1
|
Wan Y, Lv M, Zhou K, Li Z, Du X, Wu W, Xue R. Mood Disorders are Correlated with Autonomic Nervous Function in Chronic Insomnia Patients with OSA. Nat Sci Sleep 2023; 15:511-522. [PMID: 37426309 PMCID: PMC10327906 DOI: 10.2147/nss.s396773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/21/2023] [Indexed: 07/11/2023] Open
Abstract
Purpose To evaluate the correlation between sleep microstructure, autonomic nervous system activity, and neuropsychological characteristics in chronic insomnia (CI) patients with obstructive sleep apnea (OSA). Patients and Methods Forty-five CI-OSA patients, forty-six CI patients and twenty-two matched healthy control subjects (HCs) were enrolled. CI-OSA patients were then divided into two groups: mild OSA and moderate-to-severe OSA. All participants completed neuropsychological tests, which included the Hamilton Depression and Anxiety Scales (HAMD and HAMA), the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale (ESS), and the Mini-mental State Examination (MMSE). The autonomic nervous system activity and sleep microstructure were examined by the PSM-100A. Results The CI-OSA patients exhibited higher scores on the PSQI, ESS, ISI, HAMA, and HAMD than HCs and CI patients (all p < 0.01). The CI-OSA patients had a lower proportion of stable sleep, REM sleep and a higher proportion of unstable sleep ratio (all p < 0.01) than HCs and CI patients (all p < 0.01). The CI-OSA patients had higher ratios of LF and LF/HF, and lower ratios of HF and Pnn50% (all p < 0.01) than HCs and CI patients (all p < 0.01). Compared to CI-mild OSA patients, the CI-moderate-to-severe OSA patients presented with a higher ESS scores, higher ratios of LF and LF/HF, and lower ratios of HF (all p < 0.05). In CI-OSA patients, higher HAMD scores were correlated with decreased MMSE scores (r=-0.678, p < 0.01). A higher LF ratio was correlated with higher HAMD and HAMA scores (r=0.321, p=0.031, r =0.449, p =0.002), and a higher HF ratio was correlated with lower HAMD and HAMA scores (r=-0.321, P =0.031, r =-0.449, p =0.002). Conclusion OSA exacerbates the abnormalities of sleep microstructure and the autonomic nervous dysfunction in CI patients. Dysfunction of the autonomic nervous system could contribute to mood deterioration in CI with OSA patients.
Collapse
Affiliation(s)
- Yahui Wan
- Departments of Neurology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, 300308, People’s Republic of China
| | - Mengdi Lv
- Departments of Neurology, Tianjin First Central Hospital, Tianjin, 300190, People’s Republic of China
| | - Kaili Zhou
- Departments of Neurology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, 300308, People’s Republic of China
| | - Zheng Li
- Departments of Neurology, Binhai Hospital, Peking University, Tianjin, 300450, People’s Republic of China
| | - Xueyun Du
- Departments of Neurology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, 300308, People’s Republic of China
| | - Wei Wu
- Departments of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
| | - Rong Xue
- Departments of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
| |
Collapse
|
2
|
Yeh WC, Lin HJ, Li YS, Chien CF, Wu MN, Liou LM, Hsieh CF, Hsu CY. Non-rapid eye movement sleep instability in adults with epilepsy: a systematic review and meta-analysis of cyclic alternating pattern. Sleep 2022; 45:6534481. [PMID: 35192721 DOI: 10.1093/sleep/zsac041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/24/2022] [Indexed: 12/29/2022] Open
Abstract
STUDY OBJECTIVES Epilepsy is characterized by disrupted sleep architecture. Studies on sleep macro- and microstructure revealed that patients with epilepsy experience disturbed rapid eye movement (REM) sleep; however, no consensus has been reached on non-REM (NREM) sleep changes. Cyclic alternating pattern (CAP) is a marker of sleep instability that occurs only during NREM sleep. This meta-analysis investigated CAP differences between patients with epilepsy and healthy controls. METHODS This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines in searching PubMed, Embase, and Cochrane Central database for studies comparing polysomnographic sleep microstructures between patients with epilepsy and healthy controls. A meta-analysis using a random-effects model was performed. We compared CAP rates, percentages of phase A1, A2, A3 subtypes, and phase B durations between patients with epilepsy and healthy controls. RESULTS A total of 11 studies, including 209 patients with epilepsy and 197 healthy controls, fulfilled the eligibility criteria. Compared with healthy controls, patients with epilepsy had significantly increased CAP rates and decreased A1 subtype percentages, and patients with sleep-related epilepsy had increased A3 subtype percentages. Subgroup analyses revealed that antiseizure medications (ASMs) decreased CAP rates and increased phase B durations but did not affect the microstates of phase A in patients with sleep-related epilepsy. CONCLUSIONS This meta-analysis detected statistically significant differences in CAP parameters between patients with epilepsy and healthy controls. Our findings suggest patients with epilepsy experience NREM sleep instability. ASMs treatment may decrease NREM instability but did not alter the microstates of phase A.
