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1.
Washington, D.C.; PAHO; 2021-10-04. (PAHO/NMH/MH/21-0022).
em Inglês | PAHO-IRIS | ID: phr-54950

RESUMO

This one-page fact sheet provides a concise explanation of the impacts of alcohol consumption on people’s sleep. Alcohol consumption can affect the quality and duration of sleep, suppress REM sleep, and worsen the symptoms of sleep apnea and insomnia. In particular, the fact sheet highlights the vicious circle of alcohol use disorders and disturbed sleep, stresses the link between sleeping well and overall health, and urges people to seek help if their drinking is interfering with their sleep. Last, it offers five simple tips to help people improve their sleep.


Assuntos
Doenças não Transmissíveis , Consumo de Bebidas Alcoólicas , Saúde Mental , Abuso Oral de Substâncias , Fatores de Risco , Bebidas Alcoólicas , Sono , Sono REM , Síndromes da Apneia do Sono , Distúrbios do Início e da Manutenção do Sono
2.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(5): 844-848, 2021 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-34622603

RESUMO

Objective: To compare and analyze the clinical manifestations and sleep structure of children with obstructive sleep apnea-hypopneasyndrome (OSAHS) with different body mass index (BMI). Methods: 452 children who were diagnosed with OSAHS between December 2016 and February 2021 by the Department of Respiratory Medicine, Children's Hospital of Soochow University were included in the study. All of them did polysomnography (PSG). They were divided, according to their BMI, into the normal BMI group, the overweight group, and the obesity group. Their clinical data and PSG results were collected. Results: 287 boys (63.5%) and 165 girls (36.5%) were enrolled, with their age ranging between 3 and 15, and the median age being 5.5 (4.5, 7.0). Their BMI ranged between 12.09 kg/m 2 and 38.48 kg/m 2, with the median being 16.29 kg/m 2. 275 cases (60.8%) had normal BMI, 76 cases (16.8%) were overweight, and 101 cases (22.3%) were obese. There was no significant difference in the distribution of clinical manifestations and severity of OSAHS among the three groups. The duration and proportion of rapid eye movement (REM) stage sleep in the obese group was lower than that of the overweight and the normal BMI groups ( P<0.05). The lowest oxyhemoglobin saturation (LSaO 2) of children in the overweight group was lower than that of the normal BMI group ( P=0.050). The oxygen desaturation index (ODI) of the obese group was higher than that of the normal BMI and the overweight groups ( P<0.05). Conclusion: Obesity worsens the degree of hypoxia in children with OSAHS and affects their sleep structure.


Assuntos
Apneia Obstrutiva do Sono , Índice de Massa Corporal , Criança , Feminino , Humanos , Masculino , Polissonografia , Sono , Apneia Obstrutiva do Sono/complicações , Sono REM
3.
Int J Pediatr Otorhinolaryngol ; 149: 110867, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34385038

RESUMO

OBJECTIVE: The study aims to investigate into the correlation between clinical characteristics of pediatric obstructive sleep apnea (OSA) and the results of polysomnography (PSG), sleep apnea screening test (SAST) and cardiopulmonary coupling (CPC) respectively and compare their diagnostic values for pediatric OSA patients. METHODS: We recruited 239 pediatric OSA patients aged between 2 and 12 from Jan 1, 2017 to Jun 30, 2018. All the patients received PSG, SAST and CPC simultaneously and the results of these three different tests were compared and analyzed together with their clinical features. The relationship between the size of adenoid/tonsil and the severity of OSA was also analyzed. RESULTS: No statistically significant differences were noted between SAST and PSG in the oxygen desaturation index (ODI3) and lowest oxygen saturation (LsO2) respectively. No significant statistical difference was noted in the proportion of rapid eye movement sleep between CPC and PSG. The apnea-hypopnea index (AHI) from CPC was significantly lower than that from PSG. In the severe OSA group, no significant statistical difference was noted in AHI between these two tests. However, AHI from CPC was significantly lower than that from PSG in other groups. No statistically significant difference was noted in AHI and ODI3 among different groups graded by the size of adenoid or tonsil, suggesting that the size of adenoid/tonsil may not be highly related to the severity of OSA. CONCLUSION: SAST is an acceptable fast screening tool in the assessments of blood oxygen desaturation and further pediatric OSA screening. CPC is capable to screen severe pediatric OSA, but its results should be interpreted with caution for pediatric patients with non-severe OSA. The size of adenoid/tonsil may not be highly related to the severity of OSA.


