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1.
Dermatol Ther ; 35(2): e15226, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34820993

RESUMO

Cutaneous homeostasis can be modulated by sleep. Although there is little evidence about the efficacy of medications topically applied in the morning compared to those administered in the evening, they are commonly prescribed to be used overnight. Poor sleep may affect the tegument, but its repercussion on dermatological therapy is not clear. This communication aims to carry out an overview on the relationship between sleep and the skin, particularly in respect of the effectiveness of topical substances during the night versus the day; and the possible impact of sleep dysregulation on these treatments. Features related to this external organ, involving hydration, blood flow, and the permeability of the superficial barrier have physiological variations in sleep period. Our hypothesis is that sleep loss could alter drug absorption in the dermis and impair the success of the treatment. This can depend on the integrity of the mechanical skin barrier, and the enzymatic process after drug penetration, which may be influenced by the circadian rhythm. We raise the role of sleep disturbance in relation to skin aging and the cutaneous microbiota. The organ integrity and local immunology can be guided by sleep distress, which can modify the control of dermatological diseases. Future comparative analyses are warranted to explore the possible changes of the integumentary system influenced by circadian rhythm, and interference in response to topical dermal treatments. We emphasize the importance of sufficient sleep to improve the clinical management of several dermatosis and cosmetic complaints that need percutaneous therapeutics.


Assuntos
Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Humanos , Regeneração , Pele , Sono/fisiologia , Transtornos do Sono-Vigília/tratamento farmacológico , Transtornos do Sono-Vigília/etiologia
2.
Transl Psychiatry ; 12(1): 77, 2022 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-35197453

RESUMO

Serotonergic psychedelic drugs, such as psilocin (4-hydroxy-N,N-dimethyltryptamine), profoundly alter the quality of consciousness through mechanisms which are incompletely understood. Growing evidence suggests that a single psychedelic experience can positively impact long-term psychological well-being, with relevance for the treatment of psychiatric disorders, including depression. A prominent factor associated with psychiatric disorders is disturbed sleep, and the sleep-wake cycle is implicated in the homeostatic regulation of neuronal activity and synaptic plasticity. However, it remains largely unknown to what extent psychedelic agents directly affect sleep, in terms of both acute arousal and homeostatic sleep regulation. Here, chronic electrophysiological recordings were obtained in mice to track sleep-wake architecture and cortical activity after psilocin injection. Administration of psilocin led to delayed REM sleep onset and reduced NREM sleep maintenance for up to approximately 3 h after dosing, and the acute EEG response was associated primarily with an enhanced oscillation around 4 Hz. No long-term changes in sleep-wake quantity were found. When combined with sleep deprivation, psilocin did not alter the dynamics of homeostatic sleep rebound during the subsequent recovery period, as reflected in both sleep amount and EEG slow-wave activity. However, psilocin decreased the recovery rate of sleep slow-wave activity following sleep deprivation in the local field potentials of electrodes targeting the medial prefrontal and surrounding cortex. It is concluded that psilocin affects both global vigilance state control and local sleep homeostasis, an effect which may be relevant for its antidepressant efficacy.


Assuntos
Eletroencefalografia , Sono , Animais , Encéfalo/fisiologia , Humanos , Camundongos , Psilocibina/análogos & derivados , Sono/fisiologia , Privação do Sono , Vigília
3.
Physiol Rep ; 10(17): e15455, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36065854

