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Verbakel I, Bou Kheir G, de Rijk M, Dhondt K, Bliwise D, Pauwaert K, Monaghan T, Hervé F, Vogelaers D, Mariman A, Everaert K. Is the insomnia phenotype the common denominator in LUTS during transition periods? An expert NOPIA research group review. Neurourol Urodyn 2024; 43:1134-1146. [PMID: 38289321 DOI: 10.1002/nau.25372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 02/01/2024]
Abstract
AIMS As people age, sleep stages and characteristics transition over time, but sleep deficits can profoundly impact health and cognitive functioning. Chronic sleep deprivation is linked to impaired attention and productivity, weakened immunity, increased risk of cardiovascular disease, obesity, and mental health disorders. Insomnia, obstructive sleep apnea syndrome, hormonal changes, nocturia, neurological disorders, and life events interfere with sleep patterns and some are linked to lower urinary tract symptoms (LUTS). This NOPIA symposium on Lifelong LUTS aimed to analyze the literature on associations between sleep and LUTS, generate ideas for future research, and explore whether there is support for the concept of lifelong LUTS in relation to changes in sleep throughout the lifespan. METHODS An international panel of experts took part in an online meeting addressing the role of lifelong LUTS in relationship to sleep and the brain organized by the NOPIA research group. The manuscript summarizes existing literature, hypotheses, future research ideas, and clinical recommendations. RESULTS Insomnia, sleep fragmentation, hyperarousal, and sensory processing disorders emerged as potential factors in the relationship between sleep and LUTS. Insomnia is often a persistent factor and may have been the initial symptom; however, it is often unrecognized and/or unaddressed in healthcare settings. By recognizing insomnia as a primary driver of various health issues, including nocturia, transitional care aims to address root causes and underlying problems earlier to initiate appropriate treatment. CONCLUSIONS A multidisciplinary approach with collaboration between healthcare professionals from various disciplines, such as urology, sleep medicine, gynecology, pediatrics, and geriatrics, is needed and should include validated measurements such as the insomnia severity index and sleep and voiding diaries. Ensuring ongoing follow-up and monitoring through transitional care is crucial for individuals with persistent sleep problems and LUTS, allowing issues that arise or fluctuate over the lifespan to be addressed.
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Affiliation(s)
- Irina Verbakel
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - George Bou Kheir
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - Mathijs de Rijk
- Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Karlien Dhondt
- Department of Child and Adolescent Psychiatry, Pediatric Sleep Center, Ghent University Hospital, Ghent, Belgium
| | - Don Bliwise
- Sleep Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kim Pauwaert
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - Thomas Monaghan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - François Hervé
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - Dirk Vogelaers
- Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium
- Department of General Internal Medicine, AZ Delta, Roeselare, Belgium
| | - An Mariman
- Center for Integrative Medicine, Ghent University Hospital, Ghent, Belgium
| | - Karel Everaert
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
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Evangelista E, Leu-Semenescu S, Pizza F, Plazzi G, Dauvilliers Y, Barateau L, Lambert I. Long sleep time and excessive need for sleep: State of the art and perspectives. Neurophysiol Clin 2024; 54:102949. [PMID: 38387329 DOI: 10.1016/j.neucli.2024.102949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
The mechanisms underlying the individual need for sleep are unclear. Sleep duration is indeed influenced by multiple factors, such as genetic background, circadian and homeostatic processes, environmental factors, and sometimes transient disturbances such as infections. In some cases, the need for sleep dramatically and chronically increases, inducing a daily-life disability. This "excessive need for sleep" (ENS) was recently proposed and defined in a European Position Paper as a dimension of the hypersomnolence spectrum, "hypersomnia" being the objectified complaint of ENS. The most severe form of ENS has been described in Idiopathic Hypersomnia, a rare neurological disorder, but this disabling symptom can be also found in other hypersomnolence conditions. Because ENS has been defined recently, it remains a symptom poorly investigated and understood. However, protocols of long-term polysomnography recordings have been reported by expert centers in the last decades and open the way to a better understanding of ENS through a neurophysiological approach. In this narrative review, we will 1) present data related to the physiological and pathological variability of sleep duration and their mechanisms, 2) describe the published long-term polysomnography recording protocols, and 3) describe current neurophysiological tools to study sleep microstructure and discuss perspectives for a better understanding of ENS.
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Affiliation(s)
- Elisa Evangelista
- Sleep Disorder Unit, Carémeau Hospital, Centre Hospitalo-Universitaire de Nîmes, France; Institute for Neurosciences of Montpellier (INM), Univ Montpellier, INSERM, Montpellier, France
| | - Smaranda Leu-Semenescu
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Paris, France; Sleep Disorders Clinic, Pitié-Salpêtrière Hospital, APHP-Sorbonne University, Paris, France
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Yves Dauvilliers
- Institute for Neurosciences of Montpellier (INM), Univ Montpellier, INSERM, Montpellier, France; Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France
| | - Lucie Barateau
- Institute for Neurosciences of Montpellier (INM), Univ Montpellier, INSERM, Montpellier, France; Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France
| | - Isabelle Lambert
- APHM, Timone hospital, Sleep Unit, Epileptology and Cerebral Rhythmology, Marseille, France; Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France.
