Effect of sleep deprivation on NREM sleep ERPs and related activity at sleep onset

Processing in the non-dominant hand during sleep: in terms of early, middle-early and late brain responses

The aim was to investigate brain responses to non-painful tactile stimuli applied to the non-dominant hand during sleep. 21 healthy subjects participated in the study (11 female, mean age ± SD: 20.67 ± 1.91 years). A 40-channel polysomnography system and a pneumatic tactile stimulator unit were used. Stimuli were applied to the participants' non-dominant hand. Evoked potential components of the CZ electrode were examined in four sleep stages (N1, N2, N3, and REM). Repeated measures ANOVA was used in statistical analyses. Brain responses, categorized as early (P50, N100, and P200), mid-early (N300, P450, and N550), and late (P900 and Nlate), were detected all sleep stages. No notable variances were found in the amplitude and latency of early brain responses when analyzed across different sleep stages. Differences in both amplitude and latency were observed across different sleep stages for the N300, P450, P900, and Nlate response components. This study presents a pioneering exploration into the responses of the non-dominant hand throughout all sleep stages, encompassing eight distinct response components. This novel investigation contributes to the existing literature by shedding light on previously unexplored aspects. The observed early responses are identified as sensory, while middle to late responses align with cognitive processes within the realm of sleep research. Notably, N300, P450, P900, and Nlate components display variations across diverse sleep stages, marked by alterations in both amplitude and latency. These findings offer valuable insights into the dynamic nature of hand responses throughout the sleep continuum.

Primed Tactile Stimulus Processing during Sleep

The aim was to investigate how the primed and unprimed non-painful tactile stimuli during sleep would be processed. A total of 22 healthy subjects (19.55 ± 1.10 years) were randomly divided into two groups. The same stimuli were applied to both groups, but the study group (SG) received them twice (daytime and sleep), whereas the control group (CG) received them only during sleep. A 40-channel PSG and a pneumatic tactile stimulator unit were used. Evoked potential components of the CZ electrode were examined in four sleep stages (N1, N2, N3, and REM). The Mann-Whitney U test was used for group comparison, and the Wilcoxon test was used for in-group evaluations. The P50 and N300 response components were observed in all sleep stages in both groups. P50 decreased as sleep deepened in the SG. The N300 increased as sleep deepened and started to decrease again in the REM stage. Moreover, in N1, the amplitudes of P200-N300 and N300-P450 in the SG were significantly greater than those in the CG. The fact that P50 was observed even in N3 indicates that bottom-up sensory processing continues during sleep. Moreover, the central processing of primed and unprimed stimuli exhibited dynamic differences. Furthermore, an increase in N300 amplitude suggests suppressive processes to facilitate and maintain sleep.

Electrophysiological Mechanism of Attention of Sleep Deprivation: Evidence From Event-Related Potentials (ERP) Data

INTRODUCTION

The purpose of this study is to investigate the effects of sleep deprivation on individual attentional function and related electrophysiological mechanisms.

METHODS

Twenty healthy men who were deprived of sleep for 24 h were evaluated by selective attention test, persistent attention test, and event-related potentials (ERP) experiment.

RESULTS

After 24 h of sleep deprivation, the subjects' selective attention decreased, mainly manifested as prolonged response time, decreased motion stability, increased rate of neglect error, decreased sustained attention, prolonged latency of P300 at Cz (p=0.001), and decreased amplitude (p=0.000).

CONCLUSION

After 24 h of sleep deprivation, the attentional ability decreased significantly, and behavioral and ERP indicators showed certain changes.

