Sleep, synaptic connectivity, and hippocampal memory during early development

Instructional approach, sleep, and perceived academic well-being in adolescents during COVID-19: Evidence from the NESTED study

OBJECTIVES

At the peak of COVID-19, adolescent life was disrupted as schools adapted their instructional approaches such as online, in-person, or hybrid instruction. We and others have previously commented on how these shifts facilitated longer, later and (more developmentally appropriate) sleep. Here, we report how sleep contributed to associations between remote instruction and broader academic well-being (e.g., cognitive function, school connectedness, and stress).

METHODS

Adolescents from all 50 U.S. states (n = 4068) completed online self-report surveys in fall 2020. Instructional approach was operationalized from fully in-person instruction to fully asynchronous online education. Sleep parameters included sleep timing and duration, sleep disturbances, and sleep-related impairments. Perceived academic well-being was defined as cognitive function, school connectedness, and school-related stress. Sleep and perceived academic well-being are examined across instructional approaches, in their association, and in structural models.

RESULTS

Sleep and perceived academic well-being differed between hybrid and online instruction groups. Less variable or disturbed sleep was associated both with in-person instruction, and with positive outcomes in cognitive function, school connectedness, and stress domains. Sleep mediated a substantial portion of variance in perceived academic well-being attributable to instructional approach.

CONCLUSION

These data highlight the need to protect both healthy sleep and in-person instruction. Appropriate sleep timing and duration, fewer sleep disturbances and sleep-related impairments accounted for a substantial degree of variance in the association between remote instruction on academic outcomes. While many students experienced "lost learning" because of COVID-19, this study joins a broader discussion of ensuring developmentally appropriate school-start times to support both sleep and achievement.

Context memory formed in medial prefrontal cortex during infancy enhances learning in adulthood

Adult behavior is commonly thought to be shaped by early-life experience, although episodes experienced during infancy appear to be forgotten. Exposing male rats during infancy to discrete spatial experience we show that these rats in adulthood are significantly better at forming a spatial memory than control rats without such infantile experience. We moreover show that the adult rats' improved spatial memory capability is mainly based on memory for context information during the infantile experiences. Infantile spatial experience increased c-Fos activity at memory testing during adulthood in the prelimbic medial prefrontal cortex (mPFC), but not in the hippocampus. Inhibiting prelimbic mPFC at testing during adulthood abolished the enhancing effect of infantile spatial experience on learning. Adult spatial memory capability only benefitted from spatial experience occurring during the sensitive period of infancy, but not when occurring later during childhood, and when sleep followed the infantile experience. In conclusion, the infantile brain, by a sleep-dependent mechanism, favors consolidation of memory for the context in which episodes are experienced. These representations comprise mPFC regions and context-dependently facilitate learning in adulthood.

An infant sleep electroencephalographic marker of thalamocortical connectivity predicts behavioral outcome in late infancy

Infancy represents a critical period during which thalamocortical brain connections develop and mature. Deviations in the maturation of thalamocortical connectivity are linked to neurodevelopmental disorders. There is a lack of early biomarkers to detect and localize neuromaturational deviations, which can be overcome with mapping through high-density electroencephalography (hdEEG) assessed in sleep. Specifically, slow waves and spindles in non-rapid eye movement (NREM) sleep are generated by the thalamocortical system, and their characteristics, slow wave slope and spindle density, are closely related to neuroplasticity and learning. Spindles are often subdivided into slow (11.0-13.0 Hz) and fast (13.5-16.0 Hz) frequencies, for which not only different functions have been proposed, but for which also distinctive developmental trajectories have been reported across the first years of life. Recent studies further suggest that information processing during sleep underlying sleep-dependent learning is promoted by the temporal coupling of slow waves and spindles, yet slow wave-spindle coupling remains unexplored in infancy. Thus, we evaluated three potential biomarkers: 1) slow wave slope, 2) spindle density, and 3) the temporal coupling of slow waves with spindles. We use hdEEG to first examine the occurrence and spatial distribution of these three EEG features in healthy infants and second to evaluate a predictive relationship with later behavioral outcomes. We report four key findings: First, infants' EEG features appear locally: slow wave slope is maximal in occipital and frontal areas, whereas slow and fast spindle density is most pronounced frontocentrally. Second, slow waves and spindles are temporally coupled in infancy, with maximal coupling strength in the occipital areas of the brain. Third, slow wave slope, fast spindle density, and slow wave-spindle coupling are not associated with concurrent behavioral status (6 months). Fourth, fast spindle density in central and frontocentral regions at age 6 months predicts overall developmental status at age 12 months, and motor skills at age 12 and 24 months. Neither slow wave slope nor slow wave-spindle coupling predict later behavioral development. We further identified spindle frequency as a determinant of slow and fast spindle density, which accordingly, also predicts motor skills at 24 months. Our results propose fast spindle density, or alternatively spindle frequency, as early EEG biomarker for identifying thalamocortical maturation, which can potentially be used for early diagnosis of neurodevelopmental disorders in infants. These findings are in support of a role of sleep spindles in sensorimotor microcircuitry development. A crucial next step will be to evaluate whether early therapeutic interventions may be effective to reverse deviations in identified individuals at risk.

Adolescent sleep shapes social novelty preference in mice

Sleep disturbances frequently occur in neurodevelopmental disorders such as autism, but the developmental role of sleep is largely unexplored, and a causal relationship between developmental sleep defects and behavioral consequences in adulthood remains elusive. Here, we show that in mice, sleep disruption (SD) in adolescence, but not in adulthood, causes long-lasting impairment in social novelty preference. Furthermore, adolescent SD alters the activation and release patterns of dopaminergic neurons in the ventral tegmental area (VTA) in response to social novelty. This developmental sleep function is mediated by balanced VTA activity during adolescence; chemogenetic excitation mimics, whereas silencing rescues, the social deficits of adolescent SD. Finally, we show that in Shank3-mutant mice, improving sleep or rectifying VTA activity during adolescence ameliorates adult social deficits. Together, our results identify a critical role of sleep and dopaminergic activity in the development of social interaction behavior.

Dysfunctional Overnight Memory Consolidation in Patients with Schizophrenia in Comparison to Healthy Controls: Disturbed Slow-Wave Sleep as Contributing Factor?

