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Martinec Nováková L, Miletínová E, Kliková M, Bušková J. Nocturnal exposure to a preferred ambient scent does not affect dream emotionality or post-sleep core affect valence in young adults. Sci Rep 2024; 14:10369. [PMID: 38710748 DOI: 10.1038/s41598-024-60226-z] [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: 09/15/2023] [Accepted: 04/19/2024] [Indexed: 05/08/2024] Open
Abstract
Emotions experienced within sleep mentation (dreaming) affect mental functioning in waking life. There have been attempts at enhancing dream emotions using olfactory stimulation. Odors readily acquire affective value, but to profoundly influence emotional processing, they should bear personal significance for the perceiver rather than be generally pleasant. The main objective of the present sleep laboratory study was to examine whether prolonged nocturnal exposure to self-selected, preferred ambient room odor while asleep influences emotional aspects of sleep mentation and valence of post-sleep core affect. We asked twenty healthy participants (12 males, mean age 25 ± 4 years) to pick a commercially available scented room diffuser cartridge that most readily evoked positively valenced mental associations. In weekly intervals, the participants attended three sessions. After the adaptation visit, they were administered the odor exposure and odorless control condition in a balanced order. Participants were awakened five minutes into the first rapid eye movement (REM) stage that took place after 2:30 a.m. and, if they had been dreaming, they were asked to rate their mental sleep experience for pleasantness, emotional charge, and magnitude of positive and negative emotions and also to evaluate their post-sleep core affect valence. With rs < 0.20, no practically or statistically significant differences existed between exposure and control in any outcome measures. We conclude that in young, healthy participants, the practical value of olfactory stimulation with self-selected preferred scents for enhancement of dream emotions and post-sleep core affect valence is very limited.
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Affiliation(s)
- Lenka Martinec Nováková
- Department of Chemical Education and Humanities, University of Chemistry and Technology, Prague, Technická 5, 16628, Prague 6 - Dejvice, Czech Republic.
| | - Eva Miletínová
- National Institute of Mental Health, Topolová 748, 25067, Klecany, Czech Republic
- 3rd Faculty of Medicine, Charles University, Ruská 87, 10000, Prague 10, Czech Republic
| | - Monika Kliková
- National Institute of Mental Health, Topolová 748, 25067, Klecany, Czech Republic
- 3rd Faculty of Medicine, Charles University, Ruská 87, 10000, Prague 10, Czech Republic
| | - Jitka Bušková
- National Institute of Mental Health, Topolová 748, 25067, Klecany, Czech Republic
- 3rd Faculty of Medicine, Charles University, Ruská 87, 10000, Prague 10, Czech Republic
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Hu S, Chen Y, Chen J, Guo Y, Li Y, Shao Y, Yao P, Lu L, Tang X, Sun H. The insensitivity of sleep to an unfamiliar sleeping environment in patients with insomnia disorder. Sleep Breath 2024; 28:467-473. [PMID: 37747601 DOI: 10.1007/s11325-023-02914-0] [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: 05/26/2023] [Revised: 08/14/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Sleeping in an unfamiliar environment, such as a sleep laboratory, is thought to disturb sleep in healthy individuals and could express a hyperarousal state called the first night effect. Insomnia disorder (ID) is a highly prevalent health problem characterized by increased arousal during the night and daytime. Whether or not a similar phenomenon occurs in patients with ID is unclear. This study aimed to investigate the effect of an unfamiliar environment on the sleep of patients with ID. METHODS In an unfamiliar sleep laboratory, polysomnographic recording testing was performed for two consecutive nights in patients with ID and age- and sex-matched healthy control subjects (HC). We collected sleep diaries and questionnaires regarding sleep, medical conditions, psychological status, and health history. Sleep continuity and architecture in both groups were compared and analyzed for two consecutive nights. RESULTS Participants with ID (n = 39) and HC (n = 35) demonstrated differentially poor sleep on laboratory adaptation after exposure to the sleep laboratory. Patients with ID had longer rapid eye movement (REM) latency on the first night than on the second sleep night. HC showed increased duration and percentage of N1, decreased duration and percentage of N3, and decreased REM percentage during initial nights compared to subsequent nights. The other sleep variables showed no differences between the first and second sleep nights in patients with ID and HC. CONCLUSIONS An unfamiliar sleep environment does not aggravate the disruption of sleep continuity and sleep architecture but only affects the REM latency in patients with ID compared with HC.
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Affiliation(s)
- Sifan Hu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, 51 Huayuan Bei Road, Beijing, 100191, China
| | - Yun Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, 51 Huayuan Bei Road, Beijing, 100191, China
| | - Jie Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, 51 Huayuan Bei Road, Beijing, 100191, China
| | - Yupeng Guo
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, 51 Huayuan Bei Road, Beijing, 100191, China
| | - Yuezhen Li
- Department of Neuropsychiatry, Behavioral Neurology and Sleep Center, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Yan Shao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, 51 Huayuan Bei Road, Beijing, 100191, China
| | - Ping Yao
- Mental Health Institute of Inner Mongolia Autonomous Region, The Third Hospital of Inner Mongolia Autonomous Region, Hohhot, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, 51 Huayuan Bei Road, Beijing, 100191, China
| | - Xiangdong Tang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, State Key Laboratory of Biotherapy, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Hongqiang Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, 51 Huayuan Bei Road, Beijing, 100191, China.
