Polysomnographic parameters associated with cognitive function in patients with major depression and insomnia.

OBJECTIVE: To examine whether objective sleep parameters are associated with cognitive function (CF) in patients with major depressive disorder (MDD) with chronic insomnia (CI) and whether the severity of these disorders is related to CF. METHOD: Thirty patients with MDD with CI attending a tertiary care institution underwent two consecutive nights of polysomnographic (PSG) recording and a battery of neuropsychological tests, which included episodic memory, sustained attention, working memory, and executive function. The severity of MDD and CI was assessed by clinical scales. We examined the relationship between PSG parameters and CF, as well as whether the severity of the disorders is related to CF. RESULTS: Linear regression analysis revealed that total sleep time (TST) was positively associated with higher learning and recall of episodic memory, as well as better attention. Slow-wave sleep (SWS) showed a positive association with better working memory. Furthermore, wake after sleep onset (WASO) was negatively associated with episodic memory and lower attention. No significant relationships were found between the severity of MDD or CI with CF. CONCLUSION: Both sleep duration and depth are positively associated with several aspects of CF in patients with MDD with CI. Conversely, a lack of sleep maintenance is negatively related to CF in these patients. These findings could help identify modifiable therapeutic targets to reduce CF impairment.

Noribogaine acute administration in rats promotes wakefulness and suppresses REM sleep.

Ibogaine is a potent atypical psychedelic that has gained considerable attention due to its antiaddictive and antidepressant properties in preclinical and clinical studies. Previous research from our group showed that ibogaine suppresses sleep and produces an altered wakefulness state, which resembles natural REM sleep. However, after systemic administration, ibogaine is rapidly metabolized to noribogaine, which also shows antiaddictive effects but with a distinct pharmacological profile, making this drug a promising therapeutic candidate. Therefore, we still ignore whether the sleep/wake alterations depend on ibogaine or its principal metabolite noribogaine. To answer this question, we conducted polysomnographic recordings in rats following the administration of pure noribogaine. Our results show that noribogaine promotes wakefulness while reducing slow-wave sleep and blocking REM sleep, similar to our previous results reported for ibogaine administration. Thus, we shed new evidence on the mechanisms by which iboga alkaloids work in the brain.

Gender differences in the relationship between sleep and age in a Brazilian cohort: the Baependi Heart Study.

Gender and age are well-established determinants of health and sleep health that influence overall health, which also often varies by gender and age. Sleep architecture is an important component of sleep health. The goal of this analysis was to examine whether associations between age and sleep stages differ by gender in the absence of moderate-severe obstructive sleep apnea (OSA) in a rural setting in Brazil. This study conducted polysomnography recordings in the Baependi Heart Study, a cohort of Brazilian adults. Our sample included 584 women and 309 men whose apnea-hypopnea index was ≤15 events/h. We used splines to distinguish non-linear associations between age, total sleep time, wake after sleep onset (WASO), N2, N3, and rapid-eye-movement sleep. The mean (standard deviation; range) age was 47 (14; 18-89) years. All sleep outcomes were associated with age. Compared to men, women had more N3 sleep and less WASO after adjusting for age. Model-based comparisons between genders at specific ages showed statistically higher mean WASO for men at ages 60 (+13.6 min) and 70 years (+19.5 min) and less N3 for men at ages 50 (-13.2 min), 60 (-19.0 min), and 70 years (-19.5 min) but no differences at 20, 30, 40 or 80 years. The other sleep measures did not differ by gender at any age. Thus, even in the absence of moderate-severe OSA, sleep architecture was associated with age across adulthood, and there were gender differences in WASO and N3 at older ages in this rural community.

Response of sleep slow oscillations to acoustic stimulation is evidenced by distinctive synchronization processes.

