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Yan Y, Zhang H, Kang M, Lan L, Wang Z, Lin Y. Experimental study of the negative effects of raised bedroom temperature and reduced ventilation on the sleep quality of elderly subjects. INDOOR AIR 2022; 32:e13159. [PMID: 36437666 DOI: 10.1111/ina.13159] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
This study investigated the effects of air temperature and ventilation on the sleep quality of elderly subjects and elucidated the mechanisms involved. Sixteen subjects aged over 65 years old were exposed to four conditions in a 2 × 2 design: air temperatures of 27°C and 30°C (with a ceiling fan in operation at 30°C) and two ventilation conditions (with and without mechanical ventilation) in experimental bedrooms. Their electroencephalogram, electrooculogram, chin electromyogram, electrocardiogram, respiration, oxygen saturation, and wrist skin temperature were measured continuously during sleep. Saliva samples were collected, and blood pressure was measured both before and after sleep. The results showed that at the temperature of 30°C, the total sleep time, sleep efficiency, and duration of REM sleep of the elderly decreased by 26.3 min, 5.5%, and 5.3 min, respectively, and time awake increased by 27.0 min, in comparison with 27°C, indicating that the sleep quality of the elderly is very vulnerable to heat exposure. Even a small heat load led to an overactive sympathetic nervous system and increased wrist skin temperature, which reduced sleep quality. Improving the ventilation increased the duration of deep sleep and REM sleep by 10.3 min and 3.7 min, respectively. Higher pollutant concentrations affected the respiration and autonomous nervous systems to reduce sleep quality. The benefits of improved thermal environment and ventilation on sleep quality were found to be additive. Good ventilation and the avoidance of raised temperatures in the bedroom are thus both important for the sleep quality of the elderly.
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Affiliation(s)
- Yan Yan
- Department of Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Haodong Zhang
- Department of Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Mengyuan Kang
- Department of Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Li Lan
- Department of Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Zhentao Wang
- School of medicine affiliated Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yanbin Lin
- School of medicine affiliated Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
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Tort AB, Hammer M, Zhang J, Brankačk J, Draguhn A. Temporal Relations between Cortical Network Oscillations and Breathing Frequency during REM Sleep. J Neurosci 2021; 41:5229-5242. [PMID: 33963051 PMCID: PMC8211551 DOI: 10.1523/jneurosci.3067-20.2021] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 03/29/2021] [Accepted: 04/27/2021] [Indexed: 11/21/2022] Open
Abstract
Nasal breathing generates a rhythmic signal which entrains cortical network oscillations in widespread brain regions on a cycle-to-cycle time scale. It is unknown, however, how respiration and neuronal network activity interact on a larger time scale: are breathing frequency and typical neuronal oscillation patterns correlated? Is there any directionality or temporal relationship? To address these questions, we recorded field potentials from the posterior parietal cortex of mice together with respiration during REM sleep. In this state, the parietal cortex exhibits prominent θ and γ oscillations while behavioral activity is minimal, reducing confounding signals. We found that the instantaneous breathing frequency strongly correlates with the instantaneous frequency and amplitude of both θ and γ oscillations. Cross-correlograms and Granger causality revealed specific directionalities for different rhythms: changes in θ activity precede and Granger-cause changes in breathing frequency, suggesting control by the functional state of the brain. On the other hand, the instantaneous breathing frequency Granger causes changes in γ frequency, suggesting that γ is influenced by a peripheral reafference signal. These findings show that changes in breathing frequency temporally relate to changes in different patterns of rhythmic brain activity. We hypothesize that such temporal relations are mediated by a common central drive likely to be located in the brainstem.
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Affiliation(s)
- Adriano B.L. Tort
- Brain Institute, Federal University of Rio Grande do Norte, Natal, RN 59056-450, Brazil
| | - Maximilian Hammer
- Institute for Physiology and Pathophysiology, Heidelberg University, Heidelberg, 69120, Germany
| | - Jiaojiao Zhang
- Institute for Physiology and Pathophysiology, Heidelberg University, Heidelberg, 69120, Germany
| | - Jurij Brankačk
- Institute for Physiology and Pathophysiology, Heidelberg University, Heidelberg, 69120, Germany
| | - Andreas Draguhn
- Institute for Physiology and Pathophysiology, Heidelberg University, Heidelberg, 69120, Germany
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Zhang D, Long X, Xu L, Werth J, Wijshoff R, Aarts RM, Andriessen P. Characterizing cardiorespiratory interaction in preterm infants across sleep states using visibility graph analysis. J Appl Physiol (1985) 2021; 130:1015-1024. [PMID: 33539263 DOI: 10.1152/japplphysiol.00333.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cardiorespiratory interaction (CRI) has been intensively studied in adult sleep, yet not in preterm infants, in particular across different sleep states including wake (W), active sleep (AS), and quiet sleep (QS). The aim of this study was to quantify the interaction between cardiac and respiratory activities in different sleep states of preterm infants. The postmenstrual age (PMA) of preterm infants was also taken into consideration. The CRI during sleep was analyzed using a visibility graph (VG) method, enabling the nonlinear analysis of CRI in a complex network. For each sleep state, parameters quantifying various aspects of the CRI characteristics from constructed VG network including mean degree (Dm) and its variability (Dsd), clustering coefficient (CCm) and its variability (CCsd), assortativity coefficient (AC), and complexity (DSE) were extracted from the CRI networks. The interaction effect of sleep state and PMA was found to be statistically significant on all CRI parameters except for AC and DSE. The main effect between sleep state and CRI parameters was statistically significant except for CCm, and that between PMA and CRI parameters was statistically significant except for DSE. In conclusion, the CRI of preterm infants is associated with sleep states and PMA in general. For preterm infants with a larger PMA, CRI has a more clustered pattern during different sleep states, where QS shows a more regular, stratified, and stronger CRI than other states. In the future, these parameters can be potentially used to separate sleep states in preterm infants.NEW & NOTEWORTHY The interaction between cardiac and respiratory activities is investigated in preterm infant sleep using an advanced nonlinear method (visibility graph) and some important characteristics are shown to be significantly different across sleep states, which has not been studied before.
