Classification and automatic scoring of arousal intensity during sleep stages using machine learning.

Arousal during sleep can result in sleep fragmentation and various physiological effects, impairing cognitive function and raising blood pressure and heart rate. However, the current definition of arousal has limitations in assessing both amplitude and duration, making it challenging to measure sleep fragmentation accurately. Moreover, there is inconsistency among inter-raters in arousal scoring, which renders it susceptible to subjective variability. Therefore, this study aims to identify a highly accurate classifier for each sleep stage by employing optimized feature selection and machine learning models. According to electroencephalography (EEG) signals during the arousal phase, the intensity level was categorized into four levels. For control, the non-arousal cases were used as level 0 and referred as sham arousal, resulting in five arousal intensity levels. Wavelet transform was applied to analyze sleep arousal to extract features from EEG. Based on these features, we classified arousal intensity levels through machine learning algorithms. Due to the different characteristics of EEG in each sleep stage, the classification model was optimized for the four sleep stages. Excluding sham arousals, a total of 13,532 arousal events were used. The lowest intensity in the entire data, level 1, was computed to be 3107, level 2 was 3384, level 3 was 3472, and the highest intensity of level 4 was 3,569. The optimized classification model for each sleep stage achieved an average sensitivity of 82.68%, specificity of 95.68%, and AUROC of 96.30%. The sensitivity of the control, arousal intensity level 0, was 83.07%, a 1.25% increase over the unoptimized model and a 14.22% increase over previous research. This study used machine learning techniques to develop classifiers for each sleep stage, improving the accuracy of arousal intensity classification. The classifiers showed high sensitivity and specificity and revealed the unique characteristics of arousal intensity during different sleep stages. These findings represent a novel approach to arousal research and have implications for developing more accurate predictive models in sleep research.

Lower autonomic arousal as a risk factor for criminal offending and unintentional injuries among female conscripts.

BACKGROUND: Lower autonomic arousal is a well-known correlate of criminal offending and other risk-taking behaviors in men, but few studies have investigated this association in women. AIM: To test associations between autonomic arousal and criminal offending as well as unintentional injuries among female conscripts. METHODS: All women born 1958-1994 in Sweden who participated in voluntary military conscription (n = 12,499) were identified by linking Swedish population-based registers. Predictors were resting heart rate (RHR) and systolic blood pressure (SBP). Covariates were height, weight, and physical energy capacity. Main outcomes were criminal convictions (any, violent, and non-violent) from the National Crime Register. Secondary outcome was unintentional injuries requiring medical treatment or causing death. We used survival analyses to test for associations between predictors and outcomes. RESULTS: Low RHR, relative to high RHR, was associated with an increased risk of any criminal conviction, non-violent criminal convictions, and unintentional injuries. Low SBP, relative to high SBP, was associated with an increased risk of violent criminal convictions. CONCLUSIONS: Results support lower autonomic arousal, particularly lower RHR, as a correlate of criminal offending among women that warrants further examination, as the reported findings have potential implications for the prediction of future female crime.

Conceptual framework for tinnitus: a cognitive model in practice.