INTRODUCTION

Memory deficiency has been shown in schizophrenia patients, but results on the role of sleep parameters in overnight consolidation of associative verbal memory are still missing. Therefore, the aim of our study was to elucidate underlying processes of impaired sleep-related consolidation of associative word pairs in schizophrenia including standard sleep parameters as well as sleep spindle counts and spectral analysis.

METHODS

Eighteen stably medicated schizophrenia patients and 24 healthy age-matched controls performed an associative declarative memory task before and after polysomnographic recordings. Part of the participants expected verbal associative memory testing in the morning, while the others did not. Furthermore, participants filled in self-rating questionnaires of schizophrenia-typical experiences (Eppendorf Schizophrenia Inventory [ESI] and Psychotic Symptom Rating Scale).

RESULTS

Schizophrenia patients performed worse in verbal declarative memory in the evening as well as in overnight consolidation (morning compared to evening performance). While duration of slow-wave sleep was nearly comparable between groups, schizophrenia patients showed lower sleep spindle count, reduced delta power during slow-wave sleep, and reduced spindle power during the slow oscillation (SO) up-state. In healthy but not in schizophrenia patients, a linear relationship between overnight memory consolidation and slow-wave sleep duration as well as delta power was evident. No significant effect with respect to the expectation of memory retrieval was evident in our data. Additionally, we observed a negative linear relationship between total number of sleep spindles and ESI score in healthy participants.

DISCUSSION/CONCLUSION

As expected, schizophrenia patients showed deficient overnight verbal declarative memory consolidation as compared to healthy controls. Reduced sleep spindles, delta power, and spindle power during the SO up-state may link sleep and memory deficiency in schizophrenia. Additionally, the absence of a linear relationship between sleep-related memory consolidation and slow-wave sleep as well as delta power suggests further functional impairments in schizophrenia. Note that this conclusion is based on observational data. Future studies should investigate if stimulation of delta waves during sleep could improve memory performance and thereby quality of life in schizophrenia.

Synaptic dysfunction connects autism spectrum disorder and sleep disturbances: A perspective from studies in model organisms

Sleep disturbances (SD) accompany many neurodevelopmental disorders, suggesting SD is a transdiagnostic process that can account for behavioral deficits and influence underlying neuropathogenesis. Autism Spectrum Disorder (ASD) comprises a complex set of neurodevelopmental conditions characterized by challenges in social interaction, communication, and restricted, repetitive behaviors. Diagnosis of ASD is based primarily on behavioral criteria, and there are no drugs that target core symptoms. Among the co-occurring conditions associated with ASD, SD are one of the most prevalent. SD often arises before the onset of other ASD symptoms. Sleep interventions improve not only sleep but also daytime behaviors in children with ASD. Here, we examine sleep phenotypes in multiple model systems relevant to ASD, e.g., mice, zebrafish, fruit flies and worms. Given the functions of sleep in promoting brain connectivity, neural plasticity, emotional regulation and social behavior, all of which are of critical importance in ASD pathogenesis, we propose that synaptic dysfunction is a major mechanism that connects ASD and SD. Common molecular targets in this interplay that are involved in synaptic function might be a novel avenue for therapy of individuals with ASD experiencing SD. Such therapy would be expected to improve not only sleep but also other ASD symptoms.

Neural correlates of sleep quality in children: Sex-specific associations shown by brain diffusion tractography

BACKGROUND AND PURPOSE

Sleep quality is important for healthy growth and development of children. We aimed to identify associations between sleep disturbances in healthy children without clinical diagnosis of sleep disorders and brain white matter (WM) microstructure using an advanced diffusion-weighted magnetic resonance imaging (DW-MRI) based tractography analysis, and to explore whether there are sex differences in these associations.

METHODS

Brain DW-MRI data were collected from sixty-two 8-year-old children (28 boys, 34 girls) whose parents also completed Children's Sleep Habits Questionnaire (CSHQ). Track-weighted imaging (TWI) measures were computed from the DW-MRI data for 37 WM tracts in each subject. Sex-specific partial correlation analyses were performed to evaluate correlations between TWI measures and a set of sleep disturbance scores derived from the CSHQ.

RESULTS

Significant correlations (P < .05, FDR-corrected; r: .48-.67) were identified in 13 WM tracts between TWI and sleep disturbance scores. Sexually dimorphic differences in correlations between sleep disturbance scores and WM microstructure measurements were observed. Specifically, in boys, daytime sleepiness positively correlated with track-weighted mean or radial diffusivity in 10 WM tracts (bilateral arcuate fasciculus, left cingulum, right middle longitudinal fasciculus, and three bilateral segments of superior longitudinal fasciculus). In girls, total CSHQ score, night walking, or sleep onset delay negatively correlated with track-weighted fractional anisotropy or axial diffusivity in 4 WM tracts (bilateral inferior longitudinal fasciculus and uncinate fasciculus).

CONCLUSIONS

The findings suggest that sleep disturbances without clinical diagnosis of sleep disorders are associated with lower WM microstructural integrity in children. Additionally, the associations possess unique patterns in boys and girls.

Simple statistical regularities presented during sleep are detected but not retained

In recent years, there has been growing interest and excitement over the newly discovered cognitive capacities of the sleeping brain, including its ability to form novel associations. These recent discoveries raise the possibility that other more sophisticated forms of learning may also be possible during sleep. In the current study, we tested whether sleeping humans are capable of statistical learning - the process of becoming sensitive to repeating, hidden patterns in environmental input, such as embedded words in a continuous stream of speech. Participants' EEG was recorded while they were presented with one of two artificial languages, composed of either trisyllabic or disyllabic nonsense words, during slow-wave sleep. We used an EEG measure of neural entrainment to assess whether participants became sensitive to the repeating regularities during sleep-exposure to the language. We further probed for long-term memory representations by assessing participants' performance on implicit and explicit tests of statistical learning during subsequent wake. In the disyllabic-but not trisyllabic-language condition, participants' neural entrainment to words increased over time, reflecting a gradual gain in sensitivity to the embedded regularities. However, no significant behavioural effects of sleep-exposure were observed after the nap, for either language. Overall, our results indicate that the sleeping brain can detect simple, repeating pairs of syllables, but not more complex triplet regularities. However, the online detection of these regularities does not appear to produce any durable long-term memory traces that persist into wake - at least none that were revealed by our current measures and sample size. Although some perceptual aspects of statistical learning are preserved during sleep, the lack of memory benefits during wake indicates that exposure to a novel language during sleep may have limited practical value.