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Ingram DG, Cranford TA, Al-Shawwa B. Sleep Technology. Sleep Med Clin 2023; 18:235-244. [PMID: 37120166 DOI: 10.1016/j.jsmc.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Pediatric sleep providers frequently encounter issues related to sleep technology in clinical settings. In this review article, we discuss technical issues related to standard polysomnography, research on putative complementary novel metrics derived from polysomnographic signals as well as research on home sleep apnea testing in children and consumer sleep devices. Although developments across several of these domains are exciting, it remains a rapidly evolving area. When evaluating innovative devices and home sleep testing approaches, clinicians should be mindful of accurately interpreting diagnostic agreement statistics to apply these technologies appropriately.
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Evangelista E, Rassu AL, Barateau L, Lopez R, Chenini S, Jaussent I, Dauvilliers Y. Characteristics associated with hypersomnia and excessive daytime sleepiness identified by extended polysomnography recording. Sleep 2021; 44:6010320. [PMID: 33249509 DOI: 10.1093/sleep/zsaa264] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/19/2020] [Indexed: 12/20/2022] Open
Abstract
STUDY OBJECTIVES Hypersomnolence, defined by excessive daytime sleepiness (EDS) or excessive quantity of sleep (EQS), has been associated with increased morbidity. The aim of this study was to determine the clinical and polysomnographic characteristics associated with EQS and EDS assessed objectively during extended polysomnography recording. METHODS A total of 266 drug-free subjects (201 women; mean age: 26.5 years [16.08; 60.87]) underwent 32-h bed-rest polysomnography recording preceded by polysomnography and modified multiple sleep latency test (mMSLT). Participants were categorized according to their total sleep time (bed-rest TST ≥19 h, hypersomnia), objective EDS (mean sleep latency on MSLT ≤8 min), and self-reported EDS (Epworth sleepiness scale score >10) and EQS (≥9 h/24 h per week). RESULTS Subjects with hypersomnia were often younger, with normal sleep architecture, high nighttime sleep efficiency, and severe objective EDS. No association with sex, body mass index, Epworth sleepiness scale, EQS, and depressive symptoms was detected. Subjects with objective EDS had less EQS, higher sleep efficiency, and increased hypersomnia. Discrepancies were observed between objective and self-reported measures of sleep duration and EDS. Finally, 71 subjects were identified who had objective hypersomnia and/or EDS, no medical and psychiatric conditions and normal polysomnography parameters, and therefore met the stringent criteria of idiopathic hypersomnia, an orphan disorder. CONCLUSIONS Sleep duration and EDS should be quantified using self-reported and objective measures in a controlled procedure to differentiate long sleepers, patients with hypersomnia, and patients with idiopathic hypersomnia. This will help to better understand their biology, to identify specific biomarkers, and to assess related health outcomes.
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Affiliation(s)
- Elisa Evangelista
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department, Gui-de-Chauliac Hospital, University Montpellier, France.,Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, Montpellier, France
| | - Anna Laura Rassu
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department, Gui-de-Chauliac Hospital, University Montpellier, France
| | - Lucie Barateau
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department, Gui-de-Chauliac Hospital, University Montpellier, France.,Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, Montpellier, France
| | - Régis Lopez
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department, Gui-de-Chauliac Hospital, University Montpellier, France.,Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, Montpellier, France
| | - Sofiène Chenini
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department, Gui-de-Chauliac Hospital, University Montpellier, France
| | - Isabelle Jaussent
- Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, Montpellier, France
| | - Yves Dauvilliers
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department, Gui-de-Chauliac Hospital, University Montpellier, France.,Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, Montpellier, France
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5
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Schoch SF, Kurth S, Werner H. Actigraphy in sleep research with infants and young children: Current practices and future benefits of standardized reporting. J Sleep Res 2020; 30:e13134. [PMID: 32638500 PMCID: PMC8244022 DOI: 10.1111/jsr.13134] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 12/12/2022]
Abstract
Actigraphy is a cost‐efficient method to estimate sleep–wake patterns over long periods in natural settings. However, the lack of methodological standards in actigraphy research complicates the generalization of outcomes. A rapidly growing methodological diversity is visible in the field, which increasingly necessitates the detailed reporting of methodology. We address this problem and evaluate the current state of the art and recent methodological developments in actigraphy reporting with a special focus on infants and young children. Through a systematic literature search on PubMed (keywords: sleep, actigraphy, child *, preschool, children, infant), we identified 126 recent articles (published since 2012), which were classified and evaluated for reporting of actigraphy. Results show that all studies report on the number of days/nights the actigraph was worn. Reporting was good with respect to device model, placement and sleep diary, whereas reporting was worse for epoch length, algorithm, artefact identification, data loss and definition of variables. In the studies with infants only (n = 58), the majority of articles (62.1%) reported a recording of actigraphy that was continuous across 24 hr. Of these, 23 articles (63.9%) analysed the continuous 24‐hr data and merely a fifth used actigraphy to quantify daytime sleep. In comparison with an evaluation in 2012, we observed small improvements in reporting of actigraphy methodology. We propose stricter adherence to standards in reporting methodology in order to streamline actigraphy research with infants and young children, to improve comparability and to facilitate big data ventures in the sleep community.