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3
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Hu S, Shi L, Li Z, Ma Y, Li J, Bao Y, Lu L, Sun H. First-night effect in insomnia disorder: a systematic review and meta-analysis of polysomnographic findings. J Sleep Res 2024; 33:e13942. [PMID: 37254247 DOI: 10.1111/jsr.13942] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 02/20/2023] [Accepted: 05/04/2023] [Indexed: 06/01/2023]
Abstract
Polysomnographic studies have been performed to investigate the first-night effect in insomnia disorder. However, these studies have revealed discrepant findings. This meta-analysis aimed to summarise and quantify the characteristics of the first-night effect in insomnia disorder. We performed a systematic search of the PubMed, Medline, EMBASE, Web of Science and PsycINFO databases to identify studies published through October 2019. A total of 11,862 articles were identified, and seven studies with eight independent populations were included in the meta-analysis. A total of 639 patients with insomnia disorder and 171 healthy controls underwent more than 2 consecutive nights of in-laboratory polysomnography. Pooled results demonstrated that both variables of sleep continuity and sleep architecture, other than slow-wave sleep were significantly altered in the first-night effect in insomnia disorder. Furthermore, the results indicated that patients with insomnia disorder had a disruption of sleep continuity in the first-night effect, including increased sleep onset latency and reduced total sleep time, compared to healthy controls. Overall, the findings show that patients with insomnia disorder experience the first-night effect, rather than reverse first-night effect, and the profiles of the first-night effect in patients with insomnia are different from healthy controls. These indicate that an adaptation night is necessary when sleep continuity and sleep architecture is to be studied in patients with insomnia disorder. More well-designed studies with large samples are needed to confirm the results.
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Affiliation(s)
- Sifan Hu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Zhe Li
- Sleep Medicine Center, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Yundong Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jinyu Li
- Peking University Health Science Center, Beijing, China
| | - Yanping Bao
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Hongqiang Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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Shirota A, Kamimura M, Kishi A, Adachi H, Taniike M, Kato T. Discrepancies in the Time Course of Sleep Stage Dynamics, Electroencephalographic Activity and Heart Rate Variability Over Sleep Cycles in the Adaptation Night in Healthy Young Adults. Front Physiol 2021; 12:623401. [PMID: 33867997 PMCID: PMC8044772 DOI: 10.3389/fphys.2021.623401] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/12/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The aim of the present study was to characterize the cyclic sleep processes of sleep-stage dynamics, cortical activity, and heart rate variability during sleep in the adaptation night in healthy young adults. METHODS Seventy-four healthy adults participated in polysomnographic recordings on two consecutive nights. Conventional sleep variables were assessed according to standard criteria. Sleep-stage continuity and dynamics were evaluated by sleep runs and transitions, respectively. These variables were compared between the two nights. Electroencephalographic and cardiac activities were subjected to frequency domain analyses. Cycle-by-cycle analysis was performed for the above variables in 34 subjects with four sleep cycles and compared between the two nights. RESULTS Conventional sleep variables reflected lower sleep quality in the adaptation night than in the experimental night. Bouts of stage N1 and stage N2 were shorter, and bouts of stage Wake were longer in the adaptation night than in the experimental night, but there was no difference in stage N3 or stage REM. The normalized transition probability from stage N2 to stage N1 was higher and that from stage N2 to N3 was lower in the adaptation night, whereas that from stage N3 to other stages did not differ between the nights. Cycle-by-cycle analysis revealed that sleep-stage distribution and cortical beta EEG power differed between the two nights in the first sleep cycle. However, the HF amplitude of the heart rate variability was lower over the four sleep cycles in the adaptation night than in the experimental night. CONCLUSION The results suggest the distinct vulnerability of the autonomic adaptation processes within the central nervous system in young healthy subjects while sleeping in a sleep laboratory for the first time.
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Affiliation(s)
- Ai Shirota
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Mayo Kamimura
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Akifumi Kishi
- Graduate School of Education, The University of Tokyo, Bunkyo-ku, Japan
| | - Hiroyoshi Adachi
- Osaka University Hospital, Sleep Medicine Center, Suita, Japan
- Osaka University Health and Counseling Center, Toyonaka, Japan
| | - Masako Taniike
- Osaka University Hospital, Sleep Medicine Center, Suita, Japan
- Department of Child Development, Osaka University United Graduate School of Child Development, Suita, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
- Osaka University Hospital, Sleep Medicine Center, Suita, Japan
- Department of Child Development, Osaka University United Graduate School of Child Development, Suita, Japan
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Tu Q, Heitkemper MM, Jarrett ME, Buchanan DT. Sleep disturbances in irritable bowel syndrome: a systematic review. Neurogastroenterol Motil 2017; 29. [PMID: 27683238 DOI: 10.1111/nmo.12946] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 08/21/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Sleep disturbances are well-documented among persons with irritable bowel syndrome (IBS). Difficulty in falling asleep, shorter sleep time, frequent arousal and awakenings, or non-restorative sleep are the most common manifestations. Sleep disturbances are also related to a higher risk of having IBS. Some researchers have provided evidence of a positive association between poorer subjective sleep quality and increased severity and frequency in gastrointestinal (GI) symptoms in those with IBS. However, findings from studies using objective sleep and activity measures, such as polysomnography and actigraphy, are inconclusive. PURPOSE This systematic review of the literature between 1990 and 2015 evaluates the evidence of sleep disturbances in adults with IBS and their relationship with GI symptoms.