Does the maturation of early sleep patterns predict language ability at school entry? A Born in Bradford study

Children's vocabulary ability at school entry is highly variable and predictive of later language and literacy outcomes. Sleep is potentially useful in understanding and explaining that variability, with sleep patterns being predictive of global trajectories of language acquisition. Here, we looked to replicate and extend these findings. Data from 354 children (without English as an additional language) in the Born in Bradford study were analysed, describing the mean intercepts and linear trends in parent-reported day-time and night-time sleep duration over five time points between 6 and 36 months-of-age. The mean difference between night-time and day-time sleep was predictive of receptive vocabulary at age five, with more night-time sleep relative to day-time sleep predicting better language. An exploratory analysis suggested that socioeconomic status was predictive of vocabulary outcomes, with sleep patterns partially mediating this relationship. We suggest that the consolidation of sleep patterns acts as a driver of early language development.

Sleep promotes the formation of dendritic filopodia and spines near learning-inactive existing spines

Changes in synaptic connections are believed to underlie long-term memory storage. Previous studies have suggested that sleep is important for synapse formation after learning, but how sleep is involved in the process of synapse formation remains unclear. To address this question, we used transcranial two-photon microscopy to investigate the effect of postlearning sleep on the location of newly formed dendritic filopodia and spines of layer 5 pyramidal neurons in the primary motor cortex of adolescent mice. We found that newly formed filopodia and spines were partially clustered with existing spines along individual dendritic segments 24 h after motor training. Notably, posttraining sleep was critical for promoting the formation of dendritic filopodia and spines clustered with existing spines within 8 h. A fraction of these filopodia was converted into new spines and contributed to clustered spine formation 24 h after motor training. This sleep-dependent spine formation via filopodia was different from retraining-induced new spine formation, which emerged from dendritic shafts without prior presence of filopodia. Furthermore, sleep-dependent new filopodia and spines tended to be formed away from existing spines that were active at the time of motor training. Taken together, these findings reveal a role of postlearning sleep in regulating the number and location of new synapses via promoting filopodial formation.

Nonrapid eye movement sleep characteristics and relations with motor, memory, and cognitive ability from infancy to preadolescence

Sleep plays a critical role in neural neurodevelopment. Hallmarks of sleep reflected in the electroencephalogram during nonrapid eye movement (NREM) sleep are associated with learning processes, cognitive ability, memory, and motor functioning. Research in adults is well-established; however, the role of NREM sleep in childhood is less clear. Growing evidence suggests the importance of two NREM sleep features: slow-wave activity and sleep spindles. These features may be critical for understanding maturational change and the functional role of sleep during development. Here, we review the literature on NREM sleep from infancy to preadolescence to provide insight into the network dynamics of the developing brain. The reviewed findings show distinct relations between topographical and maturational aspects of slow waves and sleep spindles; however, the direction and consistency of these relationships vary, and associations with cognitive ability remain unclear. Future research investigating the role of NREM sleep and development would benefit from longitudinal approaches, increased control for circadian and homeostatic influences, and in early childhood, studies recording daytime naps and overnight sleep to yield increased precision for detecting age-related change. Such evidence could help explicate the role of NREM sleep and provide putative physiological markers of neurodevelopment.

The memory benefits of two naps per day during infancy: A pilot investigation

In infancy, sleep occurs in multiple nap and overnight bouts that change developmentally in quantity and distribution. Though studies suggest that infant memory benefits from a single nap, no work has assessed the relative benefits of different naps (morning vs. afternoon), nor how multiple naps support memory across the day. We investigated the memory benefit of a morning nap, relative to morning wake, and the effect of these intervals on afternoon nap function in 9-month-olds (n = 15). Infants participated in two within-subjects conditions (separated by 1-2 weeks). In the Nap-Nap condition, infants took their morning and afternoon naps; in the Wake-Nap condition, infants were kept awake during morning naptime, but napped unrestricted in the afternoon. Before each nap/wake interval, infants completed an imitation memory task, with memory assessed again shortly after the nap/wake interval. In the Nap-Nap condition, infants showed memory retention across morning and afternoon naps. In contrast, infants tended to forget items learned across morning wake in the Wake-Nap condition. Moreover, morning wake was associated with a significant decline in post-nap retention of items learned in the afternoon. Furthermore, relations between nap slow-wave activity (SWA) and memory varied across naps, with SWA either not predicting (morning naps) or positively predicting (afternoon naps) memory change in the Nap-Nap condition, but negatively predicting afternoon memory change in the Wake-Nap condition. We conclude that two naps per day (rather than one) aids memory at 9 months, and that skipping the morning nap may moderate relations between afternoon nap physiology and memory.

6-year course of sleep homeostasis in a case with epilepsy-aphasia spectrum disorder

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The overnight change of the slope of SSW as EEG marker for nocturnal regeneration.

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Reorganization of brain networks can rescue cognitive functions at least partially.

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Corticosteroids lead to a stabilization of the homeostasis of slope of SSW.

The epilepsy-aphasia spectrum consists of epilepsies with a strong activation of epileptic discharges during non-rapid-eye-movement (NREM) sleep, variable seizure burden and language problems. The homeostatic decrease of slow waves (SW) during NREM sleep (i.e. their amplitude/slope and power) has been related to brain recovery and cognitive function. Epileptic discharges during NREM-sleep were related to an impairment of the decrease of the slope of SW and to cognitive deficits. In this longitudinal case study, we aim to relate this electrophysiological marker, i.e. overnight change of slope of SW, to imaging and behavior.

We report a young girl with a fluctuating course in the epilepsy-aphasia spectrum, ranging from the benign end with self-limited childhood epilepsy with centrotemporal spikes (SLECTS) to the severe end with epileptic encephalopathy with continuous spike waves during sleep (CSWS) with two phases of cognitive regression. She was documented over a period of six years including 12 PSGs, six language fMRIs and seven neuropsychological assessments. We longitudinally studied focal and total spike wave index (SWI), detected SW during NREM sleep, calculated their slopes (first and last hour of NREM sleep and overnight change).