Tinnitus is a conscious attended awareness perception of sourceless sound. Widespread theoretical and evidence-based neurofunctional and psychological models have tried to explain tinnitus-related distress considering the influence of psychological and cognitive factors. However, tinnitus models seem to be less focused on causality, thereby easily misleading interpretations. Also, they may be incapable of individualization. This study proposes a Conceptual Cognitive Framework (CCF) providing insight into cognitive mechanisms involved in the predisposition, precipitation, and perpetuation of tinnitus and consequent cognitive-emotional disturbances. The current CCF for tinnitus relies on evaluative conditional learning and appraisal, generating negative valence (emotional value) and arousal (cognitive value) to annoyance, distress, and distorted perception. The suggested methodology is well-defined, reproducible, and accessible, which can help foster future high-quality clinical databases. Perceived tinnitus through the perpetual-learning process can always lead to annoyance, but only in the clinical stage directly cause annoyance. In the clinical stage, tinnitus perception can lead indirectly to distress only with experiencing annoyance either with (" I n d - 1 C " = 1.87; 95% CI 1.18-2.72)["1st indirect path in the Clinical stage model": Tinnitus Loudness → Attention Bias → Cognitive-Emotional Value → Annoyance → Clinical Distress]or without (" I n d - 2 C "= 2.03; 95% CI 1.02-3.32)[ "2nd indirect path in the Clinical stage model": Tinnitus Loudness → Annoyance → Clinical Distress] the perpetual-learning process. Further real-life testing of the CCF is expected to express a meticulous, decision-supporting platform for cognitive rehabilitation and clinical interventions. Furthermore, the suggested methodology offers a reliable platform for CCF development in other cognitive impairments and supports the causal clinical data models. It may also enhance our knowledge of psychological disorders and complicated comorbidities by supporting the design of different rehabilitation interventions and comprehensive frameworks in line with the "preventive medicine" policy.

A meta-analytic review of anger management activities that increase or decrease arousal: What fuels or douses rage?

Anger is an unpleasant emotion that most people want to get rid of. Some anger management activities focus on decreasing arousal (e.g., deep breathing, mindfulness, meditation), whereas others focus on increasing arousal (e.g., hitting a bag, jogging, cycling). This meta-analytic review, based on 154 studies including 184 independent samples involving 10,189 participants, tested the effectiveness of both types of activities. The results indicated that arousal-decreasing activities decreased anger and aggression (g = -0.63, [-0.82, -0.43]), and the results were robust. Effects were stable over time for participants of different genders, races, ages, and cultures. Arousal-decreasing activities were effective in students and non-students, in criminal offenders and non-offenders, and in individuals with and without intellectual disabilities. Arousal-decreasing activities were effective regardless of how they were delivered (e.g., digital platforms, researchers, therapists), in both group and individual sessions, and in both field and laboratory settings. In contrast, arousal-increasing activities were ineffective overall (g = -0.02, [-0.13, 0.09]) and were heterogenous and complex. These findings do not support the ideas that venting anger or going for a run are effective anger management activities. A more effective approach for managing anger is "turning down the heat" or calming down by engaging in activities that decrease arousal.

A midbrain GABAergic circuit constrains wakefulness in a mouse model of stress.

Enhancement of wakefulness is a prerequisite for adaptive behaviors to cope with acute stress, but hyperarousal is associated with impaired behavioral performance. Although the neural circuitries promoting wakefulness in acute stress conditions have been extensively identified, less is known about the circuit mechanisms constraining wakefulness to prevent hyperarousal. Here, we found that chemogenetic or optogenetic activation of GAD2-positive GABAergic neurons in the midbrain dorsal raphe nucleus (DRNGAD2) decreased wakefulness, while inhibition or ablation of these neurons produced an increase in wakefulness along with hyperactivity. Surprisingly, DRNGAD2 neurons were paradoxically wakefulness-active and were further activated by acute stress. Bidirectional manipulations revealed that DRNGAD2 neurons constrained the increase of wakefulness and arousal level in a mouse model of stress. Circuit-specific investigations demonstrated that DRNGAD2 neurons constrained wakefulness via inhibition of the wakefulness-promoting paraventricular thalamus. Therefore, the present study identified a wakefulness-constraining role DRNGAD2 neurons in acute stress conditions.

Prelimbic cortical pyramidal neurons to ventral tegmental area projections promotes arousal from sevoflurane anesthesia.