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Affiliation(s)
- Dandan Zhang
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Philips Research, Eindhoven, The Netherlands
| | - Xi Long
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Philips Research, Eindhoven, The Netherlands
| | - Lin Xu
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
| | - Jan Werth
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | | | - Ronald M Aarts
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Peter Andriessen
- Department of Neonatology, Máxima Medical Centre, Veldhoven, The Netherlands.,Department of Applied Physics, Eindhoven University of Technology, Eindhoven, The Netherlands
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Bálint A, Eleőd H, Körmendi J, Bódizs R, Reicher V, Gácsi M. Potential Physiological Parameters to Indicate Inner States in Dogs: The Analysis of ECG, and Respiratory Signal During Different Sleep Phases. Front Behav Neurosci 2019; 13:207. [PMID: 31607871 PMCID: PMC6755330 DOI: 10.3389/fnbeh.2019.00207] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/29/2019] [Indexed: 01/06/2023] Open
Abstract
The sleeping activity of family dogs has been studied increasingly in the past years. Recently, a validated, non-invasive polysomnographic method has been developed for dogs, enabling the parallel recording of several neurophysiological signals on non-anesthetized family dogs, including brain activity (EEG), eye movements (EOG), cardiac (ECG), and respiratory activity (PNG). In this study, we examined the ECG (N = 30) and respiratory signals (N = 19) of dogs during a 3-h sleep period in the afternoon, under laboratory conditions. We calculated four time-domain heart rate variables [mean heart rate (HR), SDNN, RMSSD, and pNN50] from the ECG and the estimated average respiratory frequency from the respiratory signal. We analyzed how these variables are affected by the different sleep-wake phases (wakefulness, drowsiness, NREM, and REM) as well as the dogs’ sex, age and weight. We have found that the sleep-wake phase had a significant effect on all measured cardiac parameters. In the wake phase, the mean HR was higher than in all other phases, while SDNN, RMSSD, and pNN50 were lower than in all other sleep phases. In drowsiness, mean HR was higher compared to NREM and REM phases, while SDNN and RMSSD was lower compared to NREM and REM phases. In REM, SDNN, and RMSSD was higher than in NREM. However, the sleep-wake phase had no effect on the estimated average respiratory frequency of dogs. The dogs’ sex, age and weight had no effect on any of the investigated variables. This study represents a detailed analysis of the cardiac and respiratory activity of dogs during sleep. Since variations in these physiological signals reflect the dynamics of autonomic functions, a more detailed understanding of their changes may help us to gain a better understanding of the internal/emotional processes of dogs in response to different conditions of external stimuli. As such, our results are important since they are directly comparable to human findings and may also serve as a potential basis for future studies on dogs.
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Affiliation(s)
- Anna Bálint
- Department of Ethology, Eötvös Loránd University, Budapest, Hungary.,MTA-ELTE Comparative Ethology Research Group, Budapest, Hungary
| | - Huba Eleőd
- Department of Ethology, Eötvös Loránd University, Budapest, Hungary
| | - János Körmendi
- Institute of Health Promotion and Sport Sciences, Faculty of Education and Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Róbert Bódizs
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.,National Institute of Clinical Neuroscience, Juhász Pál Epilepsy Centrum, Budapest, Hungary
| | - Vivien Reicher
- Department of Ethology, Eötvös Loránd University, Budapest, Hungary
| | - Márta Gácsi
- Department of Ethology, Eötvös Loránd University, Budapest, Hungary.,MTA-ELTE Comparative Ethology Research Group, Budapest, Hungary
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Abstract
Purpose The purpose of this review is to discuss the pathogenesis, clinical manifestations, diagnosis and treatment, including areas of controversy and uncertainty. Recent Findings Central apnea may be due to hypoventilation or to hypocapnia following hyperventilation. The occurrence of central apnea initiates a cascade of events that perpetuates breathing instability, recurrent central apnea and upper airway narrowing. In fact, breathing instability and upper airway narrowing are key elements of central and obstructive apnea. Clinically, central apnea is noted in association with obstructive sleep apnea, heart failure, atrial fibrillation, cerebrovascular accidents tetraplegia, and chronic opioid use.Management strategy for central apnea aim to eliminate abnormal respiratory events, stabilize sleep and alleviate the underlying clinical condition. Positive pressure therapy (PAP) remains a standard therapy for central as well as obstructive apnea. Other treatment options include adaptive-servo ventilation (ASV), supplemental oxygen, phrenic nerve stimulation, and pharmacologic therapy. However, ASV is contraindicated in patients with central sleep apnea who had heart failure with reduced ejection fraction, owing to increased mortality in this population. Summary There are several therapeutic options for central apnea. Randomized controlled studies are needed to ascertain the long-term effectiveness of individual, or combination, treatment modalities in different types of central apnea.
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Affiliation(s)
- M Safwan Badr
- Department of Internal Medicine, Division of pulmonary, critical; care and sleep medicine
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Oudiette D, Dodet P, Ledard N, Artru E, Rachidi I, Similowski T, Arnulf I. REM sleep respiratory behaviours mental content in narcoleptic lucid dreamers. Sci Rep 2018; 8:2636. [PMID: 29422603 PMCID: PMC5805737 DOI: 10.1038/s41598-018-21067-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 01/29/2018] [Indexed: 11/13/2022] Open
Abstract
Breathing is irregular during rapid eye-movement (REM) sleep, whereas it is stable during non-REM sleep. Why this is so remains a mystery. We propose that irregular breathing has a cortical origin and reflects the mental content of dreams, which often accompany REM sleep. We tested 21 patients with narcolepsy who had the exceptional ability to lucid dream in REM sleep, a condition in which one is conscious of dreaming during the dream and can signal lucidity with an ocular code. Sleep and respiration were monitored during multiple naps. Participants were instructed to modify their dream scenario so that it involved vocalizations or an apnoea, -two behaviours that require a cortical control of ventilation when executed during wakefulness. Most participants (86%) were able to signal lucidity in at least one nap. In 50% of the lucid naps, we found a clear congruence between the dream report (e.g., diving under water) and the observed respiratory behaviour (e.g., central apnoea) and, in several cases, a preparatory breath before the respiratory behaviour. This suggests that the cortico-subcortical networks involved in voluntary respiratory movements are preserved during REM sleep and that breathing irregularities during this stage have a cortical/subcortical origin that reflects dream content.
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Affiliation(s)
- Delphine Oudiette
- Sorbonne Université, IHU@ICM, INSERM, CNRS UMR7225, équipe MOV'IT, F-75013 Paris, France.,AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département "R3S"), F-75013 Paris, France
| | - Pauline Dodet
- AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département "R3S"), F-75013 Paris, France
| | - Nahema Ledard
- AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département "R3S"), F-75013 Paris, France
| | - Emilie Artru
- AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département "R3S"), F-75013 Paris, France
| | - Inès Rachidi
- AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département "R3S"), F-75013 Paris, France
| | - Thomas Similowski
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75013 Paris, France.,AP-HP, Hôpital Pitié-Salpêtrière, Service de Pneumologie et Réanimation Médicale (Département "R3S"), F-75013, Paris, France
| | - Isabelle Arnulf
- Sorbonne Université, IHU@ICM, INSERM, CNRS UMR7225, équipe MOV'IT, F-75013 Paris, France. .,AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département "R3S"), F-75013 Paris, France.
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Kubin L. Neural Control of the Upper Airway: Respiratory and State-Dependent Mechanisms. Compr Physiol 2016; 6:1801-1850. [PMID: 27783860 DOI: 10.1002/cphy.c160002] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Upper airway muscles subserve many essential for survival orofacial behaviors, including their important role as accessory respiratory muscles. In the face of certain predisposition of craniofacial anatomy, both tonic and phasic inspiratory activation of upper airway muscles is necessary to protect the upper airway against collapse. This protective action is adequate during wakefulness, but fails during sleep which results in recurrent episodes of hypopneas and apneas, a condition known as the obstructive sleep apnea syndrome (OSA). Although OSA is almost exclusively a human disorder, animal models help unveil the basic principles governing the impact of sleep on breathing and upper airway muscle activity. This article discusses the neuroanatomy, neurochemistry, and neurophysiology of the different neuronal systems whose activity changes with sleep-wake states, such as the noradrenergic, serotonergic, cholinergic, orexinergic, histaminergic, GABAergic and glycinergic, and their impact on central respiratory neurons and upper airway motoneurons. Observations of the interactions between sleep-wake states and upper airway muscles in healthy humans and OSA patients are related to findings from animal models with normal upper airway, and various animal models of OSA, including the chronic-intermittent hypoxia model. Using a framework of upper airway motoneurons being under concurrent influence of central respiratory, reflex and state-dependent inputs, different neurotransmitters, and neuropeptides are considered as either causing a sleep-dependent withdrawal of excitation from motoneurons or mediating an active, sleep-related inhibition of motoneurons. Information about the neurochemistry of state-dependent control of upper airway muscles accumulated to date reveals fundamental principles and may help understand and treat OSA. © 2016 American Physiological Society. Compr Physiol 6:1801-1850, 2016.