Deterioration of overnight decrease of the slope of SW was paralleled by the occurrence of the EEG picture of bilateral synchronous electrical status epilepticus during sleep (ESES) and neuropsychological deficits, and this impairment was reversible with resolution of ESES and was accompanied by cognitive improvement. A laterality switch from left to right sided language dominance occurred during recovery from the second regression phase. This might reflect a compensating process. Later, the laterality switched back to the left, possibly facilitated by a low SWI on the left hemisphere.

The qualitative analysis of this case supports the view that the longitudinal course of the overnight change of the slope of SW, as an objective, quantitative EEG measure, is related to the course of cognitive function and functional language MR analysis.

How development sculpts hippocampal circuits and function

In mammals, the selective transformation of transient experience into stored memory occurs in the hippocampus, which develops representations of specific events in the context in which they occur. In this review, we focus on the development of hippocampal circuits and the self-organized dynamics embedded within them since the latter critically support the role of the hippocampus in learning and memory. We first discuss evidence that adult hippocampal cells and circuits are sculpted by development as early as during embryonic neurogenesis. We argue that these primary developmental programs provide a scaffold onto which later experience of the external world can be grafted. Next, we review the different sequences in the development of hippocampal cells and circuits at anatomical and functional levels. We cover a period extending from neurogenesis and migration to the appearance of phenotypic diversity within hippocampal cells, and their wiring into functional networks. We describe the progressive emergence of network dynamics in the hippocampus, from sensorimotor-driven early sharp waves to sequences of place cells tracking relational information. We outline the critical turn points and discontinuities in that developmental journey, and close by formulating open questions. We propose that rewinding the process of hippocampal development helps understand the main organization principles of memory circuits.

Sleep disturbance and memory dysfunction in early multiple sclerosis

OBJECTIVE

Sleep-dependent memory processing occurs in animals including humans, and disturbed sleep negatively affects memory. Sleep disturbance and memory dysfunction are common in multiple sclerosis (MS), but little is known about the contributions of sleep disturbance to memory in MS. We investigated whether subjective sleep disturbance is linked to worse memory in early MS independently of potential confounders.

METHODS

Persons with early MS (n = 185; ≤5.0 years diagnosed) and demographically matched healthy controls (n = 50) completed four memory tests to derive a memory composite, and four speeded tests to derive a cognitive efficiency composite. Z-scores were calculated relative to healthy controls. Sleep disturbance was defined by the Insomnia Severity Index score ≥ 10. ANCOVAs examined differences in memory and cognitive efficiency between patients with and without sleep disturbance controlling for potential confounds (e.g., mood, fatigue, disability, T2 lesion volume, gray matter volume). Comparisons were made to healthy controls.

RESULTS

Seventy-four (40%) patients reported sleep disturbance. Controlling for all covariates, patients with sleep disturbance had worse memory (z = -0.617; 95% CI: -0.886, -0.348) than patients without disturbance (z = -0.171, -0.425, 0.082, P = .003). Cognitive efficiency did not differ between groups. Relative to healthy controls, memory was worse among patients with sleep disturbance, but not among patients without sleep disturbance.

INTERPRETATION

Sleep disturbance contributes to MS memory dysfunction, which may help explain differential risk for memory dysfunction in persons with MS, especially since sleep disturbance is common in MS. Potential mechanisms linking sleep disturbance and memory are discussed, as well as recommendations for further mechanistic and interventional research.

The effect of napping and nighttime sleep on memory in infants

During the first year of life, infants devote the majority of their time to sleep. Research in adults has shown that sleep supports a variety of memory processes. Surprisingly, sleep's function for infant memory has only started to receive attention in research. In this chapter, we will describe age-related changes in sleep and in memory processing over the first years of life, as well as methods to capture both sleep and memory. Then, we will review current findings on the effects of sleep on memory processing in infants. Lastly, we will also point out gaps in current knowledge and describe potential avenues for future research. Overall, the results of recent experimental studies provide evidence that timely, extended napping is involved in how memories are encoded and stored in the long-term and contribute to the formation of knowledge networks in infants.

Critical period regulation across multiple timescales

Brain plasticity is dynamically regulated across the life span, peaking during windows of early life. Typically assessed in the physiological range of milliseconds (real time), these trajectories are also influenced on the longer timescales of developmental time (nurture) and evolutionary time (nature), which shape neural architectures that support plasticity. Properly sequenced critical periods of circuit refinement build up complex cognitive functions, such as language, from more primary modalities. Here, we consider recent progress in the biological basis of critical periods as a unifying rubric for understanding plasticity across multiple timescales. Notably, the maturation of parvalbumin-positive (PV) inhibitory neurons is pivotal. These fast-spiking cells generate gamma oscillations associated with critical period plasticity, are sensitive to circadian gene manipulation, emerge at different rates across brain regions, acquire perineuronal nets with age, and may be influenced by epigenetic factors over generations. These features provide further novel insight into the impact of early adversity and neurodevelopmental risk factors for mental disorders.

Slow-wave activity and sigma activities are associated with psychomotor development at 8 months of age

STUDY OBJECTIVES

The electrophysiological properties of non-rapid eye movement sleep (NREM) EEG are homeostatically modulated on global and local use-dependent levels. Furthermore, the local NREM quality reflects age-dependent brain maturation and individual, age-independent, and psychomotor potential. Cortical maturation and its electrophysiological marker, Slow-wave activity (SWA), as well as sleep spindles are known to change in topography and quality during the early years of life, but their associations with psychomotor development in infants are unknown. Therefore, we aimed to evaluate the local properties of SWA and spindles (sigma power) and ascertain whether they correlate with psychomotor development in 8-month-old infants.

METHODS

Ambulatory polysomnographies were recorded in 56 infants at 8 months of age to calculate the local SWA and sigma powers. The associations between the SWA and sigma powers and psychomotor development (Bayley-III) were examined in 36 of these infants.