Collapse
Affiliation(s)
- Wei-Chih Yeh
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.,Department of Neurology, Sleep Disorders Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Huan-Jan Lin
- Department of Neurology, E-DA Hospital, Kaohsiung, Taiwan.,College of medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ying-Sheng Li
- Department of Neurology, Sleep Disorders Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.,Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan and
| | - Ching-Fang Chien
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.,Department of Neurology, Sleep Disorders Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Meng-Ni Wu
- Department of Neurology, Sleep Disorders Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.,Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan and
| | - Li-Min Liou
- Department of Neurology, Sleep Disorders Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.,Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan and
| | - Cheng-Fang Hsieh
- Department of Neurology, Sleep Disorders Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.,Department of Internal Medicine, Division of Geriatrics and Gerontology, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Chung-Yao Hsu
- Department of Neurology, Sleep Disorders Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.,Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan and
| |
Collapse
|
3
|
Hartmann S, Ferri R, Bruni O, Baumert M. Causality of cortical and cardiovascular activity during cyclic alternating pattern in non-rapid eye movement sleep. Philos Trans A Math Phys Eng Sci 2021; 379:20200248. [PMID: 34689628 DOI: 10.1098/rsta.2020.0248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 06/13/2023]
Abstract
The dynamic interplay between central and autonomic nervous system activities plays a pivotal role in orchestrating sleep. Macrostructural changes such as sleep-stage transitions or phasic, brief cortical events elicit fluctuations in neural outflow to the cardiovascular system, but the causal relationships between cortical and cardiovascular activities underpinning the microstructure of sleep are largely unknown. Here, we investigate cortical-cardiovascular interactions during the cyclic alternating pattern (CAP) of non-rapid eye movement sleep in a diverse set of overnight polysomnograms. We determine the Granger causality in both 507 CAP and 507 matched non-CAP sequences to assess the causal relationships between electroencephalography (EEG) frequency bands and respiratory and cardiovascular variables (heart period, respiratory period, pulse arrival time and pulse wave amplitude) during CAP. We observe a significantly stronger influence of delta activity on vascular variables during CAP sequences where slow, low-amplitude EEG activation phases (A1) dominate than during non-CAP sequences. We also show that rapid, high-amplitude EEG activation phases (A3) provoke a more pronounced change in autonomic activity than A1 and A2 phases. Our analysis provides the first evidence on the causal interplay between cortical and cardiovascular activities during CAP. Granger causality analysis may also be useful for probing the level of decoupling in sleep disorders. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.
