.6 +/- 6.7 years, respectively. Nocturnal giddiness was reported by 14.1% of the men and 9.1% of the women. Poor health was reported by 44.4% (P < 0.0001) of the men with nocturnal giddiness and by 14.0% of the men without, and among the women these figures were 45.5% and 20.0% (P < 0.0001), respectively. In a multiple logistic regression analysis significant independent correlates of nocturnal giddiness were: nocturnal micturition episodes >or=3 versus nocturia or=80 years versus <70 years (2.5; 1.7-3.6); eyesight, poor versus good (1.8; 1.4-2.4); hearing, poor versus good (1.4; 1.1-1.9); pain in the cervical spine (2.1; 1.5-2.8); spasmodic chest pain (1.5; 1.1-2.0); diabetes (1.6; 1.0-2.4); analgesics (1.8; 1.3-2.4); and diuretics (1.4; 1.1-21.8). Sex, irregular heartbeats, and sleep medication were deleted by the logistic model.

  8. Sleep Reduces False Memory in Healthy Older Adults

    PubMed Central

    Lo, June C.; Sim, Sam K. Y.; Chee, Michael W. L.

    2014-01-01

    Study Objectives: To investigate the effects of post-learning sleep and sleep architecture on false memory in healthy older adults. Design: Balanced, crossover design. False memory was induced using the Deese-Roediger-McDermott (DRM) paradigm and assessed following nocturnal sleep and following a period of daytime wakefulness. Post-learning sleep structure was evaluated using polysomnography (PSG). Setting: Sleep research laboratory. Participants: Fourteen healthy older adults from the Singapore-Longitudinal Aging Brain Study (mean age ± standard deviation = 66.6 ± 4.1 y; 7 males). Measurements and Results: At encoding, participants studied lists of words that were semantically related to non-presented critical lures. At retrieval, they made “remember”/“know” and “new” judgments. Compared to wakefulness, post-learning sleep was associated with reduced “remember” responses, but not “know” responses to critical lures. In contrast, there were no significant differences in the veridical recognition of studied words, false recognition of unrelated distractors, discriminability, or response bias between the sleep and the wake conditions. More post-learning slow wave sleep was associated with greater reduction in false memory. Conclusions: In healthy older adults, sleep facilitates the reduction in false memory without affecting veridical memory. This benefit correlates with the amount of slow wave sleep in the post-learning sleep episode. Citation: Lo JC; Sim SK; Chee MW. Sleep reduces false memory in healthy older adults. SLEEP 2014;37(4):665-671. PMID:24744453

  9. Effect of diabetes mellitus on sleep quality

    PubMed Central

    Surani, Salim; Brito, Veronica; Surani, Asif; Ghamande, Shekhar

    2015-01-01

    Diabetes mellitus (DM) is a highly prevalent condition affecting about 347 million people worldwide. In addition to its numerous clinical implications, DM also exerts a negative effect on patient’s sleep quality. Impaired sleep quality disrupts the adequate glycemic control regarded as corner stone in DM management and also lead to many deleterious effects causing a profound impact on health related quality of life. This article outlines various factors leading to impaired sleep quality among diabetics and delineates how individual factor influences sleep. The article also discusses potential interventions and lifestyle changes to promote healthy sleep among diabetics. PMID:26131327

  10. Disruptive Students.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany.

    This paper attempts to develop guidelines relating to the problem of disruptive pupils in the classroom. A disruptive student is defined as one who interferes with the learning process. He is often male, physically aggressive, verbally hostile, over-age and frequently absent. The study examines the overlap between disruptive behavior and emotional…

  11. Disturbed dreaming and sleep quality: altered sleep architecture in subjects with frequent nightmares.

    PubMed

    Simor, Péter; Horváth, Klára; Gombos, Ferenc; Takács, Krisztina P; Bódizs, Róbert

    2012-12-01

    Nightmares are intense, emotionally negative mental experiences that usually occur during late-night sleep and result in abrupt awakenings. Questionnaire-based studies have shown that nightmares are related to impaired sleep quality; however, the polysomnographic profile of nightmare subjects has been only scarcely investigated. We investigated the sleep architecture of 17 individuals with frequent nightmares and 23 control subjects based on polysomnographic recordings of a second night spent in the laboratory after an adaptation night. Nightmare subjects in comparison with control subjects were characterized by impaired sleep architecture, as reflected by reduced sleep efficiency, increased wakefulness, a reduced amount of slow wave sleep, and increased nocturnal awakenings, especially from Stage 2 sleep. While these differences were independent of the effects of waking psychopathology, nightmare subjects also exhibited longer durations of REM sleep that was mediated by heightened negative affect. Our results support that nightmares are related to altered sleep architecture, showing impaired sleep continuity and emotion-related increase in REM propensity.

  12. Circadian Rhythms, Sleep, and Disorders of Aging

    PubMed Central

    Mattis, Joanna; Sehgal, Amita

    2016-01-01

    Sleep:wake cycles are known to be disrupted in people with neurodegenerative disorders. These findings are now supported by data from animal models for some of these disorders, raising the question of whether the disrupted sleep/circadian regulation contributes to the loss of neural function. As circadian rhythms and sleep consolidation also break down with normal aging, changes in these may be part of what makes aging a risk factor for disorders like Alzheimer's disease. Mechanisms underlying the connection between circadian/sleep dysregulation and neurodegeneration remain unclear, but several recent studies provide interesting possibilities. While mechanistic analysis is underway, it is worth considering treatment of circadian/sleep disruption as a means to alleviate symptoms of neurodegenerative disorders. PMID:26947521

  13. Circadian Rhythms, Sleep, and Disorders of Aging.

    PubMed

    Mattis, Joanna; Sehgal, Amita

    2016-04-01

    Sleep-wake cycles are known to be disrupted in people with neurodegenerative disorders. These findings are now supported by data from animal models for some of these disorders, raising the question of whether the disrupted sleep/circadian regulation contributes to the loss of neural function. As circadian rhythms and sleep consolidation also break down with normal aging, changes in these may be part of what makes aging a risk factor for disorders like Alzheimer's disease (AD). Mechanisms underlying the connection between circadian/sleep dysregulation and neurodegeneration remain unclear, but several recent studies provide interesting possibilities. While mechanistic analysis is under way, it is worth considering treatment of circadian/sleep disruption as a means to alleviate symptoms of neurodegenerative disorders.

  14. The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial

    PubMed Central

    Rocco, Michael V.; Lockridge, Robert S.; Beck, Gerald J.; Eggers, Paul W.; Gassman, Jennifer J.; Greene, Tom; Larive, Brett; Chan, Christopher T.; Chertow, Glenn M.; Copland, Michael; Hoy, Christopher D.; Lindsay, Robert M.; Levin, Nathan W.; Ornt, Daniel B.; Pierratos, Andreas; Pipkin, Mary F.; Rajagopalan, Sanjay; Stokes, John B.; Unruh, Mark L.; Star, Robert A.; Kliger, Alan S.

