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1.
BMC Bioinformatics ; 20(Suppl 16): 586, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31787093

RESUMO

BACKGROUND: Sleep is a complex and dynamic biological process characterized by different sleep patterns. Comprehensive sleep monitoring and analysis using multivariate polysomnography (PSG) records has achieved significant efforts to prevent sleep-related disorders. To alleviate the time consumption caused by manual visual inspection of PSG, automatic multivariate sleep stage classification has become an important research topic in medical and bioinformatics. RESULTS: We present a unified hybrid self-attention deep learning framework, namely HybridAtt, to automatically classify sleep stages by capturing channel and temporal correlations from multivariate PSG records. We construct a new multi-view convolutional representation module to learn channel-specific and global view features from the heterogeneous PSG inputs. The hybrid attention mechanism is designed to further fuse the multi-view features by inferring their dependencies without any additional supervision. The learned attentional representation is subsequently fed through a softmax layer to train an end-to-end deep learning model. CONCLUSIONS: We empirically evaluate our proposed HybridAtt model on a benchmark PSG dataset in two feature domains, referred to as the time and frequency domains. Experimental results show that HybridAtt consistently outperforms ten baseline methods in both feature spaces, demonstrating the effectiveness of HybridAtt in the task of sleep stage classification.


Assuntos
Algoritmos , Aprendizado Profundo , Fases do Sono/fisiologia , Bases de Dados como Assunto , Eletroencefalografia/métodos , Humanos , Análise Multivariada , Polissonografia , Curva ROC
2.
PLoS Comput Biol ; 15(11): e1007268, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31725712

RESUMO

Origin and functions of intermittent transitions among sleep stages, including short awakenings and arousals, constitute a challenge to the current homeostatic framework for sleep regulation, focusing on factors modulating sleep over large time scales. Here we propose that the complex micro-architecture characterizing the sleep-wake cycle results from an underlying non-equilibrium critical dynamics, bridging collective behaviors across spatio-temporal scales. We investigate θ and δ wave dynamics in control rats and in rats with lesions of sleep-promoting neurons in the parafacial zone. We demonstrate that intermittent bursts in θ and δ rhythms exhibit a complex temporal organization, with long-range power-law correlations and a robust duality of power law (θ-bursts, active phase) and exponential-like (δ-bursts, quiescent phase) duration distributions, typical features of non-equilibrium systems self-organizing at criticality. Crucially, such temporal organization relates to anti-correlated coupling between θ- and δ-bursts, and is independent of the dominant physiologic state and lesions, a solid indication of a basic principle in sleep dynamics.


Assuntos
Fases do Sono/fisiologia , Vigília/fisiologia , Animais , Nível de Alerta/fisiologia , Ritmo Delta/fisiologia , Eletroencefalografia , Homeostase , Masculino , Neurônios , Ratos , Ratos Sprague-Dawley , Sono/fisiologia , Ritmo Teta/fisiologia
3.
Ideggyogy Sz ; 72(9-10): 304-314, 2019 Sep 30.
Artigo em Húngaro | MEDLINE | ID: mdl-31625697

RESUMO

Aims - Overview of the new data about the strong link of sleep and epilepsy and conjoining cognitive impairment. Methods - Search for relevant references and summary of our own research activity on the topic. Results - Strong interrealtionship exists between epilepsy and plastic brain functions (memory processing and synaptic homeostasis) and the working modes of NREM sleep. In the most frequent childhood and adult epilepsy networks responsible for plastic functions can be derailed to an epileptic level of excitability, and suffer a transitory or permanent epileptic transformation. Exampling on the three big epilepsies: absence epilepsy; medial temporal lobe epilepsy; and childhood idiopathic focal age dependent epilepsy spectrum we demonstrate the most important features of this epileptic transformation. The association of cognitive impairment to certain sleep dependent epilepsies gains explanation by the epilepsy caused interference with slow wave decline (ICFE) and memory consolidation (MTLE) during NREM sleep. This paper serves also to introduce the concept of sleep dependent system epilepsies. Conclusions - We provide evidences about shared mechanisms among sleep related epilepsies being the derailment of sleep plastic funcions toward exaggerated excitability determined by the inherent possibilities of the signal transduction properties.