Assuntos
Síndromes da Apneia do Sono , Apneia Obstrutiva do Sono , Criança , Pré-Escolar , Humanos , Tonsila Palatina , Polissonografia , Apneia Obstrutiva do Sono/diagnóstico , Sono REM
4.
Comput Biol Med ; 136: 104762, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34399195

RESUMO

BACKGROUND: Narcolepsy is marked by pathologic symptoms including excessive daytime drowsiness and lethargy, even with sufficient nocturnal sleep. There are two types of narcolepsy: type 1 (with cataplexy) and type 2 (without cataplexy). Unlike type 1, for which hypocretin is a biomarker, type 2 narcolepsy has no adequate biomarker to identify the causality of narcoleptic phenomenon. Therefore, we aimed to establish new biomarkers for narcolepsy using the body's systemic networks. METHOD: Thirty participants (15 with type 2 narcolepsy, 15 healthy controls) were included. We used the time delay stability (TDS) method to examine temporal information and determine relationships among multiple signals. We quantified and analyzed the network connectivity of nine biosignals (brainwaves, cardiac and respiratory information, muscle and eye movements) during nocturnal sleep. In particular, we focused on the differences in network connectivity between groups according to sleep stages and investigated whether the differences could be potential biomarkers to classify both groups by using a support vector machine. RESULT: In rapid eye movement sleep, the narcolepsy group displayed more connections than the control group (narcolepsy connections: 24.47 ± 2.87, control connections: 21.34 ± 3.49; p = 0.022). The differences were observed in movement and cardiac activity. The performance of the classifier based on connectivity differences was a 0.93 for sensitivity, specificity and accuracy, respectively. CONCLUSION: Network connectivity with the TDS method may be used as a biomarker to identify differences in the systemic networks of patients with narcolepsy type 2 and healthy controls.


Assuntos
Cataplexia , Narcolepsia , Humanos , Sono , Fases do Sono , Sono REM
5.
Clin Geriatr Med ; 37(3): 483-490, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34210452

RESUMO

Rapid eye movement (REM) behavior disorder (RBD) is characterized by loss of skeletal muscle atonia that can lead to dream enactment. This condition can cause harm to patients and their bed partners if appropriate safety measures are not ensured. This condition is often the initial presenting symptom in a group of complex neurodegenerative processes. Definitive diagnosis requires a thorough history and an in-laboratory polysomnogram to look for evidence of REM sleep without atonia. Treatment options are limited but consist of sleep safety measures and pharmacotherapy. Patients diagnosed with idiopathic RBD associated with alpha-synucleinopathy are likely to have progression of disease.


Assuntos
Parassonias/complicações , Transtorno do Comportamento do Sono REM/diagnóstico , Parassonias do Sono REM/fisiopatologia , Sono REM/fisiologia , Idoso , Humanos , Masculino , Parassonias/fisiopatologia , Polissonografia/métodos , Sono
6.
Sleep Med ; 84: 308-316, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34217921

RESUMO

BACKGROUND: Sleep disturbances are features of Parkinson's disease (PD), that can already occur before PD diagnosis. The most investigated prodromal PD sleep disorder is REM sleep behavior disorder (RBD). The relation between other polysomnographic (PSG) alterations and the prediagnostic stages of PD, however, is less clear. METHODS: We performed a retrospective case-control study to characterize polysomnographic alterations in PD and prediagnostic PD. We included 63 PD subjects (33 subjects that underwent a video-PSG before PD diagnosis [13 with and 20 without RBD] and 30 subjects that underwent a PSG after PD diagnosis) and 30 controls. PSGs were analyzed for sleep stages, different RSWA variables, body position, arousals, periodic limb movements, and REM density. RESULTS: Higher subscores of all RSWA variables were observed in subjects with PD and prediagnostic PD (with and without RBD). Total RSWA, tonic RSWA and chin RSWA severity were significant predictors for all PD and prediagnostic PD groups. Our study also shows a higher percentage of nocturnal supine body position in all PD and prediagnostic PD groups. Supine body position percentage is the highest in the PD group and has a positive correlation with time since diagnosis. CONCLUSIONS: These findings suggest that increased total, tonic and chin RSWA as well as nocturnal supine body position are already present in prediagnostic PD, independently of RBD status. Prospective longitudinal studies are necessary to confirm the additional value of these PSG abnormalities as prodromal PD biomarkers.