RESULTS

In both hemispheres, the highest SWA and sigma powers were found occipitally and centrally, respectively, with higher powers in the right hemisphere than in the left. The Bayley-III correlated with local SWA and sigma powers: the occipital SWA and centro-occipital sigma correlated with cognitive scales, and the frontal and occipital SWA and centro-occipital sigma correlated with language and fine motor scales. Most of the correlations were unilateral.

CONCLUSIONS

In 8-month-old infants, the NREM sleep quality shows local differences that are mostly attributable to the topical phase of brain maturation. The local NREM parameters correlate with psychomotor development.

Current Status and Future Challenges of Sleep Monitoring Systems: Systematic Review

Background

Sleep is essential for human health. Considerable effort has been put into academic and industrial research and in the development of wireless body area networks for sleep monitoring in terms of nonintrusiveness, portability, and autonomy. With the help of rapid advances in smart sensing and communication technologies, various sleep monitoring systems (hereafter, sleep monitoring systems) have been developed with advantages such as being low cost, accessible, discreet, contactless, unmanned, and suitable for long-term monitoring.

Objective

This paper aims to review current research in sleep monitoring to serve as a reference for researchers and to provide insights for future work. Specific selection criteria were chosen to include articles in which sleep monitoring systems or devices are covered.

Methods

This review investigates the use of various common sensors in the hardware implementation of current sleep monitoring systems as well as the types of parameters collected, their position in the body, the possible description of sleep phases, and the advantages and drawbacks. In addition, the data processing algorithms and software used in different studies on sleep monitoring systems and their results are presented. This review was not only limited to the study of laboratory research but also investigated the various popular commercial products available for sleep monitoring, presenting their characteristics, advantages, and disadvantages. In particular, we categorized existing research on sleep monitoring systems based on how the sensor is used, including the number and type of sensors, and the preferred position in the body. In addition to focusing on a specific system, issues concerning sleep monitoring systems such as privacy, economic, and social impact are also included. Finally, we presented an original sleep monitoring system solution developed in our laboratory.

Results

By retrieving a large number of articles and abstracts, we found that hotspot techniques such as big data, machine learning, artificial intelligence, and data mining have not been widely applied to the sleep monitoring research area. Accelerometers are the most commonly used sensor in sleep monitoring systems. Most commercial sleep monitoring products cannot provide performance evaluation based on gold standard polysomnography.

Conclusions

Combining hotspot techniques such as big data, machine learning, artificial intelligence, and data mining with sleep monitoring may be a promising research approach and will attract more researchers in the future. Balancing user acceptance and monitoring performance is the biggest challenge in sleep monitoring system research.

An Exploratory Study on Sleep Procrastination: Bedtime vs. While-in-Bed Procrastination

Sleep Procrastination literature has focused on the behaviors individuals engage in before going to bed (Bedtime Procrastination) but not on the behaviors individuals engage in after going to bed (While-in-Bed Procrastination). The main goal of this study is to explore whether this While-in-Bed procrastination is a novel phenomenon that adds to the Sleep Procrastination literature. The study was conducted online with 400 high school students (M_age = 16.56; 139 males) recruited through personal contacts and social media. The Bedtime procrastination scale was adapted and validated for this sample, whereas the While-in-Bed Procrastination scale was developed for this study. Data show a low correlation (r = 0.158 **) between Bedtime and While-in-Bed Procrastination scales, suggesting that Sleep Procrastination may be composed of the two facets. Additionally, results showed that more Bedtime Procrastination was related to later waking time and later dinnertime hours, whereas more While-in-Bed Procrastination was linked to being male, later desired time to sleep, and earlier dinnertime hour. Findings indicate that solely assessing Bedtime Procrastination as representing the procrastination of Sleep is limited and overlooks a significant part of this behavior. This exploratory study adds a new perspective to the literature by stressing the role of While-in-Bed Procrastination, thus opening new research pathways.

Sleep spindle and slow wave abnormalities in schizophrenia and other psychotic disorders: Recent findings and future directions

Sleep spindles and slow waves are the two main oscillatory activities occurring during NREM sleep. Slow waves are ∼1 Hz, high amplitude, negative-positive deflections that are primarily generated and coordinated within the cortex, whereas sleep spindles are 12-16 Hz, waxing and waning oscillations that are initiated within the thalamus and regulated by thalamo-cortical circuits. In healthy subjects, these oscillations are thought to be responsible for the restorative aspects of sleep and have been increasingly shown to be involved in learning, memory and plasticity. Furthermore, deficits in sleep spindles and, to lesser extent, slow waves have been reported in both chronic schizophrenia (SCZ) and early course psychosis patients. In this article, we will first describe sleep spindle and slow wave characteristics, including their putative functional roles in the healthy brain. We will then review electrophysiological, genetic, and cognitive studies demonstrating spindle and slow wave impairments in SCZ and other psychotic disorders, with particularly emphasis on recent findings in early course patients. Finally, we will discuss how future work, including sleep studies in individuals at clinical high risk for psychosis, may help position spindles and slow waves as candidate biomarkers, as well as novel treatment targets, for SCZ and related psychotic disorders.

Slow oscillation-spindle coupling predicts enhanced memory formation from childhood to adolescence

Precise temporal coordination of slow oscillations (SO) and sleep spindles is a fundamental mechanism of sleep-dependent memory consolidation. SO and spindle morphology changes considerably throughout development. Critically, it remains unknown how the precise temporal coordination of these two sleep oscillations develops during brain maturation and whether their synchronization indexes the development of memory networks. Here, we use a longitudinal study design spanning from childhood to adolescence, where participants underwent polysomnography and performed a declarative word-pair learning task. Performance on the memory task was better during adolescence. After disentangling oscillatory components from 1/f activity, we found frequency shifts within SO and spindle frequency bands. Consequently, we devised an individualized cross-frequency coupling approach, which demonstrates that SO-spindle coupling strength increases during maturation. Critically, this increase indicated enhanced memory formation from childhood to adolescence. Our results provide evidence that improved coordination between SOs and spindles indexes the development of sleep-dependent memory networks.