Oral Delivery of Honokiol Microparticles for Nonrapid Eye Movement Sleep

Honokiol (HNK) is a small-molecule lignin extracted from Magnolia Officinalis, demonstrating high potency in promoting nonrapid eye movement (NREM) sleep by modulating the benzodiazepine site of the GABA_A receptor. However, the clinical use of HNK in the treatment of insomnia is restricted by its extremely low oral bioavailability. In the present work, enhanced oral bioavailability of HNK was achieved by loading it into poly lactide-glycolide acid microparticles (HNK-MP). After oral administration, HNK-MP demonstrated 15-fold increase of AUC_0-12 h in comparison to free HNK. The maximum blood concentration ( C_max) of HNK in HNK-MP-treated rats was 3.6 μg/mL at 2 h after oral administration, which was 6.5-fold of that in free HNK-treated rats. Oral administration of HNK-MP (20 mg/kg) efficiently increased NREM sleep by 60% by enhancing the transition from wakefulness to NREM sleep in rats. The biosafety of HNK-MP was assessed in vivo, and no damage occurred in the gastrointestinal tract. The present study provides a promising oral HNK formulation for the treatment of insomnia.

Increased Evoked Potentials to Arousing Auditory Stimuli during Sleep: Implication for the Understanding of Dream Recall

High dream recallers (HR) show a larger brain reactivity to auditory stimuli during wakefulness and sleep as compared to low dream recallers (LR) and also more intra-sleep wakefulness (ISW), but no other modification of the sleep macrostructure. To further understand the possible causal link between brain responses, ISW and dream recall, we investigated the sleep microstructure of HR and LR, and tested whether the amplitude of auditory evoked potentials (AEPs) was predictive of arousing reactions during sleep. Participants (18 HR, 18 LR) were presented with sounds during a whole night of sleep in the lab and polysomnographic data were recorded. Sleep microstructure (arousals, rapid eye movements (REMs), muscle twitches (MTs), spindles, KCs) was assessed using visual, semi-automatic and automatic validated methods. AEPs to arousing (awakenings or arousals) and non-arousing stimuli were subsequently computed. No between-group difference in the microstructure of sleep was found. In N2 sleep, auditory arousing stimuli elicited a larger parieto-occipital positivity and an increased late frontal negativity as compared to non-arousing stimuli. As compared to LR, HR showed more arousing stimuli and more long awakenings, regardless of the sleep stage but did not show more numerous or longer arousals. These results suggest that the amplitude of the brain response to stimuli during sleep determine subsequent awakening and that awakening duration (and not arousal) is the critical parameter for dream recall. Notably, our results led us to propose that the minimum necessary duration of an awakening during sleep for a successful encoding of dreams into long-term memory is approximately 2 min.

K-Complexes: Interaction between the Central and Autonomic Nervous Systems during Sleep

STUDY OBJECTIVES

To investigate the relationship between K-complexes (KCs) and cardiac functioning.

METHODS

Forty healthy adolescents aged 16-22 y (19 females) participated in the study. Heart rate (HR) fluctuations associated with spontaneous and evoked KCs were investigated on two nights, one with (event-related potential night) and one without auditory tones presented across the night.

RESULTS

There was a clear biphasic cardiac response to evoked and spontaneous KCs, with an initial acceleration in HR followed by a deceleration (P < 0.001). HR acceleration occurred immediately to KCs in response to tones presented in the first third of the interbeat interval, but was delayed a beat when the tone occurred later in the cardiac cycle (P < 0.05). Sex differences were also evident. Pretone baseline HR was higher, and the magnitude of the HR response was blunted and delayed, in female compared to male adolescents (P < 0.001). Also, pretone baseline HR was lower when a tone elicited a KC compared to when it did not (P < 0.001), suggesting that KCs are possibly more likely to be elicited by external stimuli in states of reduced cardiac activation.

CONCLUSIONS

The strict dependency observed between KCs and cardiac control indicates a potential role of KCs in modulating the cardiovascular system during sleep. Sex differences in the KC-cardiac response indicate the sensitivity of this measure in capturing sex differences in cardiac regulatory physiology.

Mild Airflow Limitation during N2 Sleep Increases K-complex Frequency and Slows Electroencephalographic Activity

STUDY OBJECTIVES

To determine the effects of mild airflow limitation on K-complex frequency and morphology and electroencephalogram (EEG) spectral power.

METHODS

Transient reductions in continuous positive airway pressure (CPAP) during stable N2 sleep were performed to induce mild airflow limitation in 20 patients with obstructive sleep apnea (OSA) and 10 healthy controls aged 44 ± 13 y. EEG at C3 and airflow were measured in 1-min windows to quantify K-complex properties and EEG spectral power immediately before and during transient reductions in CPAP. The frequency and morphology (amplitude and latency of P200, N550 and N900 components) of K-complexes and EEG spectral power were compared between conditions.