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Affiliation(s)
- Leszek Kubin
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Horner RL. Neural control of the upper airway: integrative physiological mechanisms and relevance for sleep disordered breathing. Compr Physiol 2013; 2:479-535. [PMID: 23728986 DOI: 10.1002/cphy.c110023] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The various neural mechanisms affecting the control of the upper airway muscles are discussed in this review, with particular emphasis on structure-function relationships and integrative physiological motor-control processes. Particular foci of attention include the respiratory function of the upper airway muscles, and the various reflex mechanisms underlying their control, specifically the reflex responses to changes in airway pressure, reflexes from pulmonary receptors, chemoreceptor and baroreceptor reflexes, and postural effects on upper airway motor control. This article also addresses the determinants of upper airway collapsibility and the influence of neural drive to the upper airway muscles, and the influence of common drugs such as ethanol, sedative hypnotics, and opioids on upper airway motor control. In addition to an examination of these basic physiological mechanisms, consideration is given throughout this review as to how these mechanisms relate to integrative function in the intact normal upper airway in wakefulness and sleep, and how they may be involved in the pathogenesis of clinical problems such obstructive sleep apnea hypopnea.
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Xie A. Effect of sleep on breathing - Why recurrent apneas are only seen during sleep. J Thorac Dis 2012; 4:194-7. [PMID: 22833825 DOI: 10.3978/j.issn.2072-1439.2011.04.04] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 05/02/2011] [Indexed: 11/14/2022]
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Fraigne JJ, Orem JM. Phasic motor activity of respiratory and non-respiratory muscles in REM sleep. Sleep 2011; 34:425-34. [PMID: 21461320 DOI: 10.1093/sleep/34.4.425] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES In this study, we quantified the profiles of phasic activity in respiratory muscles (diaphragm, genioglossus and external intercostal) and non-respiratory muscles (neck and extensor digitorum) across REM sleep. We hypothesized that if there is a unique pontine structure that controls all REM sleep phasic events, the profiles of the phasic twitches of different muscle groups should be identical. Furthermore, we described how respiratory parameters (e.g., frequency, amplitude, and effort) vary across REM sleep to determine if phasic processes affect breathing. METHODS Electrodes were implanted in Wistar rats to record brain activity and muscle activity of neck, extensor digitorum, diaphragm, external intercostal, and genioglossal muscles. Ten rats were studied to obtain 313 REM periods over 73 recording days. Data were analyzed offline and REM sleep activity profiles were built for each muscle. In 6 animals, respiratory frequency, effort, amplitude, and inspiratory peak were also analyzed during 192 REM sleep periods. RESULTS Respiratory muscle phasic activity increased in the second part of the REM period. For example, genioglossal activity increased in the second part of the REM period by 63.8% compared to the average level during NREM sleep. This profile was consistent between animals and REM periods (η(2)=0.58). This increased activity seen in respiratory muscles appeared as irregular bursts and trains of activity that could affect rythmo-genesis. Indeed, the increased integrated activity seen in the second part of the REM period in the diaphragm was associated with an increase in the number (28.3%) and amplitude (30%) of breaths. Non-respiratory muscle phasic activity in REM sleep did not have a profile like the phasic activity of respiratory muscles. Time in REM sleep did not have an effect on nuchal activity (P=0.59). CONCLUSION We conclude that the concept of a common pontine center controlling all REM phasic events is not supported by our data. There is a drive in REM sleep that affects specifically respiratory muscles. The characteristic increase in respiratory frequency during REM sleep is induced by this drive.
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Affiliation(s)
- Jimmy J Fraigne
- Texas Tech University Health Sciences Center School of Medicine, Department of Cell Physiology and Molecular Biophysics, Lubbock TX, USA.
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Affiliation(s)
- R Tamisier
- Pulmonary Function Test and Sleep Laboratory, Department of Rehabilitation and Physiology and HP2 Laboratory, University Hospital, Grenoble, France
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Schäffer T. Respiratory physiology in sleep and wakefulness. HANDBOOK OF CLINICAL NEUROLOGY 2011; 98:371-81. [PMID: 21056199 DOI: 10.1016/b978-0-444-52006-7.00024-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Thorsten Schäffer
- Medical Faculty, Ruhr-University Bochum and Institute of Clinical Physiology, Helios Klinik Hagen-Ambrock, Germany.
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Abstract
AbstractAs neurophysiological investigations of sleep cycle control have provided an increasingly detailed picture of events at the cellular level, the concept that the sleep cycle is generated by the interaction of multiple, anatomically distributed sets of neurons has gradually replaced the hypothesis that sleep is generated by a single, highly localized neuronal oscillator.Cell groups that discharge during rapid-eye-movement (REM) sleep (REM-on) and neurons that slow or cease firing during REM sleep (REM-off) have long been thought to comprise at least two neurochemically distinct populations. The fact that putatively cholinoceptive and/or cholinergic (REM-on) and putatively aminergic (REM-off) cell populations discharge reciprocally over the sleep cycle suggests a causal interdependence.In some brain stem areas these cell groups are not anatomically segregated and may instead be neurochemically mixed (interpenetrated). This finding raises important theoretical and practical issues not anticipated in the original reciprocal-interaction model. The electrophysiological evidence concerning the REM-on and REM-off cell groups suggests a gradient of sleep-dependent membrane excitability changes that may be a function of the connectivity strength within an anatomically distributed neuronal network. The connectivity strength may be influenced by the degree of neurochemical interpenetration between the REM-on and REM-offcells. Recognition of these complexities forces us to revise the reciprocal-interaction model and to seek new methods to test its tenets.Cholinergic microinjection experiments indicate that some populations of REM-on cells can execute specific portions of the REM sleep syndrome or block the generation of REM sleep. This observation suggests that the order of activation within the anatomically distributed generator populations may be critical in determining behavioral outcome. Support for the cholinergic tenets of the reciprocal-interaction model has been reinforced by observations from sleep-disorders medicine.Specific predictions of the reciprocal-interaction model and suggestions for testing these predictions are enumerated for future experimental programs that aim to understand the cellular and molecular basis of the mammalian sleep cycle.