RESUMO

People with cervical spinal cord injury (SCI) are likely to experience chronic intermittent hypoxia while sleeping. The physiological effects of intermittent hypoxia on the respiratory system during spontaneous sleep in individuals with chronic cervical SCI are unknown. We hypothesized that individuals with cervical SCI would demonstrate higher short- and long-term ventilatory responses to acute intermittent hypoxia (AIH) exposure than individuals with thoracic SCI during sleep. Twenty participants (10 with cervical SCI [9 male] and 10 with thoracic SCI [6 male]) underwent an AIH and sham protocol during sleep. During the AIH protocol, each participant experienced 15 episodes of isocapnic hypoxia using mixed gases of 100% nitrogen (N2 ) and 40% carbon dioxide (CO2 ) to achieve an oxygen saturation of less than 90%. This was followed by two breaths of 100% oxygen (O2 ). Measurements were collected before, during, and 40 min after the AIH protocol to obtain ventilatory data. During the sham protocol, participants breathed room air for the same amount of time that elapsed during the AIH protocol and at approximately the same time of night. Hypoxic ventilatory response (HVR) during the AIH protocol was significantly higher in participants with cervical SCI than those with thoracic SCI. There was no significant difference in minute ventilation (V.E. ), tidal volume (V.T. ), or respiratory frequency (f) during the recovery period after AIH in cervical SCI compared to thoracic SCI groups. Individuals with cervical SCI demonstrated a significant short-term increase in HVR compared to thoracic SCI. However, there was no evidence of ventilatory long-term facilitation following AIH in either group.


Assuntos
Movimentos Oculares , Traumatismos da Medula Espinal , Humanos , Hipóxia , Masculino , Quadriplegia , Sono/fisiologia , Traumatismos da Medula Espinal/complicações
4.
Lancet Neurol ; 21(10): 937-946, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36115365

RESUMO

Prospective epidemiological studies in industrial societies indicate that 7 h of sleep per night in people aged 18 years or older is optimum, with higher and lower amounts of sleep predicting a shorter lifespan. Humans living a hunter-gatherer lifestyle (eg, tribal groups) sleep for 6-8 h per night, with the longest sleep durations in winter. The prevalence of insomnia in hunter-gatherer populations is low (around 2%) compared with the prevalence of insomnia in industrial societies (around 10-30%). Sleep deprivation studies, which are done to gain insights into sleep function, are often confounded by the effects of stress. Consideration of the duration of spontaneous daily sleep across species of mammals, which ranges from 2 h to 20 h, can provide important insights into sleep function without the stress of deprivation. Sleep duration is not related to brain size or cognitive ability. Rather, sleep duration across species is associated with their ecological niche and feeding requirements, indicating a role for wake-sleep balance in food acquisition and energy conservation. Brain temperature drops from waking levels during non-rapid eye movement (non-REM) sleep and rises during REM sleep. Average daily REM sleep time of homeotherm orders is negatively correlated with average body and brain temperature, with the largest amount of REM sleep in egg laying (monotreme) mammals, moderate amounts in pouched (marsupial) mammals, lower amounts in placental mammals, and the lowest amounts in birds. REM sleep might, therefore, have a key role in the regulation of temperature and metabolism of the brain during sleep and in the facilitation of alert awakening.


Assuntos
Distúrbios do Início e da Manutenção do Sono , Animais , Feminino , Humanos , Mamíferos/fisiologia , Placenta , Gravidez , Estudos Prospectivos , Sono/fisiologia
5.
Zhonghua Liu Xing Bing Xue Za Zhi ; 43(9): 1349-1356, 2022 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-36117338