RESULTS

During mild airflow limitation (18% reduction in peak inspiratory airflow from baseline, 0.38 ± 0.11 versus 0.31 ± 0.1 L/sec) insufficient to cause American Academy of Sleep Medicine-defined cortical arousal, K-complex frequency (9.5 ± 4.5 versus 13.7 ± 6.4 per min, P < 0.01), N550 amplitude (25 ± 3 versus 27 ± 3 μV, P < 0.01) and EEG spectral power (delta: 147 ± 48 versus 230 ± 99 μV(2), P < 0.01 and theta bands: 31 ± 14 versus 34 ± 13 μV(2), P < 0.01) significantly increased whereas beta band power decreased (14 ± 5 versus 11 ± 4 μV(2), P < 0.01) compared to the preceding non flow-limited period on CPAP. K-complex frequency, morphology, and timing did not differ between patients and controls.

CONCLUSION

Mild airflow limitation increases K-complex frequency, N550 amplitude, and spectral power of delta and theta bands. In addition to providing mechanistic insight into the role of mild airflow limitation on K-complex characteristics and EEG activity, these findings may have important implications for respiratory conditions in which airflow limitation during sleep is common (e.g., snoring and OSA).

Enhancement of sleep slow waves: underlying mechanisms and practical consequences

Even modest sleep restriction, especially the loss of sleep slow wave activity (SWA), is invariably associated with slower electroencephalogram (EEG) activity during wake, the occurrence of local sleep in an otherwise awake brain, and impaired performance due to cognitive and memory deficits. Recent studies not only confirm the beneficial role of sleep in memory consolidation, but also point to a specific role for sleep slow waves. Thus, the implementation of methods to enhance sleep slow waves without unwanted arousals or lightening of sleep could have significant practical implications. Here we first review the evidence that it is possible to enhance sleep slow waves in humans using transcranial direct-current stimulation (tDCS) and transcranial magnetic stimulation. Since these methods are currently impractical and their safety is questionable, especially for chronic long-term exposure, we then discuss novel data suggesting that it is possible to enhance slow waves using sensory stimuli. We consider the physiology of the K-complex (KC), a peripheral evoked slow wave, and show that, among different sensory modalities, acoustic stimulation is the most effective in increasing the magnitude of slow waves, likely through the activation of non-lemniscal ascending pathways to the thalamo-cortical system. In addition, we discuss how intensity and frequency of the acoustic stimuli, as well as exact timing and pattern of stimulation, affect sleep enhancement. Finally, we discuss automated algorithms that read the EEG and, in real-time, adjust the stimulation parameters in a closed-loop manner to obtain an increase in sleep slow waves and avoid undesirable arousals. In conclusion, while discussing the mechanisms that underlie the generation of sleep slow waves, we review the converging evidence showing that acoustic stimulation is safe and represents an ideal tool for slow wave sleep (SWS) enhancement.

Acoustic oddball during NREM sleep: a combined EEG/fMRI study

BACKGROUND

A condition vital for the consolidation and maintenance of sleep is generally reduced responsiveness to external stimuli. Despite this, the sleeper maintains a level of stimulus processing that allows to respond to potentially dangerous environmental signals. The mechanisms that subserve these contradictory functions are only incompletely understood.

METHODOLOGY/PRINCIPAL FINDINGS

Using combined EEG/fMRI we investigated the neural substrate of sleep protection by applying an acoustic oddball paradigm during light NREM sleep. Further, we studied the role of evoked K-complexes (KCs), an electroencephalographic hallmark of NREM sleep with a still unknown role for sleep protection. Our main results were: (1) Other than in wakefulness, rare tones did not induce a blood oxygenation level dependent (BOLD) signal increase in the auditory pathway but a strong negative BOLD response in motor areas and the amygdala. (2) Stratification of rare tones by the presence of evoked KCs detected activation of the auditory cortex, hippocampus, superior and middle frontal gyri and posterior cingulate only for rare tones followed by a KC. (3) The typical high frontocentral EEG deflections of KCs were not paralleled by a BOLD equivalent.

