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Campillo-Ferrer T, Alcaraz-Sánchez A, Demšar E, Wu HP, Dresler M, Windt J, Blanke O. Out-of-body experiences in relation to lucid dreaming and sleep paralysis: A theoretical review and conceptual model. Neurosci Biobehav Rev 2024; 163:105770. [PMID: 38880408 DOI: 10.1016/j.neubiorev.2024.105770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/31/2024] [Accepted: 06/11/2024] [Indexed: 06/18/2024]
Abstract
Out-of-body experiences (OBEs) are characterized by the subjective experience of being located outside the physical body. Little is known about the neurophysiology of spontaneous OBEs, which are often reported by healthy individuals as occurring during states of reduced vigilance, particularly in proximity to or during sleep (sleep-related OBEs). In this paper, we review the current state of research on sleep-related OBEs and hypothesize that maintaining consciousness during transitions from wakefulness to REM sleep (sleep-onset REM periods) may facilitate sleep-related OBEs. Based on this hypothesis, we propose a new conceptual model that potentially describes the relationship between OBEs and sleep states. The model sheds light on the phenomenological differences between sleep-related OBEs and similar states of consciousness, such as lucid dreaming (the realization of being in a dream state) and sleep paralysis (feeling paralyzed while falling asleep or waking up), and explores the potential polysomnographic features underlying sleep-related OBEs. Additionally, we apply the predictive coding framework and suggest a connecting link between sleep-related OBEs and OBEs reported during wakefulness.
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Affiliation(s)
- Teresa Campillo-Ferrer
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Neuropsychology, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany.
| | - Adriana Alcaraz-Sánchez
- Centre for Philosophical Psychology, Department of Philosophy, University of Antwerp, Antwerp, Belgium
| | - Ema Demšar
- Monash Centre for Consciousness and Contemplative Studies, Melbourne, Australia; Monash University, Department of Philosophy, Melbourne, Australia
| | - Hsin-Ping Wu
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, Faculty of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Geneva, Switzerland; Department of Clinical Neuroscience, Geneva University Hospital, Geneva, Switzerland
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jennifer Windt
- Monash Centre for Consciousness and Contemplative Studies, Melbourne, Australia; Monash University, Department of Philosophy, Melbourne, Australia
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, Faculty of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Geneva, Switzerland; Department of Clinical Neuroscience, Geneva University Hospital, Geneva, Switzerland
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2
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Kazemi K, Abiri A, Zhou Y, Rahmani A, Khayat RN, Liljeberg P, Khine M. Improved sleep stage predictions by deep learning of photoplethysmogram and respiration patterns. Comput Biol Med 2024; 179:108679. [PMID: 39033682 DOI: 10.1016/j.compbiomed.2024.108679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 07/23/2024]
Abstract
Sleep staging is a crucial tool for diagnosing and monitoring sleep disorders, but the standard clinical approach using polysomnography (PSG) in a sleep lab is time-consuming, expensive, uncomfortable, and limited to a single night. Advancements in sensor technology have enabled home sleep monitoring, but existing devices still lack sufficient accuracy to inform clinical decisions. To address this challenge, we propose a deep learning architecture that combines a convolutional neural network and bidirectional long short-term memory to accurately classify sleep stages. By supplementing photoplethysmography (PPG) signals with respiratory sensor inputs, we demonstrated significant improvements in prediction accuracy and Cohen's kappa (k) for 2- (92.7 %; k = 0.768), 3- (80.2 %; k = 0.714), 4- (76.8 %, k = 0.550), and 5-stage (76.7 %, k = 0.616) sleep classification using raw data. This relatively translatable approach, with a less intensive AI model and leveraging only a few, inexpensive sensors, shows promise in accurately staging sleep. This has potential for diagnosing and managing sleep disorders in a more accessible and practical manner, possibly even at home.
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Affiliation(s)
| | - Arash Abiri
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, United States
| | - Yongxiao Zhou
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, United States
| | - Amir Rahmani
- Department of Computer Science, University of California, Irvine, Irvine, CA, United States; School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Rami N Khayat
- Division of Pulmonary and Critical Care Medicine, The UCI Comprehensive Sleep Center, University of California. Irvine, Newport Beach, CA, United States
| | | | - Michelle Khine
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, United States.