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Affiliation(s)
- Q Tu
- Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington School of Nursing, Seattle, WA, USA
| | - M M Heitkemper
- Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington School of Nursing, Seattle, WA, USA
| | - M E Jarrett
- Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington School of Nursing, Seattle, WA, USA
| | - D T Buchanan
- Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington School of Nursing, Seattle, WA, USA
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Rotenberg VS. Search Activity Concept: Relationship between Behavior, Health and Brain Functions. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/bf03379921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Search activity concept provides a new classification of the behavior which distinguishes search activity (activity in the uncertain situation with the constant feedback between behavior and its outcome), stereotyped behavior with a definite probability forecast, panic (activity without feedback between activity and its outcome) and renunciation of search. Only search activity which includes fight, flight, orienting behavior and creativity raises the body’s resistance to stress, to natural and experimentally induced pathology whereas renunciation of search which display itself in freezing, helplessness and depression forms a nonspecific predisposition to somatic disturbances (e.g. psychosomatic diseases). Dreams in REM sleep are regarded as a specific form of search activity aimed at compensating for the lack of search in waking. REM sleep deprivation on a small as well as on rotating platform raises the requirement in REM sleep by frustrating search activity. It is suggested that in wakefulness characterized by the prominent search activity the inhibitory alpha-2- adrenoreceptors became less sensitive to stimulation and consequently in this state the activity of the brain monoamine neurons is less limited by the level of brain monoamines. During renunciation of search brain monoamine synthesis is not stimulated by monoamine exhaustion. In REM sleep the critical level of brain monoamines for search activity to start is lower than in wakefulness and alpha-2-adrenoreceptors are less sensitive than in the state of renunciation of search although more sensitive than during search behavior in waking. REM sleep indirectly contributes to memory consolidation by carrying out its main function — restoration of search activity. A functionally sufficient REM sleep contains search activity in dreams (subject is active in his/her own dream scenario) while in functionally insufficient REM sleep dreams are characterized by subject’s passive position and feeling of helplessness. REM sleep insufficiency is an obligate condition for mental and somatic disorders to appear. The difference between normal (adaptive) and pathological (maladaptive) emotional tension is determined by the presence or absence of search activity in the structure of emotional tension. Repression of the unacceptable motive causing neurotic anxiety is a human variant of renunciation of search. Hypochondriac symptoms are in negative relationships with psychosomatic disorders and they, as well as positive symptoms in schizophrenia and anorectic behavior in anorexia nervosa, represent a pathological misdirected search activity.
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Abstract
OBJECTIVES Evidence of a 'first night effect' has been documented for polysomnography. The possibility of this has not been previously assessed in wrist actigraphy, yet may have important implications for the study design of future sleep research. We sought to examine potential evidence of a 'first night effect' for wrist actigraphy in adolescents across weekdays and weekend nights for multiple sleep outcomes. DESIGN 3-year prospective cohort study (Midlands Adolescent Schools Sleep Education Study). SETTING 8 secondary schools in the Midlands region of the UK. PARTICIPANTS Adolescents (aged 11-13 years at baseline) were recruited to the study and were requested to wear a wrist actigraph for 7 consecutive days/nights at baseline and then annually for 2 years during the second term of the academic year. PRIMARY OUTCOME MEASURES We compared multiple sleep outcomes (total sleep time, wake after sleep onset, sleep efficiency, sleep onset latency, number of awakenings, length of awakenings, sleep onset time) when the device was worn on a weekday and weekend and compared these to other nights to identify possible evidence of a 'first night effect' for wrist actigraphy. RESULTS No significant differences were found between any sleep outcomes when the first night of wrist actigraphy was on a weekday compared with other weekdays. When the first night was measured on a weekend (Friday), average total sleep time was significantly greater (486±5 min) compared with the second night (Saturday; 469±6 min), p=0.01. CONCLUSIONS We found no evidence to support a 'first night effect' for wrist actigraphy in our adolescent sample. The first night of actigraphy data should not be disregarded in future studies that deploy this technique to measure sleep over prolonged time periods.