CONCLUSIONS/SIGNIFICANCE

We observed that rare tones lead to transient disengagement of motor and amygdala responses during light NREM sleep. We interpret this as a sleep protective mechanism to delimit motor responses and to reduce the sensitivity of the amygdala towards further incoming stimuli. Evoked KCs are suggested to originate from a brain state with relatively increased stimulus processing, revealing an activity pattern resembling novelty processing as previously reported during wakefulness. The KC itself is not reflected by increased metabolic demand in BOLD based imaging, arguing that evoked KCs result from increased neural synchronicity without altered metabolic demand.

The use of evoked potentials in sleep research

Averaged event-related potentials (ERPs) represent sensory and cognitive processing of stimuli during wakefulness independent of behavioral responses, and reflect the underlying state of the CNS (central nervous system) during sleep. Components measured during wakefulness which are reflective of arousal state or the automatic switching of attention are sensitive to prior sleep disruption. Components reflecting active attentional influences during the waking state appear to be preserved in a rudimentary form during REM sleep, but in a way that highlights the differences in the neurochemical environment between wakefulness and REM sleep. Certain ERP components only appear within sleep. These begin to emerge at NREM sleep onset and may reflect inhibition of information processing and thus have utility as markers of the functional status of sleep preparatory mechanisms. These large amplitude NREM components represent synchronized burst firing of large number of cortical cells and are a reflection of the nervous system's capacity to generate delta frequency EEG activity. As such they are useful in assessing the overall integrity of the nervous system in populations not showing substantial amounts of SWS as measured using traditional criteria. While requiring care in their interpretation, ERPs nonetheless provide a rich tool to investigators interested in probing the nervous system to evaluate daytime functioning in the face of sleep disruption, the ability of the sleeping nervous system to monitor the external environment, and the ability of the nervous system to respond to stimuli in a manner consistent with the initiation or maintenance of sleep.

Characteristic EEG differences between voluntary recumbent sleep onset in bed and involuntary sleep onset in a driving simulator

OBJECTIVE

To investigate the differences in electroencephalographic (EEG) characteristics for voluntary sleep onset in bed sleeping and involuntary sleep onset in driving.

METHODS

EEG measurement and analysis on 20 human subjects were conducted during recumbent bed sleeping as well as involuntary sleeping during a simulated driving platform. Each experiment was conducted on separate days.

RESULTS

Vertex and spindle waves showed differing morphology under each condition. Vertex sharpness during recumbent sleep onset was significantly sharper than involuntary sleep onset during simulated driving. Sharpness of vertices from night-driving was significantly sharper than with day-driving. Triple conjoined vertex waves only occurred with voluntary recumbent sleep onset. A conjoined vertex spindle waveform was statistically associated with sleep onset whilst driving.

CONCLUSIONS

This study has identified distinctive differences in EEG graphoelements during the sleep onset phase of recumbent and simulated driving conditions suggesting that EEG graphoelements are affected by cortical processes and vary according to the prevalent sleep condition.

SIGNIFICANCE

This study could provide a further basis for developing safety alerting devices for the detection of sleep onset in the hope of improving driving safety.

The effects of sleep stages and time of night on NREM sleep ERPs

Event-related potential (ERP) is one of the best techniques for studying information processing during sleep because it does not require behavioral responses or consciousness awareness. Several ERP components have been identified during non-rapid eye movement (NREM) sleep, but the associated underlying processes of these waveforms remain unclear. The present study examines the effect of sleep stage and time of night on the NREM ERPs to further understand these processes. An oddball paradigm was conducted in 11 healthy subjects to elicit ERPs throughout the night. Polysomnographic recordings were also applied to identify sleep stages. The results showed that P220, N350, and P900 decreased during the second half of the night, when the NREM sleep drive is partially satiated. This finding is consistent with the notion that the NREM ERPs reflect an inhibitory process associated with sleep drive. P220 and P900 were also found to increase as subjects entering deep sleep. However, the N350 was not affected by the deepening of sleep and peaked earlier during stage 1 sleep. Although these components are all related to the process for sleep preservation, the N350 may be more associated with sleep-wake transition and the P220 and P900 with the process of deepening of sleep.