RESUMO

Objective: To explore the correlation between sleep status and frailty in adults aged 30-79 years in China, and explore the potential effect modification of general and central obesity. Methods: Based on the baseline data of the China Kadoorie Biobank, we used multinomial logistic regression to analyze the correlation between long and short sleep duration, insomnia disorder, snoring, and unhealthy sleep score with risks of pre-frailty and frailty. Both overall and obesity-stratified analyses were performed. Result: Among the 512 724 participants, 2.3% had frailty and 40.1% had pre-frailty. There was a U-shaped relationship between sleep duration and frailty score. Short (OR=1.21, 95%CI: 1.19-1.23) or long sleep duration (OR=1.19, 95%CI: 1.17-1.21), insomnia disorder (OR=2.09, 95%CI: 2.02-2.17), and snoring (OR=1.61, 95%CI: 1.59-1.63) were all positively correlated with pre-frailty, and dose-response relationships were observed between unhealthy sleep score and pre-frailty (P for trend<0.001), with OR values of 1.46 (1.44-1.48), 1.97 (1.93-2.00) and 3.43 (3.21-3.67) respectively for those having unhealthy sleep score of 1 to 3. These sleep problems were also positively correlated with frailty. Compared with the overweight or obesity group, stronger relationships were observed between short sleep duration and frailty or pre-frailty and between insomnia disorder and pre-frailty, while the relationships between snoring and frailty and pre-frailty were weaker in the participants with normal weight (P for interaction <0.007 for all). We also observed similar effect modification by central obesity. Conclusion: Long or short sleep duration, insomnia disorder, snoring and higher unhealthy sleep scores were positively correlated with pre-frailty or frailty, general and central obesity status could modify the relationships.


Assuntos
Fragilidade , Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Adulto , China/epidemiologia , Fragilidade/epidemiologia , Humanos , Obesidade , Obesidade Abdominal , Sono/fisiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Ronco/epidemiologia
6.
Brain ; 145(9): 3225-3235, 2022 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-36103407

RESUMO

Pain intensity has been reported to fluctuate during the day in some experimental and clinical conditions, but the mechanisms underlying these fluctuations are unknown. Although the circadian timing system is known to regulate a wide range of physiological functions, its implication in pain regulation is largely unknown. Using highly controlled laboratory constant-routine conditions, we show that pain sensitivity is rhythmic over the 24 h and strongly controlled by the endogenous circadian timing system. We found that the circadian component of pain sensitivity can be modelled with a sinusoidal function, with a maximum in the middle of the night and a minimum in the afternoon. We also found a weak homeostatic control of pain sensitivity, with a linear increase over the 34 h of prolonged wakefulness, which slowly builds up with sleep pressure. Using mathematical modelling, we describe that the circadian system accounts for ∼80% of the full magnitude of pain sensitivity over the 24 h, and that sleep-related processes account for only ∼20%. Overall, our data reveal the neurobiological mechanisms involved in driving the rhythmicity of pain perception in humans. We show that pain sensitivity is controlled by two superimposed processes: a strong circadian component and a modest homeostatic sleep-related component. Our findings highlight the need to consider time of day in pain assessment, and indicate that personalized circadian medicine may be a promising approach to pain management.


Assuntos
Ritmo Circadiano , Sono , Ritmo Circadiano/fisiologia , Homeostase , Humanos , Dor , Sono/fisiologia , Vigília/fisiologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-36078471

RESUMO

Individual sleep dimensions have been linked to cardiovascular disease (CVD) risk and cardiometabolic health (CMH), but sleep health is multifaceted. We investigated associations of a multidimensional sleep health (MDSH) score, enabling the assessment of sleep health gradients, with CVD and CMH. Participants were 4555 adults aged ≥20 years from the 2017-2018 National Health and Nutrition Examination Survey. A MDSH score, capturing poor, moderate, and ideal sleep was computed from self-reported sleep duration, sleep regularity, difficulty falling asleep, symptoms of sleep disorders, and daytime sleepiness. Survey-weighted multivariable linear and logistic models examined associations of MDSH with CVD and CMH. Ideal and moderate vs. poor MDSH were related to lower odds of hypertension (62% and 41%), obesity (73% and 56%), and central adiposity (68% and 55%), respectively; a statistically significant linear trend was observed across gradients of MDSH (p-trend < 0.001). Ideal vs. moderate/poor MDSH was associated with 32% and 40% lower odds of prevalent CVD and type 2 diabetes, respectively. More favorable MDSH was associated with lower blood pressure, BMI, waist circumference, and fasting glucose. In sex-stratified analyses, ideal vs. moderate/poor MDSH was associated with lower CVD odds and blood pressure in women only. The MDSH framework may be more than just the sum of its parts and could better capture information regarding CVD risk.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Distúrbios do Início e da Manutenção do Sono , Adulto , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Inquéritos Nutricionais , Obesidade/complicações , Obesidade/epidemiologia , Prevalência , Fatores de Risco , Sono/fisiologia , Distúrbios do Início e da Manutenção do Sono/complicações
8.
Front Neural Circuits ; 16: 983211, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36082111