AIMS: General anesthesia has been used in surgical procedures for approximately 180 years, yet the precise mechanism of anesthetic drugs remains elusive. There is significant anatomical connectivity between the ventral tegmental area (VTA) and the prelimbic cortex (PrL). Projections from VTA dopaminergic neurons (VTADA ) to the PrL play a role in the transition from sevoflurane anesthesia to arousal. It is still uncertain whether the prelimbic cortex pyramidal neuron (PrLPyr ) and its projections to VTA (PrLPyr -VTA) are involved in anesthesia-arousal regulation. METHODS: We employed chemogenetics and optogenetics to selectively manipulate neuronal activity in the PrLPyr -VTA pathway. Electroencephalography spectra and burst-suppression ratios (BSR) were used to assess the depth of anesthesia. Furthermore, the loss or recovery of the righting reflex was monitored to indicate the induction or emergence time of general anesthesia. To elucidate the receptor mechanisms in the PrLPyr -VTA projection's impact on anesthesia and arousal, we microinjected NMDA receptor antagonists (MK-801) or AMPA receptor antagonists (NBQX) into the VTA. RESULTS: Our findings show that chemogenetic or optogenetic activation of PrLPyr neurons prolonged anesthesia induction and promoted emergence. Additionally, chemogenetic activation of the PrLPyr -VTA neural pathway delayed anesthesia induction and promoted anesthesia emergence. Likewise, optogenetic activation of the PrLPyr -VTA projections extended the induction time and facilitated emergence from sevoflurane anesthesia. Moreover, antagonizing NMDA receptors in the VTA attenuates the delayed anesthesia induction and promotes emergence caused by activating the PrLPyr -VTA projections. CONCLUSION: This study demonstrates that PrLPyr neurons and their projections to the VTA are involved in facilitating emergence from sevoflurane anesthesia, with the PrLPyr -VTA pathway exerting its effects through the activation of NMDA receptors within the VTA.

The relationship between alpha power and heart rate variability commonly seen in various mental states.

The extensive exploration of the correlation between electroencephalogram (EEG) and heart rate variability (HRV) has yielded inconsistent outcomes, largely attributable to variations in the tasks employed in the studies. The direct relationship between EEG and HRV is further complicated by alpha power, which is susceptible to influences such as mental fatigue and sleepiness. This research endeavors to examine the brain-heart interplay typically observed during periods of music listening and rest. In an effort to mitigate the indirect effects of mental states on alpha power, subjective fatigue and sleepiness were measured during rest, while emotional valence and arousal were evaluated during music listening. Partial correlation analyses unveiled positive associations between occipital alpha2 power (10-12 Hz) and nHF, an indicator of parasympathetic activity, under both music and rest conditions. These findings underscore brain-heart interactions that persist even after the effects of other variables have been accounted for.

A vertebrate family without a functional Hypocretin/Orexin arousal system.

The Hypocretin/Orexin signaling pathway suppresses sleep and promotes arousal, whereas the loss of Hypocretin/Orexin results in narcolepsy, including the involuntary loss of muscle tone (cataplexy).1 Here, we show that the South Asian fish species Chromobotia macracanthus exhibits a sleep-like state during which individuals stop swimming and rest on their side. Strikingly, we discovered that the Hypocretin/Orexin system is pseudogenized in C. macracanthus, but in contrast to Hypocretin-deficient mammals, C. macracanthus does not suffer from sudden behavioral arrests. Similarly, zebrafish mutations in hypocretin/orexin show no evident signs of cataplectic-like episodes. Notably, four additional species in the Botiidae family also lack a functional Hypocretin/Orexin system. These findings identify the first vertebrate family that does not rely on a functional Hypocretin/Orexin system for the regulation of sleep and arousal.

[Recent studies about the underlying cerebral mechanism of the fearfull arousals from slow wave sleep].