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Affiliation(s)
- Teresa Arora
- Department of Medicine and Clinical Research Core, Weill Cornell Medicine in New York USA, Doha, Qatar
| | - Omar M Omar
- Department of Medicine and Clinical Research Core, Weill Cornell Medicine in New York USA, Doha, Qatar
| | - Shahrad Taheri
- Department of Medicine and Clinical Research Core, Weill Cornell Medicine in New York USA, Doha, Qatar
- Department of Medicine, King's College London, London, UK
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Baglioni C, Nanovska S, Regen W, Spiegelhalder K, Feige B, Nissen C, Reynolds CF, Riemann D. Sleep and mental disorders: A meta-analysis of polysomnographic research. Psychol Bull 2016; 142:969-990. [PMID: 27416139 DOI: 10.1037/bul0000053] [Citation(s) in RCA: 502] [Impact Index Per Article: 62.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Investigating sleep in mental disorders has the potential to reveal both disorder-specific and transdiagnostic psychophysiological mechanisms. This meta-analysis aimed at determining the polysomnographic (PSG) characteristics of several mental disorders. Relevant studies were searched through standard strategies. Controlled PSG studies evaluating sleep in affective, anxiety, eating, pervasive developmental, borderline and antisocial personality disorders, attention-deficit-hyperactivity disorder (ADHD), and schizophrenia were included. PSG variables of sleep continuity, depth, and architecture, as well as rapid-eye movement (REM) sleep were considered. Calculations were performed with the "Comprehensive Meta-Analysis" and "R" software. Using random effects modeling, for each disorder and each variable, a separate meta-analysis was conducted if at least 3 studies were available for calculation of effect sizes as standardized means (Hedges' g). Sources of variability, that is, sex, age, and mental disorders comorbidity, were evaluated in subgroup analyses. Sleep alterations were evidenced in all disorders, with the exception of ADHD and seasonal affective disorders. Sleep continuity problems were observed in most mental disorders. Sleep depth and REM pressure alterations were associated with affective, anxiety, autism and schizophrenia disorders. Comorbidity was associated with enhanced REM sleep pressure and more inhibition of sleep depth. No sleep parameter was exclusively altered in 1 condition; however, no 2 conditions shared the same PSG profile. Sleep continuity disturbances imply a transdiagnostic imbalance in the arousal system likely representing a basic dimension of mental health. Sleep depth and REM variables might play a key role in psychiatric comorbidity processes. Constellations of sleep alterations may define distinct disorders better than alterations in 1 single variable. (PsycINFO Database Record
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Affiliation(s)
| | | | - Wolfram Regen
- Department of Clinical Psychology and Psychophysiology
| | | | - Bernd Feige
- Department of Clinical Psychology and Psychophysiology
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Lee DH, Cho CH, Han C, Bok KN, Moon JH, Lee E, Lee HJ, Kim L. Sleep Irregularity in the Previous Week Influences the First-Night Effect in Polysomnographic Studies. Psychiatry Investig 2016; 13:203-9. [PMID: 27081381 PMCID: PMC4823196 DOI: 10.4306/pi.2016.13.2.203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 06/22/2015] [Accepted: 06/26/2015] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The first-night effect is a well-known phenomenon resulting from an individual's maladaptation to the unfamiliar environment of a sleep laboratory. However, there have been no direct reports of the effect of previous sleep patterns on the first-night effect. We aimed to investigate the effect the previous week's sleep pattern on the first-night effect. METHODS Twenty-four young, healthy, male participants completed the study procedure. During one week prior to study, the participants kept sleep diaries and wore actigraphs to identify sleep-wake pattern. Two consecutive nights of polysomnography were conducted after that. Wilcoxon signed-rank tests were applied to compare sleep variables of the two nights. Variance (standard deviation) of sleep onset time during the previous week was used as an index of irregularity. A Kendall's ranked correlation analysis and a linear regression test were applied to detect correlation between sleep irregularity and the first-night effect measured by polysomnography. RESULTS There were significant differences in the values of sleep efficiency (p=0.011) and wake after sleep onset (WASO) (p=0.006) between the two nights. Sleep efficiency was lower and WASO was higher on the first night as compared to the second night. Sleep irregularity in the previous week was negatively correlated with sleep efficiency (p<0.001) of the first night, but was not significantly correlated with any other sleep parameters. CONCLUSION We replicated the existence of the first-night effect commonly observed in sleep studies. Sleep irregularity in the previous week may influence the first-night effect in polysomnographic studies.
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Affiliation(s)
- Da-Hye Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chul-Hyun Cho
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ki-Nam Bok
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jung Ho Moon
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eunil Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Leen Kim
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
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Hirscher V, Unbehaun T, Feige B, Nissen C, Riemann D, Spiegelhalder K. Patients with primary insomnia in the sleep laboratory: do they present with typical nights of sleep? J Sleep Res 2015; 24:383-9. [PMID: 25659408 DOI: 10.1111/jsr.12280] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 12/20/2014] [Indexed: 10/24/2022]
Abstract
The validity of sleep laboratory investigations in patients with insomnia is important for researchers and clinicians. The objective of this study was to examine the first-night effect and the reverse first-night effect in patients with chronic primary insomnia compared with good sleeper controls. A retrospective comparison of a well-characterised sample of 50 patients with primary insomnia and 50 good sleeper controls was conducted with respect to 2 nights of polysomnography, and subjective sleep parameters in the sleep laboratory and the home setting. When comparing the first and second sleep laboratory night, a significant first-night effect was observed across both groups in the great majority of the investigated polysomnographic and subjective variables. However, patients with primary insomnia and good sleeper controls did not differ with respect to this effect. Regarding the comparison between the sleep laboratory nights and the home setting, unlike good sleeper controls, patients with primary insomnia reported an increased subjective sleep efficiency on both nights (in part due to a reduced bed time) and an increased subjective total sleep time on the second night. These results suggest that even the second sleep laboratory night does not necessarily provide clinicians and researchers with a representative insight into the sleep perception of patients with primary insomnia. Future studies should investigate whether these findings also hold for other patient populations.