RESUMO

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death among patients with refractory epilepsy. While the exact etiology of SUDEP is unknown, mounting evidence implicates respiratory dysfunction as a precipitating factor in cases of seizure-induced death. Dysregulation of breathing can occur in epilepsy patients during and after seizures as well as interictally, with many epilepsy patients exhibiting sleep-disordered breathing (SDB), such as obstructive sleep apnea (OSA). The majority of SUDEP cases occur during the night, with the victim found prone in or near a bed. As breathing is modulated in both a time-of-day and sleep state-dependent manner, it is relevant to examine the added burden of nocturnal seizures on respiratory function. This review explores the current state of understanding of the relationship between respiratory function, sleep state and time of day, and epilepsy. We highlight sleep as a particularly vulnerable period for individuals with epilepsy and press that this topic warrants further investigation in order to develop therapeutic interventions to mitigate the risk of SUDEP.


Assuntos
Epilepsia , Morte Súbita Inesperada na Epilepsia , Morte Súbita/etiologia , Epilepsia/complicações , Humanos , Convulsões , Sono/fisiologia
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 3665-3668, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086032

RESUMO

Actigraphy allows for the remote monitoring of subjects' activity for clinical and research purposes. However, most standard methods are built for proprietary measures from specific devices that are not widely used. In this study, we develop an algorithm for classifying sleep and awake using a single day of triaxial accelerometer data, which can be acquired from all smart devices. This algorithm consists of two stages, clustering and hidden Markov modeling, and outperforms standard algorithms in sensitivity (94%), specificity (93 %), and overall accuracy (93%) across seven subjects. This method can help automate actigraphy analyses at scale using widely available technology using even a single day's worth of data. Clinical Relevance- Automated monitoring of patients' activity at home can help track recovery trajectories after surgery and injury, disease progression, treatment response.


Assuntos
Actigrafia , Sono , Actigrafia/métodos , Algoritmos , Humanos , Polissonografia/métodos , Sono/fisiologia , Vigília/fisiologia
10.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 4580-4583, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086293

RESUMO

Annotation of sleep disordered breathing, including Cheyne-Stokes Breathing (CSB), is an expensive and time-consuming process for the clinician. To solve the problem, this paper presents a deep learning-based algorithm for automatic sample-wise detection of CSB in nocturnal polysomnographic (PSG) recordings. 523 PSG recordings were retrieved from four different sleep cohorts and subsequently scored for CSB by three certified sleep technicians. The data was pre-processed and 16 time domain features were extracted and passed into a neural network inspired by the transformer unit. Finally, the network output was post-processed to achieve physiologically meaningful predictions. The algorithm reached a F1-score of 0.76, close to the certified sleep technicians showing that it is possible to automatically detect CSB with the proposed model. The algorithm had difficulties distinguishing between severe obstructive sleep apnea and CSB but this was not dissimilar to technician performance. In conclusion, the proposed algorithm showed promising results and a confirmation of the performance could make it relevant as a screening tool in a clinical setting.