    2013-01-01

    Prior small studies have shown multiple benefits of frequent nocturnal hemodialysis compared to conventional three times per week treatments. To study this further, we randomized 87 patients to three times per week conventional hemodialysis or to nocturnal hemodialysis six times per week, all with single-use high-flux dialyzers. The 45 patients in the frequent nocturnal arm had a 1.82-fold higher mean weekly stdKt/Vurea, a 1.74-fold higher average number of treatments per week, and a 2.45-fold higher average weekly treatment time than the 42 patients in the conventional arm. We did not find a significant effect of nocturnal hemodialysis for either of the two coprimary outcomes (death or left ventricular mass (measured by MRI) with a hazard ratio of 0.68, or of death or RAND Physical Health Composite with a hazard ratio of 0.91). Possible explanations for the left ventricular mass result include limited sample size and patient characteristics. Secondary outcomes included cognitive performance, self-reported depression, laboratory markers of nutrition, mineral metabolism and anemia, blood pressure and rates of hospitalization, and vascular access interventions. Patients in the nocturnal arm had improved control of hyperphosphatemia and hypertension, but no significant benefit among the other main secondary outcomes. There was a trend for increased vascular access events in the nocturnal arm. Thus, we were unable to demonstrate a definitive benefit of more frequent nocturnal hemodialysis for either coprimary outcome. PMID:21775973

  15. The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial.

    PubMed

    Rocco, Michael V; Lockridge, Robert S; Beck, Gerald J; Eggers, Paul W; Gassman, Jennifer J; Greene, Tom; Larive, Brett; Chan, Christopher T; Chertow, Glenn M; Copland, Michael; Hoy, Christopher D; Lindsay, Robert M; Levin, Nathan W; Ornt, Daniel B; Pierratos, Andreas; Pipkin, Mary F; Rajagopalan, Sanjay; Stokes, John B; Unruh, Mark L; Star, Robert A; Kliger, Alan S; Kliger, A; Eggers, P; Briggs, J; Hostetter, T; Narva, A; Star, R; Augustine, B; Mohr, P; Beck, G; Fu, Z; Gassman, J; Greene, T; Daugirdas, J; Hunsicker, L; Larive, B; Li, M; Mackrell, J; Wiggins, K; Sherer, S; Weiss, B; Rajagopalan, S; Sanz, J; Dellagrottaglie, S; Kariisa, M; Tran, T; West, J; Unruh, M; Keene, R; Schlarb, J; Chan, C; McGrath-Chong, M; Frome, R; Higgins, H; Ke, S; Mandaci, O; Owens, C; Snell, C; Eknoyan, G; Appel, L; Cheung, A; Derse, A; Kramer, C; Geller, N; Grimm, R; Henderson, L; Prichard, S; Roecker, E; Rocco, M; Miller, B; Riley, J; Schuessler, R; Lockridge, R; Pipkin, M; Peterson, C; Hoy, C; Fensterer, A; Steigerwald, D; Stokes, J; Somers, D; Hilkin, A; Lilli, K; Wallace, W; Franzwa, B; Waterman, E; Chan, C; McGrath-Chong, M; Copland, M; Levin, A; Sioson, L; Cabezon, E; Kwan, S; Roger, D; Lindsay, R; Suri, R; Champagne, J; Bullas, R; Garg, A; Mazzorato, A; Spanner, E; Rocco, M; Burkart, J; Moossavi, S; Mauck, V; Kaufman, T; Pierratos, A; Chan, W; Regozo, K; Kwok, S

    2011-11-01

    Prior small studies have shown multiple benefits of frequent nocturnal hemodialysis compared to conventional three times per week treatments. To study this further, we randomized 87 patients to three times per week conventional hemodialysis or to nocturnal hemodialysis six times per week, all with single-use high-flux dialyzers. The 45 patients in the frequent nocturnal arm had a 1.82-fold higher mean weekly stdKt/V(urea), a 1.74-fold higher average number of treatments per week, and a 2.45-fold higher average weekly treatment time than the 42 patients in the conventional arm. We did not find a significant effect of nocturnal hemodialysis for either of the two coprimary outcomes (death or left ventricular mass (measured by MRI) with a hazard ratio of 0.68, or of death or RAND Physical Health Composite with a hazard ratio of 0.91). Possible explanations for the left ventricular mass result include limited sample size and patient characteristics. Secondary outcomes included cognitive performance, self-reported depression, laboratory markers of nutrition, mineral metabolism and anemia, blood pressure and rates of hospitalization, and vascular access interventions. Patients in the nocturnal arm had improved control of hyperphosphatemia and hypertension, but no significant benefit among the other main secondary outcomes. There was a trend for increased vascular access events in the nocturnal arm. Thus, we were unable to demonstrate a definitive benefit of more frequent nocturnal hemodialysis for either coprimary outcome.

  16. Vision and visual navigation in nocturnal insects.

    PubMed

    Warrant, Eric; Dacke, Marie

    2011-01-01

    With their highly sensitive visual systems, nocturnal insects have evolved a remarkable capacity to discriminate colors, orient themselves using faint celestial cues, fly unimpeded through a complicated habitat, and navigate to and from a nest using learned visual landmarks. Even though the compound eyes of nocturnal insects are significantly more sensitive to light than those of their closely related diurnal relatives, their photoreceptors absorb photons at very low rates in dim light, even during demanding nocturnal visual tasks. To explain this apparent paradox, it is hypothesized that the necessary bridge between retinal signaling and visual behavior is a neural strategy of spatial and temporal summation at a higher level in the visual system. Exactly where in the visual system this summation takes place, and the nature of the neural circuitry that is involved, is currently unknown but provides a promising avenue for future research.

  17. Duration of activity and mode of action of modafinil: Studies on sleep and wakefulness in humans.

    PubMed

    Turner, C; Belyavin, A J; Nicholson, A N

    2014-07-01

    The duration of activity of modafinil was investigated in healthy male volunteers in two double-blind crossover studies. Mode of action was explored using a statistical model concerned with the relationship between total sleep duration and that of rapid eye movement (REM) sleep. Nocturnal sleep (23:00-07:00) followed by next-day performance (09:00-17:00) was studied in 12 subjects administered 100, 200, 300 mg modafinil and placebo, 0.5 h before bedtime. Performance overnight (19:00-08:45) followed by sleep (09:15-15:15) was studied in nine subjects administered 100, 200, 300, 400 mg modafinil, 300 mg caffeine and placebo at 22:15. Modafinil dose-dependently reduced sleep duration (nocturnal: 200 mg, p<0.05; 300 mg, p<0.001; morning: 300 and 400 mg, p<0.05) and REM sleep (nocturnal: 300 mg; morning: 400 mg; p<0.05). The statistical model revealed that reduced REM sleep was due to alerting activity, with no evidence of direct suppression of REM sleep, suggesting dopaminergic activity. Enhanced performance with modafinil during overnight work varied with dose (200 mg>100 mg; 300, 400 mg>200, 100 mg, caffeine). However, in the study of next-day performance, the enhancement was attenuated at the highest dose (300 mg) by the greater disturbance of prior sleep. These findings indicate that modafinil has a long duration of action, with alerting properties arising predominantly from dopaminergic activity.

  18. [Obstructive sleep apnea syndrome in children].