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Li C, Mu Y, Zhu P, Pan Y, Zhang S, Yang L, Xu P, Li F. Sleep stages classification by fusing the time-related synchronization analysis and brain activations. Brain Res Bull 2024; 215:111017. [PMID: 38914295 DOI: 10.1016/j.brainresbull.2024.111017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/28/2024] [Accepted: 06/15/2024] [Indexed: 06/26/2024]
Abstract
Sleep staging plays an important role in the diagnosis and treatment of clinical sleep disorders. The sleep staging standard defines every 30 seconds as a sleep period, which may mean that there exist similar brain activity patterns during the same sleep period. Thus, in this work, we propose a novel time-related synchronization analysis framework named time-related multimodal sleep scoring model (TRMSC) to explore the potential time-related patterns of sleeping. In the proposed TRMSC, the time-related synchronization analysis is first conducted on the single channel electrophysiological signal, i.e., Electroencephalogram (EEG) and Electrooculogram (EOG), to explore the time-related patterns, and the spectral activation features are also extracted by spectrum analysis to obtain the multimodal features. With the extracted multimodal features, the feature fusion and selection strategy is utilized to obtain the optimal feature set and achieve robust sleep staging. To verify the effectiveness of the proposed TRMSC, sleep staging experiments were conducted on the Sleep-EDF dataset, and the experimental results indicate that the proposed TRMSC has achieved better performance than other existing strategies, which proves that the time-related synchronization features can make up for the shortcomings of traditional spectrum-based strategies and achieve a higher classification accuracy. The proposed TRMSC model may be helpful for portable sleep analyzers and provide a new analytical method for clinical sleeping research.
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Affiliation(s)
- Cunbo Li
- Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation and School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Yufeng Mu
- Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation and School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Pengcheng Zhu
- Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation and School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Yue Pan
- Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation and School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Shuhan Zhang
- Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation and School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Lei Yang
- Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation and School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Peng Xu
- Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation and School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Fali Li
- Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation and School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China.
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Stefani A, Tang Q. Recurrent Isolated Sleep Paralysis. Sleep Med Clin 2024; 19:101-109. [PMID: 38368058 DOI: 10.1016/j.jsmc.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
Recurrent isolated sleep paralysis has a 7.6% lifetime prevalence of at least one episode in the general population. Episodes resolve spontaneously and are benign. Sleep paralysis represents a dissociate state, with persistence of the rapid eye movement (REM)-sleep muscle atonia in the waking state. The intrusion of alpha electroencephalogram into REM sleep is followed by an arousal response and then by persistence of REM atonia into wakefulness. Predisposing factors include irregular sleep-wake schedules, sleep deprivation, and jetlag. No drug treatment is required. Patients should be informed about sleep hygiene. Cognitive behavioral therapy may be useful in cases accompanied by anxiety and frightening hallucinations.
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Affiliation(s)
- Ambra Stefani
- Department of Neurology, Sleep Disorders Clinic, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
| | - Qi Tang
- Department of Neurology, Sleep Disorders Clinic, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
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Andrillon T, Oudiette D. What is sleep exactly? Global and local modulations of sleep oscillations all around the clock. Neurosci Biobehav Rev 2023; 155:105465. [PMID: 37972882 DOI: 10.1016/j.neubiorev.2023.105465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 09/29/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Abstract
Wakefulness, non-rapid eye-movement (NREM) and rapid eye-movement (REM) sleep differ from each other along three dimensions: behavioral, phenomenological, physiological. Although these dimensions often fluctuate in step, they can also dissociate. The current paradigm that views sleep as made of global NREM and REM states fail to account for these dissociations. This conundrum can be dissolved by stressing the existence and significance of the local regulation of sleep. We will review the evidence in animals and humans, healthy and pathological brains, showing different forms of local sleep and the consequences on behavior, cognition, and subjective experience. Altogether, we argue that the notion of local sleep provides a unified account for a host of phenomena: dreaming in REM and NREM sleep, NREM and REM parasomnias, intrasleep responsiveness, inattention and mind wandering in wakefulness. Yet, the physiological origins of local sleep or its putative functions remain unclear. Exploring further local sleep could provide a unique and novel perspective on how and why we sleep.