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Affiliation(s)
- Sarah F Schoch
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Salome Kurth
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.,Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Helene Werner
- Psychosomatics and Psychiatry, University Children's Hospital, Zurich, Switzerland.,Division of Child and Adolescent Health Psychology, Institute of Psychology, University of Zurich, Zürich, Switzerland
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6
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Evangelista E, Lopez R, Barateau L, Chenini S, Bosco A, Jaussent I, Dauvilliers Y. Alternative diagnostic criteria for idiopathic hypersomnia: A 32-hour protocol. Ann Neurol 2018; 83:235-247. [DOI: 10.1002/ana.25141] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 01/04/2018] [Accepted: 01/08/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Elisa Evangelista
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department; Gui de Chauliac Hospital
- National Institute of Health and Medical Research U1061
- University of Montpellier; Montpellier France
| | - Régis Lopez
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department; Gui de Chauliac Hospital
- National Institute of Health and Medical Research U1061
- University of Montpellier; Montpellier France
| | - Lucie Barateau
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department; Gui de Chauliac Hospital
- National Institute of Health and Medical Research U1061
- University of Montpellier; Montpellier France
| | - Sofiene Chenini
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department; Gui de Chauliac Hospital
| | - Adriana Bosco
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department; Gui de Chauliac Hospital
| | - Isabelle Jaussent
- National Institute of Health and Medical Research U1061
- University of Montpellier; Montpellier France
| | - Yves Dauvilliers
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department; Gui de Chauliac Hospital
- National Institute of Health and Medical Research U1061
- University of Montpellier; Montpellier France
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7
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Carrier J, Semba K, Deurveilher S, Drogos L, Cyr-Cronier J, Lord C, Sekerovick Z. Sex differences in age-related changes in the sleep-wake cycle. Front Neuroendocrinol 2017; 47:66-85. [PMID: 28757114 DOI: 10.1016/j.yfrne.2017.07.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/09/2017] [Accepted: 07/19/2017] [Indexed: 02/06/2023]
Abstract
Age-related changes in sleep and circadian regulation occur as early as the middle years of life. Research also suggests that sleep and circadian rhythms are regulated differently between women and men. However, does sleep and circadian rhythms regulation age similarly in men and women? In this review, we present the mechanisms underlying age-related differences in sleep and the current state of knowledge on how they interact with sex. We also address how testosterone, estrogens, and progesterone fluctuations across adulthood interact with sleep and circadian regulation. Finally, we will propose research avenues to unravel the mechanisms underlying sex differences in age-related effects on sleep.
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Affiliation(s)
- Julie Carrier
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montréal, Québec, Canada; Département de psychologie, Université de Montréal, Montréal, Québec, Canada.
| | - Kazue Semba
- Department of Medical Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Samuel Deurveilher
- Department of Medical Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lauren Drogos
- Departments of Physiology & Pharmacology and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Jessica Cyr-Cronier
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Catherine Lord
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Zoran Sekerovick
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
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Kurth S, Lassonde JM, Pierpoint LA, Rusterholz T, Jenni OG, McClain IJ, Achermann P, LeBourgeois MK. Development of nap neurophysiology: preliminary insights into sleep regulation in early childhood. J Sleep Res 2016; 25:646-654. [PMID: 27252144 PMCID: PMC5135687 DOI: 10.1111/jsr.12427] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 04/18/2016] [Indexed: 02/05/2023]
Abstract
Although all young children nap, the neurophysiological features and associated developmental trajectories of daytime sleep remain largely unknown. Longitudinal studies of napping physiology are fundamental to understanding sleep regulation during early childhood, a sensitive period in brain and behaviour development and a time when children transition from a biphasic to a monophasic sleep-wakefulness pattern. We investigated daytime sleep in eight healthy children with sleep electroencephalography (EEG) assessments at three longitudinal points: 2 years (2.5-3.0 years), 3 years (3.5-4.0 years) and 5 years (5.5-6.0 years). At each age, we measured nap EEG during three randomized conditions: after 4 h (morning nap), 7 h (afternoon nap) and 10 h (evening nap) duration of prior wakefulness. Developmental changes in sleep were most prevalent in the afternoon nap (e.g. decrease in sleep duration by 30 min from 2 to 3 years and by 20 min from 3 to 5 years). In contrast, nap sleep architecture (% of sleep stages) remained unchanged across age. Maturational changes in non-rapid eye movement sleep EEG power were pronounced in the slow wave activity (SWA, 0.75-4.5 Hz), theta (4.75-7.75 Hz) and sigma (10-15 Hz) frequency ranges. These findings indicate that the primary marker of sleep depth, SWA, is less apparent in daytime naps as children mature. Moreover, our fundamental data provide insight into associations between sleep regulation and functional modifications in the central nervous system during early childhood.