We consider the disorders of arousal and sleep-related hypermotor epilepsy as genetic twin-conditions, one without, one with epilepsy. They share an augmented arousal-activity during NREM sleep with sleep-wake dissociations, culminating in sleep terrors and sleep-related hypermotor seizures with similar symptoms. The known mutations underlying the two spectra are different, but there are multifold population-genetic-, family- and even individual (the two conditions occurring in the same person) overlaps supporting common genetic roots. In the episodes of disorders of arousal, the anterior cingulate, anterior insular and pre-frontal cortices (shown to be involved in fear- and emotion processing) are activated within a sleeping brain. These regions overlap with the seizure-onset zones of successfully operated sleep-related hypermotor seizures, and notably, belong to the salience network being consistent with its hubs. The arousal-relatedness and the similar fearful disorientation occurring in sleep terrors and hypermotor seizures, make them alike the acute stress-responses emerging from sleep; triggered by false alarms. An acute stress-response can easily mobilize the hypothalamo-pituitary-adrenal axis (preparing fight-flight responses in wakefulness); through its direct pathways to and from the salience network. This hypothesis has never been studied.

Clinical Hypnosis Intervention for Improving Sleep Quality: Emerging Research and Future Directions.

Research into clinical hypnosis for sleep disturbances is an expanding area with important implications for clinical practice and future research. This issue of the International Journal of Clinical and Experimental Hypnosis includes emerging research on clinical hypnosis to improve sleep quality and disturbances. While clinical hypnosis for sleep is very promising, the underlying mechanisms are largely unknown. To address this is an article that examines pre-sleep arousal and worry reduction as potential variables associated with the effects of clinical hypnosis in improving sleep quality. Related to this topic is an article entitled, "Aging adults' willingness, preferences, and access to self-hypnosis for sleep: A cross-sectional study," which identifies aging adults' preferences and access to self-hypnosis for sleep. This issue of the IJCEH also includes an important article on health care professionals' perceptions, knowledge and attitudes toward clinical hypnosis which considers the need for more training and education in clinical hypnosis among health care providers. Further, a scoping review of hypnotherapy for treatment of depression is presented, followed by an exploration of implicit rapport in hypnotherapy, and a case report on hypnotherapy in oral surgery with a highly hypnotizable patient.

A Review of the Use of Gaze and Pupil Metrics to Assess Mental Workload in Gamified and Simulated Sensorimotor Tasks.

Gaze and pupil metrics are used to represent higher cognitive processes in a variety of contexts. One growing area of research is the real-time assessment of workload and corresponding effort in gamified or simulated cognitive and motor tasks, which will be reviewed in this paper. While some measurements are consistent across studies, others vary and are likely dependent on the nature of the effort required by the task and the resulting changes in arousal. Pupil diameter is shown to consistently increase with task effort and arousal; however, the valence of arousal must be considered. In many cases, measures of pupil diameter were sensitive to both excessive and insufficient challenge. Overall, it is evident that gaze and pupil metrics are valuable to assess the cognitive state during gamified and simulated tasks, and further research is indicated regarding their use in clinical populations in rehabilitation to inform optimally engaging interventions.

FC-TFS-CGRU: A Temporal-Frequency-Spatial Electroencephalography Emotion Recognition Model Based on Functional Connectivity and a Convolutional Gated Recurrent Unit Hybrid Architecture.

The gated recurrent unit (GRU) network can effectively capture temporal information for 1D signals, such as electroencephalography and event-related brain potential, and it has been widely used in the field of EEG emotion recognition. However, multi-domain features, including the spatial, frequency, and temporal features of EEG signals, contribute to emotion recognition, while GRUs show some limitations in capturing frequency-spatial features. Thus, we proposed a hybrid architecture of convolutional neural networks and GRUs (CGRU) to effectively capture the complementary temporal features and spatial-frequency features hidden in signal channels. In addition, to investigate the interactions among different brain regions during emotional information processing, we considered the functional connectivity relationship of the brain by introducing a phase-locking value to calculate the phase difference between the EEG channels to gain spatial information based on functional connectivity. Then, in the classification module, we incorporated attention constraints to address the issue of the uneven recognition contribution of EEG signal features. Finally, we conducted experiments on the DEAP and DREAMER databases. The results demonstrated that our model outperforms the other models with remarkable recognition accuracy of 99.51%, 99.60%, and 99.59% (58.67%, 65.74%, and 67.05%) on DEAP and 98.63%, 98.7%, and 98.71% (75.65%, 75.89%, and 71.71%) on DREAMER in a subject-dependent experiment (subject-independent experiment) for arousal, valence, and dominance.