Collapse
Affiliation(s)
- Simon Hartmann
- School of Electrical and Electronic Engineering, University of Adelaide, Adelaide, Australia
| | - Raffaele Ferri
- Sleep Research Center, Department of Neurology IC, Oasi Research Institute-IRCCS, Troina, Italy
| | - Oliviero Bruni
- Department of Social and Developmental Psychology, Sapienza University, Rome, Italy
| | - Mathias Baumert
- School of Electrical and Electronic Engineering, University of Adelaide, Adelaide, Australia
| |
Collapse
|
4
|
Petruzzelli MG, Matera E, Giambersio D, Marzulli L, Gabellone A, Legrottaglie AR, Margari A, Margari L. Subjective and Electroencephalographic Sleep Parameters in Children and Adolescents with Autism Spectrum Disorder: A Systematic Review. J Clin Med 2021; 10:3893. [PMID: 34501341 DOI: 10.3390/jcm10173893] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/18/2021] [Accepted: 08/26/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Sleep problems have commonly manifested in children and adolescents with autism spectrum disorder (ASD) with a complex and multifactorial interaction between clinical and etiological components. These disorders are associated with functional impairment, and provoke significant physical and mental affliction. The purpose of this study is to update the existing literature about objective and subjective sleep parameters in children and adolescents with ASD, extrapolating information from polysomnography or sleep electroencephalography, and sleep related questionnaires. Methods: We have conducted a systematic review of case-control studies on this topic, performing a web-based search on PubMed, Scopus and the Web of Science databases according to the Preferred Reporting items for Systematic Review and Meta-analyses (PRISMA) guidelines. Results: Data collected from 20 survey result reports showed that children and adolescents with ASD experienced a higher rate of sleep abnormalities than in typically developing children. The macrostructural sleep parameters that were consistent with subjective parent reported measures unveil a greater percentage of nighttime signs of insomnia. Sleep microstructure patterns, in addition, pointed towards the bidirectional relationship between brain dysfunctions and sleep problems in children with ASD. Conclusions: Today’s literature acknowledges that objective and subjective sleep difficulties are more often recognized in individuals with ASD, so clinicians should assess sleep quality in the ASD clinical population, taking into consideration the potential implications on treatment strategies. It would be worthwhile in future studies to examine how factors, such as age, cognitive level or ASD severity could be related to ASD sleep abnormalities. Future research should directly assess whether sleep alterations could represent a specific marker for atypical brain development in ASD.
Collapse
|
5
|
Sharma M, Patel V, Tiwari J, Acharya UR. Automated Characterization of Cyclic Alternating Pattern Using Wavelet-Based Features and Ensemble Learning Techniques with EEG Signals. Diagnostics (Basel) 2021; 11:diagnostics11081380. [PMID: 34441314 PMCID: PMC8393617 DOI: 10.3390/diagnostics11081380] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/03/2022] Open
Abstract
Sleep is highly essential for maintaining metabolism of the body and mental balance for increased productivity and concentration. Often, sleep is analyzed using macrostructure sleep stages which alone cannot provide information about the functional structure and stability of sleep. The cyclic alternating pattern (CAP) is a physiological recurring electroencephalogram (EEG) activity occurring in the brain during sleep and captures microstructure of the sleep and can be used to identify sleep instability. The CAP can also be associated with various sleep-related pathologies, and can be useful in identifying various sleep disorders. Conventionally, sleep is analyzed using polysomnogram (PSG) in various sleep laboratories by trained physicians and medical practitioners. However, PSG-based manual sleep analysis by trained medical practitioners is onerous, tedious and unfavourable for patients. Hence, a computerized, simple and patient convenient system is highly desirable for monitoring and analysis of sleep. In this study, we have proposed a system for automated identification of CAP phase-A and phase-B. To accomplish the task, we have utilized the openly accessible CAP sleep database. The study is performed using two single-channel EEG modalities and their combination. The model is developed using EEG signals of healthy subjects as well as patients suffering from six different sleep disorders namely nocturnal frontal lobe epilepsy (NFLE), sleep-disordered breathing (SDB), narcolepsy, periodic leg movement disorder (PLM), insomnia and rapid eye movement behavior disorder (RBD) subjects. An optimal orthogonal wavelet filter bank is used to perform the wavelet decomposition and subsequently, entropy and Hjorth parameters are extracted from the decomposed coefficients. The extracted features have been applied to different machine learning algorithms. The best performance is obtained using ensemble of bagged tress (EBagT) classifier. The proposed method has obtained the average classification accuracy of 84%, 83%, 81%, 78%, 77%, 76% and 72% for NFLE, healthy, SDB, narcolepsy, PLM, insomnia and RBD subjects, respectively in discriminating phases A and B using a balanced database. Our developed model yielded an average accuracy of 78% when all 77 subjects including healthy and sleep disordered patients are considered. Our proposed system can assist the sleep specialists in an automated and efficient analysis of sleep using sleep microstructure.