Closed-loop acoustic stimulation (CLAS) during sleep has shown to boost slow wave (SW) amplitude and spindle power. Moreover, sleep SW have been classified based on different processes of neuronal synchronization. Thus, different types of SW events may have distinct functional roles and be differentially affected by external stimuli. However, the SW synchronization processes affected by CLAS are not well understood. Here, we studied the effect of CLAS on the dissociation of SW events based on two features of neuronal synchronization in the electroencephalogram (topological spread and wave slope). We evaluated and classified individual SW events of 14 healthy subjects during a CLAS stimulated (STM) and a control night (CNT). Three main categories of SW events were found denoting (C1) steep slope SW with global spread, (C2) flat-slope waves with localized spread and homeostatic decline, and (C3) multipeaked flat-slope events with global spread. Comparing between conditions, we found a consistent increase of event proportion and trough amplitudes for C1 events during the time of stimulation. Furthermore, we found similar increases in post-stimulus spectral power in θ, ß, and σ frequencies for CNT vs STIM condition independently of sleep stage or SW categories. However, topological analysis showed differentiated spatial dynamics in N2 and N3 for SW categories and the co-occurrence with spindle events. Our findings support the existence of multiple types of SW with differential response to external stimuli and possible distinct neuronal mechanisms.

Attentional impairment in Parkinson's disease is modulated by side of onset: Neurophysiological evidence.

OBJECTIVE: Neurophysiological studies exploring involuntary attention have reported that electroencephalographic (EEG) measures can indicate impaired neural processing from initial stages of Parkinson's disease (PD). Since involuntary attention is regulated by right hemisphere networks and PD generally initiates its motor symptomatology unilaterally, whether involuntary attention is impaired depending on the onset side of PD remains unknown. METHODS: We compared the neurophysiological correlates of involuntary attention among a PD group with left-side onset (L-PD), a PD group with right-side onset (R-PD) symptomatology, and a healthy control group (HC). All participants performed an auditory involuntary attention task while a digital EEG was recorded. RESULTS: Our main finding was a reduction both in the P3a amplitude and evoked delta-theta phase alignment in the L-PD group compared to the HC. Further, there was a significant correlation between P3a amplitude and disease duration in the R-PD, but not in the L-PD group. Behaviorally, both clinical groups, and in particular L-PD, showed reduced orientation towards novel stimuli, and no reduction of distraction effects during the experiment. CONCLUSIONS: Our results indicate that involuntary attention is differentially impaired in patients with left side onset of symptoms. Involuntary attention impairment might be present from initial stages of left onset PD and become progressively compromised in patients with right onset PD. SIGNIFICANCE: The onset side of symptomatology should be considered for attentional impairment in PD.

Benzodiazepines and Sleep Architecture: A Systematic Review.

BACKGROUND: Insomnia, defined as a difficulty in initiating or maintaining sleep, is a relevant medical issue. Benzodiazepines (BZDs) are commonly prescribed to treat insomnia. Two phases characterize human sleep structure: sleep with Non-Rapid Eye Movement (NREM) and sleep with Rapid Eye Movement (REM). Physiological sleep includes NREM and REM phases in a continuous cycle known as "Sleep Architecture." OBJECTIVE: This systematic review summarizes the studies that have investigated effects of BZDs on Sleep Architecture. METHODS: The articles selection included human clinical trials (in English, Portuguese, or Spanish) only, specifically focused on BZDs effects on sleep architecture. PubMed, BVS, and Google Scholar databases were searched. RESULTS: Findings on BZDs effects on sleep architecture confirm an increase in stage 2 of NREM sleep and a decrease in time of stages 3 and 4 of NREM sleep with a reduction in time of REM sleep during the nocturnal sleep. CONCLUSION: Variations in NREM and REM sleep may lead to deficits in concentration and working memory and weight gain. The increase in stage 2 of NREM sleep may lead to a subjective improvement of sleep quality with no awakenings. BZDz should be prescribed with zeal and professional judgment. These patients should be closely monitored for possible long-term side effects.

Sleep Facilitates Problem Solving With No Additional Gain Through Targeted Memory Reactivation.