Variation in the Photoplethysmogram Response to Arousal From Sleep Depending on the Cause of Arousal and the Presence of Desaturation.

OBJECTIVE: The aim of this study was to assess how the photoplethysmogram frequency and amplitude responses to arousals from sleep differ between arousals caused by apneas and hypopneas with and without blood oxygen desaturations, and spontaneous arousals. Stronger arousal causes were hypothesized to lead to larger and faster responses. METHODS AND PROCEDURES: Photoplethysmogram signal segments during and around respiratory and spontaneous arousals of 876 suspected obstructive sleep apnea patients were analyzed. Logistic functions were fit to the mean instantaneous frequency and instantaneous amplitude of the signal to detect the responses. Response intensities and timings were compared between arousals of different causes. RESULTS: The majority of the studied arousals induced photoplethysmogram responses. The frequency response was more intense ([Formula: see text]) after respiratory than spontaneous arousals, and after arousals caused by apneas compared to those caused by hypopneas. The amplitude response was stronger ([Formula: see text]) following hypopneas associated with blood oxygen desaturations compared to those that were not. The delays of these responses relative to the electroencephalogram arousal start times were the longest ([Formula: see text]) after arousals caused by apneas and the shortest after spontaneous arousals and arousals caused by hypopneas without blood oxygen desaturations. CONCLUSION: The presence and type of an airway obstruction and the presence of a blood oxygen desaturation affect the intensity and the timing of photoplethysmogram responses to arousals from sleep. CLINICAL IMPACT: The photoplethysmogram responses could be used for detecting arousals and assessing their intensity, and the individual variation in the response intensity and timing may hold diagnostically significant information.

Psychophysiological strategies for enhancing performance through imagery-skin conductance level analysis in guided vs. self-produced imagery.

Athletes need to achieve their optimal level of arousal for peak performance. Visualization or mental rehearsal (i.e., Imagery) often helps to obtain an appropriate level of activation, which can be detected by monitoring Skin Conductance Level (SCL). However, different types of imagery could elicit different amount of physiological arousal. Therefore, this study aims: (1) to investigate differences in SCL associated with two instructional modalities of imagery (guided vs. self-produced) and six different scripts; (2) to check if SCL could differentiate respondents according to their sport expertise. Thirty participants, aged between 14 and 42 years (M = 22.93; SD = 5.24), with different sport levels took part in the study. Participants listened to each previously recorded script and then were asked to imagine the scene for a minute. During the task, SCL was monitored. We analysed the mean value, variance, slope and number of fluctuations per minute of the electrodermal signal. Unsupervised machine learning models were used for measuring the resemblance of the signal. The Wilcoxon signed-rank test was used for distinguishing guided and self-produced imagery, and The Mann-Whitney U test was used for distinguishing results of different level athletes. We discovered that among others, self-produced imagery generates lower SCL, higher variance, and a higher number of fluctuations compared to guided imagery. Moreover, we found similarities of the SCL signal among the groups of athletes (i.e. expertise level). From a practical point of view, our findings suggest that different imagery instructional modalities can be implemented for specific purposes of mental preparation.

Selective REM sleep restriction in mice using a device designed for tunable somatosensory stimulation.