Assuntos
Doença de Parkinson , Transtorno do Comportamento do Sono REM , Estudos de Casos e Controles , Humanos , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico , Estudos Prospectivos , Transtorno do Comportamento do Sono REM/diagnóstico , Estudos Retrospectivos , Sono REM
7.
Sleep Med ; 84: 389-396, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34252845

RESUMO

BACKGROUND: Pantothenate kinase-associated neurodegeneration (PKAN) is a rare neurologic disorder included in the group of neurodegeneration with brain iron accumulation diseases (NBIA). Information regarding sleep in patients with PKAN is limited. OBJECTIVES: To describe the clinical and polysomnographic characteristics of sleep in six patients with genetically confirmed PKAN. METHODS: The evaluation included a clinical interview, sleep questionnaires -Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS)- and a video-polysomnography (VPSG). In addition to standard sleep measures we manually quantified sleep spindle density in stage N2 and rapid eye movements in REM sleep comparing the results with matched controls. Quantification of EMG activity in REM sleep was performed following standard criteria. RESULTS: All the patients reported at least one sleep complaint, most commonly sleep fragmentation (4/6) and sleep onset insomnia (3/6). ESS and PSQI were abnormal in 3/6 and 4/6, respectively. VPSG showed in 4/6 decreased ocular movements during REM sleep, an increase in sleep spindles in 3/6 (all of them with deep brain pallidal stimulation), an absence of slow wave sleep in 2 and undifferentiated NREM sleep and delayed sleep phase in one. Three patients had an abnormal sleep apnea/hypopnea index, and 2 periodic limb movements of sleep. REM sleep muscular atonia was preserved in all. CONCLUSIONS: Sleep disorders are common in patients with PKAN. Although our sample is small and heterogeneous, with different symptomatic treatments possibly influencing the results, it suggests that evaluation of sleep should be considered in their management.


Assuntos
Neurodegeneração Associada a Pantotenato-Quinase , Sono de Ondas Lentas , Humanos , Neurodegeneração Associada a Pantotenato-Quinase/genética , Polissonografia , Sono , Sono REM
8.
Cortex ; 142: 94-103, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34256198

RESUMO

The brain mechanisms by which we transition from sleep to a conscious state remain largely unknown in humans, partly because of methodological challenges. Here we study a pre-existing dataset of waking up participants originally designed for a study of dreaming (Horikawa, Tamaki, Miyawaki, & Kamitani, 2013) and suggest that suddenly awakening from early sleep stages results from a two-stage process that involves a sequence of cortical and subcortical brain activity. First, subcortical and sensorimotor structures seem to be recruited before most cortical regions, followed by fast, ignition-like whole-brain activation-with frontal regions engaging a little after the rest of the brain. Second, a comparably slower and possibly mirror-reversed stage might take place, with cortical regions activating before subcortical structures and the cerebellum. This pattern of activation points to a key role of subcortical structures for the initiation and maintenance of conscious states.


Assuntos
Imageamento por Ressonância Magnética , Sono REM , Encéfalo/diagnóstico por imagem , Estado de Consciência , Humanos , Sono , Fases do Sono , Vigília
9.
Int J Mol Sci ; 22(13)2021 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-34201760

RESUMO

Obstructive sleep apnea (OSA) is recurrent obstruction of the upper airway due to the loss of upper airway muscle tone during sleep. OSA is highly prevalent, especially in obesity. There is no pharmacotherapy for OSA. Previous studies have demonstrated the role of leptin, an adipose-tissue-produced hormone, as a potent respiratory stimulant. Leptin signaling via a long functional isoform of leptin receptor, LEPRb, in the nucleus of the solitary tract (NTS), has been implicated in control of breathing. We hypothesized that leptin acts on LEPRb positive neurons in the NTS to increase ventilation and maintain upper airway patency during sleep in obese mice. We expressed designer receptors exclusively activated by designer drugs (DREADD) selectively in the LEPRb positive neurons of the NTS of Leprb-Cre-GFP mice with diet-induced obesity (DIO) and examined the effect of DREADD ligand, J60, on tongue muscle activity and breathing during sleep. J60 was a potent activator of LEPRb positive NTS neurons, but did not stimulate breathing or upper airway muscles during NREM and REM sleep. We conclude that, in DIO mice, the stimulating effects of leptin on breathing during sleep are independent of LEPRb signaling in the NTS.