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Affiliation(s)
- Thomas Andrillon
- Paris Brain Institute, Sorbonne Université, Inserm-CNRS, Paris 75013, France; Monash Centre for Consciousness & Contemplative Studies, Monash University, Melbourne, VIC 3800, Australia.
| | - Delphine Oudiette
- Paris Brain Institute, Sorbonne Université, Inserm-CNRS, Paris 75013, France
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Raduga M, Shashkov A. Detecting Lucid Dreams by Electroencephalography and Eyebrow Movements. Sleep Sci 2023; 16:e408-e416. [PMID: 38197020 PMCID: PMC10773514 DOI: 10.1055/s-0043-1776749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 01/26/2023] [Indexed: 01/11/2024] Open
Abstract
Objective When metacognition arises during rapid eye movement (REM) sleep, people experience lucid dreaming (LD). Studies on this phenomenon face different obstacles. For example, its standard verification protocol requires at least three types of sensors. We hypothesized that preagreed frontalis movements (PAFMs), as a sign of lucidity, could be seen on electroencephalography (EEG) during REM sleep. In this case, only one EEG sensor would be needed to verify LD. Method Under laboratory observation, five volunteers were instructed to induce LD, during which they needed to use the standard verification protocol with pre-agreed eye movements (PAEMs) and then immediately raise their eyebrows three times as a PAFM. Results All participants were able to send signals from a total of eight LDs using one or both methods. Preagreed frontalis movements and PAEMs were equally distinctive on most EEGs, but PAFM quality was strongly dependent on the accuracy of the method. Preagreed frontalis movements exhibited two types of EEG patterns and led to immediate awakening when LD was not stable. Discussion Though the outcomes show that PAFMs can be used to verify LD, this method was less consistent and apparent than PAEMs. Furthermore, accurate instructions are needed before using PAFMs. When polysomnography is unavailable, PAFMs can be applied, as it requires only one EEG sensor to detect REM sleep and consciousness simultaneously.
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Affiliation(s)
- Michael Raduga
- REMspace, Phase Research Center, Novorossiysk, Krasnodar Krai, Russia
| | - Andrey Shashkov
- REMspace, Phase Research Center, Novorossiysk, Krasnodar Krai, Russia
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Krueger JM. Tripping on the edge of consciousness. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 4:zpad039. [PMID: 37954093 PMCID: PMC10632728 DOI: 10.1093/sleepadvances/zpad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Indexed: 11/14/2023]
Abstract
Herein the major accomplishments, trials and tribulations, and epiphanies experienced by James M. Krueger over the course of his career in sleep research are presented. They include the characterization of a) the supranormal EEG delta waves occurring during NREMS post sleep loss, b) Factor S as a muramyl peptide, c) the physiological roles of cytokines in sleep regulation, d) multiple other sleep regulatory substances, e) the dramatic changes in sleep over the course of infectious diseases, and f) sleep initiation within small neuronal/glial networks. The theory that the preservation of brain plasticity is the primordial sleep function is briefly discussed. These accomplishments resulted from collaborations with many outstanding scientists including James M. Krueger's mentors (John Pappenheimer and Manfred Karnovsky) and collaborators later in life, including Charles Dinarello, Louis Chedid, Mark Opp, Ferenc Obal jr., Dave Rector, Ping Taishi, Linda Toth, Jeannine Majde, Levente Kapas, Eva Szentirmai, Jidong Fang, Chris Davis, Sandip Roy, Tetsuya Kushikata, Fabio Garcia-Garcia, Ilia Karatsoreos, Mark Zielinski, and Alok De, plus many students, e.g. Jeremy Alt, Kathryn Jewett, Erika English, and Victor Leyva-Grado.