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Affiliation(s)
- Verena Hirscher
- Division of Psychosomatic Medicine, Kantonspital St. Gallen, St. Gallen, Switzerland
| | - Thomas Unbehaun
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany
| | - Christoph Nissen
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany
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Tamaki M, Bang JW, Watanabe T, Sasaki Y. The first-night effect suppresses the strength of slow-wave activity originating in the visual areas during sleep. Vision Res 2014; 99:154-61. [PMID: 24211789 PMCID: PMC4013254 DOI: 10.1016/j.visres.2013.10.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 10/29/2013] [Accepted: 10/30/2013] [Indexed: 01/12/2023]
Abstract
Our visual system is plastic and adaptive in response to the stimuli and environments we experience. Although visual adaptation and plasticity have been extensively studied while participants are awake, little is known about what happens while they are asleep. It has been documented that sleep structure as measured by sleep stages using polysomnography is altered specifically in the first sleep session due to exposure to a new sleep environment, known as the first-night effect (FNE). However, the impact of the FNE on spontaneous oscillations in the visual system is poorly understood. How does the FNE affect the visual system during sleep? To address this question, the present study examined whether the FNE modifies the strength of slow-wave activity (SWA, 1-4Hz)-the dominant spontaneous brain oscillation in slow-wave sleep-in the visual areas. We measured the strength of SWA originating in the visual areas during the first and the second sleep sessions. Magnetoencephalography, polysomnography, and magnetic resonance imaging were used to localize the source of SWA to the visual areas. The visual areas were objectively defined using retinotopic mapping and an automated anatomical parcellation technique. The results showed that the strength of SWA was reduced in the first sleep session in comparison to the second sleep session, especially during slow-wave sleep, in the ventral part of the visual areas. These results suggest that environmental novelty may affect the visual system through suppression of SWA. The impact of the FNE may not be negligible in vision research.
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Affiliation(s)
- Masako Tamaki
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Box 1821, 190 Thayer Street, Providence, RI 02912, USA.
| | - Ji Won Bang
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Box 1821, 190 Thayer Street, Providence, RI 02912, USA.
| | - Takeo Watanabe
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Box 1821, 190 Thayer Street, Providence, RI 02912, USA.
| | - Yuka Sasaki
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Box 1821, 190 Thayer Street, Providence, RI 02912, USA.
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Newell J, Mairesse O, Verbanck P, Neu D. Is a one-night stay in the lab really enough to conclude? First-night effect and night-to-night variability in polysomnographic recordings among different clinical population samples. Psychiatry Res 2012; 200:795-801. [PMID: 22901399 DOI: 10.1016/j.psychres.2012.07.045] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 06/20/2012] [Accepted: 07/29/2012] [Indexed: 11/28/2022]
Abstract
While polysomnography remains the current gold standard in sleep investigation, guidelines for single night versus consecutive recordings in a sleep laboratory have been disputed mainly because of two phenomena: the first-night effect and night-to-night variability. One hundred and twenty nine subjects, that underwent two consecutive nights of polysomnographic recording in a general University Hospital's sleep lab, were divided into four groups: sleep-related breathing disorders (SRBD), insomnia, movement and behavioral disorders and a healthy control (HC) group based on their complaints at admission and sleep study results. Sleep parameters of both consecutive two nights were compared and analyzed. All groups showed a significant first-night effect. However the latter seemed more pronounced in the insomnia group. Furthermore, a clinically significant intra-patient night-to-night variability was found for the apnea-hypopnea index in the SRBD-group. Due to the observed first-night effect among any subject group and the potential impact of night-to-night variability of the apnea-hypopnea index, we conclude that the clinical assessment of sleep disorders should be similar in every patient. Hence, the present study underlines the importance of two consecutive nights of polysomnographic recording as a potential reference standard for the execution of sleep investigations.
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Affiliation(s)
- Johan Newell
- UZ Brussel Academic University Hospital, Department of Psychiatry, Vrije Universiteit Brussel (V.U.B.), Brussels, Belgium.