According to the active systems consolidation theory, memories undergo reactivation during sleep that can give rise to qualitative changes of the representations. These changes may generate new knowledge such as gaining insight into solutions for problem solving. targeted memory reactivation (TMR) uses learning-associated cues, such as sounds or odors, which have been shown to improve memory consolidation when re-applied during sleep. Here we tested whether TMR during slow wave sleep (SWS) and/or rapid eye movement (REM) sleep increases problem solving. Young healthy volunteers participated in one of two experiments. Experiment 1 tested the effect of natural sleep on problem solving. Subjects were trained in a video game-based problem solving task until being presented with a non-solved challenge. Followed by a ~10-h incubation interval filled with nocturnal sleep or daytime wakefulness, subjects were tested on the problem solving challenge again. Experiment 2 tested the effect of TMR on problem solving, with subjects receiving auditory TMR either during SWS (SWSstim), REM sleep (REMstim), or wakefulness (Wakestim). In Experiment 1, sleep improved problem solving, with 62% of subjects from the Sleep group solving the problem compared to 24% of the Wake group. Subjects with higher amounts of SWS in the Sleep group had a higher chance to solve the problem. In Experiment 2, TMR did not change the sleep effect on problem solving: 56 and 58% of subjects from the SWSstim and REMstim groups solved the problem compared to 57% from the Wakestim group. These findings indicate that sleep, and particularly SWS, facilitates problem solving, whereas this effect is not further increased by TMR.

Cyclic AMP response element-binding protein is required in excitatory neurons in the forebrain to sustain wakefulness.

The molecular and intracellular signaling processes that control sleep and wake states remain largely unknown. A consistent observation is that the cyclic adenosine monophosphate (AMP) response element-binding protein (CREB), an activity-dependent transcription factor, is differentially activated during sleep and wakefulness. CREB is phosphorylated by the cyclic AMP/protein kinase A (cAMP/PKA) signaling pathway as well as other kinases, and phosphorylated CREB promotes the transcription of target genes. Genetic studies in flies and mice suggest that CREB signaling influences sleep/wake states by promoting and stabilizing wakefulness. However, it remains unclear where in the brain CREB is required to drive wakefulness. In rats, CREB phosphorylation increases in the cerebral cortex during wakefulness and decreases during sleep, but it is not known if this change is functionally relevant to the maintenance of wakefulness. Here, we used the Cre/lox system to conditionally delete CREB in the forebrain (FB) and in the locus coeruleus (LC), two regions known to be important for the production of arousal and wakefulness. We used polysomnography to measure sleep/wake levels and sleep architecture in conditional CREB mutant mice and control littermates. We found that FB-specific deletion of CREB decreased wakefulness and increased non-rapid eye movement sleep. Mice lacking CREB in the FB were unable to sustain normal periods of wakefulness. On the other hand, deletion of CREB from LC neurons did not change sleep/wake levels or sleep/wake architecture. Taken together, these results suggest that CREB is required in neurons within the FB but not in the LC to promote and stabilize wakefulness.

Alteraciones en el sueño por el consumo de cannabis / Sleep disturbances from the use of cannabis

RESUMEN Esta es una revisión de algunos ensayos clínicos realizados acerca de las repercusiones en la estructura, arquitectura y percepción del sueño en los consumidores de cannabis. Para la búsqueda bibliográfica se consultó bases de datos, con especial énfasis en revisiones sistemáticas, metaanálisis, estudios de cohortes, ensayos controlados aleatorios y estudios de casos y controles. Las palabras claves incluyeron términos que describen el uso del cannabis combinado con otros que se refieren al sueño o anormalidades del sueño (por ejemplo: sueño, insomnio, polisomnografía, tiempo total de sueño, latencia del sueño, sueño de onda lenta, sueño de movimiento ocular rápido y su latencia). Se extrajeron datos relevantes de cada uno de los artículos consultados. Se resumió la literatura disponible sobre mediciones subjetivas y objetivas, correlaciones clínicas y paraclínicas, diferencias entre el consumo agudo, crónico y la abstinencia, y otros puntos de discusión. Se realizaron varias correlaciones moleculares y anatómicas que explican los cambios en el sueño desde el punto de vista del sistema nervioso central. Finalmente, los resultados demuestran una disminución de la latencia del sueño con el uso agudo a dosis bajas, además menor tiempo de vigilia luego del inicio del sueño, aumento del sueño de ondas lentas y disminución del sueño de movimientos oculares rápidos; estos efectos no permanecen con el uso crónico, ya que posteriormente se presenta una peor calidad del sueño; el escenario también varía con la abstinencia, puede presentarse insomnio, disminución del tiempo total del sueño de onda lenta y del sueño total.