After effects of noise-induced sleep disturbances on inhibitory functions

The study focuses on possible after effects of noise-induced sleep disturbances on inhibitory brain processes reflecting in performance changes and alternations of inhibition-related components of event-related potentials (ERPs). Following a quiet night and three nights, in which railway noise was presented with different levels, twelve women and ten men (19-28 years) performed a visual Go/Nogo task that contained stimuli either compatible or incompatible with a response. Noise-induced sleep disturbances are highly evident in worsening of subjective sleep quality but did not show up in significant changes of reaction time and error rate. A smaller N2 amplitude and longer latency to incompatible than to compatible stimuli as well as an unspecific attenuation of N2 amplitude under Noise were found. The amplitude of the fronto-central P3 was reduced under Noise compared to baseline only in Nogo trials. The amplitude of the parietal P3 in Go trials was smaller to incompatible than to compatible stimuli but was not affected by Noise. Disturbed sleep was associated with a decreased blink rate during task performance. The results suggest that physiological costs to maintain performance are increased after noisy nights. Decisional processes underlying overt responses (Go-P3) are less vulnerable to noise-disturbed sleep than those related to inhibition (Nogo-N2, NoGo-P3). The deficits may have been compensated by increased on-task concentration and thereby did not become apparent in the performance data. Inhibition-related ERPs may be more sensitive indicators of moderate sleep disturbances caused by noise than performance measures.

K-complex, a reactive EEG graphoelement of NREM sleep: an old chap in a new garment

This review summarises data gathered on the KC phenomenon over the past 70 yr. The following issues are discussed: definitions, morphology and topography of KC, the regular participation in NREM sleep, elicitability features of evoked KC, autonomic and motor concomitants, relationship of KC with information processing during NREM sleep, relationship of KC and deltas of NREM sleep, and relationship of KC with sleep cyclicity. KC is a complex multifunctional phenomenon of the sleeping brain involved in information processing and defence against the arousal effect of sensory stimuli. To put the old chap in a new garment, the relationship of KC with synchronisation-type and desynchronisation-type micro-arousals, and the 'cyclic alternating pattern', will be discussed, with an emphasis on the sleep-protecting role of KC and synchronisation-type answers in sleep regulation executed by phasic events. Lastly, the role of KC providing gating functions in idiopathic generalized epilepsies and other, different, sleep disorders are characterised. A 'theoretical epilogue' is appended to show some system theoretical and regulational aspects.

The nature of arousal in sleep

The role of arousals in sleep is gaining interest among both basic researchers and clinicians. In the last 20 years increasing evidence shows that arousals are deeply involved in the pathophysiology of sleep disorders. The nature of arousals in sleep is still a matter of debate. According to the conceptual framework of the American Sleep Disorders Association criteria, arousals are a marker of sleep disruption representing a detrimental and harmful feature for sleep. In contrast, our view indicates arousals as elements weaved into the texture of sleep taking part in the regulation of the sleep process. In addition, the concept of micro-arousal (MA) has been extended, incorporating, besides the classical low-voltage fast-rhythm electroencephalographic (EEG) arousals, high-amplitude EEG bursts, be they like delta-like or K-complexes, which reflects a special kind of arousal process, mobilizing parallely antiarousal swings. In physiologic conditions, the slow and fast MA are not randomly scattered but appear structurally distributed within sleep representing state-specific arousal responses. MA preceded by slow waves occurs more frequently across the descending part of sleep cycles and in the first cycles, while the traditional fast type of arousals across the ascending slope of cycles prevails during the last third of sleep. The uniform arousal characteristics of these two types of MAs is supported by the finding that different MAs are associated with an increasing magnitude of vegetative activation ranging hierarchically from the weaker slow EEG types (coupled with mild autonomic activation) to the stronger rapid EEG types (coupled with a vigorous autonomic activation). Finally, it has been ascertained that MA are not isolated events but are basically endowed with a periodic nature expressed in non-rapid eye movement (NREM) sleep by the cyclic alternating pattern (CAP). Understanding the role of arousals and CAP and the relationship between physiologic and pathologic MA can shed light on the adaptive properties of the sleeping brain and provide insight into the pathomechanisms of sleep disturbances. Functional significance of arousal in sleep, and particularly in NREM sleep, is to ensure the reversibility of sleep, without which it would be identical to coma. Arousals may connect the sleeper with the surrounding world maintaining the selection of relevant incoming information and adapting the organism to the dangers and demands of the outer world. In this dynamic perspective, ongoing phasic events carry on the one hand arousal influences and on the other elements of information processing. The other function of arousals is tailoring the more or less stereotyped endogenously determined sleep process driven by chemical influences according to internal and external demands. In this perspective, arousals shape the individual course of night sleep as a variation of the sleep program.