Assuntos
Disfunção Cognitiva/fisiopatologia , Epilepsias Parciais/fisiopatologia , Epilepsia/fisiopatologia , Sono/fisiologia , Adulto , Criança , Eletroencefalografia , Humanos , Plásticos , Fases do Sono/fisiologia
4.
Biomed Res Int ; 2019: 4616417, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31534960

RESUMO

Several studies suggested that migraine attack onset shows a circadian variation; however, there has not been an overview and synthesis of these findings. A PubMed search with keywords "migraine" AND "circadian" resulted in ten studies directly investigating this topic. Results of these studies mostly show that migraine attacks follow a monophasic 24-hour cyclic pattern with an early morning or late night peak while other studies reported an afternoon peak and also a biphasic 24-hour cycle of attacks. The identified studies showed methodological variation including sample size, inclusion of medication use, comorbidities, and night or shift workers which could have contributed to the contradictory results. Several theories emerged explaining the diurnal distribution of migraine attacks suggesting roles for different phenomena including a morning rise in cortisol levels, a possible hypothalamic dysfunction, a circadian variation of migraine triggers, sleep stages, and a potentially different setting of the circadian pacemaker among migraineurs. At the moment, most studies show an early morning or late night peak of migraine attack onset, but a significant amount of studies reveals contradictory results. Further studies should investigate the arising hypotheses to improve our understanding of the complex mechanism behind the circadian variation of migraine attacks that can shed light on new targets for migraine therapy.


Assuntos
Ritmo Circadiano , Hidrocortisona/sangue , Transtornos de Enxaqueca/sangue , Transtornos de Enxaqueca/fisiopatologia , Jornada de Trabalho em Turnos , Fases do Sono , Feminino , Humanos , Masculino , Transtornos de Enxaqueca/terapia
5.
Biomed Eng Online ; 18(1): 92, 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31484584

RESUMO

BACKGROUND: Sleep problem or disturbance often exists in pain or neurological/psychiatric diseases. However, sleep scoring is a time-consuming tedious labor. Very few studies discuss the 5-stage (wake/NREM1/NREM2/transition sleep/REM) automatic fine analysis of wake-sleep stages in rodent models. The present study aimed to develop and validate an automatic rule-based classification of 5-stage wake-sleep pattern in acid-induced widespread hyperalgesia model of the rat. RESULTS: The overall agreement between two experts' consensus and automatic scoring in the 5-stage and 3-stage analyses were 92.32% (κ = 0.88) and 94.97% (κ = 0.91), respectively. Standard deviation of the accuracy among all rats was only 2.93%. Both frontal-occipital EEG and parietal EEG data showed comparable accuracies. The results demonstrated the performance of the proposed method with high accuracy and reliability. Subtle changes exhibited in the 5-stage wake-sleep analysis but not in the 3-stage analysis during hyperalgesia development of the acid-induced pain model. Compared with existing methods, our method can automatically classify vigilance states into 5-stage or 3-stage wake-sleep pattern with a promising high agreement with sleep experts. CONCLUSIONS: In this study, we have performed and validated a reliable automated sleep scoring system in rats. The classification algorithm is less computation power, a high robustness, and consistency of results. The algorithm can be implanted into a versatile wireless portable monitoring system for real-time analysis in the future.