Assuntos
Síndromes da Apneia do Sono , Apneia Obstrutiva do Sono , Respiração de Cheyne-Stokes/diagnóstico , Humanos , Redes Neurais de Computação , Sono/fisiologia , Síndromes da Apneia do Sono/diagnóstico , Apneia Obstrutiva do Sono/diagnóstico
11.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 3401-3404, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086371

RESUMO

Circadian rhythms in blood pressure (BP) may in some cases be indicative of an increased risk of adverse cardiovascular events. However, current methods for assessing these rhythms can be disruptive to sleep, work, and daily activities. Features of the photoplethysmogram (PPG), which can be non-invasively and unobtrusively recorded, have been suggested as surrogate measures of BP. This work investigates the presence of a circadian rhythm in these features and evaluates their potential to classify nocturnal BP patterns. 742 patients who were discharged home from the ICU were selected from the MIMIC-III database. Our results show that a number of PPG features exhibit a clear and observable circadian rhythm. Of the 19 features evaluated, the circadian rhythms of 5 features outperformed heart rate (HR) in terms of correlation with the circadian rhythm of SBP ( ). We also present evidence that a metric combining the PPG features significantly improves BP phenotype classification accuracy. Clinical Relevance-This work suggests that a combined metric of PPG features may be able to accurately assess an individual's circadian rhythm of BP.


Assuntos
Ritmo Circadiano , Fotopletismografia , Pressão Sanguínea/fisiologia , Ritmo Circadiano/fisiologia , Frequência Cardíaca , Sono/fisiologia
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 4135-4138, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086492

RESUMO

Stage 2 sleep spindles are considered useful biomarkers for the integrity of the central nervous system and for cognitive and memory skills. We investigated sleep spindles patterns in subjects after 12 months of their hospitalization in the intensive care unit (ICU) of the Padova Teaching Hospital due to COVID-19 between March and November 2020. Before the nap, participants (13 hospitalized in ICU - ICU; 9 hospitalized who received noninvasive ventilation - nonlCU; 9 age and sex-matched healthy controls - CTRL, i.e., not infected by COVID-19) underwent a cognitive and psychological as-sessment. During the nap, high-density electroencephalography (EEG) recordings were acquired. Slow (i.e., [9]-[12] Hz) and fast (i.e.,]12-16] Hz) spindles were automatically detected. Spindle density and spindle source reconstruction in brain grey matter were extracted. The psychological assessment revealed a statistical difference comparing CTRL and nonlCU in Beck Depression Inventory score and in the Physical Quality of Life index (pvalue = 0.03). The cognitive assessment revealed a trend of worsening results in executive functions in COVID-19 survivors. Slow spindle density significantly decreased comparing CTRL to COVID-19 survivors (pvalue= 0.001). There were statistically significant differences in EEG source-waveforms fast spindle amplitude onset among the three groups, mainly between CTRL and nonlCU. Clinical Relevance- Our results suggest that nonlCU were more susceptible to the hospitalization experience than ICU participants with a slight effect on cognitive tests. This impacted the spindle generation revealing a decreased density of slow spindles and affecting the generators of fast spindles in COVID-19 survivors especially in nonlCU.


Assuntos
COVID-19 , Eletroencefalografia/métodos , Humanos , Testes Neuropsicológicos , Qualidade de Vida , Sono/fisiologia
13.
Medicina (B Aires) ; 82 Suppl 3: 30-34, 2022 Aug 30.
Artigo em Espanhol | MEDLINE | ID: mdl-36054854

RESUMO

Sleep is the main activity of the developing brain and indispensable for the maturation of the central nervous system. Sleep habits are influenced by biological, social and cultural factors and play a role in learning and memory processes. It is estimated that 25-50% of children have sleep difficulties. There is consensus that insufficient sleep has a negative impact on neurodevelopment. Sleep disorders double their incidence in children with neurological disorders, with a bidirectional reciprocal causal link. They are classified into: insomnia, sleep-related breathing disorders, centrally caused hypersomnolence disorders, circadian cycle disorders, parasomnias, sleep-related movement disorders, and others. Despite the scientific evidence of the importance of sleep in early childhood, a high percentage of children do not comply with the recommended hours of sleep, which reflects the importance of training the pediatrician in this problem, which has increased during the pandemic.