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Affiliation(s)
- Salome Kurth
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Jonathan M Lassonde
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Lauren A Pierpoint
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Thomas Rusterholz
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
| | - Oskar G Jenni
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Ian J McClain
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Peter Achermann
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Monique K LeBourgeois
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
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Abstract
The shift from a biphasic to a monophasic sleep schedule is a fundamental milestone in early childhood. This transition, however, may result in periods of acute sleep loss as children may nap on some but not all days. Although data indicating the behavioral consequences of nap deprivation in young children are accumulating, little is known about changes to sleep neurophysiology following daytime sleep loss. This study addresses this gap in knowledge by examining the effects of acute nap deprivation on subsequent nighttime sleep electroencephalographic (EEG) parameters in toddlers. Healthy children (n=25; 11 males; ages 30–36 months) followed a strict sleep schedule for ≥5 days before sleep EEG recordings performed on 2 non-consecutive days: one after 13 h of prior wakefulness and another at the same clock time but preceded by a daytime nap. Total slow-wave energy (SWE) was computed as cumulative slow-wave activity (SWA; EEG power in 0.75–4.5 Hz range) over time. Nap and subsequent night SWE were added and compared to SWE of the night after a missed nap. During the night following a missed nap, children fell asleep faster (11.9±8.7 min versus 37.3±22.1 min; d=1.6, p=0.01), slept longer (10.1±0.7 h versus 9.6±0.6 h; d=0.7, p<0.01) and exhibited greater SWA (133.3±37.5% versus 93.0±4.7%; d=0.9, p<0.01) compared to a night after a daytime nap. SWE for combined nap and subsequent night sleep did not significantly differ from the night following nap deprivation (12141.1±3872.9 μV²*h versus 11,588±3270.8 μV²*h; d=0.6, p=0.12). However, compared to a night following a missed nap, children experienced greater time in bed (13.0±0.8 h versus 10.9±0.5 h; d=3.1, p<0.01) and total sleep time (11.2±0.8 h versus 10.1±0.7 h; d=1.4, p<0.01). Shorter sleep latency, longer sleep duration, and increased SWA in the night following a missed nap indicate that toddlers experience a physiologically meaningful homeostatic challenge after prolonged wakefulness. Whether toddlers fully recover from missing a daytime nap in the subsequent night necessitates further examination of daytime functioning. During nighttime sleep following a missed nap, 2-year-olds experience shorter sleep onset latency and increased sleep duration, slow wave sleep, slow wave activity, and slow-wave energy (cumulative slow wave activity), compared to a night of sleep following a daytime nap. Slow-wave energy is similar in 24 h sleep recordings on a day containing nap and night sleep compared to a day containing only night sleep. Children show large inter-individual variability in neurophysiological recovery from a missed nap, as measured by the sleep EEG.
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10
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Mazzotti DR, Guindalini C, Moraes WADS, Andersen ML, Cendoroglo MS, Ramos LR, Tufik S. Human longevity is associated with regular sleep patterns, maintenance of slow wave sleep, and favorable lipid profile. Front Aging Neurosci 2014; 6:134. [PMID: 25009494 PMCID: PMC4067693 DOI: 10.3389/fnagi.2014.00134] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 06/07/2014] [Indexed: 11/13/2022] Open
Abstract
Some individuals are able to successfully reach very old ages, reflecting higher adaptation against age-associated effects. Sleep is one of the processes deeply affected by aging; however few studies evaluating sleep in long-lived individuals (aged over 85) have been reported to date. The aim of this study was to characterize the sleep patterns and biochemical profile of oldest old individuals (N = 10, age 85–105 years old) and compare them to young adults (N = 15, age 20–30 years old) and older adults (N = 13, age 60–70 years old). All subjects underwent full-night polysomnography, 1-week of actigraphic recording and peripheral blood collection. Sleep electroencephalogram spectral analysis was also performed. The oldest old individuals showed lower sleep efficiency and REM sleep when compared to the older adults, while stage N3 percentage and delta power were similar across the groups. Oldest old individuals maintained strictly regular sleep-wake schedules and also presented higher HDL-cholesterol and lower triglyceride levels than older adults. The present study revealed novel data regarding specific sleep patterns and maintenance of slow wave sleep in the oldest old group. Taken together with the favorable lipid profile, these results contribute with evidence to the importance of sleep and lipid metabolism regulation in the maintenance of longevity in humans.