Assuntos
Neurônios/metabolismo , Receptores de Droga/metabolismo , Receptores para Leptina/metabolismo , Síndromes da Apneia do Sono/fisiopatologia , Núcleo Solitário/citologia , Animais , Eletromiografia , Leptina/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Neurônios/efeitos dos fármacos , Obesidade/etiologia , Obesidade/fisiopatologia , Sono REM , Núcleo Solitário/metabolismo
10.
Neuroscience ; 468: 176-185, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34147563

RESUMO

Pharmacological and optogenetic studies have demonstrated that the basolateral amygdala (BLA) plays a pivotal role in regulating fear-conditioned changes in sleep, in particular, rapid eye movement sleep (REM). However, the linkage between BLA and REM regulation has been minimally examined. In this study, we optogenetically activated or inhibited BLA selectively during spontaneous REM, and determined the effects on REM amounts and on hippocampus regulated EEG-theta (θ) activity. Excitatory (CaMKIIα-hChR2 (E123A)-eYFP-WPRE) or inhibitory (CaMKIIα-eNpHR3.0-eYFP-WPRE) optogenetic constructs were stereotaxically delivered targeting glutamatergic cells in BLA (BLAGlu) of mice. Viral constructs without opsin (CaMKIIα-eYFP-WPRE) were used as controls. All mice were implanted with telemetry transmitters for monitoring electroencephalography (EEG), activity, and body temperature, and with optic cannulas for light delivery to the BLA. BLAGlu were optogenetically activated by blue light (473 nm), or inhibited by green light (532 nm), in 10 s epochs during REM, or non-REM (NREM), in undisturbed mice. Sleep amounts and EEG activity were analyzed. Projections from BLAGlu to neurons in hippocampus were immunohistochemically (IHC) examined. Brief optogenetic activation of BLAGlu during REM immediately reduced EEG theta activity (5-8 Hz, REM-θ), without affecting overall amount and propensity of sleep, while optogenetic inhibition increased REM-θ. Stimulation during NREM had no effect on EEG spectra or sleep. IHC results showed that glutamatergic and GABAergic cells in CA3 of the hippocampus received inputs from BLAGlu projection neurons. Activation of BLAGlu reduced, and inhibition increased, REM-θ without otherwise altering sleep. Optogenetic stimulation of BLAGlu may be useful for systematically manipulating sleep-related amygdalo-hippocampal interactions.


Assuntos
Complexo Nuclear Basolateral da Amígdala , Sono REM , Animais , Eletroencefalografia , Medo , Camundongos , Sono
11.
Int J Pediatr Otorhinolaryngol ; 147: 110783, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34091429

RESUMO

OBJECTIVE: REM sleep is known to be closely associated with behavioral problems in children. Our previous study showed that children with decreased REM sleep (REM < 10%) suffered from severe sleep-disordered breathing (SDB). In this study we explored the characteristics of behavioral problems in children with SDB and decreased REM sleep. METHODS: A total of 223 children were enrolled in the study. Sleep was evaluated by Polysomnography (PSG). Behavioral problems were assessed by a Chinese version of Child Behavior Checklist (parent-reported). Parameters of SDB and behavioral problem scores (internalizing, externalizing, and total scores) were compared between the children with decreased REM (REM < 10%) and those with REM ≥ 10% before and after controlling overweight/obesity and obstructive sleep apnea hypopnea syndrome (OSAHS). Parameters of SDB were also compared between the normal behavior group and the abnormal behavior group. The correlation between the behavioral problems and the sleep parameters was analyzed. RESULTS: The children with decreased REM sleep (<10%) had more severe externalizing and total behavioral problems, even when controlled for overweight/obesity. The abnormal behavior group had significantly shorter total sleep time and REM sleep compared to the normal behavior group. CONCLUSION: Children with SDB and decreased REM sleep showed more severe behavioral problems, especially the externalizing behavioral problems. The behavioral problems can be aggravated by insufficient total sleep. Decreased REM sleep in children may be an independent parameter that is associated with the behavioral problems in children with SDB.