BACKGROUND: Sleep perturbation is widely used to investigate the physiological mechanisms that mediate sleep-wake dynamics, and to isolate the specific roles of sleep in health and disease. However, state-of-the-art methods to accomplish sleep perturbation in preclinical models are limited in their throughput, flexibility, and specificity. NEW METHOD: A system was developed to deliver vibro-tactile somatosensory stimulation aimed at controlled, selective sleep perturbation. The frequency and intensity of stimulation can be tuned to target a variety of experimental applications, from sudden arousal to sub-threshold transitions between light and deep stages of NREM sleep. This device was activated in closed-loop to selectively interrupt REM sleep in mice. RESULTS: Vibro-tactile stimulation effectively and selectively interrupted REM sleep - significantly reducing the average REM bout duration relative to matched, unstimulated baseline recordings. As REM sleep was repeatedly interrupted, homeostatic mechanisms prompted a progressively quicker return to REM sleep. These effects were dependent on the parameters of stimulation applied. COMPARISON WITH EXISTING METHODS: Existing sleep perturbation systems often require moving parts within the cage and/or restrictive housing. The system presented is unique in that it interrupts sleep without invading the animal's space. The ability to vary stimulation parameters is a great advantage over existing methods, as it allows for adaptation in response to habituation and/or circadian/homeostatic changes in arousal threshold. CONCLUSIONS: The proposed method of stimulation demonstrates feasibility in affecting mouse sleep within a standard home cage environment, thus limiting environmental stress. Furthermore, the ability to tune frequency and intensity of stimulation allows for graded control over the extent of sleep perturbation, which potentially expands the utility of this technology beyond applications related to sleep.

Sleep-related attentional bias in insomnia: The mediating role of arousal.

BACKGROUND AND OBJECTIVES: Characterize the nature of attentional biases toward nocturnal and diurnal sleep-related stimuli in individuals with insomnia disorder. We investigated the contributing role of sleep-related attentional biases in insomnia severity and whether their effects on insomnia severity were mediated by arousal and valence levels of the presented stimuli. METHODS: Sixty-four individuals with insomnia disorder and 70 controls completed two Posner spatial cueing tasks including both nocturnal (alarm clocks) and diurnal (fatigue) pictorial stimuli associated with neutral cues. Arousal and valence of the sleep-related stimuli were assessed using a 5-point Likert type scale. RESULTS: Attention biases characterized by difficulty disengaging from and increased avoidance for daytime fatigue, and by difficulty disengaging from alarm clocks were observed in individuals with insomnia disorder compared to controls. On the whole sample, difficulty to disengage from diurnal and nocturnal sleep-related stimuli were related mostly to higher arousal rating of sleep-related stimuli and insomnia severity. Higher arousal rating for sleep-related stimuli mediates the relationship between difficulty disengaging and insomnia severity. LIMITATIONS: The cross-sectional nature of the study. CONCLUSIONS: We provide first initial evidence for an attentional bias characterized by on one side, avoidance for diurnal sleep-related stimuli and on other side, disengagement for both diurnal and nocturnal sleep-related stimuli in patients with insomnia. Disengagement difficulties for both diurnal and nocturnal sleep-related stimuli indirectly affected insomnia severity through arousal elicited by these stimuli. It appears important to develop and apply attentional bias modification training therapeutic interventions that can effectively reduce sleep-related arousal and attentional biases.

Danavorexton (TAK-925): an orexin receptor 2 agonist as a new 'arousal' agent.

A preclinical study in animals has further characterised a new 'arousal' agent. Danavorexton (TAK-925) is an agonist for orexin receptor 2 where it promotes recovery from inhalational and i.v. anaesthesia and opioid sedation. Although danavorexton reverses opioid sedation, it does not compromise analgesia. This could be a useful addition to the postoperative drug cupboard.

Hibernating female big brown bats (Eptesicus fuscus) adjust huddling and drinking behaviour, but not arousal frequency, in response to low humidity.