Assuntos
Processamento de Sinais Assistido por Computador , Fases do Sono , Animais , Automação , Eletroencefalografia , Hiperalgesia/fisiopatologia , Polissonografia , Ratos , Vigília
6.
Comput Methods Programs Biomed ; 178: 19-30, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31416548

RESUMO

BACKGROUND AND OBJECTIVE: The recognition of many sleep related pathologies highly relies on an accurate classification of sleep stages. Clinically, sleep stages are usually labelled by sleep experts through visually inspecting the whole-night polysomnography (PSG) recording of patients, wherein electroencephalogram (EEG), electrooculogram (EOG) and electromyogram (EMG) play the dominant role. Developing an automatic sleep staging system based on multi-channel physiological signals could relieve the burden of manual labeling by experts, and obtain reliable and repeatable recognition results as well. METHODS: In this work, we find the correlation between the spatial covariance matrices of multi-channel signals and their corresponding sleep stages. Based on that, we propose two novel sleep stage classification methods based on the features extracted from the covariance matrices of multi-channel signals. Sleep stages are classified using a minimum distance classifier according to their corresponding covariance matrices mapped on Riemannian manifolds. An alternative way to classify these covariance matrices is to represent the features of covariance matrices on the tangent space of Riemannian manifolds and classify them with an ensemble learning classifier. After any of these classification methods, a rule-free refinement process is utilized to further optimize the classification results. RESULTS: On the MASS dataset that includes 61 whole-night PSG recordings, both two methods provide satisfactory classification results while the one based on tangent space projection has better performance. On average, an accuracy of 0.812 and a Cohen's Kappa coefficient of 0.722 are obtained under leave-one-subject-out cross validation, using EEG, EOG and EMG signals. Meanwhile, the most effective combinations of EEG channels for sleep staging have been found in this work. CONCLUSIONS: The correlation between spatial covariance matrices of multi-channel signals and their corresponding sleep stages have been found. Features based on that are used for sleep stage classification, and experimental results show the superior performance of proposed methods compared to state-of-the-art works. Results of this work are expected to provide a new vision for dealing with multi-channel or multi-modal signal processing tasks in various applications.


Assuntos
Eletroencefalografia , Eletroculografia , Aprendizado de Máquina , Polissonografia , Fases do Sono , Algoritmos , Simulação por Computador , Interpretação Estatística de Dados , Bases de Dados Factuais , Humanos , Reprodutibilidade dos Testes , Processamento de Sinais Assistido por Computador , Sono
7.
Stud Health Technol Inform ; 264: 848-852, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438044

RESUMO

Interest in sleep has been growing in the last decades, considering its benefits for well-being, but also to diagnose sleep troubles. The gold standard to monitor sleep consists of recording the course of many physiological parameters during a whole night. The human interpretation of resulting curves is time consuming. We propose an automatic knowledge-based decision system to support sleep staging. This system handles temporal data, such as events, to combine and aggregate atomic data, so as to obtain high-abstraction-levels contextual decisions. The proposed system relies on a semantic reprentation of observations, and on contextual knowledge base obtained by formalizing clinical practice guidelines. Evaluated on a dataset composed of 131 full night polysomnographies, results are encouraging, but point out that further knowledge need to be integrated.


Assuntos
Sistemas Especialistas , Fases do Sono , Eletroencefalografia , Humanos , Polissonografia , Semântica
8.
J Clin Neurophysiol ; 36(4): 250-256, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31274687

RESUMO

Knowledge of normal patterns is essential for correct EEG interpretation. The overinterpretation of EEG (i.e., ascribing abnormality to EEG patterns that are not associated with disease) is a common problem and can contribute to misdiagnosis and mismanagement. Here, the authors concisely review normal patterns that might be improperly interpreted as abnormal. These include posterior slow waves of youth, central theta, K complexes, asymmetric sleep spindles, hypnagogic and hypnopompic hypersynchrony, arousal patterns, rhythmic midtemporal theta of drowsiness, and the wicket rhythm. Recognition of these patterns will lead to greater accuracy in EEG interpretation and help avoid incorrect management.