Assuntos
Comportamento Problema , Síndromes da Apneia do Sono , Apneia Obstrutiva do Sono , Criança , Humanos , Polissonografia , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/epidemiologia , Sono REM
12.
J Affect Disord ; 292: 405-415, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34144365

RESUMO

BACKGROUND: . Although sleep disturbances are ubiquitous in depression, studies assessing sleep architecture lead to conflicting results, possibly because of the heterogeneity in this disorder. We aimed to focus on Seasonal Affective Disorder (SAD), which is directly associated with circadian and sleep homeostasis impairments. METHODS: . A systematic search was conducted in July 2019. Original papers reporting data about night sleep architecture using polysomnography (PSG), in SAD or remitted-SAD and controls, were included. RESULTS: . Seven studies were retained and included 183 individuals, including 109 patients with SAD and 74 healthy controls. The random-effects meta-analysis showed that rapid eye movement sleep (REM) was significantly increased in SAD compared to controls (REM amount: SMD=1[0.11,1.88], p = 0.027; REM percentage: SMD=0.71[0.02,1.40], p = 0.045). Remitted SAD patients, compared to controls, also had a significantly increased REM sleep (REM amount: SMD=1.84[0.78,2.90], p<0.001; REM percentage: SMD=1.27[0.51,2.03], p = 0.001) and a significantly decreased REM latency (SMD=-0.93[-1.73,-0.13], p = 0.022). No differences were observed for total sleep time, sleep efficiency, and slow-wave-sleep. LIMITATIONS: . Most studies had small sample size, with no placebo group and with open designs. CONCLUSIONS: . REM sleep amount and latency appear altered both during the acute and remitted phase of SAD, representing trait markers with interesting diagnosis and therapeutic implications.


Assuntos
Transtorno Afetivo Sazonal , Transtornos do Sono-Vigília , Humanos , Polissonografia , Sono , Sono REM
13.
Commun Biol ; 4(1): 722, 2021 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-34117351

RESUMO

Understanding human sleep requires appropriate animal models. Sleep has been extensively studied in rodents, although rodent sleep differs substantially from human sleep. Here we investigate sleep in tree shrews, small diurnal mammals phylogenetically close to primates, and compare it to sleep in rats and humans using electrophysiological recordings from frontal cortex of each species. Tree shrews exhibited consolidated sleep, with a sleep bout duration parameter, τ, uncharacteristically high for a small mammal, and differing substantially from the sleep of rodents that is often punctuated by wakefulness. Two NREM sleep stages were observed in tree shrews: NREM, characterized by high delta waves and spindles, and an intermediate stage (IS-NREM) occurring on NREM to REM transitions and consisting of intermediate delta waves with concomitant theta-alpha activity. While IS-NREM activity was reliable in tree shrews, we could also detect it in human EEG data, on a subset of transitions. Finally, coupling events between sleep spindles and slow waves clustered near the beginning of the sleep period in tree shrews, paralleling humans, whereas they were more evenly distributed in rats. Our results suggest considerable homology of sleep structure between humans and tree shrews despite the large difference in body mass between these species.


Assuntos
Sono/fisiologia , Tupaiidae/fisiologia , Animais , Eletroencefalografia , Feminino , Lobo Frontal/fisiologia , Humanos , Masculino , Ratos , Ratos Long-Evans/fisiologia , Fases do Sono/fisiologia , Sono REM/fisiologia , Adulto Jovem
14.
PLoS Comput Biol ; 17(6): e1009045, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34181642

RESUMO

The brain exhibits capabilities of fast incremental learning from few noisy examples, as well as the ability to associate similar memories in autonomously-created categories and to combine contextual hints with sensory perceptions. Together with sleep, these mechanisms are thought to be key components of many high-level cognitive functions. Yet, little is known about the underlying processes and the specific roles of different brain states. In this work, we exploited the combination of context and perception in a thalamo-cortical model based on a soft winner-take-all circuit of excitatory and inhibitory spiking neurons. After calibrating this model to express awake and deep-sleep states with features comparable with biological measures, we demonstrate the model capability of fast incremental learning from few examples, its resilience when proposed with noisy perceptions and contextual signals, and an improvement in visual classification after sleep due to induced synaptic homeostasis and association of similar memories.