ABSTRACT This is a review of some clinical trials conducted on the impact on sleep structure, architecture and perception in cannabis users. For the literature search, consult database queries with special emphasis on systematic reviews, meta-analyzes, cohort studies, randomized controlled trials, and case-control studies. Keywords include terms that describe cannabis use combined with others that specify sleep or sleep abnormalities (for example: sleep, insomnia, polysomnography, total sleep time, sleep latency, slow wave sleep, motion sleep fast eyepiece and its latency). Relevant data was extracted in each of the articles consulted. The available literature is summarized on: subjective and objective measurements, clinical and paraclinical correlations, differences between acute and chronic consumption and abstinence, and other points of discussion. Tese are various molecular and anatomical correlations that explain changes in sleep from the point of view of the central nervous system. Finally, results frequently decrease sleep latency with acute use at low doses, plus shorter waking time after sleep onset, increased slow wave sleep and decreased rapid eye movement sleep, these effects do not persist with chronic use since later there is a worse quality of sleep; The setting also changes with abstinence where insomnia may occur, decreased total time for slow wave sleep and total sleep.

El sueño en el crustáceo acocil.

Sleep is defined as a state of unconsciousness, reduced locomotive activity and rapid awakening, and is well established in mammals, birds, reptiles and teleosts. Commonly, it is also defined with electrical records (electroencephalogram), which are only well established in mammals and to some extent in birds. However, sleep states similar to those of mammals, except for electrical criteria, appear to occur in some invertebrates. Currently, the most compelling evidence of sleep in invertebrates has been obtained in the crayfish. In mammals, sleep is characterized by a brain state that is different from that of wakefulness, which includes a change to slow waves that has not been observed in Drosophila or bees. Herein, we show that the crayfish enters a brain state with a high threshold to vibratory stimuli, accompanied by a form of slow wave activity in the brain, quite different from that of wakefulness. Therefore, the crayfish can enter a state of sleep that is comparable to that of mammals.

El sueño es definido como un estado de inconciencia, reducción en la actividad locomotora y despertar rápido, el cual está bien identificado en mamíferos, aves, reptiles y teleosteos. Comúnmente también es definido con registros eléctricos (electroencefalograma), los cuales solo están bien establecidos en mamíferos y, en cierta manera, en aves. Sin embargo, estados de sueño similares a los de mamíferos, excepto por los criterios eléctricos, parecen ocurrir en algunos invertebrados. Actualmente la mejor evidencia de sueño en invertebrados ha sido obtenida en el acocil. En los mamíferos, el sueño se caracteriza por un estado cerebral diferente al de la vigilia, que incluye un cambio a ondas lentas, lo que no se ha visto en Drosophila o abejas. Aquí mostramos que el acocil tiene un estado cerebral con umbral elevado a estímulos vibratorios, acompañado por una forma de actividad de ondas lentas en el cerebro, muy diferente al de la vigilia. Por lo tanto, el acocil puede experimentar un estado de sueño comparable al de los mamíferos.

Sleep in the crustacean crayfish

Sleep is defined as a state of unconsciousness, reduced locomotive activity and rapid awakening, and is well established in mammals, birds, reptiles and teleosts. Commonly, it is also defined with electrical records (electroencephalogram), which are only well established in mammals and to some extent in birds. However, sleep states similar to those of mammals, except for electrical criteria, appear to occur in some invertebrates. Currently, the most compelling evidence of sleep in invertebrates has been obtained in the crayfish. In mammals, sleep is characterized by a brain state that is different from that of wakefulness, which includes a change to slow waves that has not been observed in insects. Herein, we show that the crayfish enters a brain state with a high threshold to vibratory stimuli, accompanied by a form of slow wave activity in the brain, quite different from that of wakefulness. Therefore, the crayfish can enter a state of sleep that is comparable to that of mammals.

Association between inflammatory potential of the diet and sleep parameters in sleep apnea patients.