Collapse
Affiliation(s)
- Manish Sharma
- Department of Electrical and Computer Science Engineering, Institute of Infrastructure, Technology, Research and Management (IITRAM), Ahmedabad 380026, India; (V.P.); (J.T.)
- Correspondence:
| | - Virendra Patel
- Department of Electrical and Computer Science Engineering, Institute of Infrastructure, Technology, Research and Management (IITRAM), Ahmedabad 380026, India; (V.P.); (J.T.)
| | - Jainendra Tiwari
- Department of Electrical and Computer Science Engineering, Institute of Infrastructure, Technology, Research and Management (IITRAM), Ahmedabad 380026, India; (V.P.); (J.T.)
| | - U. Rajendra Acharya
- School of Engineering, Ngee Ann Polytechnic, Singapore 599489, Singapore;
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 41354, Taiwan
- School of Management and Enterprise, University of Southern Queensland, Springfield 4300, Australia
| |
Collapse
|
6
|
Mutti C, Bernabè G, Barozzi N, Ciliento R, Trippi I, Pedrazzi G, Azzi N, Parrino L. Commonalities and Differences in NREM Parasomnias and Sleep-Related Epilepsy: Is There a Continuum Between the Two Conditions? Front Neurol 2020; 11:600026. [PMID: 33362702 PMCID: PMC7759670 DOI: 10.3389/fneur.2020.600026] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/19/2020] [Indexed: 01/17/2023] Open
Abstract
Introduction: Differential diagnosis between disorders of arousal (DoA) and sleep-related hypermotor epilepsy (SHE) often represents a clinical challenge. The two conditions may be indistinguishable from a semiological point of view and the scalp video-polysomnography is often uninformative. Both disorders are associated with variable hypermotor manifestations ranging from major events to fragments of a hierarchical continuum of increasing intensity, complexity, and duration. Given their semiological overlap we decided to explore the sleep texture of DoA and SHE seeking for similarities and differences. Methods: We analyzed sleep macrostructure and CAP (cyclic alternating pattern) parameters in a cohort of 35 adult DoA patients, 40 SHE patients and 24 healthy sleepers, all recorded and scored in the same sleep laboratory. Nocturnal behavioral manifestations included minor motor events, paroxysmal arousals and major attacks in SHE, and simple, rising, or complex arousal movements in DoA. Results: Compared to healthy controls, DoA and SHE showed similar amounts of sleep efficiency, light sleep, deep sleep, REM sleep, CAP subtypes. Both groups also showed slow wave sleep fragmentation and an increased representation of stage N3 in the second part of the night. The only discriminating elements between the two conditions regarded sleep length (more reduced in DoA) and sleep instability (more elevated in SHE). In DoA recordings, all motor episodes arose from NREM sleep: 37% during light NREM stages and 63% during stage N3 (simple arousal movements: 94%). In SHE recordings, 57% of major attacks occurred during stage N3. Conclusions: So far, emphasis has been placed on the differentiation of sleep-related epilepsy and NREM arousal disorders. However, the impressive analogies between DoA and SHE suggest the existence of an underestimated continuum across the conditions, linked by increased levels of sleep instability, higher amounts of slow wave sleep and NREM/REM sleep imbalance. Sleep texture is extremely similar in the two conditions, although CAP metrics disclose quantitative differences. In particular, SHE patients show a higher arousal instability compared to DoA subjects. Given their clinical and epidemiological overlap, a common genetic background is also hypothesized. In such a perspective, we suggest that the consolidated dichotomy DoA vs. SHE should be reappraised.