Assuntos
Potenciais de Ação , Córtex Cerebral/fisiologia , Modelos Neurológicos , Sono REM/fisiologia , Tálamo/fisiologia , Algoritmos , Córtex Cerebral/citologia , Homeostase , Humanos , Aprendizagem , Neurônios/fisiologia , Sinapses/fisiologia , Tálamo/citologia
15.
J Stroke Cerebrovasc Dis ; 30(8): 105913, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34130104

RESUMO

OBJECTIVES: Sleep-disordered breathing adversely impacts stroke outcomes. We investigated whether sleep-disordered breathing during rapid eye movement sleep and non-rapid eye movement sleep differentially influenced stroke outcomes. MATERIALS AND METHODS: Acute ischemic stroke patients who finished polysomnography within 14 days of stroke onset from April 2010 to August 2018 were reviewed. Patients were divided into four groups according to apnea-hypopnea index during rapid eye movement sleep and non-rapid eye movement sleep. The modified Rankin Scale was used to evaluate short-term outcome. During January and April 2019, another follow-up was performed for long-term outcomes, including stroke-specific quality-of-life scale, modified Rankin Scale, stroke recurrence and death. RESULTS: Of 140 patients reviewed, 109 were finally recruited. Although patients with sleep-disordered breathing during non-rapid eye movement sleep only and with sleep-disordered breathing during both rapid eye movement sleep and non-rapid eye movement sleep had higher apnea-hypopnea indices and more disrupted sleep structures, short-term and long-term outcomes did not significantly different between four groups. In Logistic regression analysis, apnea-hypopnea index (p = 0.013, OR 1.023, 95%CI 1.005-1.042) was found independently associated with short-term outcome. Rapid eye movement sleep latency (p = 0.045, OR 0.994, 95%CI 0.987-1.000) was found independently associated with quality of life. Apnea-hypopnea indices during rapid eye movement sleep or non-rapid eye movement sleep were not significantly associated with short-term or long-term outcomes. CONCLUSIONS: Apnea-hypopnea index is an independent risk factor of short-term outcome of acute ischemic stroke while sleep-disordered breathing during rapid eye movement sleep and non-rapid eye movement sleep do not affect stroke outcomes differently.


Assuntos
AVC Isquêmico/complicações , Pulmão/fisiopatologia , Respiração , Síndromes da Apneia do Sono/complicações , Sono REM , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , AVC Isquêmico/diagnóstico , AVC Isquêmico/fisiopatologia , AVC Isquêmico/reabilitação , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/fisiopatologia , Reabilitação do Acidente Vascular Cerebral , Fatores de Tempo , Resultado do Tratamento
16.
Zh Nevrol Psikhiatr Im S S Korsakova ; 121(4. Vyp. 2): 6-13, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34078853

RESUMO

OBJECTIVE: To develop of a chronic sleep restriction model in rats by repeated sleep deprivation using an orbital shaker and to determine whether this model leads to disturbances in sleep homeostatic mechanisms. MATERIAL AND METHODS: Male Wistar rats (7-8 months old) underwent sleep restriction for five consecutive days: 3 h of sleep deprivation and 1 h of sleep opportunity repeating throughout each day. Polysomnograms were recorded telemetrically throughout the day before sleep restriction (baseline), on the 1st, 3rd, 5th day of sleep restriction and 2 days after the end of sleep restriction (recovery period). RESULTS: During the period of sleep restriction, the total amount of slow-wave sleep (SWS) and rapid eye movement (REM) sleep decreased by 61% and 55%, respectively, compared to baseline. On the first day of recovery, amount of SWS increased mainly in the dark (active) phase of the day, while REM sleep increased in both light and dark phases; there was no marked rebound of daily SWS amount, while REM sleep increased by 30% from baseline. On the first day of recovery, an elevation of EEG beta and sigma power in sleep states was observed mainly in the light phase of the day. The loss of deep SWS throughout the sleep restriction period increased from 50% on 1st day to 75% on 5th day. The level of deep SWS remained below the baseline by 15-20% on the two subsequent days of recovery. The findings suggest that homeostatic mechanisms of SWS are persistently impaired after 5-day chronic sleep restriction. Besides, a decline of wakefulness accompanied by an increase of SWS in the active phase of the recovery period indicates a disruption in circadian rhythm. CONCLUSION: The proposed model leads to the disruption of sleep homeostatic mechanisms, which, in turn, impede compensation of SWS loss caused by chronic insufficient sleep.