OBJECTIVES: The aim of this study was to analyze the association between the inflammatory potential of diet and sleep parameters in individuals with obstructive sleep apnea (OSA) and to evaluate the sensitivity and specificity of the dietary inflammatory index (DII) at predicting sleep pattern. METHODS: Patients diagnosed with mild to severe OSA were included in the study (N = 296). Sleep pattern was analyzed by polysomnography and subjective sleep parameters. DII scores were calculated from a validated food frequency questionnaire. Receiver operating characteristic curve analysis and generalized linear models were conducted. RESULTS: DII scores were efficient at predicting apnea severity (P < 0.05) and daytime sleepiness (P = 0.02) in age stratification and predicting rapid eye movement latency in obese individuals (P = 0.03). No significant associations were found between DII scores and the majority of sleep parameters. The DII was only associated with daytime sleepiness; patients with a more proinflammatory diet (quintile 4) showed more subjective sleepiness than the group with a more anti-inflammatory diet (quintile 1; P < 0.05). CONCLUSION: Findings from this study indicated that the DII could be sensitive and specific for predicting apnea severity in individuals commonly associated with OSA. Although the DII was not associated with most of the sleep parameters, the few associations found demonstrated the need for more studies that evaluate whether DII is associated with the risk for OSA symptoms.

Sleep accelerates re-stabilization of human declarative memories.

Consolidated memories can return to a labile state upon presentation of a reminder, followed by a period of re-stabilization known as reconsolidation. This period can take several hours, and if an amnesic agent (e.g. new learning) is administered inside the time window of reconsolidation (when the memory is still labile) the memory is impaired, whereas the memory remains unaffected if the amnesic agent is administered outside this time window. Sleep plays a fundamental role in the consolidation and integration of new memories, and recently sleep has also been implicated in memory reconsolidation. Here, we studied the role of sleep in accelerating the reconsolidation time window. On day 1, participants learned a list of syllable-pairs (List 1). On day 2, they received a reminder, followed by interference learning (List 2) administered either after 90 min of wakefulness, after 90 min of sleep, or after 10 h of wakefulness. On day 3, participants had to recall List 1 first, followed by List 2, and we assessed the Retrieval-Induced-Forgetting Effect (RIF) on List 2 as a measure of List 1 memory stability. We found that the 90 min sleep group showed an intact RIF effect similar to the 10 h wake group, reflecting stable List 1 memory after 90 min of sleep and after 10 h of wakefulness. However, the RIF effect was absent after 90 min of wakefulness, suggesting that the List 1 memory was still labile at that time. Moreover, the RIF effect in the 90 min sleep group was associated with power density in the slow oscillation frequency band (0.5-1 Hz) during SWS and S2. These findings suggest that 90 min of sleep accelerate memory re-stabilization after reminder presentation, shortening the reconsolidation time window and protecting the memory against subsequent interference. This rapid memory re-stabilization may depend on slow oscillation activity during NREM sleep.

Eating Late Negatively Affects Sleep Pattern and Apnea Severity in Individuals With Sleep Apnea.

STUDY OBJECTIVES: This study aimed to analyze the association between habitual meal timing and sleep parameters, as well as habitual meal timing and apnea severity in individuals with obstructive sleep apnea (OSA). METHODS: Patients in whom mild to severe OSA was diagnosed were included in the study (n = 296). Sleep parameters were analyzed by polysomnography. Dietary pattern was obtained by a food frequency questionnaire and meal timing of the participants. Individuals with OSA were categorized by meal timing (early, late, and skippers). RESULTS: Dinner timing was associated with sleep latency (ß = 0.130, P = .022), apnea-hypopnea index (AHI) (ß = 1.284, P = .033) and poor sleep quality (ß = 1.140, P = .015). Breakfast timing was associated with wake after sleep onset (WASO) (ß = 3.567, P = .003), stage N1 sleep (ß = 0.130, P < .001), and stage R sleep (ß = -1.189, P = .001). Lunch timing also was associated with stage N1 sleep (ß = 0.095, P = .025), sleep latency (ß = 0.293, P = .001), and daytime sleepiness (ß = 1.267, P = .009). Compared to early eaters, late eaters presented lower duration of stage R sleep and greater values of sleep latency, WASO, stage N1 sleep, and AHI, in addition to increased risk of poor sleep quality and daytime sleepiness (P < .005). CONCLUSIONS: Late meal timing was associated with worse sleep pattern and quality and apnea severity than early meal timing. Despite some of these results having limited clinical significance, they can lead to a better understanding about how meal timing affects OSA and sleep parameters.