Assuntos
Eletroencefalografia/métodos , Erros de Diagnóstico , Humanos , Sono/fisiologia , Fases do Sono/fisiologia , Vigília/fisiologia
9.
PLoS One ; 14(7): e0218948, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31291270

RESUMO

The overnight polysomnographic (PSG) recordings of patients were scored by an expert to diagnose sleep disorders. Visual sleep scoring is a time-consuming and subjective process. Automatic sleep staging methods can help; however, the mechanism and reliability of these methods are not fully understood. Therefore, experts often need to rescore the recordings to obtain reliable results. Here, we propose a human-computer collaborative sleep scoring system. It is a rule-based automatic sleep scoring method that follows the American Academy of Sleep Medicine (AASM) guidelines to perform an initial scoring. Then, the reliability level of each epoch is analyzed based on physiological patterns during sleep and the characteristics of various stage changes. Finally, experts would only need to rescore epochs with a low-reliability level. The experimental results show that the average agreement rate between our system and fully manual scorings can reach 90.42% with a kappa coefficient of 0.85. Over 50% of the manual scoring time can be reduced. Due to the demonstrated robustness and applicability, the proposed approach can be integrated with various PSG systems or automatic sleep scoring methods for sleep monitoring in clinical or homecare applications in the future.


Assuntos
Eletroencefalografia/métodos , Polissonografia/métodos , Projetos de Pesquisa/estatística & dados numéricos , Fases do Sono/fisiologia , Interface Usuário-Computador , Adolescente , Eletroencefalografia/estatística & dados numéricos , Feminino , Voluntários Saudáveis , Humanos , Masculino , Polissonografia/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Adulto Jovem
10.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(4. Vyp. 2): 50-55, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31317915

RESUMO

The article covers the current state of the problem of disorders of arousal (DOAs). The clinical features and diagnostics of the disease are described in detail. Separately, emphasis is placed on the mechanisms of the occurrence of DOAs and the characteristic changes in the central nervous system. The question of neurophysiological changes preceding the clinical manifestation of DOAs and the concept of local sleep as a physiological basis for the occurrence of DOAs are considered. Current therapeutic approaches in the treatment of these forms of parasomnias are reviewed.


Assuntos
Nível de Alerta , Parassonias , Fases do Sono , Humanos , Neurofisiologia , Sono
12.
Handb Clin Neurol ; 160: 359-370, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31277860

RESUMO

This chapter presents hypotheses on the mechanisms responsible for the succession of the three vigilance states, namely waking, nonrapid eye movement (non-REM) (slow-wave sleep-SWS), and REM sleep (paradoxical sleep-PS). It can be proposed that waking is induced by the activity of multiple waking systems, including the serotonergic, noradrenergic, cholinergic, and hypocretin systems. At the onset of sleep, the SWS-active neurons are activated by the circadian clock localized in the suprachiasmatic nucleus and a hypnogenic factor, adenosine, which progressively accumulates in the brain during waking. A number of studies support the hypothesis that SWS results from the activation of GABAergic neurons localized in the ventrolateral preoptic nucleus. However, additional GABAergic systems have been described, localized in the parafacial, accumbens, and reticular thalamic nuclei, and these are also presented. In addition, the chapter discusses the fact that a large body of data strongly suggests that the switch from SWS to PS is due to the interaction of multiple populations of glutamatergic and GABAergic neurons localized in the posterior hypothalamus and the brainstem.


Assuntos
Encéfalo/metabolismo , Fases do Sono/fisiologia , Vigília/fisiologia , Animais , Neurônios GABAérgicos/metabolismo , Humanos , Melatonina/metabolismo , Sono/fisiologia
13.
Handb Clin Neurol ; 160: 371-379, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31277861

RESUMO

Actigraphy involves acquisition of data using a movement sensor worn continuously on the nondominant wrist, typically for a week or more. Computer-based algorithms estimate sleep episodes by analysis of continuous minutes of no to low movement, or spans of time when movement is relatively low compared with movements during presumed ambulatory wakefulness. Inherent advantages of actigraphy over polysomnography include its noninvasive nature, cost-effectiveness, lesser burden on patients/research participants, and ability to collect data over multiple days/nights, thereby allowing examination of sleep-wake patterning. Therefore, actigraphy is emerging as a common method to objectively assess sleep parameters providing estimates of sleep duration and continuity. Modes of actigraphy data collection, scoring algorithms, sleep quality/disturbance measures, validation studies, and clinical and research applications are discussed.