    PubMed

    Aubertin, G

    2013-08-01

    Obstructive sleep apnea (OSA) is highly prevalent in school-aged children. Tonsillar and/or adenoids hypertrophy is the most common etiology of OSA in children. OSA has been associated with sleep quality disturbance (frequent arousals) and nocturnal gas-exchange abnormalities (hypoxemia and sometimes hypercapnia), complicated with a large array of negative health outcomes. The clinical symptoms are not able to distinguish primary snoring from OSA. Polysomnography remains the gold standard for the diagnosis of sleep disordered breathing, but the demand is increasing for this highly technical sleep test. So, some other simpler diagnostic methods are available, as respiratory polygraphy, but need to be validated in children. Treatment of OSA in children must be based on a mutlidisciplinary approach with pediatricians, ENT surgeons and orthodontists.

  19. Rhythmic movement disorder (head banging) in an adult during rapid eye movement sleep.

    PubMed

    Anderson, Kirstie N; Smith, Ian E; Shneerson, John M

    2006-06-01

    Sleep-related rhythmic movements (head banging or body rocking) are extremely common in normal infants and young children, but less than 5% of children over the age of 5 years old exhibit these stereotyped motor behaviors. They characteristically occur during drowsiness or sleep onset rather than in deep sleep or rapid eye movement (REM) sleep. We present a 27-year-old man with typical rhythmic movement disorder that had persisted into adult life and was restricted to REM sleep. This man is the oldest subject with this presentation reported to date and highlights the importance of recognizing this nocturnal movement disorder when it does occur in adults.

  20. Sleep apnea syndrome in the morbidly obese as an indication for weight reduction surgery.

    PubMed Central

    Peiser, J; Lavie, P; Ovnat, A; Charuzi, I

    1984-01-01

    Fifteen morbidly obese patients with Sleep Apnea Syndrome (SAS) were studied during nocturnal sleep before and between 2 to 4 months after a weight reduction surgery. Six patients were also recorded between 4 to 8 months after surgery. Postoperative recordings revealed a dramatic reduction in the sleep apnea index and an improvement in sleep motility and daytime vigilance levels. A further decrease in apneas and sleep motility was seen in the late post-treatment recording. These results indicate that weight reduction surgery is an effective definitive treatment for obesity associated SAS. PMID:6691724

  1. 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

  2. The Role of Sleep Hygiene in Promoting Public Health: A Review of Empirical Evidence

    PubMed Central

    Irish, Leah A.; Kline, Christopher E.; Gunn, Heather E.; Buysse, Daniel J.; Hall, Martica H.

    2014-01-01

    Summary The ineffectiveness of sleep hygiene as a treatment in clinical sleep medicine has raised some interesting questions. If it is known that, individually, each specific component of sleep hygiene is related to sleep, why wouldn't addressing multiple individual components (i.e., sleep hygiene education) result in improved sleep? Is there still a use for sleep hygiene? Global public health concern over poor sleep has increased the demand for effective sleep promotion strategies that are easily accessible to the general population. However, the extent to which sleep hygiene principles and strategies apply outside of clinical settings is not well known. The present review sought to evaluate the empirical evidence for several common sleep hygiene recommendations, including regular exercise, stress management, noise reduction, sleep timing regularity, and avoidance of caffeine, nicotine, alcohol, and daytime napping, with a particular emphasis on their public health utility. Thus, our review is not intended to be exhaustive regarding the clinical application of these techniques, but rather to focus on broader applications. Overall, though epidemiologic and experimental research generally supported an association between individual sleep hygiene recommendations and nocturnal sleep, the direct effects of individual recommendations on sleep remains largely untested in the general population. Suggestions for further clarification of sleep hygiene recommendations and considerations for the use of sleep hygiene in nonclinical populations are discussed. PMID:25454674

  3. The relationships among sleep efficiency, pulmonary functions, and quality of life in patients with asthma

    PubMed Central

    Yamasaki, Akira; Kawasaki, Yuji; Takeda, Kenichi; Harada, Tomoya; Fukushima, Takehito; Takata, Miki; Hashimoto, Kiyoshi; Watanabe, Masanari; Kurai, Jun; Nishimura, Koichi; Shimizu, Eiji

    2014-01-01

    Background Sleep disturbance is commonly observed in patients with asthma, especially in those with poorly controlled asthma. Evaluating sleep quality to achieve good control of asthma is important since nocturnal asthmatic symptoms such as cough, wheezing, and chest tightness may disturb sleep. Actigraphy is an objective, ambulatory monitoring method for tracking a patient’s sleep and wake activities and for assessing sleep quality, as reflected by total sleep time, sleep efficiency, duration of awakening after sleep onset (WASO), and sleep onset latency. Patients and methods Fifty patients with asthma were enrolled in this study. Sleep quality was assessed employing wristwatch-type actigraphy (Actiwatch 2). The level of asthma control was assessed by the Asthma Control Questionnaire (ACQ), and asthma-related quality of life was assessed by the Asthma Quality of Life Questionnaire (AQLQ). The parameters for sleep quality were compared using ACQ scores, AQLQ scores, and pulmonary function test results. Results The total sleep time was 387.2 minutes, WASO was 55.8 minutes, sleep efficiency was 87.01%, sleep onset latency was 8.17 minutes, and the average ACQ was 0.36. Neither sleep efficiency nor WASO correlated with respiratory functions, ACQ scores, or AQLQ scores. Conclusion Sleep-related parameters assessed by actigraphy in well-controlled asthma do not correlate with pulmonary functions, the asthma control level, or daytime quality of life. Sleep quality should be evaluated independently when asthma is well-controlled. PMID:25419157

  4. Epileptic and nonepileptic paroxysmal events out of sleep in children.

    PubMed

    Vendrame, Martina; Kothare, Sanjeev V

    2011-04-01

    The distinction between epileptic and nonepileptic events out of sleep may represent a significant challenge to the pediatrician. It is known that sleep can facilitate epileptic activity and that seizures in sleep tend to occur during specific sleep stages. Certain epilepsy syndromes have a well-documented and strong association with sleep and these can present with a variety of bizarre behaviors and motor activity. Disorders that may present with nocturnal nonepileptic paroxysmal events may include not only sleep-related disorders per se but also psychiatric/behavioral conditions"benign" paroxysmal phenomena with unrelated etiology, and nonneurologic disorders. These phenomena, especially when involving complex motor activity, such as that observed in parasomnias, nocturnal panic attacks, and rapid eye movement behavior disorders may be difficult to differentiate from seizures. Moreover, there is increasing awareness that certain sleep disorders, such as sleep-disordered breathing, may coexist with epilepsy. There are several clinical and electrographical features that allow an accurate diagnosis, and diagnostic tools such as video-EEG polysomnography may be essential.