Sleep in the crustacean crayfish.

Sleep is defined as a state of unconsciousness, reduced locomotive activity and rapid awakening, and is well established in mammals, birds, reptiles and teleosts. Commonly, it is also defined with electrical records (electroencephalogram), which are only well established in mammals and to some extent in birds. However, sleep states similar to those of mammals, except for electrical criteria, appear to occur in some invertebrates. Currently, the most compelling evidence of sleep in invertebrates has been obtained in the crayfish. In mammals, sleep is characterized by a brain state that is different from that of wakefulness, which includes a change to slow waves that has not been observed in insects. Herein, we show that the crayfish enters a brain state with a high threshold to vibratory stimuli, accompanied by a form of slow wave activity in the brain, quite different from that of wakefulness. Therefore, the crayfish can enter a state of sleep that is comparable to that of mammals.

Re-examining sleep׳s effect on motor skills: How to access performance on the finger tapping task?

Here our goal was to determine the magnitude of sleep-related motor skill enhancement. Performance on the finger tapping task (FTT) was evaluated after a 90 min daytime nap (n=15) or after quiet wakefulness (n=15). By introducing a slight modification in the formula used to calculate the offline gains we were able to refine the estimated magnitude of sleep׳s effect on motor skills. The raw value of improvement after a nap decreased after this correction (from ~15% to ~5%), but remained significantly higher than the control. These results suggest that sleep does indeed play a role in motor skill consolidation.

African Genetic Ancestry is Associated with Sleep Depth in Older African Americans.

STUDY OBJECTIVES: The mechanisms that underlie differences in sleep characteristics between European Americans (EA) and African Americans (AA) are not fully known. Although social and psychological processes that differ by race are possible mediators, the substantial heritability of sleep characteristics also suggests genetic underpinnings of race differences. We hypothesized that racial differences in sleep phenotypes would show an association with objectively measured individual genetic ancestry in AAs. DESIGN: Cross sectional. SETTING: Community-based study. PARTICIPANTS: Seventy AA adults (mean age 59.5 ± 6.7 y; 62% female) and 101 EAs (mean age 60.5 ± 7 y, 39% female). MEASUREMENTS AND RESULTS: Multivariate tests were used to compare the Pittsburgh Sleep Quality Index (PSQI) and in-home polysomnographic measures of sleep duration, sleep efficiency, apnea-hypopnea index (AHI), and indices of sleep depth including percent visually scored slow wave sleep (SWS) and delta EEG power of EAs and AAs. Sleep duration, efficiency, and sleep depth differed significantly by race. Individual % African ancestry (%AF) was measured in AA subjects using a panel of 1698 ancestry informative genetic markers and ranged from 10% to 88% (mean 67%). Hierarchical linear regression showed that higher %AF was associated with lower percent SWS in AAs (ß (standard error) = -4.6 (1.5); P = 0.002), and explained 11% of the variation in SWS after covariate adjustment. A similar association was observed for delta power. No association was observed for sleep duration and efficiency. CONCLUSION: African genetic ancestry is associated with indices of sleep depth in African Americans. Such an association suggests that part of the racial differences in slow-wave sleep may have genetic underpinnings.

Cognitive workload and sleep restriction interact to influence sleep homeostatic responses.