Assuntos
Eletroencefalografia , Sono , Animais , Masculino , Ratos , Ratos Wistar , Privação do Sono , Sono REM , Vigília
17.
Neurology ; 97(1): e23-e33, 2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-33931534

RESUMO

OBJECTIVE: To evaluate sleepiness and central hypersomnia in multiple sclerosis (MS)-associated fatigue, we performed long-term polysomnography in patients with MS and healthy controls. METHODS: Patients with MS and healthy controls completed questionnaires on sleep, fatigue, sleepiness, and depression. They underwent nocturnal polysomnography, multiple sleep latency tests, and bed rest 24-hour polysomnography. Patients were divided into 3 groups (fatigue and sleepiness, fatigue and no sleepiness, neither fatigue nor sleepiness). RESULTS: Among 44 patients with MS, 19 (43.2%) had fatigue and sleepiness, 15 (34%) had only fatigue, and 10 (22.7%) had neither fatigue nor sleepiness. Compared to 24 controls, patients with fatigue and sleepiness had higher REM sleep percentages (median [interquartile range] 20.5% [19.6-24.7] vs 18.1% [12.6-20.6]), lower arousal indexes (12.7 [7.5-17.0] vs 22.4 [14.3-34.4]), and shorter daytime mean sleep latencies (8.6 [6.3-14.3] vs 16.6 [12.6-19.5] min). Restless leg syndrome, periodic leg movements, and sleep apnea had similar frequencies between groups. Central hypersomnia was found in 10 (53%) patients with fatigue and sleepiness (narcolepsy type 2, n = 2), in 2 (13%) patients with fatigue only, and in 3 (30%) patients with neither fatigue nor sleepiness. Patients with central hypersomnia were younger and sleepier than those without hypersomnia, but had similar levels of fatigue, disability, depression, cognitive performance, and frequencies of the human leukocyte antigen DQB1*0602 genotype. The severity of fatigue increased with higher depression scores, higher sleepiness severity, and lower sleep efficacy. CONCLUSION: Central hypersomnias are frequent in MS when fatigue and sleepiness are present. Screening them through polysomnography studies is recommended.


Assuntos
Distúrbios do Sono por Sonolência Excessiva/etiologia , Fadiga/etiologia , Esclerose Múltipla/complicações , Polissonografia/métodos , Adulto , Envelhecimento , Cognição , Depressão/complicações , Avaliação da Deficiência , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Fadiga/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/epidemiologia , Pacientes Ambulatoriais , Desempenho Psicomotor , Descanso , Síndrome das Pernas Inquietas/complicações , Síndromes da Apneia do Sono/complicações , Latência do Sono , Fases do Sono , Sono REM
18.
Brain Behav ; 11(6): e02068, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33960731

RESUMO

OBJECTIVES: To assess the correlation of cognitive function with sleep stability and depressive-anxious symptoms in insomnia patients. METHODS: Twenty-two insomnia patients with cognitive impairment (insomnia-CI), 21 insomnia patients with normal cognition (insomnia-CN), and 15 matched healthy control subjects (HCs) were enrolled and completed neuropsychological tests, the Hamilton Depression and Anxiety Scales (HAMD and HAMA), the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index (PSQI),the Insomnia Severity Index (ISI), and the cardiopulmonary coupling (CPC) examination. Ratios of high-frequency coupling (HFC), low-frequency coupling (LFC), and very low-frequency coupling (VLFC) measured by CPC analysis represent stable sleep, unstable sleep, and wake/rapid eye movement (REM) sleep, respectively. RESULTS: The HAMD, HAMA, PSQI, and ISI scores were higher in the insomnia-CN patients than in the HCs (all p < .01). However, no differences were found in the HFC, LFC, and VLFC ratio between the HCs and insomnia-CN groups. Compared with the insomnia-CN patients, insomnia-CI patients exhibited higher scores on the HAMD, HAMA (all p < .01), and PSQI (p < .05), performed worse on the Auditory Verbal Learning Test, Trial Making Test B, and Stroop Test B (all p < .01), had a lower HFC ratio, and had a higher LFC ratio in the CPC analysis (all p < .01). Furthermore, in the insomnia patients, poorer cognition was correlated with a decreased HFC ratio and an increased VLFC ratio (r = .356, p = .019; r = -.339, p =.026, respectively) and increased HAMD and HAMA scores (r = -.507, p < .001; r = -.561, p < .001, respectively); a higher VLFC ratio was correlated with an increased ISI score (r = .346, p = .023). CONCLUSIONS: Cognitive deterioration in insomnia patients was associated with a decreased stable sleep ratio, an increased wake/REM sleep ratio and more severe symptoms of depression and anxiety. CPC analysis can reflect the severity of insomnia.