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McKay LC, Feldman JL. Unilateral ablation of pre-Botzinger complex disrupts breathing during sleep but not wakefulness. Am J Respir Crit Care Med 2008; 178:89-95. [PMID: 18420958 DOI: 10.1164/rccm.200712-1901oc] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE In adult rats, bilateral ablation of pre-Bötzinger complex (preBötC) neurokinin 1-expressing (NK1R) neurons leads to a progressive and irreversible disruption in breathing pattern, initially during sleep, eventually resulting in an ataxic breathing pattern during wakefulness. OBJECTIVES Here we determine whether ablation of fewer preBötC NK1R neurons leads to a persistent pattern of disordered breathing during sleep but not during wakefulness. METHODS Adult male Sprague-Dawley rats (n = 12) were instrumented to record diaphragmatic, abdominal, and neck EMG, and EEG. Fourteen days later, a second surgery was performed to stereotaxically microinject into the preBötC on one side the toxin saporin conjugated to substance P (SP-SAP), which selectively ablates NK1R neurons. MEASUREMENTS AND MAIN RESULTS Postinjection, rats were monitored within a plethysmograph until they were killed (Days 21-51). At Days 6-9 post-unilateral SP-SAP injection, respiratory pattern during sleep, particularly REM sleep, became increasingly disordered, characterized by an increase in frequency of central sleep apnea and hypopneas (36.8 +/- 7.4 episodes/h of REM vs. 6 +/- 2.0 episodes/h in preinjection controls; P < 0.05), whereas breathing during resting wakefulness remained stable. Unlike bilateral SP-SAP-injected rats, an ataxic breathing pattern did not develop during wakefulness. Rats that were monitored up to 51 days post-SP-SAP injection continued to have sleep-disordered breathing; breathing during wakefulness remained relatively stable. Histologic analysis of the ventrolateral medulla confirmed that NK1R neurons within the preBötC on the injected but not on the contralateral side of the medulla were ablated. CONCLUSIONS Gradual loss of preBötC NK1R neurons may be an underlying factor of sleep-disordered breathing, in particular of central sleep apnea.
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Affiliation(s)
- Leanne C McKay
- Department of Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1763, USA
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Abstract
A doença pulmonar obstrutiva crônica é uma condição freqüente e é hoje a quarta principal causa de mortes nos Estados Unidos. A prevalência de perturbação respiratória durante o sono, ou síndrome de superposição, como anteriormente denominada, ainda não foi determinada devido à publicação de relatos conflitantes. Esta condição deve continuar sendo investigada devido aos efeitos adversos causados por transtornos respiratórios relacionados ao sono em pacientes com doença pulmonar de base. Neste relato, discutiremos brevemente os mecanismos envolvidos na origem da perturbação respiratória durante o sono em doença pulmonar obstrutiva crônica e auxiliaremos o leitor a distinguir àqueles pacientes que se beneficiariam de uma avaliação do padrão do sono mais detalhada, com a discussão de tópicos de gerenciamento e opções de tratamento.
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Holditch-Davis D, Scher M, Schwartz T, Hudson-Barr D. Sleeping and waking state development in preterm infants. Early Hum Dev 2004; 80:43-64. [PMID: 15363838 DOI: 10.1016/j.earlhumdev.2004.05.006] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2004] [Indexed: 11/25/2022]
Abstract
BACKGROUND Most studies of sleep-wake states of preterm infants have been cross-sectional. Thus, the extent to which sleep-wake development occurs within individuals and how environmental factors affect the development of sleeping and waking is unclear. AIMS This study examined the development of sleeping and waking during the preterm and early post-term periods and the effects of infant health and environmental characteristics. DESIGN Longitudinal, descriptive design. PARTICIPANTS 134 preterm infants at high risk for developmental problems because of birthweights under 1500 g or mechanical ventilation. OUTCOME MEASURES Weekly 2-h behavioral observations were conducted from the time infants were no longer critically ill until 43 weeks post-conceptional age or discharge. A single follow-up observation was conducted 1-3 months later. RESULTS Active sleep, large body movements and the percent of no REM during active sleep decreased with age, and quiet waking, active waking, quiet sleep and regularity of respiration in active sleep and quiet sleep increased. The state of sleep-wake transition increased until 40 weeks and then decreased after 43 weeks CA. Negative facial expressions showed a quadratic decrease over age. Active waking, active sleep, negative facial expressions and quiet sleep regularity showed a change of development after term. Infant characteristics, illness severity and medical treatments, the handling due to performing an EEG and hospital had only minor effects. CONCLUSIONS Significant development of sleeping and waking occurs over the preterm period. Additional research is needed to determine how the change from the hospital to the home environment affects on these developmental trajectories.
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Affiliation(s)
- Diane Holditch-Davis
- School of Nursing, University of North Carolina at Chapel Hill, CB# 7460, Chapel Hill, NC, 27599-7460, USA.
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Bell HJ, Duffin J. Respiratory response to passive limb movement is suppressed by a cognitive task. J Appl Physiol (1985) 2004; 97:2112-20. [PMID: 15273238 DOI: 10.1152/japplphysiol.00302.2004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Feedback from muscles stimulates ventilation at the onset of passive movement. We hypothesized that central neural activity via a cognitive task source would interact with afferent feedback, and we tested this hypothesis by examining the fast changes in ventilation at the transition from rest to passive leg movement, under two conditions: 1) no task and 2) solving a computer-based puzzle. Resting breathing was greater in condition 2 than in condition 1, evidenced by an increase in mean +/- SE breathing frequency (18.2 +/- 1.1 vs. 15.0 +/- 1.2 breaths/min, P = 0.004) and ventilation (10.93 +/- 1.16 vs. 9.11 +/- 1.17 l/min, P < 0.001). In condition 1, the onset of passive movement produced a fast increase in mean +/- SE breathing frequency (change of 2.9 +/- 0.4 breaths/min, P < 0.001), tidal volume (change of 233 +/- 95 ml, P < 0.001), and ventilation (change of 6.00 +/- 1.76 l/min, P < 0.001). However, in condition 2, the onset of passive movement only produced a fast increase in mean +/- SE breathing frequency (change of 1.3 +/- 0.4 breaths/min, P = 0.045), significantly smaller than in condition 1 (P = 0.007). These findings provide evidence for an interaction between central neural cognitive activity and the afferent feedback mechanism, and we conclude that the performance of a cognitive task suppresses the respiratory response to passive movement.
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Affiliation(s)
- Harold J Bell
- Dept. of Physiology, University of Toronto, 1 King's College Circle, Toronto, ON, Canada M5S 1A8
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Cairns BE, Kiang T, McErlane SA, Fragoso MC, Soja PJ. Eye movement-related modulation of trigeminal neuron activity during active sleep and wakefulness. Brain Res 2003; 975:110-9. [PMID: 12763598 DOI: 10.1016/s0006-8993(03)02595-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The amplitude of electrically-evoked mass action potentials recorded in the spinal cord and brainstem has been reported to decrease only during eye movement events of active sleep. In contrast, we have reported that the response of trigeminal sensory neurons to peripheral stimuli is modulated throughout the behavioral state of active sleep. It is unclear whether eye movement events contribute to the modulation of trigeminal sensory neuron activity during active sleep. In the present study, eye movement events were demarcated in order to investigate how these events affect peripheral input to trigeminal sensory neurons in chronic, intact, behaving cats. When compared with wakefulness, the mean response of 45 trigeminal sensory neurons to low-intensity electrical stimulation of the canine tooth pulp was significantly suppressed by 28% during periods of active sleep where no eye movement activity was present and by 41% during periods of active sleep with eye movement events. Hence, during active sleep, tooth pulp-evoked responses were significantly decreased by 16% during eye movement events when compared with non-eye movement active sleep. To investigate whether presynaptic inhibition played a role in this phenomenon, the excitability of eight individual tooth pulp afferent terminals during eye movement periods was compared with non-eye movement periods of active sleep. No evidence of eye movement-related depolarization of tooth pulp terminals was detected. When compared to wakefulness, the responses of six trigeminal sensory neurons to air puff stimulation of facial hair mechanoreceptors were significantly increased by 96% during periods of active sleep where no eye movement activity was present but were significantly decreased by 15% during eye movement events when compared with non-eye movement active sleep. The results of the present study indicate that neuronal responses to both tooth pulp and facial hair mechanoreceptor stimulation are significantly attenuated during eye movement events of active sleep.