STUDY OBJECTIVES: Determine the effects of high versus moderate workload on sleep physiology and neurobehavioral measures, during sleep restriction (SR) and no sleep restriction (NSR) conditions. DESIGN: Ten-night experiment involving cognitive workload and SR manipulations. SETTING: Controlled laboratory environment. PARTICIPANTS: Sixty-three healthy adults (mean ± standard deviation: 33.2 ± 8.7 y; 29 females), age 22-50 y. INTERVENTIONS: Following three baseline 8 h time in bed (TIB) nights, subjects were randomized to one of four conditions: high cognitive workload (HW) + SR; moderate cognitive workload (MW) + SR; HW + NSR; or MW + NSR. SR entailed 5 consecutive nights at 4 h TIB; NSR entailed 5 consecutive nights at 8 h TIB. Subjects received three workload test sessions/day consisting of 15-min preworkload assessments, followed by a 60-min (MW) or 120-min (HW) workload manipulation comprised of visually based cognitive tasks, and concluding with 15-min of postworkload assessments. Experimental nights were followed by two 8-h TIB recovery sleep nights. Polysomnography was collected on baseline night 3, experimental nights 1, 4, and 5, and recovery night 1 using three channels (central, frontal, occipital [C3, Fz, O2]). MEASUREMENTS AND RESULTS: High workload, regardless of sleep duration, increased subjective fatigue and sleepiness (all P < 0.05). In contrast, sleep restriction produced cumulative increases in Psychomotor Vigilance Test (PVT) lapses, fatigue, and sleepiness and decreases in PVT response speed and Maintenance of Wakefulness Test (MWT) sleep onset latencies (all P < 0.05). High workload produced longer sleep onset latencies (P < 0.05, d = 0.63) and less wake after sleep onset (P < 0.05, d = 0.64) than moderate workload. Slow-wave energy-the putative marker of sleep homeostasis-was higher at O2 than C3 only in the HW + SR condition (P < 0.05). CONCLUSIONS: High cognitive workload delayed sleep onset, but it also promoted sleep homeostatic responses by increasing subjective fatigue and sleepiness, and producing a global sleep homeostatic response by reducing wake after sleep onset. When combined with sleep restriction, high workload increased local (occipital) sleep homeostasis, suggesting a use-dependent sleep response to visual work. We conclude that sleep restriction and cognitive workload interact to influence sleep homeostasis.

Human longevity is associated with regular sleep patterns, maintenance of slow wave sleep, and favorable lipid profile.

Some individuals are able to successfully reach very old ages, reflecting higher adaptation against age-associated effects. Sleep is one of the processes deeply affected by aging; however few studies evaluating sleep in long-lived individuals (aged over 85) have been reported to date. The aim of this study was to characterize the sleep patterns and biochemical profile of oldest old individuals (N = 10, age 85-105 years old) and compare them to young adults (N = 15, age 20-30 years old) and older adults (N = 13, age 60-70 years old). All subjects underwent full-night polysomnography, 1-week of actigraphic recording and peripheral blood collection. Sleep electroencephalogram spectral analysis was also performed. The oldest old individuals showed lower sleep efficiency and REM sleep when compared to the older adults, while stage N3 percentage and delta power were similar across the groups. Oldest old individuals maintained strictly regular sleep-wake schedules and also presented higher HDL-cholesterol and lower triglyceride levels than older adults. The present study revealed novel data regarding specific sleep patterns and maintenance of slow wave sleep in the oldest old group. Taken together with the favorable lipid profile, these results contribute with evidence to the importance of sleep and lipid metabolism regulation in the maintenance of longevity in humans.

Morning blood pressure is associated with sleep quality in obese adolescents.

OBJECTIVE: To examine relationships among blood pressure (BP), adiposity, and sleep quality with the use of overnight polysomnography in obese adolescents. STUDY DESIGN: Overnight polysomnogram and morning BP measurements were performed in obese (body mass index [BMI] >95th percentile) nondiabetic adolescents (eligible age range 12-18 years, n = 49). Subjects were stratified into 2 groups, one with normal BP, and one with elevated BP, and demographic and clinical characteristics were compared between the groups. Multiple linear regression analysis was used to assess the effects of sleep quality on BP. RESULTS: Participants (n = 27) had a normal morning BP, and 22 (44.9%) had elevated morning BP. There were no differences in age (P = .53), sex (P = .44), race (P = .58), or BMI (P = .56) between the 2 BP groups. The group with elevated BP spent shorter percentages of time in rapid eye movement (REM; P = .006) and slow-wave sleep (SWS; P = .024). Multiple linear regression analysis showed that a lower percentage of both REM and SWS was associated with increased morning BP after we adjusted for pubertal stage, sex, race, and BMI. CONCLUSION: Lack of deeper stages of sleep, REM sleep, and SWS is associated with greater morning BP in obese adolescents, independent of BMI. Poor sleep quality should be considered in the work-up of obese youth with hypertension. Intervention studies are needed to evaluate whether improving the quality of sleep will decrease BP elevation.