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Affiliation(s)
| | - Camila Guindalini
- Departamento de Psicobiologia, Universidade Federal de São Paulo São Paulo, Brazil
| | | | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo São Paulo, Brazil
| | | | - Luiz Roberto Ramos
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo São Paulo, Brazil
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11
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Tamura N, Tanaka H. Effects of sleep education with self-help treatment for elementary schoolchild with nocturnal lifestyle and irritability. Sleep Biol Rhythms 2014. [DOI: 10.1111/sbr.12055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Norihisa Tamura
- Department of Clinical Psychology; Graduate school of Psychological Sciences; Higashi-Hiroshima Hiroshima Japan
| | - Hideki Tanaka
- Department of Clinical Psychology; Faculty of Psychological Sciences; Hiroshima International University; Higashi-Hiroshima Hiroshima Japan
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12
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Fogel SM, Albouy G, Vien C, Popovicci R, King BR, Hoge R, Jbabdi S, Benali H, Karni A, Maquet P, Carrier J, Doyon J. fMRI and sleep correlates of the age-related impairment in motor memory consolidation. Hum Brain Mapp 2013; 35:3625-45. [PMID: 24302373 DOI: 10.1002/hbm.22426] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 10/25/2013] [Accepted: 10/28/2013] [Indexed: 12/14/2022] Open
Abstract
Behavioral studies indicate that older adults exhibit normal motor sequence learning (MSL), but paradoxically, show impaired consolidation of the new memory trace. However, the neural and physiological mechanisms underlying this impairment are entirely unknown. Here, we sought to identify, through functional magnetic resonance imaging during MSL and electroencephalographic (EEG) recordings during daytime sleep, the functional correlates and physiological characteristics of this age-related motor memory deficit. As predicted, older subjects did not exhibit sleep-dependent gains in performance (i.e., behavioral changes that reflect consolidation) and had reduced sleep spindles compared with young subjects. Brain imaging analyses also revealed that changes in activity across the retention interval in the putamen and related brain regions were associated with sleep spindles. This change in striatal activity was increased in young subjects, but reduced by comparison in older subjects. These findings suggest that the deficit in sleep-dependent motor memory consolidation in elderly individuals is related to a reduction in sleep spindle oscillations and to an associated decrease of activity in the cortico-striatal network.
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Affiliation(s)
- Stuart M Fogel
- The Brain & Mind Institute, Department of Psychology, Western University, London, Ontario, Canada; Functional Neuroimaging Unit, University of Montreal, Montreal, Quebec, Canada; Department of Psychology, University of Montreal, Montreal, Quebec, Canada
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Lafortune M, Gagnon JF, Latreille V, Vandewalle G, Martin N, Filipini D, Doyon J, Carrier J. Reduced slow-wave rebound during daytime recovery sleep in middle-aged subjects. PLoS One 2012; 7:e43224. [PMID: 22912833 PMCID: PMC3418233 DOI: 10.1371/journal.pone.0043224] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 07/18/2012] [Indexed: 11/19/2022] Open
Abstract
Cortical synchronization during NREM sleep, characterized by electroencephalographic slow waves (SW <4Hz and >75 µV), is strongly related to the number of hours of wakefulness prior to sleep and to the quality of the waking experience. Whether a similar increase in wakefulness length leads to a comparable enhancement in NREM sleep cortical synchronization in young and older subjects is still a matter of debate in the literature. Here we evaluated the impact of 25-hours of wakefulness on SW during a daytime recovery sleep episode in 29 young (27y ±5), and 34 middle-aged (51y ±5) subjects. We also assessed whether age-related changes in NREM sleep cortical synchronization predicts the ability to maintain sleep during daytime recovery sleep. Compared to baseline sleep, sleep efficiency was lower during daytime recovery sleep in both age-groups but the effect was more prominent in the middle-aged than in the young subjects. In both age groups, SW density, amplitude, and slope increased whereas SW positive and negative phase duration decreased during daytime recovery sleep compared to baseline sleep, particularly in anterior brain areas. Importantly, compared to young subjects, middle-aged participants showed lower SW density rebound and SW positive phase duration enhancement after sleep deprivation during daytime recovery sleep. Furthermore, middle-aged subjects showed lower SW amplitude and slope enhancements after sleep deprivation than young subjects in frontal and prefrontal derivations only. None of the SW characteristics at baseline were associated with daytime recovery sleep efficiency. Our results support the notion that anterior brain areas elicit and may necessitate more intense recovery and that aging reduces enhancement of cortical synchronization after sleep loss, particularly in these areas. Age-related changes in the quality of wake experience may underlie age-related reduction in markers of cortical synchronization enhancement after sustained wakefulness.
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Affiliation(s)
- Marjolaine Lafortune
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Jean-François Gagnon
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
- Département de psychologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Véronique Latreille
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Gilles Vandewalle
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
- Centre de recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Nicolas Martin
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
- Centre de recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Daniel Filipini
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Julien Doyon
- Centre de recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
- Centre de recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
- * E-mail:
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14
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Waterhouse J, Fukuda Y, Morita T. Daily rhythms of the sleep-wake cycle. J Physiol Anthropol 2012; 31:5. [PMID: 22738268 PMCID: PMC3375033 DOI: 10.1186/1880-6805-31-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 03/13/2012] [Indexed: 11/22/2022] Open
Abstract
The amount and timing of sleep and sleep architecture (sleep stages) are determined by several factors, important among which are the environment, circadian rhythms and time awake. Separating the roles played by these factors requires specific protocols, including the constant routine and altered sleep-wake schedules. Results from such protocols have led to the discovery of the factors that determine the amounts and distribution of slow wave and rapid eye movement sleep as well as to the development of models to determine the amount and timing of sleep. One successful model postulates two processes. The first is process S, which is due to sleep pressure (and increases with time awake) and is attributed to a 'sleep homeostat'. Process S reverses during slow wave sleep (when it is called process S'). The second is process C, which shows a daily rhythm that is parallel to the rhythm of core temperature. Processes S and C combine approximately additively to determine the times of sleep onset and waking. The model has proved useful in describing normal sleep in adults. Current work aims to identify the detailed nature of processes S and C. The model can also be applied to circumstances when the sleep-wake cycle is different from the norm in some way. These circumstances include: those who are poor sleepers or short sleepers; the role an individual's chronotype (a measure of how the timing of the individual's preferred sleep-wake cycle compares with the average for a population); and changes in the sleep-wake cycle with age, particularly in adolescence and aging, since individuals tend to prefer to go to sleep later during adolescence and earlier in old age. In all circumstances, the evidence that sleep times and architecture are altered and the possible causes of these changes (including altered S, S' and C processes) are examined.