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Affiliation(s)
- Brian E Cairns
- Department of Anesthesia, Harvard Medical School/Children's Hospital, Boston, MA, USA
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Abstract
Obstructive sleep apnea-hypopnea syndrome occurs because of various combinations of anatomic, mechanical, and neurologic anomalies that jeopardize ventilation only when normal state-dependent reductions in drive to upper airway respiratory muscles and pump muscles occur. A well thought out and carefully described infrastructure of the normal and abnormal physiology in persons with OSAHS has been developed over the past few decades, which enables the development of innovative and largely effective therapies. The most recent data complement the infrastructure with the neurochemical changes underlying the state-dependent respiratory disorder and observations that the disease process itself can impair muscles, neural inputs, and soft tissue in a manner that has the potential to worsen disease. Oxidative and nitrosative stress from the repeated oxyhemoglobin desaturations and re-oxygenations is implicated in the injury to these tissues. An improved understanding of the mechanisms through which OSAHS progresses may lead to alternative therapies and aid in the identification of persons at risk for disease progression.
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Affiliation(s)
- Sigrid Carlen Veasey
- Division of Sleep Medicine, University of Pennsylvania School of Medicine, 3600 Spruce Street, Philadelphia, PA 19104, USA.
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Abstract
Obesity can profoundly alter pulmonary function and diminish exercise capacity by its adverse effects on respiratory mechanics, resistance within the respiratory system, respiratory muscle function, lung volumes, work and energy cost of breathing, control of breathing, and gas exchange. Weight loss can reverse many of the alterations of pulmonary function produced by obesity. Obesity places the patient at risk of aspiration pneumonia, pulmonary thromboembolism, and respiratory failure. It is the most common precipitating factor for obstructive sleep apnea and is a requirement for the obesity hypoventilation syndrome, both of which are associated with substantial morbidity and increased mortality. There are numerous medical and surgical therapies for obstructive sleep apnea and obesity hypoventilation. Weight reduction in the obese is among the most effective of these measures.
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Affiliation(s)
- S M Koenig
- Department of Medicine, University of Virginia School of Medicine and the University of Virginia Health System, Charlottesville 22908-00546, USA.
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Orem J, Lovering AT, Dunin-Barkowski W, Vidruk EH. Endogenous excitatory drive to the respiratory system in rapid eye movement sleep in cats. J Physiol 2000; 527 Pt 2:365-76. [PMID: 10970437 PMCID: PMC2270082 DOI: 10.1111/j.1469-7793.2000.00365.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A putative endogenous excitatory drive to the respiratory system in rapid eye movement (REM) sleep may explain many characteristics of breathing in that state, e.g. its irregularity and variable ventilatory responses to chemical stimuli. This drive is hypothetical, and determinations of its existence and character are complicated by control of the respiratory system by the oscillator and its feedback mechanisms. In the present study, endogenous drive was studied during apnoea caused by mechanical hyperventilation. We reasoned that if there was a REM-dependent drive to the respiratory system, then respiratory activity should emerge out of the background apnoea as a manifestation of the drive. Diaphragmatic muscle or medullary respiratory neuronal activity was studied in five intact, unanaesthetized adult cats who were either mechanically hyperventilated or breathed spontaneously in more than 100 REM sleep periods. Diaphragmatic activity emerged out of a background apnoea caused by mechanical hyperventilation an average of 34 s after the onset of REM sleep. Emergent activity occurred in 60 % of 10 s epochs in REM sleep and the amount of activity per unit time averaged approximately 40 % of eupnoeic activity. The activity occurred in episodes and was poorly related to pontogeniculo-occipital waves. At low CO2 levels, this activity was non-rhythmic. At higher CO2 levels (less than 0.5 % below eupnoeic end-tidal percentage CO2 levels in non-REM (NREM) sleep), activity became rhythmic. Medullary respiratory neurons were recorded in one of the five animals. Nineteen of twenty-seven medullary respiratory neurons were excited in REM sleep during apnoea. Excited neurons included inspiratory, expiratory and phase-spanning neurons. Excitation began about 43 s after the onset of REM sleep. Activity increased from an average of 6 impulses s-1 in NREM sleep to 15.5 impulses s-1 in REM sleep. Neuronal activity was non-rhythmic at low CO2 levels and became rhythmic when levels were less than 0.5 % below eupnoeic end-tidal levels in NREM sleep. The level of CO2 at which rhythmic neuronal activity developed corresponded to eupnoeic end-tidal CO2 levels in REM sleep. These results demonstrate an endogenous excitatory drive to the respiratory system in REM sleep and account for rapid and irregular breathing and the lower set-point to CO2 in that state.
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Affiliation(s)
- J Orem
- Department of Physiology, Texas Tech University School of Medicine, Lubbock, TX 79430, USA.
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Morrell MJ, Browne HA, Adams L. The respiratory response to inspiratory resistive loading during rapid eye movement sleep in humans. J Physiol 2000; 526 Pt 1:195-202. [PMID: 10878111 PMCID: PMC2270002 DOI: 10.1111/j.1469-7793.2000.00195.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/1999] [Accepted: 04/04/2000] [Indexed: 11/28/2022] Open
Abstract
We investigated the respiratory response to an added inspiratory resistive load (IRL) during rapid eye movement (REM) sleep in humans and compared this with those in non-REM (NREM) sleep and wakefulness. Results were obtained from 7 out of 15 healthy subjects (n = 7; 32 +/- 9 years, mean +/- s.d.). Linearised IRLs (4 and 12 cmH(2)O l(-1) s(-1)) were applied for five breaths during NREM sleep (4-10 trials per subject; total 101), REM sleep (2-5 trials; total 46) and wakefulness (2-3 trials; total 40). Respiratory variables were compared, between unloaded breathing (UL: mean of 5 breaths preceding IRL) and the 1st (B1) and 5th (B5) loaded breaths in each state. During wakefulness, 12 cmH(2)O l(-1) s(-1) IRL produced an immediate respiratory compensation with prolongation of inspiratory time (T(I); UL: 2.0 +/- 0.6; B1: 2.6 +/- 0.7 s) and an increase in tidal volume (V(T); UL: 0.49 +/- 0.12; B1: 0.52 +/- 0.12 l). During REM sleep, T(I) was prolonged (UL: 2.0 +/- 0.3; B1: 2.2 +/- 0.5 s), although V(T) fell (UL: 0.27 +/- 0.15; B1: 0.22 +/- 0.10 l). For both wakefulness and REM sleep the TI response was significantly greater than seen in NREM sleep (UL: 1.9 +/- 0.3; B1: 1.9 +/- 0.3 s.). For VT, only the wakefulness response was significantly different from NREM sleep (UL: 0.31 +/- 0.14; B1: 0.21 +/- 0.10 l). The B5 responses were not significantly different between states for any of the variables. REM sleep is associated with partial respiratory load compensation suggesting that exacerbation of sleep disordered breathing in REM (compared to NREM) sleep is unlikely to be secondary to an inability to overcome increases in upper airway resistance.
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Affiliation(s)
- M J Morrell
- National Heart and Lung Institute, Imperial College School of Medicine, Charing Cross Campus, St Dunstans Road, London W6 8RP, UK.