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Elwan M, Rashed N, El Hamrawy L, Fekry M, Asaad T, Shalaby A. Polysomnographic assessment of patients with somatoform disorder in comparison with patients with major depressive disorder. MIDDLE EAST CURRENT PSYCHIATRY 2012. [DOI: 10.1097/01.xme.0000412996.88257.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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McCall C, McCall WV. Objective vs. subjective measurements of sleep in depressed insomniacs: first night effect or reverse first night effect? J Clin Sleep Med 2012; 8:59-65. [PMID: 22334811 PMCID: PMC3266334 DOI: 10.5664/jcsm.1664] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES This study examined changes in sleep parameters between the laboratory and the home setting before and after laboratory monitoring in depressed insomniacs undergoing treatment. METHODS This study was a post hoc analysis of a double-blind, randomized, placebo-controlled clinical trial performed with 60 depressed, insomniac outpatients. Patients underwent actigraphic monitoring along with sleep diaries over a continuous 2-week period. After one week of baseline monitoring, subjects spent one night in the laboratory with concurrent actigraphic and PSG monitoring with sleep diaries. Actigraphic monitoring and sleep diaries were continued for another week at home, along with initiation of open-label fluoxetine (FLX). RESULTS Actigraphically recorded laboratory sleep during the night in the laboratory was found to be improved relative to actigraphically recorded sleep at home, with less wake time and greater sleep time and sleep efficiency occurring in the laboratory. In contrast, sleep diaries indicated a slight worsening of sleep in the laboratory compared to home, with significantly more awakenings in the laboratory compared to the week at home before and after the laboratory night. CONCLUSIONS The differences between objective and subjective sleep measurements seen in depressed insomniacs may be influenced by the monitoring setting and measurement modality. CLINICAL TRIAL INFORMATION ClinicalTrials.gov Identifier: NCT00247624.
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Affiliation(s)
- Catherine McCall
- Department of Psychiatry and Behavioral Medicine, Wake Forest University Health Sciences, Winston-Salem, NC 27157, USA.
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Affiliation(s)
- V S Rotenberg
- Department of Psychiatry, Tel Aviv University, Tel Aviv, Israel.
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Verhulst SL, Schrauwen N, De Backer WA, Desager KN. First night effect for polysomnographic data in children and adolescents with suspected sleep disordered breathing. Arch Dis Child 2006; 91:233-7. [PMID: 16352624 PMCID: PMC2065916 DOI: 10.1136/adc.2005.085365] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2005] [Indexed: 11/04/2022]
Abstract
AIMS To assess the presence of a first night effect (FNE) in children and adolescents and to examine if a single night polysomnography (PSG) is sufficient for diagnosing obstructive sleep apnoea syndrome (OSAS). METHODS Prospective case study of 70 patients (group 1: 2-6 years, n = 22; group 2: 7-12 years, n = 32; group 3: 13-17 years, n = 16) referred for OSAS. Diagnostic criteria for OSAS: one or more of the following: (1) obstructive apnoea index (OAI) > or =1; (2) obstructive apnoea hypopnoea index (oAHI) > or =2; (3) SaO2 < or =89% in association with obstruction. RESULTS In all age groups, but mainly in the oldest children, REMS increased during the second night, mainly at the expense of stage 2 sleep. The first night PSG correctly identified OSAS in 86%, 91%, and 100% of the children for groups 1, 2, and 3 respectively. This represents 9% false negatives for OSAS when only the first night PSG was used. All cases missed had mild OSAS, except for one with oAHI >5 on night 2. There were also seven patients with OSAS on night 1 but with a normal PSG on night 2: all had oAHI <5. CONCLUSION There is a FNE in children and adolescents. A single night PSG is sufficient for diagnosing OSAS, but in cases with a suggestive history and examination and with a negative first night, a second night study might be advisable.
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Affiliation(s)
- S L Verhulst
- Department of Pediatrics, University Hospital of Antwerp, Belgium.
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Shen J, Chung SA, Kayumov L, Moller H, Hossain N, Wang X, Deb P, Sun F, Huang X, Novak M, Appleton D, Shapiro CM. Polysomnographic and symptomatological analyses of major depressive disorder patients treated with mirtazapine. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2006; 51:27-34. [PMID: 16491981 DOI: 10.1177/070674370605100106] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aimed to characterize the effects of mirtazapine on polysomnographic sleep, especially slow wave sleep (SWS) and rapid eye movement (REM) sleep, as well as its effects on clinical symptoms in patients with major depressive disorder (MDD). METHOD Sixteen MDD patients were treated with mirtazapine 30 mg taken 30 minutes before bedtime. Polysomnographic and subjective sleep, as well as other clinical data, were collected at baseline and on Days or Nights 2, 9, 16, 30, and 58 during treatment. We used repeated measures analysis of variance, including pairwise comparison, to analyze data statistically. RESULTS Mirtazapine administration increased total SWS and the SWS in the first sleep cycle, but not SWS in the second sleep cycle. The medication increased REM latency and the duration of the first REM episode; it also decreased the number of REM episodes. Simultaneously, mirtazapine significantly reduced wake-after-sleep onset and scores on the Athens Insomnia Scale. After patients took the medication, scores on the Hamilton Depression Rating Scale-17 (HDRS-17) decreased rapidly and continuously. The changes on the Beck Depression Inventory-II were consistent with those on the HDRS-17. The medication has a tendency to increase weight. CONCLUSIONS Mirtazapine significantly improved sleep quality, reversed sleep markers of depression, and reduced depressive symptoms in this group of MDD patients.
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Affiliation(s)
- Jianhua Shen
- Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario.