Collapse
Affiliation(s)
- Carlotta Mutti
- Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Giorgia Bernabè
- Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Noemi Barozzi
- Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Rosario Ciliento
- Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Irene Trippi
- Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Giuseppe Pedrazzi
- Unit of Neuroscience & Interdepartmental Center of Robust Statistics, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Nicoletta Azzi
- Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Liborio Parrino
- Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| |
Collapse
|
7
|
Abstract
STUDY OBJECTIVES The association of snoring and sleep-disordered breathing (SDB) with daytime sleepiness is well documented; however, the exact mechanisms, and especially the role of sleep microstructure that may account for this association remain incompletely understood. In a cohort of children with SDB, we aimed to compare sleep spindle activity between children with daytime sleepiness versus those without daytime sleepiness. METHODS Children with SDB who reported daytime sleepiness were recruited and compared with age- and sex-matched SDB controls. Polysomnographic recordings were analyzed evaluating sleep spindle activity. A statistical comparison was carried out in both groups to assess the association between sleepiness and sleep spindle activity. RESULTS Thirty-three children with SDB (mean age: 7.5 ± 1.7 years) were included, 10 with and 23 without daytime sleepiness. Spindle activity was lower in children with daytime sleepiness compared with those without; in stage N2, median (interquartile range) sleep spindle indexes were 77.5 (37.3) and 116.9 (71.2) (P = .015), respectively. CONCLUSIONS Spindles were significantly reduced in children with SDB and daytime sleepiness. The exact mechanisms of this association remain unknown and future research is needed in order to establish the exact role of sleep spindle activity on daytime symptoms in children with SDB.
Collapse
Affiliation(s)
- Pablo E Brockmann
- Department of Pediatric Cardiology and Pulmonology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Pediatric Sleep Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute-Istituto di Ricovero e Cura Carattere Scientifico, Troina, Italy
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy
| |
Collapse
|
8
|
Karimzadeh F, Nami M, Boostani R. Sleep microstructure dynamics and neurocognitive performance in obstructive sleep apnea syndrome patients. J Integr Neurosci 2018; 16:127-142. [PMID: 28891505 DOI: 10.3233/jin-170004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The present study examined the relationship between the increment in cyclic alternating patterns (CAPs) in sleep electroencephalography and neurocognitive decline in obstructive Sleep Apnea Syndrome (OSAS) patients through source localization of the phase-A of CAPs. All-night polysomnographic recordings of 10 OSAS patients and 4 control subjects along with their cognitive profile using the Addenbrooke's Cognitive Examination (ACE) test were acquired. The neuropsychological assessment involved five key domains including attention and orientation, verbal fluency, memory, language and visuo-spatial skills. The standardized low-resolution brain electromagnetic tomography (sLORETA) tool was used to source-localize the phase-A of CAPs in sleep EEG aiming to investigate the correlation between CAP phase-A and cognitive functions. Our findings suggested a significant increase in CAP rates among OSAS subjects versus control subjects. Moreover, sLORETA revealed that CAP phase-A is mostly activated in frontoparietal cortices. As CAP rate increases, the activity of phase-A in such areas is dramatically enhanced leading to arousal instability, lower sleep efficiency and a possibly impaired cortical capacity to consolidate cognitive inputs in frontal and parietal areas during sleep. As such, cognitive domains including verbal fluency, memory and visuo-spatial skills which predominantly relate to frontoparietal areas tend to be affected. Based on our findings, CAP activity may possibly be considered as a predictor of cognitive decline among OSAS patients.