  5. New frontiers in obstructive sleep apnoea

    PubMed Central

    AYAS, Najib T.; HIRSCH, Allen A. J.; LAHER, Ismail; BRADLEY, T. Douglas; MALHOTRA, Atul; POLOTSKY, Vsevolod Y.; TASALI, Esra

    2015-01-01

    OSA (obstructive sleep apnoea), the most common respiratory disorder of sleep, is caused by the loss of upper airway dilating muscle activity during sleep superimposed on a narrow upper airway. This results in recurrent nocturnal asphyxia. Termination of these events usually requires arousal from sleep and results in sleep fragmentation and hypoxaemia, which leads to poor quality sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences. Furthermore, patients with untreated sleep apnoea are at an increased risk of hypertension, stroke, heart failure and atrial fibrillation. Although there are many predisposing risk factors for OSA, including male gender, endocrine disorders, use of muscle relaxants, smoking, fluid retention and increased age, the strongest risk factor is obesity. The aim of the present review is to focus on three cutting-edge topics with respect to OSA. The section on animal models covers various strategies used to simulate the physiology or the effects of OSA in animals, and how these have helped to understand some of the underlying mechanisms of OSA. The section on diabetes discusses current evidence in both humans and animal models demonstrating that intermittent hypoxia and sleep fragmentation has a negative impact on glucose tolerance. Finally, the section on cardiovascular biomarkers reviews the evidence supporting the use of these biomarkers to both measure some of the negative consequences of OSA, as well as the potential benefits of OSA therapies. PMID:24780001

  6. Timing of spontaneous sleep-paralysis episodes.

    PubMed

    Girard, Todd A; Cheyne, J Allan

    2006-06-01

    The objective of this prospective naturalistic field study was to determine the distribution of naturally occurring sleep-paralysis (SP) episodes over the course of nocturnal sleep and their relation to bedtimes. Regular SP experiencers (N = 348) who had previously filled out a screening assessment for SP as well as a general sleep survey were recruited. Participants reported, online over the World Wide Web, using a standard reporting form, bedtimes and subsequent latencies of spontaneous episodes of SP occurring in their homes shortly after their occurrence. The distribution of SP episodes over nights was skewed to the first 2 h following bedtime. Just over one quarter of SP episodes occurred within 1 h of bedtime, although episodes were reported throughout the night with a minor mode around the time of normal waking. SP latencies following bedtimes were moderately consistent across episodes and independent of bedtimes. Additionally, profiles of SP latencies validated self-reported hypnagogic, hypnomesic, and hypnopompic SP categories, as occurring near the beginning, middle, and end of the night/sleep period respectively. Results are consistent with the hypothesis that SP timing is controlled by mechanisms initiated at or following sleep onset. These results also suggest that SP, rather than uniquely reflecting anomalous sleep-onset rapid eye movement (REM) periods, may result from failure to maintain sleep during REM periods at any point during the sleep period. On this view, SP may sometimes reflect the maintenance of REM consciousness when waking and SP hallucinations the continuation of dream experiences into waking life.

  7. Sleep and Adjustment in Preschool Children: Sleep Diary Reports by Mothers Relate to Behavior Reports by Teachers.

    ERIC Educational Resources Information Center

    Bates, John E.; Viken, Richard J.; Alexander, Douglas B.; Beyers, Jennifer; Stockton, Lesley

    2002-01-01

    Investigated the relationship between sleep patterns and behavioral adjustment with 4- to 5-year-old children from low-income families. Found that disrupted child sleep patterns, including variability in parentally reported amount of sleep, variability in bedtime, and lateness of bedtime, predicted less optimal adjustment in preschool, even after…

  8. Impaired off-line consolidation of motor memories after combined blockade of cholinergic receptors during REM sleep-rich sleep.

    PubMed

    Rasch, Björn; Gais, Steffen; Born, Jan

    2009-06-01

    Rapid eye movement (REM) sleep has been considered important for the consolidation of memories, particularly of procedural skills. REM sleep, in contrast to slow-wave sleep (SWS), is hallmarked by the high, wake-like activity of the neurotransmitter acetylcholine (ACh), which promotes certain synaptic plastic processes underlying the formation of memories. Here, we show in healthy young men that off-line consolidation of a motor skill during a period of late sleep with high amounts of REM sleep depends essentially on high cholinergic activity. After a 3-h sleep period during the early night to satisfy the need for SWS, subjects learned a procedural finger sequence tapping task and a declarative word-pair learning task. After learning, they received either placebo or a combination of the muscarinic receptor antagonist scopolamine (4 microg/kg bodyweight, intravenously) and the nicotinic receptor antagonist mecamylamine (5 mg, orally), and then slept for another 3 h, ie, the late nocturnal sleep period, which is dominated by REM sleep. Retrieval was tested the following evening. Combined cholinergic receptor blockade significantly impaired motor skill consolidation, whereas word-pair memory remained unaffected. Additional data show that the impairing effect of cholinergic receptor blockade is specific to sleep-dependent consolidation of motor skill and does not occur during a wake-retention interval. Taken together, these results identify high cholinergic activity during late, REM sleep-rich sleep as an essential factor promoting sleep-dependent consolidation of motor skills.

  9. The Behavioral Treatment of Childhood Nocturnal Enuresis.

    ERIC Educational Resources Information Center

    Wagner, William G.

    1987-01-01

    Notes that of the treatments attempted for nocturnal enuresis, pharmacotherapy, individual psychotherapy, and behavioral conditioning, the most effective is behavioral conditioning with a urine alarm. Reviews the enuresis literature and provides recommendations for use of the urine alarm approach. (Author/ABB)

  10. Factors influencing phototaxis in nocturnal migrating birds.

    PubMed

    Zhao, Xuebing; Chen, Mingyan; Wu, Zhaolu; Wang, Zijiang

    2014-12-01

    Many migratory bird species fly during the night (nocturnal migrants) and have been shown to display some phototaxis to artificial light. During 2006 to 2009, we investigated phototaxis in nocturnal migrants at Jinshan Yakou in Xinping County (N23°56', E101°30'; 2400 m above sea-level), and at the Niaowang Mountain in Funing County (N23°30', E105°35'; 1400 m above sea-level), both in the Yunnan Province of Southwest China. A total of 5069 birds, representing 129 species, were captured by mist-netting and artificial light. The extent of phototaxis effect on bird migration was examined during all four seasons, three phases of the moon, and under two weather conditions (mist and wind). Data were statistically analyzed to determine the extent to which these factors may impact phototaxis of nocturnal migrants. The results point to phototaxis in birds migrating in the spring and autumn, especially in the autumn. Furthermore, migrating birds were more readily attracted to artificial lights during nights with little moonlight, mist, and a headwind. Regardless of the initial orientation in which birds flew, either following the wind or against the wind, birds would always fly against the wind when flying towards the light. This study broadens our understanding of the nocturnal bird migration, potentially resulting in improved bird ringing practices, increased awareness, and better policies regarding bird protection.

  11. Sleep patterns and fatigue in new mothers and fathers.

    PubMed

    Gay, Caryl L; Lee, Kathryn A; Lee, Shih-Yu

    2004-04-01

    The purpose of this study was to describe the sleep patterns and fatigue of both mothers and fathers before and after childbirth. The authors used wrist actigraphy and questionnaires to estimate sleep and fatigue in 72 couples during their last month of pregnancy and 1st month postpartum. Both parents experienced more sleep disruption at night during the postpartum period as compared to the last month of pregnancy. Compared to fathers, with their stable 24-h sleep patterns over time, mothers had less sleep at night and more sleep during the day after the baby was born. Sleep patterns were also related to parents' work status and type of infant feeding. Both parents self-reported more sleep disturbance and fatigue during the 1st month postpartum than during pregnancy. Mothers reported more sleep disturbance than fathers, but there was no gender difference in ratings of fatigue. At both time points, fathers obtained less total sleep than mothers when sleep was objectively measured throughout the entire 24-h day. Further research is needed to determine the duration of sleep loss for both mothers and fathers, to evaluate the effect of disrupted sleep and sleep loss on psychosocial functioning and job performance, and to develop interventions for improving sleep patterns of new parents.