El sueño es la principal actividad del cerebro en desarrollo e indispensable para la maduración del sistema nervioso central. Los hábitos de sueño están influenciados por factores biológicos, sociales y culturales y cumplen un rol en procesos de aprendizaje y memoria. Se estima que el 25-50% de los niños presentan dificultades del sueño. Existe consenso de que el sueño insuficiente ejerce un impacto negativo en el neurodesarrollo. Los trastornos del sueño duplican su incidencia en niños con trastornos neurológicos, con un vínculo de causalidad recíproco bidireccional. Se clasifican en: insomnio, trastornos de la respiración relacionados con el sueño, trastornos de hipersomnolencia de causa central, trastornos del ciclo circadiano, parasomnias, trastornos del movimiento relacionados con el sueño y otros. A pesar de la evidencia científica de la importancia del sueño en la primera infancia, un alto porcentaje de niños no cumplen con las horas de sueño recomendadas, lo que refleja la importancia de capacitar al pediatra en esta problemática, incrementada en el curso de la pandemia.


Assuntos
Doenças do Sistema Nervoso , Parassonias , Transtornos do Sono-Vigília , Encéfalo , Criança , Pré-Escolar , Humanos , Sono/fisiologia , Transtornos do Sono-Vigília/complicações
14.
Sleep Med Rev ; 64: 101667, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36064209

RESUMO

Light is a potent circadian entraining agent. For many people, daily light exposure is fundamentally dysregulated with reduced light during the day and increased light into the late evening. This lighting schedule promotes chronic disruption to circadian physiology resulting in a myriad of impairments. Developmental changes in sleep-wake physiology suggest that such light exposure patterns may be particularly disruptive for adolescents and further compounded by lifestyle factors such as early school start times. This narrative review describes evidence that reduced light exposure during the school day delays the circadian clock, and longer exposure durations to light-emitting electronic devices in the evening suppress melatonin. While home lighting in the evening can suppress melatonin secretion and delay circadian phase, the patterning of light exposure across the day and evening can have moderating effects. Photic countermeasures may be flexibly and scalably implemented to support sleep-wake health; including manipulations of light intensity, spectra, duration and delivery modality across multiple contexts. An integrative approach addressing physiology, attitudes, and behaviors will support optimization of light-driven sleep-wake outcomes in adolescents.


Assuntos
Relógios Circadianos , Melatonina , Adolescente , Ritmo Circadiano/fisiologia , Humanos , Iluminação , Sono/fisiologia
15.
Neurologia (Engl Ed) ; 37(7): 575-585, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36064286

RESUMO

Melatonin is the main hormone involved in the control of the sleep-wake cycle. It is easily synthesisable and can be administered orally, which has led to interest in its use as a treatment for insomnia. Moreover, as production of the hormone decreases with age, in inverse correlation with the frequency of poor sleep quality, it has been suggested that melatonin deficit is at least partly responsible for sleep disorders. Treating this age-related deficit would therefore appear to be a natural way of restoring sleep quality, which is lost as patients age. However, despite the undeniable theoretical appeal of this approach to insomnia, little scientific evidence is available that supports any benefit of this substitutive therapy. Furthermore, the most suitable dose ranges and pharmaceutical preparations for melatonin administration are yet to be clearly defined. This review addresses the physiology of melatonin, the different pharmaceutical preparations, and data on its clinical usefulness.


Assuntos
Melatonina , Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Humanos , Melatonina/fisiologia , Melatonina/uso terapêutico , Preparações Farmacêuticas , Sono/fisiologia , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Transtornos do Sono-Vigília/tratamento farmacológico
16.
Epileptic Disord ; 24(6): 1-13, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36125364