Collapse
Affiliation(s)
- Foroozan Karimzadeh
- Department of Computer Science and Information Technology, School of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran. E-mails: ,
| | - Mohammad Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran. E-mail: .,Neuroscience Laboratory - NSL (Brain, Cognition and Behavior), School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences Shiraz, Iran
| | - Reza Boostani
- Department of Computer Science and Information Technology, School of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran. E-mails: ,
| |
Collapse
|
9
|
Chamorro R, Ferri R, Algarín C, Garrido M, Lozoff B, Peirano P. Sleep cyclic alternating pattern in otherwise healthy overweight school-age children. Sleep 2014; 37:557-60. [PMID: 24587578 DOI: 10.5665/sleep.3496] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES To compare sleep microstructure (cyclic alternating pattern, CAP) characteristics in otherwise healthy overweight (OW) and normal weight (NW) children. DESIGN Polysomnographic cross-sectional study. SETTING Sleep laboratory. PARTICIPANTS Fifty-eight (26 NW and 32 OW) 10-year-old children. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Participants were part of a longitudinal study beginning in infancy and free of sleep disorders. Groups were based on body-mass index (BMI) z-score. From polysomnographic overnight recordings, sleep-waking states were scored according to international criteria. CAP analysis was performed visually during NREM sleep. Conventional sleep parameters were similar between groups. BMI was positively related to CAP rate and CAP sequences but inversely related to CAP B phase duration. Differences between groups were confined to slow-wave sleep (SWS), with OW children showing higher CAP rate, CAP cycles, and CAP A1 number and index and shorter CAP cycles and B phase duration. They also showed more CAP class intervals shorter than 30 s, and a suggestive trend for fewer intervals longer than 30 s. CONCLUSIONS Cyclic alternating pattern characteristics in children related to nutritional status and were altered in overweight subjects during slow-wave sleep. We suggest that the more frequent oscillatory pattern of electroencephalographic slow activity in overweight subjects might reflect less stable slow-wave sleep episodes.
Collapse
Affiliation(s)
- Rodrigo Chamorro
- Sleep Laboratory, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Raffaele Ferri
- Sleep Research Center, Department of Neurology IC, OASI Research Institute (IRCCS), Troina, Italy
| | - Cecilia Algarín
- Sleep Laboratory, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Marcelo Garrido
- Sleep Laboratory, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Betsy Lozoff
- Center for Human Growth and Development and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI
| | - Patricio Peirano
- Sleep Laboratory, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| |
Collapse
|
10
|
|
11
|
Simor P, Bódizs R, Horváth K, Ferri R. Disturbed dreaming and the instability of sleep: altered nonrapid eye movement sleep microstructure in individuals with frequent nightmares as revealed by the cyclic alternating pattern. Sleep 2013; 36:413-9. [PMID: 23449753 DOI: 10.5665/sleep.2462] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Nightmares are disturbing mental experiences during sleep that usually result in abrupt awakenings. Frequent nightmares are associated with poor subjective sleep quality, and recent polysomnographic data suggest that nightmare sufferers exhibit impaired sleep continuity during nonrapid eye movement (NREM) sleep. Because disrupted sleep might be related to abnormal arousal processes, the goal of this study was to examine polysomnographic arousal-related activities in a group of nightmare sufferers and a healthy control group. DESIGN Sleep microstructure analysis was carried out by scoring the cyclic alternating pattern (CAP) in NREM sleep and the arousal index in rapid eye movement (REM) sleep on the second night of the polysomnographic examination. SETTING Hospital-based sleep research laboratory. PARTICIPANTS There were 17 in the nightmare (NMs) group and 23 in the healthy control (CTLs) group. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS The NMs group exhibited reduced amounts of CAP A1 subtype and increased CAP A2 and A3 subtypes, as well as longer duration of CAP A phases in comparison with CTLs. Moreover, these differences remained significant after controlling for the confounding factors of anxious and depressive symptoms. The absolute number and frequency of REM arousals did not differ significantly between the two groups. CONCLUSIONS The results of our study indicate that NREM sleep microstructure is altered during nonsymptomatic nights of nightmares. Disrupted sleep in the NMs group seems to be related to abnormal arousal processes, specifically an imbalance in sleep-promoting and arousing mechanisms during sleep. CITATION Simor P; Bódizs R; Horváth K; Ferri R. Disturbed dreaming and the instability of sleep: altered nonrapid eye movement sleep microstructure in individuals with frequent nightmares as revealed by the cyclic alternating pattern. SLEEP 2013;36(3):413-419.
Collapse
Affiliation(s)
- Péter Simor
- Department of Cognitive Sciences, Budapest University of Technology and Economics, Budapest, Hungary.
| | | | | | | |
Collapse
|