Assuntos
Actigrafia/métodos , Polissonografia/métodos , Fases do Sono/fisiologia , Transtornos do Sono-Vigília/fisiopatologia , Actigrafia/tendências , Humanos , Polissonografia/tendências , Transtornos do Sono-Vigília/diagnóstico
15.
PLoS One ; 14(6): e0218894, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31226161

RESUMO

Although most research on sleep and adolescent health has focused on how long each youth sleeps on average, variability in sleep duration may be just as problematic. Existing findings have been inconsistent and unable to address cause-effect relationships. This study piloted an experimental protocol to induce sleep variability and explore its impact on daytime sleepiness in adolescents. Healthy adolescents aged 14-17 participated in a 3-week, at-home protocol. Sleep was monitored by sleep diaries and actigraphy. Following a run-in period to stabilize wake times (set at 6:30am throughout the protocol), participants were randomly counterbalanced across two 5-night experimental conditions. Bedtimes were consistent at 11:00pm during the stable sleep condition (7.5-hour sleep period each night) but changed on alternating nights during the variable sleep condition (ranging from 9:30pm to 12:30am) so that sleep duration averaged 7.5 hours across the condition with a standard deviation of 1.37 hours. Difficulty waking was assessed each morning and daytime sleepiness was assessed by end-of-condition parent- and adolescent-reports. Of the 20 participants who completed the study, 16 met the predetermined adherence definition. For those who were adherent, there were no differences in overall sleep duration between the stable and variable sleep conditions (p>.05) but adolescents had 58.6 minutes greater night-to-night variation in sleep duration in the variable condition (p < .001). Across all nights, youth reported greater difficulty waking following nights of shorter assigned sleep (p = .004) and greater overall sleepiness during the variable condition (p = .03). It is feasible to experimentally vary how long adolescents sleep on a nightly basis while holding average sleep duration constant. Such a protocol will promote tests of the acute effects of day-to-day changes in sleep duration on health.


Assuntos
Privação do Sono/diagnóstico , Fases do Sono/fisiologia , Sono/fisiologia , Actigrafia , Adolescente , Saúde do Adolescente , Estudos de Viabilidade , Feminino , Humanos , Masculino , Cooperação do Paciente , Projetos Piloto , Distribuição Aleatória
16.
NeuroRehabilitation ; 44(3): 353-360, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31177246

RESUMO

BACKGROUND: Activity levels and disturbances of the sleep-wake pattern affect health and quality of life and need to be further explored in patients with stroke. OBJECTIVE: To evaluate activity levels and their association with sleep-wake patterns in patients with stroke. METHODS: Ten adults with (51±6 years) and 10 without stroke (52±7 years) participated in the study; they were matched on age, sex and educational level. Neurological status, motor function, sleep quality, and activity levels were measured. The groups were compared using Student t-tests and the association between the measures was assessed using Pearson's correlation. RESULTS: Compared to people without stroke, those with stroke had worse sleep quality (p = 0.044), twice lower 24h-activity levels (p < 0.0001), higher interdaily stability and intradaily variability, lower activity during the most active 10 h and during the least active 5 h. Sleep quality was associated with activity level (r= -0.72) and with within-day activity variability (r= 0.53). CONCLUSIONS: Activity level and fragmentation are associated with sleep-wake patterns and sleep quality in patients with stroke.