Event-related potential measures of the inhibition of information processing: II. The sleep onset period

The loss of consciousness during the sleep onset period is associated with dramatic changes in information processing. Human event-related potentials (ERPs) reflect these changes. Short- and mid-latency ERPs are only minimally affected by sleep onset. On the other hand, long-latency ERPs are very much affected. A negative wave, N1, peaking at approximately 100 ms gradually decreases in amplitude until it reaches baseline level during definitive stage 2 sleep. The changes in N1 are especially apparent when the subject no longer signals awareness of the external stimulus or when stage 1 is dominated by theta activity in the EEG. The positive peaks, P1 and P2, peaking at approximately 50 and 180 ms, respectively, may appear to increase in amplitude (i.e. also be less negative). A long-lasting processing negativity (PN) may overlap and summate with these peaks during the waking state. During sleep onset, the PN dissipates, thus explaining the apparent positive baseline shift in the ERP waveform. In an oddball task, when an alert and awake subject detects a rare, relevant stimulus, a large positive wave, P300, maximum over parietal areas of the scalp, is observed. This P300 is, however, widely dispersed and can be observed over frontal areas of the scalp. When the subject no longer signals detection of this target stimulus, P300 can no longer be recorded. During stage 1, the parietal P300 remains large, providing the subject overtly detects the target. The amplitude of the frontal aspect of P300 is much reduced as response times slow. This may reflect deactivation of the frontal lobes during the sleep onset period. The infrequent change of an otherwise rapidly presented homogenous train of stimuli is associated with another long-lasting negativity, the mismatch negativity (MMN). The MMN also decreases in amplitude during the sleep onset period, reaching baseline level during definitive sleep. The vertex sharp wave (VSW) becomes apparent during the sleep onset period. Associated with the VSW is a late negative ERP, sometimes called the sleep N2 or the N350, peaking between 300 and 350 ms. It is unique to the sleep onset and sleep periods, becoming very large during stage 1-theta or when the subject no longer shows signs of awareness of the external stimulus.

Evoked potential components unique to non-REM sleep: relationship to evoked K-complexes and vertex sharp waves

Following the loss of wakeful consciousness, the averaging of responses to stimuli produce evoked potential waveforms with prominent components either unique to or greatly enhanced by non-REM sleep. In the sleep onset periods (stage 1) these are the P2 and N350. Following the establishment of stable sleep (stage 2 and SWS), the N550 and P900 are also prominent. Investigation of the EEG associated with individual responses indicates that a good proportion of stimuli elicit, K-complexes or vertex sharp waves (VSWs) and occasionally will elicit both. Recent work has indicated that the N550 in the averaged response is due to the presence of K-complexes and that the N350 is at least largely due to the presence of VSWs. The large size of these grapho-elements indicates that they are probably produced by a synchronized discharge of multiple neural units. Both are readily observed in the absence of external stimulation and occur as normal components of sleep, indeed the K-complex is used as one of the identifying features of the onset of stable non-REM sleep. The present review details the investigation of these features and their associated evoked potential components, in terms of stimulus features, brain states associated with their production, their scalp topography, and changes as a function of age.