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Horner RL, Kubin L. Pontine carbachol elicits multiple rapid eye movement sleep-like neural events in urethane-anaesthetized rats. Neuroscience 1999; 93:215-26. [PMID: 10430485 DOI: 10.1016/s0306-4522(99)00126-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Microinjection of a cholinergic agonist, carbachol, into the pontine reticular formation of chronically instrumented intact or acutely decerebrate rats and cats has been used extensively to study rapid eye movement sleep mechanisms. In this study, we sought to develop a reduced carbachol model of rapid eye movement sleep-like neural events exhibiting multiple physiological markers of this state, and allowing for the use of invasive electrophysiological techniques. Accordingly, we investigated whether pontine carbachol could produce rapid eye movement sleep-like motor atonia and electrocortical changes in urethane-anaesthetized rats. We recorded cortical and hippocampal electroencephalograms and genioglossus and inspiratory intercostal muscle activities in 13 urethane-anaesthetized, spontaneously breathing, tracheotomized and vagotomized rats. In steady-state periods with high-voltage/low-frequency electroencephalogram activity, carbachol microinjections (15-40 nl, 10 mM) were placed in the medial pontine reticular formation. In 12 rats, carbachol elicited episodes of stereotyped hypotonia of genioglossus but not intercostal muscle activity, typical of rapid eye movement sleep, with a latency and duration of 2.2+/-0.3min (mean+/-S.E.M.) and 11.0+/-2.9 min, respectively. In four of these rats, also similar to rapid eye movement sleep, the major suppression of genioglossus activity (-74+/-9%) was accompanied by electroencephalogram desynchronization, appearance of hippocampal theta rhythm, and a respiratory rate increase (+ 14+/-3%). In the remaining eight rats, the stereotyped suppression of genioglossus activity (-48+/-3%) occurred without electroencephalogram desynchronization and hippocampal theta, and was accompanied by a respiratory rate decrease (-6+/-2%); a pattern of response typical of decerebrate animals. Within a rat, similar patterns of response to repeated carbachol injections at the same anatomical site were obtained. Pontine atropine prevented responses to subsequent carbachol injections. Thus, in urethane-anaesthetized rats, pontine carbachol consistently produced a differential suppression of pharyngeal versus respiratory pump muscle activity, and in a subset of animals, this was also accompanied by cortical and hippocampal electrographic changes typical of rapid eye movement sleep. This shows that complex and stereotyped neuronal events underlying both ascending and descending signs of rapid eye movement sleep can be pharmacologically activated under general anaesthesia. Such a reduced preparation may be useful for studies into the central neuronal mechanisms underlying generation of rapid eye movement sleep; particularly for studies requiring techniques that are difficult to implement in intact, naturally sleeping animals. The acceleration of the respiratory rate observed only when carbachol induced electroencephalogram desynchronization suggests that neural events associated with electrocortical changes contribute to the respiratory rate increases observed in natural rapid eye movement sleep.
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Affiliation(s)
- R L Horner
- Center for Sleep and Respiratory Neurobiology, University of Pennsylvania, Philadelphia 19104-4283, USA
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Schäfer T, Schläfke ME. Respiratory changes associated with rapid eye movements in normo- and hypercapnia during sleep. J Appl Physiol (1985) 1998; 85:2213-9. [PMID: 9843545 DOI: 10.1152/jappl.1998.85.6.2213] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Rapid eye movements during rapid-eye-movement (REM) sleep are associated with rapid, shallow breathing. We wanted to know whether this effect persisted during increased respiratory drive by CO2. In eight healthy subjects, we recorded electroencephalographic, electrooculographic, and electromyographic signals, ventilation, and end-tidal PCO2 during the night. Inspiratory PCO2 was changed to increase end-tidal PCO2 by 3 and 6 Torr. During normocapnia, rapid eye movements were associated with a decrease in total breath time by -0.71 +/- 0.19 (SE) s (P < 0.05) because of shortened expiratory time (-0.52 +/- 0.08 s, P < 0.001) and with a reduced tidal volume (-89 +/- 27 ml, P < 0.05) because of decreased rib cage contribution (-75 +/- 18 ml, P < 0.05). Abdominal (-11 +/- 16 ml, P = 0.52) and minute ventilation (-0.09 +/- 0.21 ml/min, P = 0.66) did not change. In hypercapnia, however, rapid eye movements were associated with a further shortening of total breath time. Abdominal breathing was also inhibited (-79 +/- 23 ml, P < 0.05), leading to a stronger inhibition of tidal volume and minute ventilation (-1.84 +/- 0.54 l/min, P < 0.05). We conclude that REM-associated respiratory changes are even more pronounced during hypercapnia because of additional inhibition of abdominal breathing. This may contribute to the reduction of the hypercapnic ventilatory response during REM sleep.
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Affiliation(s)
- T Schäfer
- Department of Applied Physiology, Ruhr-University Bochum, D-44780 Bochum, Germany.
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Rowley JA, Zahn BR, Babcock MA, Badr MS. The effect of rapid eye movement (REM) sleep on upper airway mechanics in normal human subjects. J Physiol 1998; 510 ( Pt 3):963-76. [PMID: 9660905 PMCID: PMC2231075 DOI: 10.1111/j.1469-7793.1998.00963.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/1998] [Accepted: 04/16/1998] [Indexed: 11/26/2022] Open
Abstract
1. It has been proposed that the upper airway is more compliant during rapid eye movement (REM) sleep than during non-rapid eye movement (NREM) sleep. The purpose of this study was to test this hypothesis in a group of subjects without sleep-disordered breathing. 2. On the first night, the effect of sleep stage on the relationship of retropalatal cross-sectional area (CSA; visualized with a fibre-optic scope) to pharyngeal pressure (PPH) measured at the soft palate during eupnoeic breathing was studied. Breaths during REM sleep were divided into phasic (associated with eye movements) and tonic (not associated with eye movements). There was a significant decrease in pharyngeal CSA during NREM sleep compared with wakefulness. There was no further decrease observed during either tonic or phasic REM sleep. Pharyngeal compliance, defined as the slope of the regression CSA versus PPH, was significantly increased during NREM sleep compared with wakefulness and REM sleep, with the compliance during both tonic and phasic REM sleep being similar to that observed in wakefulness. 3. On the second night, the effect of sleep stage on pressure-flow relationships of the upper airway was investigated. There was a trend towards the upper airway resistance being highest in NREM sleep compared with wakefulness and REM sleep. 4. We conclude that the upper airway is stiffer and less compliant during REM sleep than during NREM sleep. We postulate that this difference is secondary to differences in upper airway vascular perfusion between REM and NREM sleep.
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Affiliation(s)
- J A Rowley
- Medical Service, John F. Dingell Veterans Affairs Medical Center and Division of Pulmonary/Critical Care Medicine, Department of Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USA.
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Abstract
Patients with chronic obstructive pulmonary disease (COPD) become hypoxemic during sleep, particularly during rapid eye movement (REM) sleep. Those who are most hypoxemic when awake experience the most severe hypoxemia during sleep. The major cause of REM hypoxemia is hypoventilation, with additional contributions from alteration in ventilation/perfusion matching and functional residual capacity (FRC) reduction. REM hypoxemia probably contributes to the development of pulmonary hypertension and polycythemia and may predispose to cardiac arrhythmias in some patients. The most effective form of therapy is nocturnal oxygen therapy, but the indications for the use of nocturnal oxygen therapy are entirely based on daytime oxygenation levels. Routine polysomnography is not indicated in patients with COPD but should be performed in patients who have symptoms suggestive of coexisting sleep apnea/ hypopnea syndrome.