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Affiliation(s)
- James M Krueger
- Integrative Physiology and Neuroscience, College of Veterinary Medicine, Washington State University, USA
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Memon AA, Catiul C, Irwin Z, Pilkington J, Memon RA, Joop A, Wood KH, Cutter G, Miocinovic S, Amara AW. Quantitative sleep electroencephalogram and cognitive performance in Parkinson's disease with and without rapid eye movement sleep behavior disorder. Front Neurol 2023; 14:1223974. [PMID: 37745647 PMCID: PMC10512724 DOI: 10.3389/fneur.2023.1223974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Parkinson's disease (PD) patients with REM sleep behavior disorder (RBD) are at greater risk for cognitive decline and RBD has been associated with alterations in sleep-related EEG oscillations. This study evaluates differences in sleep quantitative EEG (qEEG) and cognition in PD participants with (PD-RBD) and without RBD (PD-no-RBD). Methods In this cross-sectional study, polysomnography (PSG)-derived qEEG and a comprehensive level II neuropsychological assessment were compared between PD-RBD (n = 21) and PD-no-RBD (n = 31). Following artifact rejection, qEEG analysis was performed in the frontal and central leads. Measures included Scalp-slow wave (SW) density, spindle density, morphological properties of SW and sleep spindles, SW-spindle phase-amplitude coupling, and spectral power analysis in NREM and REM. The neurocognitive battery had at least two tests per domain, covering five cognitive domains as recommended by the Movement Disorders Society Task Force for PD-MCI diagnosis. Differences in qEEG features and cognitive performance were compared between the two groups. Stepwise linear regression was performed to evaluate predictors of cognitive performance. Multiple comparisons were corrected using the Benjamini-Hochberg method. Results Spindle density and SW-spindle co-occurrence percent were lower in participants with PD-RBD compared to PD-no-RBD. The PD-RBD group also demonstrated higher theta spectral power during REM. Sleep spindles and years of education, but not RBD, were predictors of cognitive performance. Conclusion PD participants with RBD have alterations in sleep-related qEEG compared to PD participants without RBD. Although PD-RBD participants had worse cognitive performance compared to PD-no-RBD, regression models suggest that lower sleep spindle density, rather than presence of RBD, predicts worse comprehensive cognitive score. Future studies should include longitudinal evaluation to determine whether sleep-related qEEG alterations are associated with more rapid cognitive decline in PD-RBD.
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Affiliation(s)
- Adeel A. Memon
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
- Department of Neurology, West Virginia University, Morgantown, WV, United States
| | - Corina Catiul
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Zachary Irwin
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jennifer Pilkington
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Raima A. Memon
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Allen Joop
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kimberly H. Wood
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
- Department of Psychology, Samford University, Birmingham, AL, United States
| | - Gary Cutter
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States
| | | | - Amy W. Amara
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
- Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
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Mendonça F, Mostafa SS, Morgado-Dias F, Ravelo-García AG, Rosenzweig I. Towards automatic EEG cyclic alternating pattern analysis: a systematic review. Biomed Eng Lett 2023; 13:273-291. [PMID: 37519874 PMCID: PMC10382419 DOI: 10.1007/s13534-023-00303-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/21/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023] Open
Abstract
This study conducted a systematic review to determine the feasibility of automatic Cyclic Alternating Pattern (CAP) analysis. Specifically, this review followed the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to address the formulated research question: is automatic CAP analysis viable for clinical application? From the identified 1,280 articles, the review included 35 studies that proposed various methods for examining CAP, including the classification of A phase, their subtypes, or the CAP cycles. Three main trends were observed over time regarding A phase classification, starting with mathematical models or features classified with a tuned threshold, followed by using conventional machine learning models and, recently, deep learning models. Regarding the CAP cycle detection, it was observed that most studies employed a finite state machine to implement the CAP scoring rules, which depended on an initial A phase classifier, stressing the importance of developing suitable A phase detection models. The assessment of A-phase subtypes has proven challenging due to various approaches used in the state-of-the-art for their detection, ranging from multiclass models to creating a model for each subtype. The review provided a positive answer to the main research question, concluding that automatic CAP analysis can be reliably performed. The main recommended research agenda involves validating the proposed methodologies on larger datasets, including more subjects with sleep-related disorders, and providing the source code for independent confirmation.