RESUMO

Objective: We firstly aimed to describe and classify EEG patterns in electrical status epilepticus in sleep (ESES), and secondly subclassify EEG patterns based on analysis of spikes using spatio-temporal mapping and electrical source analysis. Methods: Overnight EEGs (minimum: eight hours) of 30 children, aged 2-12 years, with ESES (spike-wave index: at least 50%) were selected. Average reference montage was used for dipole analysis and mapping. The location and orientation of the dipoles were determined by mapping positive and negative poles and applying the rules of mapping. The onset and propagation of the spikes and the latency between the two hemispheres (for bisynchronous spikes) were determined (based on source analysis using BESA research 7.1). Results: (1) ESES was classified as "generalised" (80%) and focal (20%) patterns; (2) the bisynchronous subtype in the "generalised" pattern was due to apparently synchronous bilateral activation of spikes (with lead-in of 20-60 ms from one hemisphere) with a tangential/oblique dipole (source analysis localised these spikes to around the peri-rolandic cortex); (3) the classic description of ESES spikes as "diffuse" spikes with bifrontal maxima is a misinterpretation using the 10-20 EEG system .Using voltage mapping and source analysis, cortical activation in the rolandic cortex was identified which imparts diffuse frontal negativity and parieto-occipital positivity; (4) ESES spikes showed intraspike and interspike dipole instability and the orientation of dipoles changed due to local spike propagation around the source and into the depth of the sulcus (which we refer to herein as "dancing dipoles"); and (5) focal ESES were classified as parietal, occipital and temporo-occipital patterns;a frontal ESES pattern was not seen. Significance: Based on detailed mapping and source analysis of ESES, we have successfully reinterpreted various misconceptions in the literature. We have simplified the interpretation of complicated EEG patterns by extracting the primary and propagated sources which aid the classification of ESES. As the dipole is always stable in self-limited childhood epilepsy with centrotemporal spikes, we believe that the phenomenon of an intrinsically unstable dipole is a reliable qualitative EEG marker of ESES.


Assuntos
Estado Epiléptico , Criança , Eletroencefalografia , Humanos , Sono/fisiologia , Estado Epiléptico/complicações , Estado Epiléptico/diagnóstico
17.
Cell Rep ; 40(12): 111367, 2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36130495

RESUMO

Sleep spindles are crucial for learning in the cortex and basal ganglia (BG) because they facilitate the reactivation of previously active neuronal ensembles. Studying field potentials (FPs) and spiking in the cortex and BG during sleep in non-human primates following pre-sleep learning, we show that FP sleep spindles are widespread in the BG and are similar to cortical spindles in morphology, spectral content, and response to the pre-sleep task. Further, BG spindles are concordant with electroencephalogram (EEG) spindles and associated with increased cortico-BG correlation. However, spindles across the BG differ markedly in their entrainment of local spiking. The spiking activity of striatal projection neurons exhibits consistent phase locking to striatal and EEG spindles, producing phase windows of peaked cross-region spindling. In contrast, firing in other BG nuclei is not entrained to either local or EEG sleep spindles. These results suggest corticostriatal synapses as the main hub for offline cortico-BG communication.


Assuntos
Gânglios da Base , Sono , Animais , Gânglios da Base/fisiologia , Córtex Cerebral/fisiologia , Corpo Estriado , Eletroencefalografia , Neurônios/fisiologia , Sono/fisiologia
18.
Eur Respir Rev ; 31(165)2022 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-36130786

RESUMO

Sleep brings major challenges for the control of ventilation in humans, particularly the regulation of arterial carbon dioxide pressure (P aCO2 ). In patients with COPD, chronic hypercapnia is associated with increased mortality. Therefore, nocturnal high-level noninvasive positive-pressure ventilation (NIV) is recommended with the intention to reduce P aCO2 down to normocapnia. However, the long-term physiological consequences of P aCO2 "correction" on the mechanics of breathing, gas exchange efficiency and resulting symptoms (i.e. dyspnoea) remain poorly understood. Investigating the influence of sleep on the neural drive to breathe and its translation to the mechanical act of breathing is of foremost relevance to create a solid rationale for the use of nocturnal NIV. In this review, we critically discuss the mechanisms by which sleep influences ventilatory neural drive and mechanical consequences in healthy subjects and hypercapnic patients with advanced COPD. We then discuss the available literature on the effects of nocturnal NIV on ventilatory neural drive and respiratory mechanics, highlighting open avenues for further investigation.