Assuntos
Ritmo Circadiano/fisiologia , Qualidade de Vida/psicologia , Sono/fisiologia , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Vigília/fisiologia , Adulto , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fases do Sono/fisiologia
17.
Zhonghua Jie He He Hu Xi Za Zhi ; 42(6): 413-418, 2019 Jun 12.
Artigo em Chinês | MEDLINE | ID: mdl-31189226

RESUMO

Objective: To analyze the polysomnography and clinical characteristics of Tibetan and Han residents with obstructive sleep apnea syndrome (OSAS) in high altitude areas of Tibet, and to explore whether nationality difference existed. Methods: The clinical data of 425 OSAS patients admitted to the Tibet Autonomous Region People's Hospital from November 2011 to February 2018 were retrospectively analyzed, which were divided into Tibetan group and Han group. Information including sex, age, body mass index (BMI), neck circumference, waist circumference and hip circumference was collected, and apnea-hyponea index (AHI), mean oxygen saturation (MSaO(2)) during sleep, lowest oxygen saturation (LSaO(2)) during sleep, sleep phases and Epworth scores were compared between Tibetan and Han groups. Results: No significant difference was found in AHI between Tibetan and Han patients. AHI was positively correlated with BMI, neck circumference and waist circumference. Oxygen saturation in the daytime was not significantly different between groups. However, MSaO(2) and LSaO(2) during sleep were lower in Tibetan group compared with Han group (79% vs 82%, 65% vs 69%, respectively, P=0.000). Subgroup analysis showed no significant difference in MSaO(2) in mild OSAS patients, while the LSaO(2) in mild OSAS patients, the MSaO(2) and LSaO(2) in moderate and severe OSAS patients all showed significant differences between groups. Adjusted for BMI, the LSaO(2) in moderate OSAS patients, the MSaO(2) and LSaO(2) in severe OSAS patients in Tibetan group were still significantly lower than Han group. Stage-1 non-rapid eye movement was prolonged in moderate OSAS patients in Tibetan group compared with Han group (P=0.033), while other sleep phases and Epworth scores showed no significant difference between groups. Conclusion: In the circumstances of similar AHI, the MSaO(2) and LSaO(2) in moderate and severe OSAS patients were significantly lower in Tibetan group than in Han group, and the differences partially remained after adjusting for BMI, and the mechanisms needed to be further investigated in high altitude areas.


Assuntos
Polissonografia/métodos , Apneia Obstrutiva do Sono/etnologia , Fases do Sono/fisiologia , Humanos , Estudos Retrospectivos , Apneia Obstrutiva do Sono/diagnóstico , Tibet
18.
Comput Methods Programs Biomed ; 176: 81-91, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31200914

RESUMO

BACKGROUND AND OBJECTIVE: Sleep is an important part of our life. That importance is highlighted by the multitude of health problems which result from sleep disorders. Detecting these sleep disorders requires an accurate interpretation of physiological signals. Prerequisite for this interpretation is an understanding of the way in which sleep stage changes manifest themselves in the signal waveform. With that understanding it is possible to build automated sleep stage scoring systems. Apart from their practical relevance for automating sleep disorder diagnosis, these systems provide a good indication of the amount of sleep stage related information communicated by a specific physiological signal. METHODS: This article provides a comprehensive review of automated sleep stage scoring systems, which were created since the year 2000. The systems were developed for Electrocardiogram (ECG), Electroencephalogram (EEG), Electrooculogram (EOG), and a combination of signals. RESULTS: Our review shows that all of these signals contain information for sleep stage scoring. CONCLUSIONS: The result is important, because it allows us to shift our research focus away from information extraction methods to systemic improvements, such as patient comfort, redundancy, safety and cost.