  12. Review article: putting immediate-release proton-pump inhibitors into clinical practice--improving nocturnal acid control and avoiding the possible complications of excessive acid exposure.

    PubMed

    Katz, P O

    2005-12-01

    Nocturnal gastro-oesphageal reflux is an under-appreciated clinical challenge. This condition may cause symptoms such as nocturnal heartburn, or it may be asymptomatic. In addition, patients may experience sleep disturbances that can potentially lead to complications such as erosive oesophagitis and Barrett's oesophagus, and may be a risk factor for development of oesophageal adenocarcinoma. Delayed-release proton-pump inhibitors (PPIs) have traditionally been effective in treating both daytime and night-time reflux symptoms, but are limited in control of nocturnal acidity by their pharmacodynamic characteristics. This narrative review addresses the prevalence, impact and pharmacologic approaches used to control nocturnal acidity. Methods to optimize nocturnal acid control include careful attention to dosing schedule, using higher doses of PPIs, adding an histamine H2-receptor antagonist at bedtime to once or twice daily delayed-release PPI, or using immediate-release omeprazole (Zegerid powder for oral suspension; Santarus, Inc., San Diego, CA, USA). This new formulation appears to provide sustained control of intragastric pH at steady state, and when dosed at bedtime, and may be effective in improving control of nocturnal pH and treating night-time GERD.

  13. Is sleep-related verbal memory consolidation impaired in sleepwalkers?

    PubMed

    Uguccioni, Ginevra; Pallanca, Olivier; Golmard, Jean-Louis; Leu-Semenescu, Smaranda; Arnulf, Isabelle

    2015-04-01

    In order to evaluate verbal memory consolidation during sleep in subjects experiencing sleepwalking or sleep terror, 19 patients experiencing sleepwalking/sleep terror and 19 controls performed two verbal memory tasks (16-word list from the Free and Cued Selective Reminding Test, and a 220- and 263-word modified story recall test) in the evening, followed by nocturnal video polysomnography (n = 29) and morning recall (night-time consolidation after 14 h, n = 38). The following morning, they were given a daytime learning task using the modified story recall test in reverse order, followed by an evening recall test after 9 h of wakefulness (daytime consolidation, n = 38). The patients experiencing sleepwalking/sleep terror exhibited more frequent awakenings during slow-wave sleep and longer wakefulness after sleep onset than the controls. Despite this reduction in sleep quality among sleepwalking/sleep terror patients, they improved their scores on the verbal tests the morning after sleep compared with the previous evening (+16 ± 33%) equally well as the controls (+2 ± 13%). The performance of both groups worsened during the daytime in the absence of sleep (-16 ± 15% for the sleepwalking/sleep terror group and -14 ± 11% for the control group). There was no significant correlation between the rate of memory consolidation and any of the sleep measures. Seven patients experiencing sleepwalking also sleep-talked during slow-wave sleep, but their sentences were unrelated to the tests or the list of words learned during the evening. In conclusion, the alteration of slow-wave sleep during sleepwalking/sleep terror does not noticeably impact on sleep-related verbal memory consolidation.

  14. Pineal melatonin and the innate immune response: the TNF-alpha increase after cesarean section suppresses nocturnal melatonin production.

    PubMed

    Pontes, Gerlândia N; Cardoso, Elaine C; Carneiro-Sampaio, Magda M S; Markus, Regina P

    2007-11-01

    The nocturnal surge of melatonin is the endocrine expression of the circadian system and is essential for organizing the timing of various endogenous processes. Previous works suggest that, in the beginning of a defense response, the increase in circulating tumor necrosis factor-alpha (TNF-alpha) leads to a transient block of nocturnal melatonin production and promotes a disruption of internal time organization. In the present paper, the concentration of melatonin and cytokines [TNF-alpha, interferon-gamma (IFN-gamma), interleukin (IL)-2, IL-4, IL-5, IL-10, IL-12] in the colostrum (postdelivery day 3) and in the milk (postdelivery days 10, 15, 20 and 30) obtained at midday and midnight from mothers who gave birth by vaginal or cesarean section were compared. The nocturnal melatonin surge observed 3 days after vaginal delivery was absent after cesarean section. IL-12 presented no daily variation in either case, while daily variations in IFN-gamma, IL-10, IL-4 and IL-5 were observed after vaginal delivery and cesarean section. On the other hand, the increase in TNF-alpha after cesarean section resulted in suppression of the nocturnal melatonin surge. Daily variation of IL-2 was only observed after recovery of the nocturnal melatonin surge, 30 days after cesarean section. The present paper supports the hypothesis of a cross-talk between the pineal gland and the immune system, which could represent a putative immune-pineal axis.

  15. Myotonic dystrophy type 1, daytime sleepiness and REM sleep dysregulation.

    PubMed

    Dauvilliers, Yves A; Laberge, Luc

    2012-12-01

    Myotonic dystrophy type 1 (DM1), or Steinert's disease, is the most common adult-onset form of muscular dystrophy. DM1 also constitutes the neuromuscular condition with the most significant sleep disorders including excessive daytime sleepiness (EDS), central and obstructive sleep apneas, restless legs syndrome (RLS), periodic leg movements in wake (PLMW) and periodic leg movements in sleep (PLMS) as well as nocturnal and diurnal rapid eye movement (REM) sleep dysregulation. EDS is the most frequent non-muscular complaint in DM1, being present in about 70-80% of patients. Different phenotypes of sleep-related problems may mimic several sleep disorders, including idiopathic hypersomnia, narcolepsy without cataplexy, sleep apnea syndrome, and periodic leg movement disorder. Subjective and objective daytime sleepiness may be associated with the degree of muscular impairment. However, available evidence suggests that DM1-related EDS is primarily caused by a central dysfunction of sleep regulation rather than by sleep fragmentation, sleep-related respiratory events or periodic leg movements. EDS also tends to persist despite successful treatment of sleep-disordered breathing in DM1 patients. As EDS clearly impacts on physical and social functioning of DM1 patients, studies are needed to identify the best appropriate tools to identify hypersomnia, and clarify the indications for polysomnography (PSG) and multiple sleep latency test (MSLT) in DM1. In addition, further structured trials of assisted nocturnal ventilation and randomized trials of central nervous system (CNS) stimulant drugs in large samples of DM1 patients are required to optimally treat patients affected by this progressive, incurable condition.

  16. Crepuscular and nocturnal illumination and its effects on color perception by the nocturnal hawkmoth Deilephila elpenor.