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Curcio G, Ferrara M, Piergianni A, Fratello F, De Gennaro L. Paradoxes of the first-night effect: a quantitative analysis of antero-posterior EEG topography. Clin Neurophysiol 2004; 115:1178-88. [PMID: 15066543 DOI: 10.1016/j.clinph.2003.12.018] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2003] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The first-night effect (FNE) is a common issue in sleep research. Being considered fragmented and poorly efficient, the adaptation night is discarded for data analysis. The present study aims to provide a quantitative and topographical EEG analysis of this phenomenon. METHODS Eight healthy subjects slept for two consecutive nights (adaptation (AD) and baseline (BSL)), and their polysomnography was visually scored and then submitted to spectral power analysis. RESULTS The results showed a decreased quality and quantity of first-night sleep as indicated by more stage 1 and intrasleep wake, paralleled by a reduced sleep efficiency and a longer sleep onset latency. On the other hand, EEG quantitative data showed a more complex and apparently paradoxical picture. An increase in delta power was observed, particularly over the central areas during the first night, paralleled by an increased power in beta bin frequencies solely at posterior scalp locations. CONCLUSIONS These results have been interpreted as caused by, respectively, a reduced total sleep time during the adaptation night and a cortical hyperactivity, typical of psychophysiological insomnia. The present results confirm the need to exclude the laboratory sleep adaptation night from data analysis since it is not a reliable index of sleep on subsequent nights as regards both visual scoring and quantitative EEG analysis. Finally, regional differences between REM and NREM sleep have been confirmed. SIGNIFICANCE This is the first attempt to evaluate the FNE with a quantitative approach to the antero-posterior EEG topography, providing both a Hz-by-Hz and a classical EEG band-based analysis.
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Affiliation(s)
- Giuseppe Curcio
- Laboratorio di Psicofisiologia del Sonno, Department of Psychology, University of Rome La Sapienza, Via dei Marsi 78, 00185 Rome, Italy.
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Abstract
The question as to whether the beneficial effect of sleep deprivation in depression is related to the increased wakefulness or to the sleep suppression by itself, is made moot by the search activity concept. According to this concept, rapid eye movement (REM) sleep is functionally deficient in depression and increases feelings of helplessness and hopelessness instead of restoring mood and search activity. Thus, REM sleep deprivation, either selective or not, is beneficial by breaking a vicious circle: depression in wakefulness…giving up (helplessness) in dream scenario…increased depression in the subsequent wakefulness. In addition, sleep deprivation is an important challenge for the depressed patient. The ability to confront this challenge and maintain wakefulness has a positive outcome on depression, especially when wakefulness is accompanied by active behavior.
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Rotenberg VS, Shami E, Barak Y, Indursky P, Kayumov L, Mark M. REM sleep latency and wakefulness in the first sleep cycle as markers of major depression: a controlled study vs. schizophrenia and normal controls. Prog Neuropsychopharmacol Biol Psychiatry 2002; 26:1211-5. [PMID: 12452549 DOI: 10.1016/s0278-5846(02)00216-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION REM sleep latency is a clinically significant sleep variable that is found to be decreased in several psychiatric disorders. However, it is not known whether alteration of REM sleep latency is similar across disorders. In order to test whether incorporation of wakefulness in the first sleep cycle has a different outcome on REM sleep latency in different clinical groups, the authors have investigated correlation between sleep variables in the first sleep cycle in 25 patients with major depression, 24 patients with chronic schizophrenia, and in 10 healthy subjects. RESULTS REM sleep latency correlates with the duration of wakefulness in the first cycle in patients suffering from chronic schizophrenia and in healthy subjects. This correlation does not hold true in patients suffering from major depression. CONCLUSION Wakefulness incorporated in the first cycle influences REM sleep latency in healthy subjects and in patients suffering from chronic schizophrenia but not in patients suffering from major depression. This finding further supports the evidence that reduced REM sleep latency is a nonflexible marker of depression.
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Shamir E, Rotenberg VS, Laudon M, Zisapel N, Elizur A. First-night effect of melatonin treatment in patients with chronic schizophrenia. J Clin Psychopharmacol 2000; 20:691-4. [PMID: 11106143 DOI: 10.1097/00004714-200012000-00017] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The first-night effect (FNE) is the tendency for individuals to sleep worse than normal during their first night of polysomnographic sleep evaluation. FNE reflects the adaptive increase of alertness and perhaps the stress resulting from an unfamiliar sleeping environment. This effect is usually absent in patients with chronic schizophrenia. Melatonin (N-acetyl-5-methoxy-tryptamine), the hormone secreted by the pineal gland at night, has been found to improve sleep in elderly patients with insomnia and recently in patients with chronic schizophrenia. The authors used FNE as a marker to explore the neurobehavioral responses of patients with chronic schizophrenia to melatonin treatment. In a randomized, double-blind, crossover trial, 14 patients with chronic schizophrenia were administered melatonin (2 mg in a controlled-release formulation) or placebo for 3 weeks with a 1-week washout between treatment periods. Polysomnography was performed during the last two consecutive nights of each treatment period. The following significant FNEs were observed with melatonin treatment: (1) rapid eye movement sleep latency was longer; (2) sleep efficiency was lower; and (3) the duration of wakefulness during sleep was lower on the first night than on the second night. These effects were not found when the patients received a placebo. The FNE was manifested regardless of whether melatonin was administered before or after the placebo treatment period. For the first time, these results show that melatonin treatment exaggerates FNE in patients with chronic schizophrenia, thereby suggesting an improved ability of these patients to mobilize alertness in unfamiliar surroundings.
