Energy expenditure and restorative sleep

The Virtual Sleep Lab-A Novel Method for Accurate Four-Class Sleep Staging Using Heart-Rate Variability from Low-Cost Wearables

Sleep staging based on polysomnography (PSG) performed by human experts is the de facto "gold standard" for the objective measurement of sleep. PSG and manual sleep staging is, however, personnel-intensive and time-consuming and it is thus impractical to monitor a person's sleep architecture over extended periods. Here, we present a novel, low-cost, automatized, deep learning alternative to PSG sleep staging that provides a reliable epoch-by-epoch four-class sleep staging approach (Wake, Light [N1 + N2], Deep, REM) based solely on inter-beat-interval (IBI) data. Having trained a multi-resolution convolutional neural network (MCNN) on the IBIs of 8898 full-night manually sleep-staged recordings, we tested the MCNN on sleep classification using the IBIs of two low-cost (<EUR 100) consumer wearables: an optical heart rate sensor (VS) and a breast belt (H10), both produced by POLAR®. The overall classification accuracy reached levels comparable to expert inter-rater reliability for both devices (VS: 81%, κ = 0.69; H10: 80.3%, κ = 0.69). In addition, we used the H10 and recorded daily ECG data from 49 participants with sleep complaints over the course of a digital CBT-I-based sleep training program implemented in the App NUKKUAA™. As proof of principle, we classified the IBIs extracted from H10 using the MCNN over the course of the training program and captured sleep-related changes. At the end of the program, participants reported significant improvements in subjective sleep quality and sleep onset latency. Similarly, objective sleep onset latency showed a trend toward improvement. Weekly sleep onset latency, wake time during sleep, and total sleep time also correlated significantly with the subjective reports. The combination of state-of-the-art machine learning with suitable wearables allows continuous and accurate monitoring of sleep in naturalistic settings with profound implications for answering basic and clinical research questions.

Sleep Dysregulation and Daytime Electrodermal Patterns in Children With Autism: A Descriptive Study

Sleep deficiency influences emotion and behavior regulation but the mechanisms of influence are poorly understood. Emotion, behavioral, and sleep theories highlight differences in autonomic function as a potential pathway of influence and research in typical populations draw links between sleep deficiency and autonomic dysregulation (e.g., elevated reactivity within the sympathetic nervous system). In populations at elevated risk for sleep deficiency/problems (i.e., individuals with autism), greater variability in sleep and autonomic/arousal profiles may be particularly informative. Using electrodermal activity (EDA) as an indicator of sympathetic nervous system activation, this descriptive pilot study aimed to document daytime EDA patterns in children with autism and to explore their relations with sleep dysregulation/deficiency. EDA and sleep were measured using ankle and wrist worn sensors in 13 children (Mean_age 6.11 years). EDA indices included nonspecific skin conductance responses (NSSCR) and tonic skin conductance levels (SCL). Descriptively, children in the dysregulated sleep group had fewer NSSCRs and lower SCL in the afternoon. This blunted physiological arousal profile/pattern is consistent with previous research, but this is the first study to explore how sleep may be linked. Notably, this pattern may not reflect sleep but an overall dysregulation profile which in this sample included: dysregulated sleep, a blunted afternoon arousal profile, and elevated ASD symptom severity. Replication with larger, more diverse samples is needed to disentangle the complex relations among sleep, arousal, and ASD behavioral features. However, this study represents an important first step in documenting extended daytime arousal patterns.

Sick of sitting

Sitting too much kills. Epidemiological, physiological and molecular data suggest that sedentary lifestyle can explain, in part, how modernity is associated with obesity, more than 30 chronic diseases and conditions and high healthcare costs. Excessive sitting--sitting disease--is not innate to the human condition. People were designed to be bipedal and, before the industrial revolution, people moved substantially more throughout the day than they do presently. It is encouraging that solutions exist to reverse sitting disease. Work environments, schools, communities and cities can be re-imagined and re-invented as walking spaces, and people thereby offered more active, happier, healthier and more productive lives.

An Investigation of Subjective Sleep and Fatigue Measures for Use With Elite Athletes

This study investigated the properties of the Athens Insomnia Scale (Soldatos et al., 2000), the Fatigue Severity Scale (Krupp et al., 1989), and subscales of the SLEEP-50 Questionnaire (Spoormaker et al., 2005) in elite Australian athletes, to determine their appropriateness for this population. Fifty-nine athletes (29 male, 30 female, M = 21.86 yrs, SD = 7.44) from elite basketball, rowing, netball, beach volleyball, and sailing squads completed measures. A subset (n= 20) completed measures again at a 1-month interval, and a further subset (n= 5) were interviewed about their thoughts regarding the measures and their understanding of sleep. All scales and subscales displayed high internal consistency, apart from that which contained items not theoretically related, and all displayed good 1-month test-retest reliability. All measures were significantly correlated, demonstrating convergent validity. Athletes reported few sleep problems, but moderate fatigue. Athletes stated the measures produced accurate reflections of their sleep and fatigue, but also suggested improvements. Research limitations and implications are discussed.

Sleeping brain, learning brain. The role of sleep for memory systems

The hypothesis that sleep participates in the consolidation of recent memory traces has been investigated using four main paradigms: (1) effects of post-training sleep deprivation on memory consolidation, (2) effects of learning on post-training sleep, (3) effects of within sleep stimulation on the sleep pattern and on overnight memories, and (4) re-expression of behavior-specific neural patterns during post-training sleep. These studies convincingly support the idea that sleep is deeply involved in memory functions in humans and animals. However, the available data still remain too scarce to confirm or reject unequivocally the recently upheld hypothesis that consolidations of non-declarative and declarative memories are respectively dependent upon REM and NREM sleep processes.