    PubMed

    Johnsen, Sönke; Kelber, Almut; Warrant, Eric; Sweeney, Alison M; Widder, Edith A; Lee, Raymond L; Hernández-Andrés, Javier

    2006-03-01

    Recent studies have shown that certain nocturnal insect and vertebrate species have true color vision under nocturnal illumination. Thus, their vision is potentially affected by changes in the spectral quality of twilight and nocturnal illumination, due to the presence or absence of the moon, artificial light pollution and other factors. We investigated this in the following manner. First we measured the spectral irradiance (from 300 to 700 nm) during the day, sunset, twilight, full moon, new moon, and in the presence of high levels of light pollution. The spectra were then converted to both human-based chromaticities and to relative quantum catches for the nocturnal hawkmoth Deilephila elpenor, which has color vision. The reflectance spectra of various flowers and leaves and the red hindwings of D. elpenor were also converted to chromaticities and relative quantum catches. Finally, the achromatic and chromatic contrasts (with and without von Kries color constancy) of the flowers and hindwings against a leaf background were determined under the various lighting environments. The twilight and nocturnal illuminants were substantially different from each other, resulting in significantly different contrasts. The addition of von Kries color constancy significantly reduced the effect of changing illuminants on chromatic contrast, suggesting that, even in this light-limited environment, the ability of color vision to provide reliable signals under changing illuminants may offset the concurrent threefold decrease in sensitivity and spatial resolution. Given this, color vision may be more common in crepuscular and nocturnal species than previously considered.

  17. Nocturnal Oviposition Behavior of Forensically Important Diptera in Central England.

    PubMed

    Barnes, Kate M; Grace, Karon A; Bulling, Mark T

    2015-11-01

    Timing of oviposition on a corpse is a key factor in entomologically based minimum postmortem interval (mPMI) calculations. However, there is considerable variation in nocturnal oviposition behavior of blow flies reported in the research literature. This study investigated nocturnal oviposition in central England for the first time, over 25 trials from 2011 to 2013. Liver-baited traps were placed in an urban location during control (diurnal), and nocturnal periods and environmental conditions were recorded during each 5-h trial. No nocturnal activity or oviposition was observed during the course of the study indicating that nocturnal oviposition is highly unlikely in central England.

  18. Rapid eye movement sleep behaviour disorder symptomatic of a brain stem cavernoma.

    PubMed

    Felix, Sandra; Thobois, Stephane; Peter-Derex, Laure

    2016-04-01

    A 75-year-old man complained of excessive daytime sleepiness (EDS), difficulty falling asleep and nocturnal agitation during sleep. Restless legs syndrome (RLS) was diagnosed and treated. Because of persistent EDS, snoring and nycturia, a nocturnal polysomnography (PSG) was performed. PSG showed high sleep fragmentation related to a moderate to severe obstructive sleep apnea syndrome. Continuous positive airway pressure treatment (CPAP) was proposed. Because of the persistence of abnormal nocturnal behaviours, characterized by screaming, punching and falling out of bed, a video-PSG with CPAP treatment was performed. The recording showed typical chin electromyography (EMG) activity increase associated with violent movements during rapid eye movement (REM) sleep, suggesting REM sleep behaviour disorders (RBD). Clinical neurological examination found no parkinsonian syndrome, no dysautonomic sign and no neurological focal sign. Dopamine transporter imaging [123I-FP-CIT single photon emission computed tomography (SPECT)] did not find any presynaptic dopaminergic pathways degeneration. Brain magnetic resonance imaging showed a vascular lesion suggestive of cavernoma located in the pons. The present case illustrates the complexity of sleep disturbance diagnosis with a possible entanglement of aetiologies responsible for nocturnal agitation, and confirms that an isolated pons cavernoma should be considered among the rare causes of RBD.

  19. Sleep and Performance Research Center

    DTIC Science & Technology

    2013-05-01

    factor. Karatsoreos (2012) reviewed the effect of circadian rhythm disruption on mental and physical health. Rector (2012) reviewed...circadian disruption on mental and physical health”. Current Neurology and Neuroscience Reports, 12(2):218-25. Nathaniel, T. I., Huber, R...of Fatty Acid Synthase, on Sleep and Metabolism in Mice. PLoS One, 7: e30651. Ramanathan, S., Panksepp, J., & Johnson, B. (2012). Is fibromyalgia

  20. The impact of nocturnal disturbances on daily quality of life in patients with Parkinson’s disease

    PubMed Central

    Yu, Rwei-Ling; Tan, Chun-Hsiang; Wu, Ruey-Meei

    2015-01-01

    Objectives The aims of this study were to explore nocturnal disturbances in patients with Parkinson’s disease (PD) and to assess their impact on quality of life (QoL). Methods A total of 211 patients with PD were recruited for this study, and each participant was evaluated using the mini-mental state examination, PD sleep scale – second version (PDSS-2), pittsburgh sleep quality index (PSQI), PD QoL questionnaire (PDQ), Epworth sleepiness scale, Hoehn and Yahr (H&Y) staging, and unified Parkinson’s disease rating scale (UPDRS). Multiple regression analyses were performed to determine the contribution of the predictive variables on QoL. Results There were 56.4% males (mean age: 64.08 years; disease duration: 6.02 years; H&Y stage: 2.25; and UPDRS: 33.01) in this study. Our patients’ actual sleep time was 5.96±1.16 hours and the average sleep efficiency was 82.93%±12.79%. Up to 64.4% of patients were classified as “poor” sleepers and 23.8% suffered from daytime sleepiness. The final stepwise regression model revealed that UPDRS parts I and II, the sleep disturbance and daytime dysfunction components of the PSQI, the PD symptoms at night subscale of the PDSS-2, and the levodopa equivalent dose were significant predictors of the PDQ score (R2=53, F7,165=28.746; P<0.001). Conclusion Most of the PD patients have sleep problems, and nearly one-quarter of them have abnormal daytime somnolence. The nocturnal disturbances were found to result in worse QoL in PD patients. Ethnicity-specific effects of susceptibility to sleep disturbances were discussed, and these results also highlighted the direction for further studies to explore when examining effective management programs toward these disturbances. PMID:26273203

  1. 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

  2. Nocturnal bruxing events in healthy geriatric subjects.

    PubMed

    Okeson, J P; Phillips, B A; Berry, D T; Cook, Y; Paesani, D; Galante, J

    1990-09-01

    Thirty healthy geriatric subjects were studied during a single night of sleep in a sleep laboratory. Unilateral masseter muscle activity was recorded in addition to the standard polysomnographic study. The geriatric subjects in this study exhibited fewer bruxing events than other subjects reported in the literature. Certain conditions that have not been previously investigated, such as sleep position, type of bruxing event, and relationship to the state of the dentition, are reported.

  3. Sleep Talking (Somniloquy)

    MedlinePlus

    ... Overview & Facts Symptoms & Risk Factors Diagnosis & Treatment Sleep Hallucinations Overview & Facts Symptoms & Risk Factors Diagnosis & Treatment Exploding ... Sleep Behavior Disorder Sleep Paralysis Nightmares Bedwetting Sleep Hallucinations Exploding Head Syndrome Sleep Talking Sleep Talking – Overview ...

  4. Scaling behavior of EEG amplitude and frequency time series across sleep stages

    NASA Astrophysics Data System (ADS)

    Kantelhardt, Jan W.; Tismer, Sebastian; Gans, Fabian; Schumann, Aicko Y.; Penzel, Thomas

    2015-10-01

    We study short-term and long-term persistence properties (related with auto-correlations) of amplitudes and frequencies of EEG oscillations in 176 healthy subjects and 40 patients during nocturnal sleep. The amplitudes show scaling from 2 to 500 seconds (depending on the considered band) with large fluctuation exponents during (nocturnal) wakefulness (0.73-0.83) and small ones during deep sleep (0.50-0.69). Light sleep is similar to deep sleep, while REM sleep (0.64-0.76) is closer to wakefulness except for the EEG γ band. Some of the frequency time series also show long-term scaling, depending on the selected bands and stages. Only minor deviations are seen for patients with depression, anxiety, or Parkinson's disease.