Sleep architecture and homeostasis in children with epilepsy: a neurodevelopmental perspective

Although the influence of sleep on epilepsy has long been recognized, this relationship has yet to be fully exploited to benefit patients. The past decade has seen significant advances in understanding paediatric sleep, providing a framework by which to properly evaluate the sleep of children with epilepsy, which itself has been subject to increasing scrutiny. The role of sleep in learning and the potential for interictal discharges to disrupt sleep-related memory consolidation provide a novel perspective for understanding the association of childhood epilepsy with a high rate of intellectual disability. In this review, I outline the evolution of sleep duration, architecture, and homeostasis across childhood, relating this to the development of cognitive functions. I describe how these may be disrupted or preserved in children with epilepsy; in particular, collating data from polysomnography. Finally, I explore how sleep may, in the future, be modulated to improve cognitive outcome in these patients. WHAT THIS PAPER ADDS: Children with epilepsy have less rapid eye movement sleep than controls, but this improves with seizure cessation. Deep or slow-wave sleep is highly conserved in children with epilepsy. Sleep homeostasis may be disrupted either at a local or global level by the presence of interictal epileptiform discharges.

Maternal Sleep in Pregnancy and Postpartum Part I: Mental, Physical, and Interpersonal Consequences

PURPOSE OF REVIEW

Sleep is a critical restorative behavior which occupies approximately one third of people's lives. Extensive data link sleep health with disease and mortality risk in the general population. During pregnancy and following childbirth, unique factors contribute to overall sleep health. In addition, there are unique implications of poor sleep during these time periods.

RECENT FINDINGS

Poor maternal sleep may contribute to risk for adverse birth outcomes as well as poor maternal physical and mental health in pregnancy, postpartum, and longer term during childrearing. Moreover, the extent to which notable racial disparities in sleep contribute to disparities in adverse perinatal health outcomes remains to be fully explicated. Part I of this two-part review details these implications of poor sleep for mental health, physical health outcomes, and relationship functioning, while Part II delves into biological mechanisms as well as treatment approaches.

Beyond the Bayley: Neurocognitive Assessments of Development During Infancy and Toddlerhood

The use of global, standardized instruments is conventional among clinicians and researchers interested in assessing neurocognitive development. Exclusively relying on these tests for evaluating effects may underestimate or miss specific effects on early cognition. The goal of this review is to identify alternative measures for possible inclusion in future clinical trials and interventions evaluating early neurocognitive development. The domains included for consideration are attention, memory, executive function, language, and socioemotional development. Although domain-based tests are limited, as psychometric properties have not yet been well-established, this review includes tasks and paradigms that have been reliably used across various developmental psychology laboratories.

Infant wake after sleep onset serves as a marker for different trajectories in cognitive development

BACKGROUND

Sleep variables have been linked to improved functioning of learning and memory throughout life, with most studies focusing on older children and adults. Since infancy is a time of outstanding plasticity, sleep variables could be particularly important for cognitive development in that age group.

METHODS

This is a longitudinal study collecting data from 40 infants at four different time points of 4, 6, 8 and 10 months. Sleep variables were assessed using actigraphy for a week, as well as a sleep questionnaire. Eye-tracking was employed to examine developmental cognitive trajectories. Infants had to remember the location of a toy that had previously been linked to a sound and an eye-tracker recorded whether they were searching the correct location upon hearing the sound.

RESULTS

Based on their trajectories between 4 and 10 months, infants were divided into two groups who shifted their response strategies at different time points. Those two groups also differed in other aspects of their looking patterns and scored increasingly differently in the Ages & Stages Questionnaire over time. Time spent awake in the night early in life was reduced in the group who changed their strategy earlier.

CONCLUSIONS

While previous research examined the relation of infant sleep and cognitive functioning measured once, this paper provides first evidence that night wake time can serve as a marker for different cognitive trajectories.

Screen viewing behavior and sleep duration among children aged 2 and below

Background

Few studies have investigated the association between screen viewing (SV) and sleep duration among young children. This study aims to examine the association between total and device-specific SV and sleep duration among children aged 2 and below.

Methods

We conducted a cross-sectional study of 714 Singaporean children aged 2 years and below. Parents were recruited during routine well-child clinic visits from two national polyclinics. In Singapore, all parents visit well-child clinics with their children at regular intervals for routine check-ups and vaccinations. Socio-demographic characteristics, duration of total and device-specific SV, and sleep duration were reported by parents via interviewer-administered questionnaires. Multiple linear regression analysis was used to assess associations between various types of SV and sleep duration, adjusted for socio-demographic variables. Due to significant interaction between SV and age, stratified analyses for children aged less than 6 months and those aged 7–24 months were performed.

Results

The prevalence of daily SV among children was 53.1%; 28.3% in children up to 6 months and 73.8% in children aged 7 to 24 months. TV viewing was reported for 44.3% of all children and mobile device SV for 30.1%. Children’s average sleep duration was 13.9 (SD = 3.5) hours daily and younger children had longer sleep duration than older ones (up to 6 months: mean = 15.6 h, SD = 3.9; 7–24 months: mean = 12.4 h, SD = 2.2; P < 0.01). In the regression analysis among all children, each 1 h per day increment in total SV was significantly associated with 0.26 h shorter sleep duration with similar significant associations for TV (β = − 0.28 h, 95%CI: -0.50, − 0.06) and mobile devices (β = − 0.35 h, 95%CI: -0.61, − 0.09). Stratified analysis revealed significantly greater reductions in sleep with higher SV among children aged 6 months and below (β = − 0.73 h, 95%CI: -1.12, − 0.34), while associations were weaker in older children (β = − 0.13 h, 95% CI: -0.24, − 0.01).

Conclusions

This study provides evidence for a substantial association between longer SV and shorter sleep duration among very young children. These associations appeared stronger among children aged 6 months and below as compared with those aged 7 to 24 months. Further studies are warranted to confirm our findings.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-6385-6) contains supplementary material, which is available to authorized users.

Sleep-dependent selective imitation in infants

In adults, sleep selectively consolidates those memories that are relevant for future events. The present study tested whether napping after encoding plays a role in selective memory consolidation in infants. Infants aged 15 and 24 months (n = 48 per age) were randomly assigned to a nap or a no-nap demonstration condition, or a baseline control condition. In the demonstration conditions, infants observed an experimenter perform an irrelevant action followed by a relevant action to achieve a desirable outcome on four different toys. Infant imitation of irrelevant and relevant actions was coded at a test session that occurred after a 24-hr delay. The demonstration and test sessions were scheduled around infants' naturally occurring sleeping patterns. When order of actions was not taken into account, infants in both demonstration conditions exhibited retention of the relevant and irrelevant target actions. Contrary to expectations, infants in the nap condition did not perform the relevant action only more often than infants in the no-nap condition. As expected, only infants in the no-nap condition faithfully reproduced the two actions in the demonstrated order: irrelevant action first, followed by the relevant action. Thus, sleep might help infants to selectively "discard" aspects of a learning experience that they identify as being not useful or relevant in the future.