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Affiliation(s)
- Jim Waterhouse
- Research Institute for Sport and Exercise Physiology, Liverpool John Moores University, Liverpool, UK.
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15
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Frey S, Birchler-Pedross A, Hofstetter M, Brunner P, Götz T, Münch M, Blatter K, Knoblauch V, Wirz-Justice, A, Cajochen C. Young Women With Major Depression Live on Higher Homeostatic Sleep Pressure Than Healthy Controls. Chronobiol Int 2012; 29:278-94. [DOI: 10.3109/07420528.2012.656163] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Campbell IG, Darchia N, Higgins LM, Dykan IV, Davis NM, de Bie E, Feinberg I. Adolescent changes in homeostatic regulation of EEG activity in the delta and theta frequency bands during NREM sleep. Sleep 2011; 34:83-91. [PMID: 21203377 PMCID: PMC3001800 DOI: 10.1093/sleep/34.1.83] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Slow wave EEG activity in NREM sleep decreases by more than 60% between ages 10 and 20 years. Slow wave EEG activity also declines across NREM periods (NREMPs) within a night, and this decline is thought to represent the dynamics of sleep homeostasis. We used longitudinal data to determine whether these homeostatic dynamics change across adolescence. DESIGN All-night sleep EEG was recorded semiannually for 6 years. SETTING EEG was recorded with ambulatory recorders in the subjects' homes. PARTICIPANTS Sixty-seven subjects in 2 cohorts, one starting at age 9 and one starting at age 12 years. MEASUREMENTS AND RESULTS For NREM delta (1-4 Hz) and theta (4-8 Hz) EEG, we tested whether the proportion of spectral energy contained in the first NREMP changes with age. We also tested for age changes in the parameters of the process S exponential decline. For both delta and theta, the proportion of energy in the first NREMP declined significantly across ages 9 to 18 years. Process S parameters SWA(0) and TWA(0), respectively, represent slow wave (delta) activity and theta wave activity at the beginning of the night. SWA(0) and TWA(0) declined significantly (P < 0.0001) across ages 9 to 18. CONCLUSIONS These declines indicate that the intensity of the homeostatic or restorative processes at the beginning of sleep diminished across adolescence. We propose that this change in sleep regulation is caused by the synaptic pruning that occurs during adolescent brain maturation.
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Affiliation(s)
- Ian G Campbell
- University of California Davis, Department of Psychiatry and Behavioral Sciences, Davis, CA 95618, USA.
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Abstract
The electroencephalogram (EEG) is the most common tool used in sleep research. This unit describes the methods for recording and analyzing the EEG. Detailed protocols describe recorder calibration, electrode application, EEG recording, and computer EEG analysis with power spectral analysis. Computer digitization of an analog EEG signal is discussed, along with EEG filtering and the parameters of fast Fourier transform (FFT) power spectral analysis. Sample data are provided for a typical night's analysis of EEG during NREM (non-REM) and REM sleep.
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Carrier J, Paquet J, Fernandez-Bolanos M, Girouard L, Roy J, Selmaoui B, Filipini D. Effects of caffeine on daytime recovery sleep: A double challenge to the sleep-wake cycle in aging. Sleep Med 2009; 10:1016-24. [PMID: 19342294 DOI: 10.1016/j.sleep.2009.01.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Revised: 12/18/2008] [Accepted: 01/05/2009] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Caffeine is the most widely used stimulant to counteract the effects of sleepiness, but it also produces important detrimental effects on subsequent sleep, especially when sleep is initiated at a time when the biological clock sends a strong waking signal such as during daytime. This study compares the effects of caffeine on daytime recovery sleep in young (20-30 y.) and middle-aged subjects (45-60 y.). METHODS Subjects participated in both caffeine (200mg) and placebo conditions (double-blind cross-over design), spaced one month apart. For each condition, subjects initially came to the laboratory for a nocturnal sleep episode. Daytime recovery sleep started in the morning after 25h of wakefulness. Subjects were administered either one caffeine (100mg) or placebo capsule three hours before daytime recovery sleep and the remaining dose one hour before daytime recovery sleep. RESULTS Middle-aged subjects showed greater decrements of sleep duration and sleep efficiency than young subjects during daytime recovery under placebo compared to nocturnal sleep. Caffeine decreased sleep efficiency, sleep duration, slow-wave sleep (SWS) and REM sleep during daytime recovery sleep similarly in both age groups. Caffeine also reduced N-REM sleep EEG synchronization during daytime recovery sleep (reduced delta, theta, and alpha power, and greater beta power). CONCLUSIONS The combined influence of age and caffeine made the sleep of middle-aged subjects particularly vulnerable to the circadian waking signal. We propose that lower brain synchronization due to age and caffeine produces greater difficulty in overriding the circadian waking signal during daytime sleep and leads to fragmented sleep. These results have implications for the high proportion of the population using caffeine to cope with night work and jet lag, particularly the middle-aged.