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Affiliation(s)
- Fábio Mendonça
- University of Madeira, Funchal, Portugal
- Interactive Technologies Institute (ITI/ARDITI/LARSyS), Funchal, Portugal
| | | | - Fernando Morgado-Dias
- University of Madeira, Funchal, Portugal
- Interactive Technologies Institute (ITI/ARDITI/LARSyS), Funchal, Portugal
| | - Antonio G. Ravelo-García
- Interactive Technologies Institute (ITI/ARDITI/LARSyS), Funchal, Portugal
- Institute for Technological Development and Innovation in Communications, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Ivana Rosenzweig
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, UK
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Nir Y, de Lecea L. Sleep and vigilance states: Embracing spatiotemporal dynamics. Neuron 2023; 111:1998-2011. [PMID: 37148873 DOI: 10.1016/j.neuron.2023.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/08/2023] [Accepted: 04/12/2023] [Indexed: 05/08/2023]
Abstract
The classic view of sleep and vigilance states is a global stationary perspective driven by the interaction between neuromodulators and thalamocortical systems. However, recent data are challenging this view by demonstrating that vigilance states are highly dynamic and regionally complex. Spatially, sleep- and wake-like states often co-occur across distinct brain regions, as in unihemispheric sleep, local sleep in wakefulness, and during development. Temporally, dynamic switching prevails around state transitions, during extended wakefulness, and in fragmented sleep. This knowledge, together with methods monitoring brain activity across multiple regions simultaneously at millisecond resolution with cell-type specificity, is rapidly shifting how we consider vigilance states. A new perspective incorporating multiple spatial and temporal scales may have important implications for considering the governing neuromodulatory mechanisms, the functional roles of vigilance states, and their behavioral manifestations. A modular and dynamic view highlights novel avenues for finer spatiotemporal interventions to improve sleep function.
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Affiliation(s)
- Yuval Nir
- Department of Physiology and Pharmacology, Faculty of Medicine, Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 69978, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 69978, Israel; Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv 69978, Israel; The Sieratzki-Sagol Center for Sleep Medicine, Tel-Aviv Sourasky Medical Center, Tel-Aviv 64239, Israel.
| | - Luis de Lecea
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
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Liu L, Tian Y. Capsaicin Changes the Pattern of Brain Rhythms in Sleeping Rats. Molecules 2023; 28:4736. [PMID: 37375291 DOI: 10.3390/molecules28124736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
The heat and capsaicin sensor TRPV1 ion channels were originally discovered in sensory neurons of dorsal root ganglia, and later found in many other tissues and organs. However, whether TRPV1 channels are present in brain regions other than the hypothalamus has been a subject of debate. Here, we addressed this issue with an unbiased functional test by recording electroencephalograms (EEGs) to examine whether capsaicin injection directly into the rat lateral ventricle could alter brain electrical activity. We observed that EEGs during the sleep stage could be significantly perturbed by capsaicin, whereas EEGs during the awake stage did not show a detectable change. Our results are consistent with TRPV1 expression in selective brain regions whose activities are dominative during the sleep stage.
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Affiliation(s)
- Lei Liu
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College, No. 1 Ningde Road, Qingdao 266073, China
| | - Yuhua Tian
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College, No. 1 Ningde Road, Qingdao 266073, China
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12
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Sodré ME, Wießner I, Irfan M, Schenck CH, Mota-Rolim SA. Awake or Sleeping? Maybe Both… A Review of Sleep-Related Dissociative States. J Clin Med 2023; 12:3876. [PMID: 37373570 DOI: 10.3390/jcm12123876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 06/29/2023] Open
Abstract
Recent studies have begun to understand sleep not only as a whole-brain process but also as a complex local phenomenon controlled by specific neurotransmitters that act in different neural networks, which is called "local sleep". Moreover, the basic states of human consciousness-wakefulness, sleep onset (N1), light sleep (N2), deep sleep (N3), and rapid eye movement (REM) sleep-can concurrently appear, which may result in different sleep-related dissociative states. In this article, we classify these sleep-related dissociative states into physiological, pathological, and altered states of consciousness. Physiological states are daydreaming, lucid dreaming, and false awakenings. Pathological states include sleep paralysis, sleepwalking, and REM sleep behavior disorder. Altered states are hypnosis, anesthesia, and psychedelics. We review the neurophysiology and phenomenology of these sleep-related dissociative states of consciousness and update them with recent studies. We conclude that these sleep-related dissociative states have a significant basic and clinical impact since their study contributes to the understanding of consciousness and the proper treatment of neuropsychiatric diseases.