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Affiliation(s)
- E Shamir
- Abarbanel Mental Health Center, Tel-Aviv University, Israel
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Rotenberg VS, Indursky P, Kayumov L, Sirota P, Melamed Y. The relationship between subjective sleep estimation and objective sleep variables in depressed patients. Int J Psychophysiol 2000; 37:291-7. [PMID: 10858574 DOI: 10.1016/s0167-8760(00)00110-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION To our knowledge there is no evidence in the literature about the relationship between subjective sleep estimation and objective sleep variables in depression. It is not known whether the subjective estimation of sleep quality and sleep duration is directly related to any objective sleep variable in depressed patients. METHODS Thirty patients with major depression and 10 healthy subjects have been investigated in our sleep laboratory during 1 or 2 consecutive nights after 1 night for adaptation. Every subject, after final awakening in the laboratory, answered questions concerning the subjective feelings about sleep duration, number of awakenings and sleep depth. We compared the sleep estimation in both groups and calculated the correlation between objective and subjective sleep variables in depressed patients. RESULTS The degree of a wrong sleep estimation in depressed patients is larger than in healthy subjects. Slow wave sleep (SWS) in depressed patients correlates positively with the subjective estimation of sleep duration. Eye movement density in REM sleep correlates with the subjective estimation of the number of awakenings. CONCLUSION SWS in depression has a positive influence on the subjective feeling of sleep duration while phasic REM sleep activity has a negative influence.
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Affiliation(s)
- V S Rotenberg
- Sackler School of Medicine, Tel-Aviv University, The Y. Abarbanel Mental Health Center, 15 Keren Kayemet St., 59100, Bat-Yam, Israel
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Kirveskari E, Partinen M, Salmi T, Sainio K, Telakivi T, Hämäläinen M, Larsen A, Santavuori P. Sleep alterations in juvenile neuronal ceroid-lipofuscinosis. Pediatr Neurol 2000; 22:347-54. [PMID: 10913725 DOI: 10.1016/s0887-8994(00)00138-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In juvenile neuronal ceroid-lipofuscinosis (JNCL), sleep disorders are common. The purpose of this study was to investigate the sleep structure of 28 patients with JNCL compared with healthy controls subjects and to clarify the pathophysiology underlying the sleep disturbances in these patients. Each of 28 patients with JNCL (age range = 6-27 years), with or without sleep complaints, underwent one night of polysomnography. Electroencephalographic, electro-oculographic, electromyographic, and electrocardiographic findings were recorded. Sleep was scored and analyzed visually. The sleep parameters of the patients were compared with those of healthy control subjects. In most of the patients, the total sleep time, sleep efficiency, and percentages of rapid eye movement (REM) and non-REM (NREM) stage 2 sleep were significantly decreased, and the percentages of NREM stage 1 and slow-wave sleep and the number of nocturnal awakenings significantly increased. The percentage of NREM stage 1 and the number of awakenings increased with age and clinical stage. Paroxysmal epileptiform activity during light sleep (NREM stages 1-2) and high-amplitude delta-wave activity with intermingled sharp waves during slow-wave sleep were characteristic of the recordings. The present study revealed that in patients with JNCL, sleep is consistently altered.
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Affiliation(s)
- E Kirveskari
- Department of Pediatric Neurology; Hospital for Children and Adolescents, Helsinki University Central Hospital, Finland
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Toussaint M, Luthringer R, Staner L, Muzet A, Macher J. Changes in EEG power density during sleep laboratory adaptation in depressed inpatients. Biol Psychiatry 2000; 47:626-33. [PMID: 10745055 DOI: 10.1016/s0006-3223(99)00161-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of the present study was to evaluate the first-night effect in depressed inpatients, using standard sleep measures as well as all-night spectral analysis of the sleep electroencephalogram (EEG). METHODS Eighteen drug-free, depressed inpatients were studied for 3 consecutive nights in the hospital sleep laboratory. RESULTS Visual sleep scoring results showed a slight but measurable first-night effect, characterized by a reduction of rapid eye movement (REM) sleep amount and increased wakefulness. Sleep EEG spectral analysis showed significantly reduced delta (p <.01) and theta (p <.05) power density in non-REM (NREM) sleep of the first night compared with that of the second and third nights. These differences were limited to the early part of the sleep period, a time during the night that is particularly vulnerable to the effects of depressive disorder. In contrast to the NREM sleep findings, spectral REM variables studied did not significantly vary across the three nights. CONCLUSIONS The results obtained suggest that first-night data should not be simply discarded but could be used in subsequent analyses and could be considered useful in the evaluation of the sleep of depressed patients.
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Affiliation(s)
- M Toussaint
- Foundation for Applied Neuroscience Research in Psychiatry (FORENAP) Centre Hospitalier, Rouffach, France
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