Lack of frequency-tagged magnetic responses suggests statistical regularities remain undetected during NREM sleep

Hypnopedia, or the capacity to learn during sleep, is debatable. De novo acquisition of reflex stimulus-response associations was shown possible both in man and animal. Whether sleep allows more sophisticated forms of learning remains unclear. We recorded during diurnal Non-Rapid Eye Movement (NREM) sleep auditory magnetoencephalographic (MEG) frequency-tagged responses mirroring ongoing statistical learning. While in NREM sleep, participants were exposed at non-awakenings thresholds to fast auditory streams of pure tones, either randomly organized or structured in such a way that the stream statistically segmented in sets of 3 elements (tritones). During NREM sleep, only tone-related frequency-tagged MEG responses were observed, evidencing successful perception of individual tones. No participant showed tritone-related frequency-tagged responses, suggesting lack of segmentation. In the ensuing wake period however, all participants exhibited robust tritone-related responses during exposure to statistical (but not random) streams. Our data suggest that associations embedded in statistical regularities remain undetected during NREM sleep, although implicitly learned during subsequent wakefulness. These results suggest intrinsic limitations in de novo learning during NREM sleep that might confine the NREM sleeping brain's learning capabilities to simple, elementary associations. It remains to be ascertained whether it similarly applies to REM sleep.

ASSOCIATION BETWEEN PERCEPTION OF SLEEP QUALITY AND ASSIMILATION OF CONTENT COVERED IN CLASS

Objective:

To analyze the association between self-perception of sleep quality and assimilation of content covered in classes by adolescents.

Methods:

Epidemiological cross-sectional study conducted with 481 high-school students (14 to 19 years), both genders, enrolled in public schools in the city of Caruaru, Pernambuco, and selected by random cluster sampling strategy. Analyses were conducted using the Chi-square test and binary logistic regression.

Results:

44.1% of the adolescents reported learning difficulties during classes, 77.1% slept less than eight hours per day, and 28.9% had a bad perception of their sleep quality. Young people who studied at least one extra hour per day out of school had less difficulty in assimilating class content (OR=0.34; 95%CI 0.19-0.58). We also found that participants who reported a bad perception of sleep quality were more likely to have learning difficulties at school (OR=1.73; 95%CI 1.13-2.65) regardless of gender, age, school shift, study time out of school, and sleeping hours.

Conclusions:

Perception of sleep quality was associated with learning difficulties at school regardless of the number of sleeping and study hours.

Social, motor, and cognitive development through the lens of sleep network dynamics in infants and toddlers between 12 and 30 months of age

Widespread change in behavior and the underlying brain network substrate is a hallmark of early development. Sleep plays a fundamental role in this process. Both slow waves and spindles are key features of nonrapid eye movement sleep (NREM) that exhibit pronounced developmental trajectories from infancy to adulthood. Yet, these prominent features of NREM sleep are poorly understood in infants and toddlers in the age range of 12 to 30 months. Moreover, it is unknown how network dynamics of NREM sleep are associated with outcomes of early development. Addressing this gap in our understanding of sleep during development will enable the subsequent study of pathological changes in neurodevelopmental disorders. The aim of the current study was to characterize the sleep topography with high-density electroencephalography in this age group. We found that δ, θ, and β oscillations and sleep spindles exhibited clear developmental changes. Low δ and high θ oscillations correlated with motor, language, and social skills, independent of age. These findings suggest an important role of network dynamics of NREM sleep in cortical maturation and the associated development of skills during this important developmental period.

Association of Sleep and Circadian Activity Rhythm with Emotional Face Processing among 12-month-old Infants

Sleep and circadian rhythmicity both play an important role in human’s cognitive functioning, yet the way in which early development of sleep and circadian rhythm affects cognitive processes and social learning in infants remains less understood. We examined the association of sleep and circadian activity rhythm (CAR) with face and emotional information processing in 12-month old infants. Face processing was measured by eye tracking, whereby infants’ scanning patterns and pupil dilations were calculated when they were presented with neutral, pleasant and unpleasant faces. Infants with better sleep quality (i.e., less waking after sleep onset) and lower sleep-wake pattern variability (i.e., higher inter-daily stability) exhibited a higher eyes over mouth fixation ratio (EMR). Infants with longer total sleep time showed larger pupil diameter changes in response to emotional facial expressions, more closely resembling the responses of adults. Our findings suggest the role of sleep and circadian rhythm in waking cognition and have implications for understanding the early development of social learning in young children.

Dissociating Long and Short-term Memory in Three-Month-Old Infants Using the Mismatch Response to Voice Stimuli

Auditory event-related potentials (ERPs) have been successfully used in adults as well as in newborns to discriminate recall of longer-term and shorter-term memories. Specifically the Mismatch Response (MMR) to deviant stimuli of an oddball paradigm is larger if the deviant stimuli are highly familiar (i.e., retrieved from long-term memory) than if they are unfamiliar, representing an immediate change to the standard stimuli kept in short-term memory. Here, we aimed to extend previous findings indicating a differential MMR to familiar and unfamiliar deviants in newborns (Beauchemin et al., 2011), to 3-month-old infants who are starting to interact more with their social surroundings supposedly based on forming more (social) long-term representations. Using a voice discrimination paradigm, each infant was repeatedly presented with the word “baby” (400 ms, interstimulus interval: 600 ms, 10 min overall duration) pronounced by three different female speakers. One voice that was unfamiliar to the infants served as the frequently presented “standard” stimulus, whereas another unfamiliar voice served as the “unfamiliar deviant” stimulus, and the voice of the infant’s mother served as the “familiar deviant.” Data collection was successful for 31 infants (mean age = 100 days). The MMR was determined by the difference between the ERP to standard stimuli and the ERP to the unfamiliar and familiar deviant, respectively. The MMR to the familiar deviant (mother’s voice) was larger, i.e., more positive, than that to the unfamiliar deviant between 100 and 400 ms post-stimulus over the frontal and central cortex. However, a genuine MMR differentiating, as a positive deflection, between ERPs to familiar deviants and standard stimuli was only found in the 300–400 ms interval. On the other hand, a genuine MMR differentiating, as a negative deflection, between ERPs to unfamiliar deviants from ERPs to standard stimuli was revealed for the 200–300 ms post-stimulus interval. Overall results confirm a differential MMR response to unfamiliar and familiar deviants in 3-month-olds, with the earlier negative MMR to unfamiliar deviants likely reflecting change detection based on comparison processes in short-term memory, and the later positive MMR to familiar deviants reflecting subsequent long-term memory-based processing of stimulus relevance.