Effects of training volume on sleep, psychological, and selected physiological profiles of elite female swimmers

Excessive training is reported to cause sleep disturbances and mood changes. We examined sleep and psychological changes in female swimmers across a competitive swimming season, that is, at the start of the season (onset), during peak training period (peak), and after a precompetition reduction in training (taper). For each phase, polysomnographic recordings, body composition, psychological parameters, and swimming performance were obtained. A daily training log and sleep diary were maintained for the entire study period. Sleep onset latency (SOL) time awake after sleep onset, total sleep time (TST), and rapid eye movement (REM) sleep times were similar at all three training levels. Slow wave sleep (SWS) formed a very high percentage of total sleep in the onset (26%) and peak (31%) training periods, but was significantly reduced following precompetition taper (16%), supporting the theory that the need for restorative SWS is reduced with reduced physical demand. The number of movements during sleep was significantly higher at the higher training volumes, suggesting some sleep disruption. In contrast to other studies, mood deteriorated with a reduction in training volume and/or impending competition.

Alleviating sleep-related discontinuance symptoms associated with benzodiazepine withdrawal: a new approach

There is limited information on the time course of recovery of sleep architecture in patients withdrawn from benzodiazepines (BDZ). This study examined the effects of substituting a new class of hypnotic drugs, namely the cyclopyrrolones, for current BDZs in patients presenting with BDZ dependence. The results indicated a clear improvement in a variety of sleep parameters after commencing with a cyclopyrrolone (zopiclone). These changes remained to some extent after zopiclone was discontinued. Also, the absence of certain withdrawal effects (i.e. rebound insomnia) upon discontinuation of zopiclone allows for patients to be carried through a potentially difficult period after stopping BDZs, while expediting the eventual discontinuation of all hypnotic medication.

Restless sleep, illness intrusiveness, and depressive symptoms in three chronic illness conditions: rheumatoid arthritis, end-stage renal disease, and multiple sclerosis

Restless sleep was compared across 110 out-patients with rheumatoid arthritis (RA), 101 with end-stage renal disease (ESRD), 94 with multiple sclerosis (MS), and an unselected control group of 176 individuals attending their family practitioners (FP). It was also investigated in the three chronic illness groups as a contributor to illness intrusiveness--the extent to which one's illness and/or its treatment interfere with continued involvements in valued activities and interests--a determinant of depression and emotional distress in chronic conditions. Reported frequencies of restless sleep were highest in RA, lower in ESRD, and lowest in MS; FP patients reported frequencies that were similar, overall, to those observed in MS. These differences were evident among nondepressed, (chi 2 9, N = 309, p < 0.0001), but not depressed, individuals. The occurrence of restless sleep correlated significantly with increased illness intrusiveness, r (279) = 0.31, p < 0.001, in RA, ESRD, and MS. Results supported the hypothesis that the relation between restless sleep and emotional distress is mediated by illness intrusiveness. Treatment of restless sleep may offer the added benefit of diminishing illness intrusiveness and may, thereby, enhance quality of life in chronic physical illness.

Cerebral glucose utilization during sleep-wake cycle in man determined by positron emission tomography and [18F]2-fluoro-2-deoxy-D-glucose method

Using the [18F]fluorodeoxyglucose method and positron emission tomography, we studied cerebral glucose utilization during sleep and wakefulness in 11 young normal subjects. Each of them was studied at least thrice: during wakefulness, slow wave sleep (SWS) and rapid eye movement sleep (REMS), at 1 week intervals. Four stage 3-4 SWS and 4 REMS fulfilled the steady state conditions of the model. The control population consisted of 9 normal age-matched subjects studied twice during wakefulness at, at least, 1 week intervals. Under these conditions, the average difference between the first and the second cerebral glucose metabolic rates (CMRGlu was: -7.91 +/- 15.46%, which does not differ significantly from zero (P = 0.13). During SWS, a significant decrease in CMRGlu was observed as compared to wakefulness (mean difference: -43.80 +/- 14.10%, P less than 0.01). All brain regions were equally affected but thalamic nuclei had significantly lower glucose utilization than the average cortex. During REMS, the CMRGlu were as high as during wakefulness (mean difference: 4.30 +/- 7.40%, P = 0.35). The metabolic pattern during REMS appeared more heterogeneous than at wake. An activation of left temporal and occipital areas is suggested. It is hypothetized that energy requirements for maintaining membrane polarity are reduced during SWS because of a decreased rate of synaptic events. During REMS, cerebral glucose utilization is similar to that of wakefulness, presumably because of reactivated neurotransmission and increased need for ion gradients maintenance.

Cerebral and local cerebral metabolism in the cat during slow wave and REM sleep

[14C]2-deoxyglucose autoradiography was used to show cerebral and regional cerebral metabolism during slow-wave sleep (SWS) and rapid-eye-movement sleep (REM) in the cat. Lower levels of mean cerebral metabolism, reflecting cerebral energy conservation, were associated with SWS. A clear link between REM and mean cerebral metabolism was not observed. At the regional level, SWS was associated with markedly low metabolism in thalamic sensory relays and in cortex. REM was associated with relatively low metabolism in the cerebellum, but with relatively high metabolism in the hippocampus, and in some 'motor' regions including the trigeminal and red nuclei. Thus, SWS was linked to cerebral energy conservation and to particularly low levels of functional activity in cortical and sub-cortical sensory regions. REM was unlike SWS in that: REM did not appear to be strongly linked to cerebral energy conservation; REM was linked to metabolism in fewer brain regions than was SWS; and most REM-linked regions exhibited relatively high levels of metabolism. In addition, while SWS was most clearly associated with functional activity in sensory regions, REM was linked to functional activity in a small number of limbic and motor regions. In sum, SWS and REM are associated with distinctive cerebral metabolic and functional states.