Assuntos
Disfunção Cognitiva , Distúrbios do Início e da Manutenção do Sono , Cognição , Humanos , Sono , Sono REM
19.
J Neurosci Methods ; 360: 109224, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34052291

RESUMO

BACKGROUND: Recent advancement in deep learning provides a pivotal opportunity to potentially supplement or supplant the limiting step of manual sleep scoring. NEW METHOD: In this paper, we characterize the WaveSleepNet (WSN), a deep convolutional neural network (CNN) that uses wavelet transformed images of mouse EEG/EMG signals to autoscore sleep and wake. RESULTS: WSN achieves an epoch by epoch mean accuracy of 0.86 and mean F1 score of 0.82 compared to manual scoring by a human expert. In mice experiencing mechanically induced sleep fragmentation, an overall epoch by epoch mean accuracy of 0.80 is achieved by WSN and classification of non-REM (NREM) sleep is not compromised, but the high level of sleep fragmentation results in WSN having greater difficulty differentiating REM from NREM sleep. We also find that WSN achieves similar levels of accuracy on an independent dataset of externally acquired EEG/EMG recordings with an overall epoch by epoch accuracy of 0.91. We also compared conventional summary sleep metrics in mice sleeping ad libitum. WSN systematically biases sleep fragmentation metrics of bout number and bout length leading to an overestimated degree of sleep fragmentation. COMPARISON WITH EXISTING METHODS: In a cross-validation, WSN has a greater macro and stage-specific accuracy compared to a conventional random forest classifier. Examining the WSN, we find that it automatically learns spectral features consistent with manual scoring criteria that are used to define each class. CONCLUSION: These results suggest to us that WSN is capable of learning visually agreeable features and may be useful as a supplement to human manual scoring.


Assuntos
Eletroencefalografia , Fases do Sono , Animais , Humanos , Camundongos , Redes Neurais de Computação , Sono , Sono REM
20.
Eur J Neurosci ; 54(2): 4445-4455, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33942407

RESUMO

γ-Aminobutyric acid (GABA) acting through heteropentameric GABAA receptors plays a pivotal role in the sleep-promoting circuitry. Whereas the role of the different GABAA receptor α-subunits in sleep regulation and in mediating the effect of benzodiazepines for treatment of insomnia is well-described, the ß-subunits are less studied. Here we report the first study characterizing sleep in mice lacking the GABAA receptor ß1 -subunit (ß1 -/- mice). We show that ß1 -/- mice have a distinct and abnormal sleep phenotype characterized by increased delta power in non-rapid eye movement (NREM) sleep and decreased theta activity in rapid eye movement (REM) sleep compared to ß1 +/+ mice, without any change in the overall sleep-wake architecture. From GABAA receptor-specific autoradiography, it is further demonstrated that functional ß1 -subunit-containing GABAA receptors display the highest binding levels in the hippocampus and frontal cortex. In conclusion, this study suggests that the GABAA receptor ß1 -subunit does not play an important role in sleep initiation or maintenance but instead regulates the power spectrum and especially the expression of theta rhythm. This provides new knowledge on the complex role of GABAA receptor subunits in sleep regulation. In addition, ß1 -/- mice could provide a useful mouse model for future studies of the physiological role of delta and theta rhythms during sleep.


Assuntos
Receptores de GABA-A , Sono REM , Animais , Eletroencefalografia , Camundongos , Camundongos Knockout , Receptores de GABA-A/genética , Sono , Ácido gama-Aminobutírico
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