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Affiliation(s)
| | - Isabel Wießner
- Brain Institute, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Muna Irfan
- Department of Neurology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Carlos H Schenck
- Department of Neurology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Sergio A Mota-Rolim
- Brain Institute, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
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13
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Violent and Complex Behaviors and Non-Restorative Sleep Are the Main Features of Disorders of Arousal in Adulthood: Real Picture or a More Severe Phenotype? J Clin Med 2023; 12:jcm12010372. [PMID: 36615171 PMCID: PMC9821298 DOI: 10.3390/jcm12010372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/28/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023] Open
Abstract
Disorders of arousal (DoA) are NREM parasomnias characterized by motor and emotional behaviors emerging from incomplete arousals from deep sleep. DoA are largely present in pediatric populations, a period during which they are labeled as self-limited manifestations. However, an extensive literature has shown that DoA can persist in adulthood, with different characteristics from childhood DoA. Adult DoA patients usually report excessive daily sleepiness, sleep-related violence during DoA episodes or potentially harmful behaviors, which are rare in childhood. The semeiological features of DoA episodes in adulthood may complicate differential diagnoses with other motor manifestations during sleep, in particular sleep-related hypermotor epilepsy. However, it cannot be excluded that adults with DoA attending sleep centers constitute a more severe phenotype, thus not being representative of adult DoA in the general population. Video-polysomnographic studies of DoA document a spectrum of motor patterns of different complexities, the simplest of which may often go unnoticed. Despite the different complexities of the episodes, neurophysiologic studies showed the co-existence of deep sleep and wakefulness during DoA episodes or even before their onset. These aspects make DoA an ideal model to investigate the mechanisms regulating local sleep, sleep arousal and cognitive functions including spatial and temporal orientation, attention or memory.
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Si Y, Wei W, Chen X, Xie X, Guo T, Sasaki Y, Zhang Y, Wang L, Zhang F, Feng S. A comprehensive study on the relieving effect of Lilium brownii on the intestinal flora and metabolic disorder in p-chlorphenylalanine induced insomnia rats. PHARMACEUTICAL BIOLOGY 2022; 60:131-143. [PMID: 34978949 PMCID: PMC8725957 DOI: 10.1080/13880209.2021.2019283] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/07/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
CONTEXT The bulb of Lilium brownii F. E. Brown (Liliaceae) (LB) is a common Chinese medicine to relieve insomnia. OBJECTIVE To investigate the molecular mechanism of LB relieving insomnia. MATERIALS AND METHODS Insomnia model was induced by intraperitoneally injection p-chlorophenylalanine (PCPA) in Wistar rats. Rats were divided into three groups: Control, PCPA (400 mg/kg, i.p. 2 days), LB (598.64 mg/kg, oral 7 days). The levels of 5-hydroxytryptamine (5-HT), norepinephrine (NE), melatonin (MT), and the expression of GABAA, 5-HT1A and MT receptors, as well as pathological changes in hypothalamus, were evaluated. 16S rDNA sequencing and UPLC-MS/MS were used to reveal the change of the intestinal flora and metabolic profile. RESULTS The adverse changes in the abundance and diversity of intestinal flora and faecal metabolic phenotype altered by PCPA in rats were reversed after LB treatment, accompanied by the up-regulated levels of 5-HT as 8.14 ng/mL, MT as 16.16 pg/mL, 5-HT1A R and GABAA R, down-regulated level of NE as 0.47 ng/mL, and the improvement of pathological phenomena of cells in the hypothalamus. And the arachidonic acid metabolism and tryptophan metabolism pathway most significantly altered by PCPA were markedly regulated by LB. Besides, it was also found that LB reduced the levels of kynurenic acid related to psychiatric disorders and trimethylamine-N-oxide associated with cardiovascular disease. CONCLUSION The mechanism of LB relieving insomnia involves regulating flora and metabolites to resemble the control group. As a medicinal and edible herb, LB could be considered for development as a health-care food to relieve increasing insomniacs in the future.