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Affiliation(s)
- Julie Carrier
- Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré-Coeur de Montréal, Que., Canada.
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Modeling slow-wave activity dynamics: Does an exponentially dampened periodic function really fit a single night of normal human sleep? Clin Neurophysiol 2008; 119:2753-61. [DOI: 10.1016/j.clinph.2008.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2007] [Revised: 08/06/2008] [Accepted: 09/08/2008] [Indexed: 11/22/2022]
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20
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Siegel JM. Do all animals sleep? Trends Neurosci 2008; 31:208-13. [PMID: 18328577 DOI: 10.1016/j.tins.2008.02.001] [Citation(s) in RCA: 253] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2007] [Revised: 02/05/2008] [Accepted: 02/05/2008] [Indexed: 01/21/2023]
Abstract
Some animals never exhibit a state that meets the behavioral definition of sleep. Others suspend or greatly reduce 'sleep' behavior for many weeks during the postpartum period or during seasonal migrations without any consequent 'sleep debt.' Rats die from one form of sleep deprivation, but sleep loss has not been shown to cause death in well-controlled studies in other vertebrate species. Some marine mammal species do not show evidence for REM sleep, and convincing evidence for this state in reptiles, fish and insects is lacking. The enormous variation in the nature of rest and sleep states across the animal kingdom and within the mammalian class has important implications for understanding the evolution and functions of sleep.
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Affiliation(s)
- Jerome M Siegel
- Department of Psychiatry, School of Medicine, University of California, Los Angeles and Neurobiology Research (151-A3), VA-GLAHS, North Hills, CA 91343, USA.
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MILNER CE, COTE KA. A dose-response investigation of the benefits of napping in healthy young, middle-aged and older adults. Sleep Biol Rhythms 2008. [DOI: 10.1111/j.1479-8425.2007.00328.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Munch M, Knoblauch V, Blatter K, Wirz-Justice A, Cajochen C. Is homeostatic sleep regulation under low sleep pressure modified by age? Sleep 2007; 30:781-92. [PMID: 17580600 PMCID: PMC1978345 DOI: 10.1093/sleep/30.6.781] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES We have previously shown that healthy older volunteers react with an attenuated frontal predominance of sleep electroen-cephalogram (EEG) delta activity in response to high sleep pressure. Here, we investigated age-related changes in homeostatic sleep regulation under low sleep pressure conditions, with respect to regional EEG differences and their dynamics. DESIGN Analysis of the sleep EEG during an 8-hour baseline night, during a 40-hour multiple nap protocol (150 minutes of wakefulness and 75 minutes of sleep) and during the following 8-hour recovery night under constant posture conditions. SETTING Centre for Chronobiology, Psychiatric University Clinics, Basel, Switzerland PARTICIPANTS Sixteen young (20-31 years) and 15 older (57-74 years) healthy volunteers INTERVENTIONS N/A. MEASUREMENTS AND RESULTS All-night EEG spectra revealed an increase in spindle activity (13-15.25 Hz) for both age groups, but only in the young did we find a significant decrease of delta activity (0.5-1.25 Hz) in response to low sleep pressure conditions, predominantly in occipital brain regions. However, delta activity during the first non-rapid eye movement (NREM) sleep episode was equally reduced in both age groups. This response lasted significantly longer in the young (across the first 2 NREM sleep episodes) than in the older participants (only the first NREM sleep episode). CONCLUSION The initial EEG delta response to low sleep pressure was similar in healthy older and young participants. Therefore, age-related sleep deteriorations cannot solely be attributed to alterations in the homeostatic sleep-regulatory system. It is, rather, the interplay of circadian and homeostatic factors of sleep regulation, which is changed with aging.