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Serotonin at the laterodorsal tegmental nucleus suppresses rapid-eye-movement sleep in freely behaving rats. J Neurosci 1997. [PMID: 9295399 DOI: 10.1523/jneurosci.17-19-07541.1997] [Citation(s) in RCA: 79] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Serotonin [5-hydroxytryptamine (5-HT)] is believed to play an important inhibitory role in the regulation of rapid-eye-movement (REM) sleep. 5-HT may exert this effect on neurons of the laterodorsal tegmental (LDT) nuclei that are implicated as important in the generation of REM sleep and phasic REM events such as ponto-geniculo-occipital (PGO) waves and respiratory variability. In rat brainstem in vitro, 5-HT hyperpolarizes and inhibits the bursting properties of LDT neurons assumed to be involved in generating REM sleep and PGO waves. This study tests the hypothesis that in vivo 5-HT at the LDT nuclei suppresses REM sleep and phasic REM events. Ten rats were implanted with bilateral cannulae aimed at the LDT and with electrodes for recording the electroencephalogram, neck electromyogram, PGO waves, and diaphragm electromyogram. During REM sleep, 5-HT (100 nl; 1-1.5 mM), saline, or sham microinjections were performed; repeated microinjections were separated by approximately 1 hr. After the first microinjection, REM sleep as a percent of the total sleep time was reduced with 5-HT (mean percent REM, 19.9 +/- 2.5% for 5-HT vs 26.8 +/- 2.4% for saline; p = 0.02). REM duration was reduced by 37% with 5-HT (p = 0.01), but REM episode frequency was changed less consistently (p = 0.21), suggesting that 5-HT mainly disrupted REM sleep maintenance. Per unit time of REM sleep, 5-HT had no effect on the amount or variability of REM PGO activity (p > 0.740) or on the mean or coefficient of variation of REM respiratory rate (p > 0.11). With subsequent microinjections, the effects of 5-HT on REM sleep were similar. A dose-dependent REM sleep suppression with 5-HT was observed in five rats tested. These data suggest that in vivo 5-HT at the LDT nuclei suppresses REM sleep expression. Although 5-HT did not disproportionately reduce the occurrence of phasic events within REM, total REM phasic activity was reduced because of less REM sleep after 5-HT.
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Togores Solivellas B, Agustí A. Trastornos respiratorios durante el sueño en la enfermedad pulmonar obstructiva crónica. Arch Bronconeumol 1996. [DOI: 10.1016/s0300-2896(15)30836-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Stalder S, Rösler KM, Nirkko AC, Hess CW. Magnetic stimulation of the human brain during phasic and tonic REM sleep: recordings from distal and proximal muscles. J Sleep Res 1995; 4:65-70. [PMID: 10607143 DOI: 10.1111/j.1365-2869.1995.tb00153.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
During REM sleep, a powerful postsynaptic inhibition of spinal motoneurons induces a generalized muscle hypotonia. Despite this inhibition, it has been shown that by transcranial magnetic stimulation of the brain (TMS), muscle responses of normal amplitude can be evoked in small hand muscles of humans. Tonic innervation during sleep is different in postural vs. limb muscles, and the spinal inhibition differs during tonic vs. phasic REM episodes, Both phenomena may affect muscle responses to TMS. In this study, muscle responses of 14 healthy subjects were compared to TMS in abductor digiti minimi, lumbar erector spinae, trapezius, and diaphragm during phasic and tonic REM sleep. In all four muscles, the amplitudes of the muscle responses were extremely variable, ranging for example in trapezius from -100% to +473% as compared to wakefulness. There was no systematic difference between the muscles. Moreover, no differences were found for TMS during phasic REM events compared to tonic REM sleep. Thus, responses to TMS during REM sleep may be preserved, with a decreased or increased amplitude. As a likely explanation, the cortical excitability and/or the spinal inhibition fluctuates during REM sleep in humans.
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Affiliation(s)
- S Stalder
- Department of Neurology, University of Berne, Inselspital, CH-3010 Berne/Switzerland
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42
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Furukawa Y, Cook IJ, Panagopoulos V, McEvoy RD, Sharp DJ, Simula M. Relationship between sleep patterns and human colonic motor patterns. Gastroenterology 1994; 107:1372-81. [PMID: 7926501 DOI: 10.1016/0016-5085(94)90539-8] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND/AIMS The precise relationships among colonic motor patterns, depth of sleep, and awakening are incompletely understood. The aim of this study was to correlate human colonic motor patterns with sleep stage, nocturnal arousals, and waking. METHODS We monitored sleep and correlated sleep stage, arousals, and waking with pressures (area under curve and propagating contractions) recorded from the entire colon in 11 healthy volunteers. RESULTS Propagating contraction frequency (P = 0.01) and area under the curve (P = 0.001) were significantly reduced at night. There was a highly significant correlation between depth of sleep and suppression of area under curve (P = 0.001) and propagating contraction frequency (P = 0.0001). Propagating contractions were eliminated during slow-wave sleep. During rapid eye movement sleep, colonic pressure and propagating contraction frequency increased sharply to levels comparable with those found in stage 2 sleep. Transient arousal from stable sleep, with or without waking, was a potent and immediate stimulus for colonic propagating contractions. CONCLUSIONS Sleep per se has a profound inhibitory effect on propagating and nonpropagating activity and is the major determinant of diurnal variation of colonic motility. Propagating contractions are eliminated in slow-wave sleep. Rapid eye movement sleep, arousals, and waking have immediate stimulatory effects on colonic motility.
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Affiliation(s)
- Y Furukawa
- Department of Gastroenterology, Royal Adelaide Hospital, University of Adelaide, Australia
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Hendricks JC, Petrof BJ, Panckeri K, Pack AI. Upper airway dilating muscle hyperactivity during non-rapid eye movement sleep in English bulldogs. THE AMERICAN REVIEW OF RESPIRATORY DISEASE 1993; 148:185-94. [PMID: 8317796 DOI: 10.1164/ajrccm/148.1.185] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Sleep-disordered breathing (SDB) is seen during rapid eye movement (REM) sleep in English bulldogs, but it is absent during non-REM sleep. The SDB during REM sleep is associated with changes in neural drive to the diaphragm (DIA) and to an upper airway dilator, the sternohyoid (SH). In the present study, the EMG activity of the DIA was recorded in unrestrained, naturally sleeping, English bulldogs (n = 6) and in control dogs (n = 5). The EMG of the SH was recorded in five of these bulldogs and in four of the control dogs. The activity of the DIA was similar in the two groups of dogs throughout sleep, with the normal increased variability and altered recruitment patterns during REM sleep in all dogs. However, in the presence of the narrowed upper airway of bulldogs, the pattern of the upper airway dilator was dramatically different. In bulldogs, SH activity was virtually always related to inspiration (96 to 100% of breaths during both waking and non-REM sleep). In contrast, SH activity showed inspiratory-related increases in only a minority of breaths during non-REM sleep (32%) in control dogs (p < 0.05). Furthermore, SH drive, as measured by the plateau amplitude, fell during REM sleep in bulldogs, whereas it increased in control dogs (p < 0.05). In control dogs without SDB, we found that central respiratory drive to the SH was highest but variable during waking and minimal during non-REM sleep and that it fluctuated with phasic events during REM sleep. In bulldogs, however, high levels of SH activity occurred during waking and throughout non-REM sleep, apparently preventing SDB in these states. Episodic decreases in SH drive were observed during REM, and they were associated with SDB. These data support the proposition that compensatory pharyngeal dilator hyperactivity is necessary to maintain airway patency and normal breathing in bulldogs, a canine breed with an anatomically compromised upper airway.