  5. Vapor Rub, Petrolatum, and No Treatment for Children With Nocturnal Cough and Cold Symptoms

    PubMed Central

    Paul, Ian M.; Beiler, Jessica S.; King, Tonya S.; Clapp, Edelveis R.; Vallati, Julie; Berlin, Cheston M.

    2013-01-01

    OBJECTIVE To determine if a single application of a vapor rub (VR) or petrolatum is superior to no treatment for nocturnal cough, congestion, and sleep difficulty caused by upper respiratory tract infection. METHODS Surveys were administered to parents on 2 consecutive days—on the day of presentation when no medication had been given the previous evening, and the next day when VR ointment, petrolatum ointment, or no treatment had been applied to their child’s chest and neck before bedtime according to a partially double-blinded randomization scheme. RESULTS There were 138 children aged 2 to 11 years who completed the trial. Within each study group, symptoms were improved on the second night. Between treatment groups, significant differences in improvement were detected for outcomes related to cough, congestion, and sleep difficulty; VR consistently scored the best, and no treatment scored the worst. Pairwise comparisons demonstrated the superiority of VR over no treatment for all outcomes except rhinorrhea and over petrolatum for cough severity, child and parent sleep difficulty, and combined symptom score. Petrolatum was not significantly better than no treatment for any outcome. Irritant adverse effects were more common among VR-treated participants. CONCLUSIONS In a comparison of VR, petrolatum, and no treatment, parents rated VR most favorably for symptomatic relief of their child’s nocturnal cough, congestion, and sleep difficulty caused by upper respiratory tract infection. Despite mild irritant adverse effects, VR provided symptomatic relief for children and allowed them and their parents to have a more restful night than those in the other study groups. PMID:21059712

  6. Do psychosocial sleep interventions improve infant sleep or maternal mood in the postnatal period? A systematic review and meta-analysis of randomised controlled trials.

    PubMed

    Kempler, Liora; Sharpe, Louise; Miller, Christopher B; Bartlett, Delwyn J

    2016-10-01

    Sleep complaints are common amongst mothers of infants and insufficient, inefficient or fragmented sleep is associated with postnatal depression. The aim of this review is to determine whether psychosocial sleep-focused interventions offered in the perinatal period improve infant sleep or maternal mood. We searched PubMed, PsycInfo, EMBASE and CINAHL with no date restriction. We reviewed 1097 articles, resulting in nine papers (n = 1,656) that fit the eligibility criteria for inclusion in the analyses. The primary outcome was infant sleep, defined as maternal reports of infant nocturnal total sleep time and number of night-time wakes. The secondary outcome was maternal mood. The meta-analysis indicated improvements in reported infant nocturnal total sleep time (Hedge's g = 0.204, p < 0.01). However, there was no evidence for reducing infant night wakes (Hedge's g = 0.103, p = 0.134). There was evidence of maternal mood improvements (Hedge's g = 0.152, p = 0.014), however, this could have been influenced by publication bias. Psychosocial sleep interventions appear to impact the amount of sleep that a mother reports her baby to have, although the infants continue to wake as frequently. More research is needed to confirm whether sleep-related improvements can translate into improvements in maternal mood.

  7. Sleep and neuromuscular disease: bilevel positive airway pressure by nasal mask as a treatment for sleep disordered breathing in patients with neuromuscular disease

    PubMed Central

    Guilleminault, C.; Philip, P.; Robinson, A.

    1998-01-01

    OBJECTIVE—Investigation of the therapeutic effects of bilevel positive airway pressure delivered by nasal mask in patients with neuromuscular disease.
METHODS—20 patients with neuromuscular disease were evaluated for symptoms of nocturnal sleep disruption. These symptoms included daytime tiredness, fatigue, sleepiness, and complaints of insomnia. The patients were studied with nocturnal polysomnograms and daytime multiple sleep latency tests (MSLT). Their immediate and long term responses to bilevel positive airway pressure were also investigated. The study took place at the Stanford University Sleep Disorders Clinic. Some of the polygraphic evaluations were performed with portable equipment in the patients' homes. The reported population comprised 20 patients, all of whom had progressive neuromuscular disease. Five of the patients were women. Four patients had muscular dystrophy, six had myotonic dystrophy, and two patients each had mitochondrial myopathy and glycogen storage disease. Two patients had post-traumatic lesions, one bulbar and the other phrenic. The remaining patients had vascular myopathy, unclassified myopathy, syringomyelia, and slow evolving spinocerebellar degeneration.
RESULTS—19 of the 20 patients accepted some form of non-invasive ventilation. All but one of these were initially maintained on bilevel positive airway pressure spontaneous (S) mode, although one patient required a switch to the timed (T) mode within a year. The mean expiratory positive airway pressure (EPAP) used was 4.5 with a range of 4 to 5 cm H2O. The mean inspiratory positive airway pressure (IPAP) was 11.5, range 9 to 14 cm H2O. Before treatment the MSLTs were ⩽ 8 minutes in 11 of the patients. The overall mean score was 8.2 (SD) 1.3 minutes. After long term treatment the mean MSLT was 12.5 (SD 2) minutes and the mean ESS score was 7 (SD 3). During the mean 3.5 years of follow up, three patients needed supplemental oxygen at a flow of 0.5 to 1.0 l/min bled into

  8. INSIGHT Responsive Parenting Intervention and Infant Sleep

    PubMed Central

    Paul, Ian M.; Savage, Jennifer S.; Anzman-Frasca, Stephanie; Marini, Michele E.; Mindell, Jodi A.; Birch, Leann L.

    2016-01-01

    OBJECTIVES Inadequate sleep during infancy is associated with adverse outcomes for infants and families. We sought to improve sleep behaviors and duration through a responsive parenting (RP) intervention designed for obesity prevention. METHODS The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study is a randomized trial comparing a RP intervention with a safety control. Primiparous mother-newborn dyads were randomized after childbirth, and research nurses delivered intervention content at home visits at infant ages 3, 16, 28, and 40 weeks and at a research center visit at 1 year. The RP sleep component included developmentally appropriate messages about bedtime routines, sleep location and behaviors, and responses to wakings. Portions of the Brief Infant Sleep Questionnaire were administered 2, 8, and 52 weeks after birth with expanded sleep-related data collection at 16 and 40 weeks. RESULTS Two hundred and seventy-nine dyads completed the first home visit; 90.7% completed the 1-year visit. Compared with controls, RP group infants were less likely to have prolonged bedtime routines >45 minutes and more likely to have earlier bedtimes at 16 and 40 weeks. They were less likely to be fed immediately before bed and more likely to self-soothe to sleep. At 8, 16, and 40 weeks, RP group nocturnal sleep duration was longer by 35, 25, and 22 minutes, respectively (P < .05 for all). Sleep duration at 1 year was similar between groups. CONCLUSIONS The INSIGHT RP intervention positively influenced developmentally appropriate bedtime routines, sleep-related behaviors, and sleep duration for infants. PMID:27354460

  9. Sleep Disturbances

    MedlinePlus

    ... middle of the night. Sleep in a cool dark place and use the bed only for sleeping ... in Parkinson's Navigating Employment, Insurance, Financial and Legal Matters PD Take Three: Tips from the Health Care ...