Assuntos
Aprendizado Profundo , Frequência Cardíaca , Polissonografia , Processamento de Sinais Assistido por Computador , Fases do Sono , Algoritmos , Eletrocardiografia , Eletroencefalografia , Eletroculografia , Humanos , Internet , Informática Médica , Distribuição Normal
19.
Artigo em Chinês | MEDLINE | ID: mdl-31163554

RESUMO

Objective: To investigate the sleep structure and related factors in children with severe obstructive sleep apnea-hypopnea syndrome(OSAHS). Method: We summarized the characteristics of 250 children withsevere OSAHS diagnosed by polysomnography(PSG)in our hospital from January 1, 2017 to December 31, 2017. According to AHI, the patients were divided into three groups, 159 in group A with 20 < AHI≤0, 57 in group B with 40 < AHI≤60, and 34 in group C with AHI > 60. We collected the basic data, sleep parameters (sleep efficiency, latency, sleep stage, sleep index, etc.), preoperative arterial blood gas test results (awake and postsleep state), echocardiographic findings of the three groups. Statistical comparisons between groups were performed with SPSS19.0. Result: BMI, AHI, OAHI, LSaO2 was significantly different with among the three groups (all P<0.01), and there was a linear correlation between BMI and AHI (r=0.251). There was significant differences in sleep efficiency (SE), sleep latency (SO), and rapid eye movement (REM) latency among the three groups. Compared with group A, the proportion of sleep in stage 1 increased by 38%, the proportion of sleep in stage 3+4 was decreased by 19%, and the proportion of REM was decreased by 14% in group C. There was no significant difference between group A and B. There was a significant linear correlation between AHI and ODI in NREM and REM, respectively (r¹=0.663, r2=0.499, P< 0.001), and the ODI in REM (63.8±35.0) was significantly higher than that in NREM (29.7±36.0), accounting for 68% of the sleep. Sixty-five children had received preoperative arterial blood gas test (awake and post-sleep state). There was a significant negative correlation between AHI and SaO2 after sleep (r=-0.444, P=0.000), and no significant correlation in awake state. Forty-four patients underwent preoperative echocardiographic examination. There was significant differences between group A and C in interventricular septum thickness, left ventricular diameter, and main pulmonary artery diameter (P<0.05). There was no significant difference between group A and B. There were no significant differences in aortic annulus diameter, left atrial diameter, left ventricular end diastolic dimension (LVEDD), ejection fraction(EF), and right ventricular anteroposterior diameter among the groups (P>0.05). Conclusion: Obesity is an important factor affecting the severity of OSAHS. As the severity of disease increased, the proportion of awakening time and stage 1 of sleep increased, but stage 3, 4 and REM decreased significantly. The SE, SO, and REM latency were significantly associated with the severity of OSAHS. The severity of hypoxemia is significantly related to AHI, and mainly occur in REM stage. Severe OSAHS is risk factor for cardiovascular complications.


Assuntos
Apneia Obstrutiva do Sono/diagnóstico , Sono , Criança , Humanos , Polissonografia , Apneia Obstrutiva do Sono/fisiopatologia , Fases do Sono , Sono REM
20.
Nat Commun ; 10(1): 2478, 2019 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-31171779

RESUMO

During non-rapid eye movement (NREM) sleep, neuronal populations in the mammalian forebrain alternate between periods of spiking and inactivity. Termed the slow oscillation in the neocortex and sharp wave-ripples in the hippocampus, these alternations are often considered separately but are both crucial for NREM functions. By directly comparing experimental observations of naturally-sleeping rats with a mean field model of an adapting, recurrent neuronal population, we find that the neocortical alternations reflect a dynamical regime in which a stable active state is interrupted by transient inactive states (slow waves) while the hippocampal alternations reflect a stable inactive state interrupted by transient active states (sharp waves). We propose that during NREM sleep in the rodent, hippocampal and neocortical populations are excitable: each in a stable state from which internal fluctuations or external perturbation can evoke the stereotyped population events that mediate NREM functions.


Assuntos
Ondas Encefálicas/fisiologia , Hipocampo/fisiologia , Neocórtex/fisiologia , Neurônios/fisiologia , Sono de Ondas Lentas/fisiologia , Animais , Eletroencefalografia , Masculino , Modelos Neurológicos , Ratos , Sono/fisiologia , Fases do Sono/fisiologia
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