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Affiliation(s)
- J C Hendricks
- Department of Clinical Studies, School of Veterinary Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104-6010
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Kubin L, Kimura H, Tojima H, Pack AI, Davies RO. Behavior of VRG neurons during the atonia of REM sleep induced by pontine carbachol in decerebrate cats. Brain Res 1992; 592:91-100. [PMID: 1450925 DOI: 10.1016/0006-8993(92)91662-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The microinjection of carbachol into the pons of acute decerebrate cats elicits a REM sleep-like atonia and a profound suppression of respiratory motoneuronal activity (J. Appl. Physiol., 69 (1990) 2280-2289). To assess whether this suppression is mediated by medullary neurons that provide respiratory drive to motoneurons of the respiratory pump muscles (diaphragm and intercostals), we studied the effect of pontine carbachol on the activity of neurons of the ventral respiratory group (VRG) in decerebrate, vagotomized, paralyzed and artificially ventilated cats. VRG neurons were recorded extracellularly along with the activity of phrenic and intercostal (external and internal) nerves. Both inspiratory (I) and expiratory (E) VRG neurons had incrementing, ramp-like bursts of activity during their firing periods and were not vagal motoneurons. Carbachol produced a depression of the peak firing rate in most (42/57) neurons studied. However, five cells showed no change and ten had an increase in activity in spite of consistent depression at the motoneuronal level. For the total population of cells (34 I and 23 E), the peak firing was reduced to 88.5% +/- 16.3 (S.D.) of control. The simultaneously recorded phrenic activity was reduced to 77.9% +/- 11.5, while inspiratory intercostal activity fell to 63.4% +/- 21.6 and expiratory to 23.2% +/- 21.2 of control. The carbachol-induced changes in peak firing of both I and E cells were quantitatively similar, and positively correlated to changes in peak phrenic activity. Analysis of this correlation suggested that phrenic and intercostal activities will be depressed to some degree by carbachol even when the average VRG cell activity remains unchanged. In addition, our data show that VRG cells may receive a combination of inhibitory and excitatory inputs during the carbachol-induced depression of respiratory motoneurons. Thus, although some disfacilitation from VRG cells may occur, there must be additional inhibitory or disfacilitatory pathways that mediate the decrease in activity of both phrenic and intercostal motoneurons that accompanies the REM sleep-like atonia.
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Affiliation(s)
- L Kubin
- Department of Animal Biology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia 19104-6046
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Chang FC. Modification of medullary respiratory-related discharge patterns by behaviors and states of arousal. Brain Res 1992; 571:281-92. [PMID: 1611499 DOI: 10.1016/0006-8993(92)90666-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The modulatory influences of behaviors and states of arousal on bulbar respiratory-related unit (RRU) discharge patterns were studied in an unanesthetized, freely behaving guinea pig respiratory model system. When fully instrumented, this model system permits concurrent monitoring and recording of (i) single units from either Bötzinger complex or nucleus para-ambiguus; (ii) electrocorticogram; and, (iii) diaphragmatic EMG. In addition to being used in surveys of RRU discharge patterns in freely behaving states, the model system also offered a unique opportunity in investigating the effects of pentobarbital on RRU discharge patterns before, throughout the course of, and during recovery from anesthesia. In anesthetized preparations, a particular RRU discharge pattern (such as tonic, incrementing or decrementing) typically displayed little, if any notable variation. The most striking development following pentobarbital was a state of progressive bradypnea attributable to a significantly augmented RRU cycle duration, burst duration and an increase in the RRU spike frequencies during anesthesia. In freely behaving states, medullary RRU activities rarely adhered to a fixed, immutable discharge pattern. More specifically, the temporal organization (such as burst duration, cycle duration, and the extent of modulation of within-burst spike frequencies) of RRU discharge patterns regularly showed complex and striking variations, not only with states of arousal (sleep/wakefulness, anesthesia) but also with discrete alterations in electrocorticogram (ECoG) activities and a multitude of on-going behavioral repertoires such as volitional movement, postural modification, phonation, mastication, deglutition, sniffing/exploratory behavior, alerting/startle reflexes. Only during sleep, and on occasions when the animal assumed a motionless, resting posture, could burst patterns of relatively invariable periodicity and uniform temporal attributes be observed. RRU activities during sniffing reflex is worthy of further note in that, based on power spectrum analyses of concurrently recorded ECoG activities, this particular discharge pattern was clearly associated with the activation of a 6-10 Hz theta rhythm. These findings indicated that bulbar RRU activity patterns are subject to change by not only behaviors and sleep/wakefulness cycles, but also a variety of modulatory influences and feedback/feedforward biases from other central and peripheral physiological control mechanisms.
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Affiliation(s)
- F C Chang
- Neurotoxicology Branch, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD 21010-5425
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Douglas NJ, Flenley DC. Breathing during sleep in patients with obstructive lung disease. THE AMERICAN REVIEW OF RESPIRATORY DISEASE 1990; 141:1055-70. [PMID: 2183654 DOI: 10.1164/ajrccm/141.4_pt_1.1055] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- N J Douglas
- Department of Respiratory Medicine, University of Edinburgh, United Kingdom
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Gould GA, Gugger M, Molloy J, Tsara V, Shapiro CM, Douglas NJ. Breathing pattern and eye movement density during REM sleep in humans. THE AMERICAN REVIEW OF RESPIRATORY DISEASE 1988; 138:874-7. [PMID: 3202462 DOI: 10.1164/ajrccm/138.4.874] [Citation(s) in RCA: 61] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Changes in the density of eye movement during rapid eye movement (REM) sleep are associated with changes in ventilation and ventilatory response in animals. Recent data in patients with chronic obstructive pulmonary disease suggest that periods of frequent eye movements may be associated with hypoxemia during REM sleep. We have therefore investigated the association between eye movements and ventilation and ventilatory pattern in 10 normal men. Expired ventilation was measured using a pneumotachograph attached to a valved face mask with a dead space of 50 ml and incorporating a peripheral CO2 leak detector. Ventilation was reduced (p less than 0.02) in all stages of sleep compared with that during wakefulness, with no difference between the level of ventilation in each sleep stage (awake, 7.18 +/- 0.43 SEM; Stage 2, 6.47 +/- 0.43; Stage 3/4, 6.45 +/- 0.52; REM sleep, 6.55 +/- 0.47 L/min). During REM sleep, eye movements (EMs) were associated with rapid shallow breathing. Dividing REM into 20-s epochs with or without EMs, EMs were associated with a raised breathing frequency (no EMs, 14.4 +/- 0.4 breaths/min; EMs, 15.8 +/- 0.5 breaths/min; p = 0.01), reduced tidal volume (0.49 +/- 0.03 L; 0.41 +/- 0.03 L; p less than 0.01), and reduced minute ventilation (6.87 +/- 0.45 L; 6.27 +/- 0.51 L; p = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- G A Gould
- Rayne Laboratory, Department of Respiratory Medicine, University of Edinburgh, United Kingdom
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