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Affiliation(s)
- Yanpo Si
- Department of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China
| | - Wenjun Wei
- Department of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiaohui Chen
- Department of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiaolong Xie
- Department of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China
| | - Tao Guo
- Department of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China
| | - Yohei Sasaki
- Graduate School of Medical Sciences, Kanazawa University, Kanazawa City, Japan
| | - Youbo Zhang
- State Key Laboratory of Natural and Biomimetic Drugs and Department of Natural Medicines, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Lili Wang
- Department of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China
| | - Fei Zhang
- Department of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China
| | - Shuying Feng
- Medical College, Henan University of Chinese Medicine, Zhengzhou, China
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15
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Predictive coding, multisensory integration, and attentional control: A multicomponent framework for lucid dreaming. Proc Natl Acad Sci U S A 2022; 119:e2123418119. [PMID: 36279459 PMCID: PMC9636904 DOI: 10.1073/pnas.2123418119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Lucid dreaming (LD) is a mental state in which we realize not being awake but are dreaming while asleep. It often involves vivid, perceptually intense dream images as well as peculiar kinesthetic sensations, such as flying, levitating, or out-of-body experiences. LD is in the cross-spotlight of cognitive neuroscience and sleep research as a particular case to study consciousness, cognition, and the neural background of dream experiences. Here, we present a multicomponent framework for the study and understanding of neurocognitive mechanisms and phenomenological aspects of LD. We propose that LD is associated with prediction error signals arising during sleep and occurring at higher or lower levels of the processing hierarchy. Prediction errors are resolved by generating a superordinate self-model able to integrate ambiguous stimuli arriving from sensory periphery and higher-order cortical regions. While multisensory integration enables lucidity maintenance and contributes to peculiar kinesthetic experiences, attentional control facilitates multisensory integration by dynamically regulating the balance between the influence of top-down mental models and the precision weighting of bottom-up sensory inputs. Our novel framework aims to link neural correlates of LD with current concepts of sleep and arousal regulation and provide testable predictions on interindividual differences in LD as well as neurocognitive mechanisms inducing lucid dreams.
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16
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Huang Z, Wing-Kuen Ling B. Joint ensemble empirical mode decomposition and tunable Q factor wavelet transform based sleep stage classifications. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103760] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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17
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Tamada M, Ueno S, Watanabe K, Muramatsu SI. Effective Treatment of Adult Parasomnias with Keishikaryukotsuboreito in Four Cases. Intern Med 2022; 61:1433-1438. [PMID: 34670887 PMCID: PMC9152866 DOI: 10.2169/internalmedicine.7952-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/29/2021] [Indexed: 11/06/2022] Open
Abstract
Parasomnias are undesirable behaviors or experiences during sleep that manifest clinically as abnormal behavior, emotions, and nightmares. We herein report four elderly parasomnia patients who were successfully treated for abnormal nocturnal behaviors, including rapid eye movement (REM) sleep behavior disorders, with Keishikaryukotsuboreito (KRB), a Japanese traditional herbal medicine. KRB resolved nocturnal violent behaviors and sleep walking without any adverse effects. In one patient, occipital dominant spike-wave complexes induced by 3-Hz photic stimulation were reduced after KRB treatment, suggesting that KRB has inhibitory effects on brain irritability. KRB may represent a safe therapeutic option for treating parasomnias in the elderly.