Many mammals hibernate during winter, reducing energy expenditure via bouts of torpor. The majority of a hibernator's energy reserves are used to fuel brief, but costly, arousals from torpor. Although arousals likely serve multiple functions, an important one is to restore water stores depleted during torpor. Many hibernating bat species require high humidity, presumably to reduce torpid water loss, but big brown bats (Eptesicus fuscus) appear tolerant of a wide humidity range. We tested the hypothesis that hibernating female E. fuscus use behavioural flexibility during torpor and arousals to maintain water balance and reduce energy expenditure. We predicted: (1) E. fuscus hibernating in dry conditions would exhibit more compact huddles during torpor and drink more frequently than bats in high humidity conditions; and (2) the frequency and duration of torpor bouts and arousals, and thus total loss of body mass would not differ between bats in the two environments. We housed hibernating E. fuscus in temperature- and humidity-controlled incubators at 50% or 98% relative humidity (8°C, 110 days). Bats in the dry environment maintained a more compact huddle during torpor and drank more frequently during arousals. Bats in the two environments had a similar number of arousals, but arousal duration was shorter in the dry environment. However, total loss of body mass over hibernation did not differ between treatments, indicating that the two groups used similar amounts of energy. Our results suggest that behavioural flexibility allows hibernating E. fuscus to maintain water balance and reduce energy costs across a wide range of hibernation humidities.

Impaired post-sleep apnea autonomic arousals in patients with drug-resistant epilepsy.

OBJECTIVE: Sudden and unexpected deaths in epilepsy (SUDEP) pathophysiology may involve an interaction between respiratory dysfunction and sleep/wake state regulation. We investigated whether patients with epilepsy exhibit impaired sleep apnea-related arousals. METHODS: Patients with drug-resistant (N = 20) or drug-sensitive (N = 20) epilepsy and obstructive sleep apnea, as well as patients with sleep apnea but without epilepsy (controls, N = 20) were included. We explored (1) the respiratory arousal threshold based on nadir oxygen saturation, apnea-hypopnea index, and fraction of hypopnea among respiratory events; (2) the cardiac autonomic response to apnea/hypopnea quantified as percentages of changes from the baseline in RR intervals (RRI), high (HF) and low (LF) frequency powers, and LF/HF. RESULTS: The respiratory arousal threshold did not differ between groups. At arousal onset, RRI decreased (-9.42%) and LF power (179%) and LF/HF ratio (190%) increased. This was followed by an increase in HF power (118%), p < 0.05. The RRI decrease was lower in drug-resistant (-7.40%) than in drug-sensitive patients (-9.94%) and controls (-10.91%), p < 0.05. LF and HF power increases were higher in drug-resistant (188%/126%) than in drug-sensitive patients (172%/126%) and controls (177%/115%), p < 0.05. CONCLUSIONS: Cardiac reactivity following sleep apnea is impaired in drug-resistant epilepsy. SIGNIFICANCE: This autonomic dysfunction might contribute to SUDEP pathophysiology.

Similar social attention, physiological arousal, and familiarity effect in autistic and neurotypical children: A real-life recreational eye-tracking paradigm.

Social attention is reported to be crucial for the development of social skills, and, according to the social cognitive developmental theory, is fostered by social interactions. Autism is of central importance to the study of social attention, as autism is characterized by atypical social interactions and low social attention, both linked according to the social motivation theory to diminished social interest. Much evidence for positing low social interest in autism comes from eye-tracking studies, which, however, lack ecological validity. Our study documents social attention and physiological arousal, within close to real-life settings, in autistic children, as well as in their neurotypical peers, matched on gender and mental or chronological age. To explore the potential influence of partner familiarity or of the conversational topic, children gaze and electrodermal activity were recorded while they engaged in watercolor activities with, first a familiar and, next, an unfamiliar adult experimenter, who both introduced various topics. Autistic and neurotypical children exhibited comparable attention to their partners' eyes. Notably, across all groups, heightened visual attention was directed to familiar rather than unfamiliar partners. Moreover, parallel arousal patterns emerged, with all children displaying increased skin conductance responses during more engaging topics and when looking at their interactional partner's eyes. These findings underscore the task- and context-dependent nature of social attention and highlight the role of familiarity in an ecologically valid context. The absence of group differences challenges the universality of the social cognitive developmental theory and questions the scope of the social motivation theory of autism. (PsycInfo Database Record (c) 2024 APA, all rights reserved).