Assuntos
Ventilação não Invasiva , Doença Pulmonar Obstrutiva Crônica , Insuficiência Respiratória , Dióxido de Carbono , Humanos , Hipercapnia/complicações , Hipercapnia/terapia , Ventilação não Invasiva/efeitos adversos , Ventilação não Invasiva/métodos , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/terapia , Sono/fisiologia
19.
Bull Exp Biol Med ; 173(4): 399-408, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36058972

RESUMO

Analysis of the microstructure of sleep using extended EEG monitoring can provide deep understanding of the neuronal activity of the brain. Sleep spindles (SS) are one of the main EEG patterns occurring during the non-rapid eye movement sleep. SS reflect the process of synchronization and provide sleep initiation and maintenance by suppressing sensory information. SS are associated with a wide range of brain functions, such as memory and neuroplasticity, general intelligence and cognitive performance, which undergo various changes throughout the life. In this review we discuss the features of the formation and regression of SS in humans during ontogeny on the basis of published data of the last 5-6 years and fundamental results of previous studies at the Scientific Centre for Family Health and Human Reproduction Problems that formed the basis of the modern study of neurophysiological phenomena of the wakefulness and sleep. The search for diagnostic patterns and prognostic markers of the pathology of higher nervous activity remains a priority in fundamental studies and medical practice. Modern methods for studying sleep and its EEG patterns are the next step in understanding the neurophysiological aspects of the sleep-wake cycle. This will open prospects for predicting postnatal maturation, understanding the mechanisms of brain neuroplasticity in the "sleep-wakefulness" continuum, which is one of the tasks of modern somnology and neurophysiology.


Assuntos
Eletroencefalografia , Sono , Encéfalo/fisiologia , Humanos , Polissonografia , Sono/fisiologia , Vigília/fisiologia
20.
Epidemiol Psychiatr Sci ; 31: e63, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36073029

RESUMO

AIMS: To assess the association of sleep factors (sleep duration, trouble sleeping, sleep disorder) and combined sleep behaviours with the risk of clinically relevant depression (CRD). METHODS: A total of 17 859 participants (8806 males and 9053 females) aged 20-79 years from the National Health and Nutrition Examination Survey (NHANES) 2007-2014 waves were included. Sleep duration, trouble sleeping and sleep disorder were asked in the home by trained interviewers using the Computer-Assisted Personal Interviewing (CAPI) system. The combined sleep behaviours were referred to as 'sleep patterns (healthy, intermediate and poor)', with a 'healthy sleep pattern' defined as sleeping 7-9 h per night with no self-reported trouble sleeping or sleep disorders. And intermediate and poor sleep patterns indicated 1 and 2-3 sleep problems, respectively. Weighted logistic regression was performed to evaluate the association of sleep factors and sleep patterns with the risk of depressive symptoms. RESULTS: The total prevalence of CRD was 9.5% among the 17 859 participants analysed, with females having almost twice as frequency than males. Compared to normal sleep duration (7-9 h), both short and long sleep duration were linked with a higher risk of CRD (short sleep: OR: 1.66, 95% CI: 1.39-1.98; long sleep: OR: 2.75, 95% CI: 1.93-3.92). The self-reported sleep complaints, whether trouble sleeping or sleep disorder, were significantly related with CRD (trouble sleeping: OR: 3.04, 95% CI: 2.59-3.56; sleep disorder: OR: 1.83, 95% CI: 1.44-2.34). Furthermore, the correlations appeared to be higher for individuals with poor sleep pattern (OR: 5.98, 95% CI: 4.91-7.29). CONCLUSIONS: In this national representative survey, it was shown that there was a dose-response relationship between sleep patterns and CRD.


Assuntos
Depressão , Transtornos do Sono-Vigília , Adulto , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Sono/fisiologia , Transtornos do Sono-Vigília/epidemiologia
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