Local changes in computational non-rapid eye movement sleep depth in infants

OBJECTIVE

Deep NREM sleep and its hallmark EEG phenomenon slow wave activity (SWA) are under homeostatic control in adults. SWA is also locally regulated as it increases in the brain areas that have been used intensively. Moreover, in children, SWA is a marker of cortical maturation. In the present study the local properties of NREM sleep depth were evaluated using the quantitative mean frequency method. We aimed to study if age is related to NREM sleep depth in young infants. In addition, we studied if young infants have local differences in their NREM sleep.

METHODS

Ambulatory over-night polysomnographies were recorded in 59 healthy and full-term infants at the age of one month. The infants were divided into two age groups (<44 weeks and ≥44 weeks) to allow maturational evaluations.

RESULTS

The quantitative sleep depth analysis showed differences between the age groups. In addition, there were local sleep depth differences within the age groups.

CONCLUSIONS

The sleep depth change with age is most likely related to cortical maturation, whereas the local sleep depth gradients might also reflect the use-dependent properties of SWA.

SIGNIFICANCE

The results support the idea that young infants have frontal cortical processing.

Effects of Sleep on Word Pair Memory in Children - Separating Item and Source Memory Aspects

Word paired-associate learning is a well-established task to demonstrate sleep-dependent memory consolidation in adults as well as children. Sleep has also been proposed to benefit episodic features of memory, i.e., a memory for an event (item) bound into the spatiotemporal context it has been experienced in (source). We aimed to explore if sleep enhances word pair memory in children by strengthening the episodic features of the memory, in particular. Sixty-one children (8-12 years) studied two lists of word pairs with 1 h in between. Retrieval testing comprised cued recall of the target word of each word pair (item memory) and recalling in which list the word pair had appeared in (source memory). Retrieval was tested either after 1 h (short retention interval) or after 11 h, with this long retention interval covering either nocturnal sleep or daytime wakefulness. Compared with the wake interval, sleep enhanced separate recall of both word pairs and the lists per se, while recall of the combination of the word pair and the list it had appeared in remained unaffected by sleep. An additional comparison with adult controls (n = 37) suggested that item-source bound memory (combined recall of word pair and list) is generally diminished in children. Our results argue against the view that the sleep-induced enhancement in paired-associate learning in children is a consequence of sleep specifically enhancing the episodic features of the memory representation. On the contrary, sleep in children might strengthen item and source representations in isolation, while leaving the episodic memory representations (item-source binding) unaffected.

More Effective Consolidation of Episodic Long-Term Memory in Children Than Adults-Unrelated to Sleep

Abilities to encode and remember events in their spatiotemporal context (episodic memory) rely on brain regions that mature late during childhood and are supported by sleep. We compared the temporal dynamics of episodic memory formation and the role of sleep in this process between 62 children (8-12 years) and 57 adults (18-37 years). Subjects recalled "what-where-when" memories after a short 1-hr retention interval or after a long 10.5-hr interval containing either nocturnal sleep or daytime wakefulness. Although children showed diminished recall of episodes after 1 hr, possibly resulting from inferior encoding, unlike adults, they showed no further decrease in recall after 10.5 hr. In both age groups, episodic memory benefitted from sleep. However, children's more effective offline retention was unrelated to sleep.

Blindfolding during wakefulness causes decrease in sleep slow wave activity

Slow wave activity (SWA, 0.5–4 Hz) represents the predominant EEG oscillatory activity during slow wave sleep (SWS). Its amplitude is considered in part a reflection of synaptic potentiation in cortical networks due to encoding of information during prior waking, with higher amplitude indicating stronger potentiation. Previous studies showed that increasing and diminishing specific motor behaviors produced corresponding changes in SWA in the respective motor cortical areas during subsequent SWS. Here, we tested whether this relationship can be generalized to the visual system, that is, whether diminishing encoding of visual information likewise leads to a localized decrease in SWA over the visual cortex. Experiments were performed in healthy men whose eyes on two different days were or were not covered for 10.5 h before bedtime. The subject's EEG was recorded during sleep and, after sleep, visual evoked potentials (VEPs) were recorded. SWA during nonrapid eye movement sleep (NonREM sleep) was lower after blindfolding than after eyes open (P < 0.01). The decrease in SWA that was most consistent during the first 20 min of NonREM sleep, did not remain restricted to visual cortex regions, with changes over frontal and parietal cortical regions being even more pronounced. In the morning after sleep, the N75‐P100 peak‐to‐peak‐amplitude of the VEP was significantly diminished in the blindfolded condition. Our findings confirm a link between reduced wake encoding and diminished SWA during ensuing NonREM sleep, although this link appears not to be restricted to sensory cortical areas.

Effects of Sleep Deprivation on Spatial Learning and Memory in Juvenile and Young Adult Rats

Sleepiness is commonly seen in adolescents and can negatively impact school performance. Little research has investigated the impact of sleepiness in juvenile animals on spatial learning. Sprague-Dawley juvenile (<30 days) and young adult (>60 days) rats were sleep deprived for 24 hours and tested, along with controls, in a water maze task. Sleep deprived juveniles were slower to learn the location of the hidden platform than controls; however, adult performance was not impaired. Sleep deprivation did not impair recall during a probe trial for either age group. Sleep deprivation prior to testing slowed spatial learning in juveniles but not adults.