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Affiliation(s)
- Mirjam Munch
- Centre for Chronobiology, Psychiatric University Clinics, Basel, Switzerland
| | - Vera Knoblauch
- Centre for Chronobiology, Psychiatric University Clinics, Basel, Switzerland
| | - Katharina Blatter
- Centre for Chronobiology, Psychiatric University Clinics, Basel, Switzerland
| | - Anna Wirz-Justice
- Centre for Chronobiology, Psychiatric University Clinics, Basel, Switzerland
| | - Christian Cajochen
- Centre for Chronobiology, Psychiatric University Clinics, Basel, Switzerland
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Hardin KA, Seyal M, Stewart T, Bonekat HW. Sleep in Critically Ill Chemically Paralyzed Patients Requiring Mechanical Ventilation. Chest 2006; 129:1468-77. [PMID: 16778263 DOI: 10.1378/chest.129.6.1468] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE To determine sleep characteristics in patients receiving mechanical ventilation who require a neuromuscular blocking agent (NMBA). DESIGN Observational study. SETTING Adult medical ICU at a university hospital. PARTICIPANTS Eighteen patients with respiratory failure requiring mechanical ventilation were classified into three groups based on medication regimen determined a priori: intermittent sedation (IS), continuous sedation (CS), or CS and an NMBA. MEASUREMENTS Twenty-four-hour polysomnography was performed to determine sleep architecture and fragmentation. Measurement of severity of illness, laboratory indexes, patient-care interventions, and drug dosage were compared between groups, and the effects on sleep staging and fragmentation were analyzed. Sleep stages were scored manually using criteria of Rechtschaffen and Kales, as well as by a modified 50-muV voltage criteria for scoring delta activity. RESULTS All patients demonstrated abnormal sleep architecture. In each group of patients, the total sleep time (TST) was > 10 h. There was no statistical difference in the delta activity between the two scoring methods; delta activity was increased in all groups: 32.9%, 49.6%, and 43.7% in the IS, CS, and CS/NMBA groups, respectively. Patients receiving NMBAs spent 22% of the sleep period awake. Rapid eye movement sleep could not be detected in the patients receiving NMBAs and was reduced in the other two groups (3.5%). TST, sleep stage, or arousal/awakening index were not statistically correlated with either severity of illness, clinical laboratory indexes, drug dosage, patient-care interventions, or mode of mechanical ventilation. CONCLUSION TST during a 24-h period is not reduced in patients requiring mechanical ventilation. Delta activity is increased and may reflect age, drug, or a contributing metabolic process. The effect of wakefulness in patients receiving chemical paralysis on recovery and weaning from mechanical ventilation, and overall clinical outcome is unknown.
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Affiliation(s)
- Kimberly A Hardin
- Department of Internal Medicine, University of California, Davis, Sacramento, CA 95817, USA.
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Campbell IG, Higgins LM, Darchia N, Feinberg I. Homeostatic behavior of fast fourier transform power in very low frequency non-rapid eye movement human electroencephalogram. Neuroscience 2006; 140:1395-9. [PMID: 16631313 DOI: 10.1016/j.neuroscience.2006.03.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2005] [Revised: 02/08/2006] [Accepted: 03/01/2006] [Indexed: 11/29/2022]
Abstract
Basic research shows that the physiological and molecular mechanisms of very low frequency (<1 Hz) electroencephalogram (EEG) waves of non-rapid eye movement (NREM) sleep differ from those of the higher (1-4 Hz) delta frequencies. Human studies show that the across-NREM period dynamics of very low frequency and 1-4 Hz EEG also differ. These differences and the reported failure of very low frequency EEG power to increase after a night of total sleep deprivation raise the question of whether very low frequency EEG shows the other homeostatic properties established for higher delta frequencies. Here we tested the relation of very low frequency EEG power density to prior waking duration across a normal day and whether these low frequencies meet another criterion for homeostatic sleep EEG: conservation of power across a late nap and post-nap sleep. Data from 19 young adults recorded in four separate sessions of baseline, daytime nap and post-nap sleep were analyzed. Power density in very low frequency NREM EEG increased linearly when naps were taken later in the day (i.e. were preceded by longer waking durations). In the night following an 18:00 h nap, very low frequency power was reduced by roughly the amount of power in the nap. Thus, very low frequency EEG meets two major homeostatic criteria. We hypothesize that these low frequencies reflect the executive rather than the functional processes by which NREM sleep reverses the effects of waking brain activity.
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Affiliation(s)
- I G Campbell
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, CA 95616, USA.
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Münch M, Knoblauch V, Blatter K, Schröder C, Schnitzler C, Kräuchi K, Wirz-Justice A, Cajochen C. Age-related attenuation of the evening circadian arousal signal in humans. Neurobiol Aging 2005; 26:1307-19. [PMID: 16182904 DOI: 10.1016/j.neurobiolaging.2005.03.004] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2004] [Revised: 03/09/2005] [Accepted: 03/15/2005] [Indexed: 11/19/2022]
Abstract
The human circadian pacemaker maintains timing and consolidation of sleep-wake behavior by opposing the build-up of homeostatic sleep pressure during the wake episode, particularly in the evening during the 'wake maintenance zone'. We tested whether age-related changes in sleep are a consequence of a weaker circadian arousal signal in the evening. Circadian rhythms and spectral components of the sleep EEG were investigated in 17 young (20-31 year) and 15 older (57-74 year) volunteers under constant posture conditions during a 40-h nap protocol (75/150 min sleep/wake schedule). Quantitative evidence for a weaker circadian arousal signal in aging arose from significantly more sleep occurring during the wake maintenance zone and higher subjective sleepiness ratings in the late afternoon and evening in the older group. In addition, we found a diminished melatonin secretion and a reduced circadian modulation of REM sleep together with less pronounced day-night differences in the lower alpha and spindle range of sleep EEG activity in the older group. Thus, our data indicate that age-related changes in sleep propensity are clearly related to a reduced circadian signal opposing the homeostatic drive for sleep.
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Affiliation(s)
- Mirjam Münch
- Centre for Chronobiology, University Psychiatric Hospitals, Wilhelm-Kleinstr. 27, CH-4025 Basel, Switzerland
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