  10. Sleep Apnea

    MedlinePlus

    Sleep apnea is a common disorder that causes your breathing to stop or get very shallow. Breathing ... an hour. The most common type is obstructive sleep apnea. It causes your airway to collapse or ...

  11. Sleeping sickness

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/001362.htm Sleeping sickness To use the sharing features on this page, please enable JavaScript. Sleeping sickness is an infection caused by germs carried ...

  12. Sleep-related sweating in obstructive sleep apnoea: association with sleep stages and blood pressure.

    PubMed

    Arnardottir, Erna Sif; Thorleifsdottir, Bjorg; Svanborg, Eva; Olafsson, Isleifur; Gislason, Thorarinn

    2010-03-01

    The aim of this study was to investigate sleep-related sweating as a symptom of obstructive sleep apnoea (OSA). Fifteen otherwise healthy male non-smoking patients with untreated moderate-to-severe OSA underwent polysomnography, including measurements of skin and core body temperature and electrodermal activity (EDA) as an objective indicator of sweating. Evening and morning blood pressure was measured as well as catecholamines in nocturnal urine. All measurements were repeated after 3 months on successful continuous positive airway pressure (CPAP) treatment. The untreated OSA subjects had a mean (+/-SD) apnoea-hypopnoea index of 45.3 +/- 3.9 and a mean EDA index during sleep of 131.9 +/- 22.4 events per hour. Patients with higher EDA indices had higher systolic blood pressure in the evening and morning (P = 0.001 and 0.006) and lower rapid eye movement (REM) sleep percentage (P = 0.003). The EDA index decreased significantly to 78.5 +/- 17.7 in the patients on CPAP treatment (P = 0.04). The decrease correlated with lower evening systolic and diastolic blood pressure (P = 0.05 and 0.006) and an increase in REM% (P = 0.02). No relationship was observed between EDA and skin or core body temperature, or to catecholamine levels in urine. OSA patients who experience sleep-related sweating may have increased blood pressure and decreased REM sleep compared with other OSA patients. CPAP treatment appears to lower blood pressure and increase REM sleep to a higher extent in these patients compared with other OSA patients.

  13. Sleep enhances false memories depending on general memory performance.

    PubMed

    Diekelmann, Susanne; Born, Jan; Wagner, Ullrich

    2010-04-02

    Memory is subject to dynamic changes, sometimes giving rise to the formation of false memories due to biased processes of consolidation or retrieval. Sleep is known to benefit memory consolidation through an active reorganization of representations whereas acute sleep deprivation impairs retrieval functions. Here, we investigated whether sleep after learning and sleep deprivation at retrieval enhance the generation of false memories in a free recall test. According to the Deese, Roediger, McDermott (DRM) false memory paradigm, subjects learned lists of semantically associated words (e.g., "night", "dark", "coal", etc.), lacking the strongest common associate or theme word (here: "black"). Free recall was tested after 9h following a night of sleep, a night of wakefulness (sleep deprivation) or daytime wakefulness. Compared with memory performance after a retention period of daytime wakefulness, both post-learning nocturnal sleep as well as acute sleep deprivation at retrieval significantly enhanced false recall of theme words. However, these effects were only observed in subjects with low general memory performance. These data point to two different ways in which sleep affects false memory generation through semantic generalization: one acts during consolidation on the memory trace per se, presumably by active reorganization of the trace in the post-learning sleep period. The other is related to the recovery function of sleep and affects cognitive control processes of retrieval. Both effects are unmasked when the material is relatively weakly encoded.

  14. The Effect of Sleep on Children's Word Retention and Generalization

    PubMed Central

    Axelsson, Emma L.; Williams, Sophie E.; Horst, Jessica S.

    2016-01-01

    In the first few years of life children spend a good proportion of time sleeping as well as acquiring the meanings of hundreds of words. There is now ample evidence of the effects of sleep on memory in adults and the number of studies demonstrating the effects of napping and nocturnal sleep in children is also mounting. In particular, sleep appears to benefit children's memory for recently-encountered novel words. The effect of sleep on children's generalization of novel words across multiple items, however, is less clear. Given that sleep is polyphasic in the early years, made up of multiple episodes, and children's word learning is gradual and strengthened slowly over time, it is highly plausible that sleep is a strong candidate in supporting children's memory for novel words. Importantly, it appears that when children sleep shortly after exposure to novel word-object pairs retention is better than if sleep is delayed, suggesting that napping plays a vital role in long-term word retention for young children. Word learning is a complex, challenging, and important part of development, thus the role that sleep plays in children's retention of novel words is worthy of attention. As such, ensuring children get sufficient good quality sleep and regular opportunities to nap may be critical for language acquisition. PMID:27588007

  15. Neurophysiological basis of rapid eye movement sleep behavior disorder: informing future drug development.

    PubMed

    Jennum, Poul; Christensen, Julie Ae; Zoetmulder, Marielle

    2016-01-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by a history of recurrent nocturnal dream enactment behavior and loss of skeletal muscle atonia and increased phasic muscle activity during REM sleep: REM sleep without atonia. RBD and associated comorbidities have recently been identified as one of the most specific and potentially sensitive risk factors for later development of any of the alpha-synucleinopathies: Parkinson's disease, dementia with Lewy bodies, and other atypical parkinsonian syndromes. Several other sleep-related abnormalities have recently been identified in patients with RBD/Parkinson's disease who experience abnormalities in sleep electroencephalographic frequencies, sleep-wake transitions, wake and sleep stability, occurrence and morphology of sleep spindles, and electrooculography measures. These findings suggest a gradual involvement of the brainstem and other structures, which is in line with the gradual involvement known in these disorders. We propose that these findings may help identify biomarkers of individuals at high risk of subsequent conversion to parkinsonism.

  16. The Neurobiological Mechanisms and Treatments of REM Sleep Disturbances in Depression.

    PubMed

    Wang, Yi-Qun; Li, Rui; Zhang, Meng-Qi; Zhang, Ze; Qu, Wei-Min; Huang, Zhi-Li

    2015-01-01

    Most depressed patients suffer from sleep abnormalities, which are one of the critical symptoms of depression. They are robust risk factors for the initiation and development of depression. Studies about sleep electroencephalograms have shown characteristic changes in depression such as reductions in non-rapid eye movement sleep production, disruptions of sleep continuity and disinhibition of rapid eye movement (REM) sleep. REM sleep alterations include a decrease in REM sleep latency, an increase in REM sleep duration and REM sleep density with respect to depressive episodes. Emotional brain processing dependent on the normal sleep-wake regulation seems to be failed in depression, which also promotes the development of clinical depression. Also, REM sleep alterations have been considered as biomarkers of depression. The disturbances of norepinephrine and serotonin systems may contribute to REM sleep abnormalities in depression. Lastly, this review also discusses the effects of different antidepressants on REM sleep disturbances in depression.

  17. The Neurobiological Mechanisms and Treatments of REM Sleep Disturbances in Depression

    Pub