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Affiliation(s)
- Mayumi Tamada
- Division of Oriental Medicine, Center for Community Medicine, Jichi Medical University, Japan
- Azabu Muse Clinic, Japan
| | - Shinji Ueno
- Division of Oriental Medicine, Center for Community Medicine, Jichi Medical University, Japan
| | | | - Shin-Ichi Muramatsu
- Division of Oriental Medicine, Center for Community Medicine, Jichi Medical University, Japan
- Division of Neurology, Department of Medicine, Jichi Medical University, Japan
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18
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Liu C, Tang X, Gong Z, Zeng W, Hou Q, Lu R. Circadian Rhythm Sleep Disorders: Genetics, Mechanisms, and Adverse Effects on Health. Front Genet 2022; 13:875342. [PMID: 35571019 PMCID: PMC9099045 DOI: 10.3389/fgene.2022.875342] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/29/2022] [Indexed: 01/14/2023] Open
Abstract
Nearly all living organisms, from cyanobacteria to humans, have an internal circadian oscillation with a periodicity of approximately 24 h. In mammals, circadian rhythms regulate diverse physiological processes including the body temperature, energy metabolism, immunity, hormone secretion, and daily sleep-wake cycle. Sleep is tightly regulated by circadian rhythms, whereas a misalignment between the circadian rhythms and external environment may lead to circadian rhythm sleep disorders (CRSD). CRSD includes four main kinds of disorders: the advanced sleep-wake phase disorder (ASPD), the delayed sleep-wake phase disorder (DSPD), the irregular sleep-wake rhythm disorder and the non-24-h sleep-wake rhythm disorder. Recent studies have begun to shed light on the genetic basis of CRSD. Deciphering the genetic codes for ASPD and DSPD has so far been more successful than the other CRSDs, which allow for the development of animal models and understanding of the pathological mechanisms for these disorders. And studies from humans or animal models implicate CRSDs are associated with adverse health consequences, such as cancer and mental disorders. In this review, we will summarize the recent advances in the genetics, underlying mechanisms and the adverse effects on health of ASPD and DSPD.
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Affiliation(s)
| | - Xiangrong Tang
- Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China
| | - Zishan Gong
- Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China
| | - Wang Zeng
- Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China
| | - Qiao Hou
- Department of Rehabilitation Medicine, Xiangya Third Hospital, Central South University, Changsha, China
- *Correspondence: Renbin Lu, ; Qiao Hou,
| | - Renbin Lu
- Hunan Key Laboratory of Molecular Precision Medicine, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geratric Disorder, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Renbin Lu, ; Qiao Hou,
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19
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Wang Z, Zhong YH, Jiang S, Qu WM, Huang ZL, Chen CR. Case Report: Dysfunction of the Paraventricular Hypothalamic Nucleus Area Induces Hypersomnia in Patients. Front Neurosci 2022; 16:830474. [PMID: 35360167 PMCID: PMC8964012 DOI: 10.3389/fnins.2022.830474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundHypersomnia is a common and highly impairing symptom marked by pathological excessive sleepiness, which induces suboptimal functioning and poor quality of life. Hypersomnia can be both a primary (e.g., hypersomnolence disorder) and secondary (e.g., tumors, and head trauma) symptom of disorders. However, its underlying mechanisms remain largely unknown.Case PresentationWe report that three clinical cases with lesions around the paraventricular nucleus of the hypothalamus (PVH) area showed excessive daytime sleepiness and a prolonged nocturnal sleep lasting more than 20 h per day. Sleep architecture and subjective daytime sleepiness were examined by polysomnography. These cases were presented with stroke, myelin oligodendrocyte glycoprotein (MOG) antibody associated disorders and neuromyelitis optical spectrum disorder (NMOSD), respectively. Magnetic resonance imaging (MRI) showed lesions around the PVH area in all these three patients. After treatment of their primary disorders, their excessive sleep decreased as the PVH area recovered.ConclusionOur findings suggest that the PVH may play an essential role in the occurrence of hypersomnia.
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Affiliation(s)
- Zan Wang
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Zan Wang, ,
| | - Yu-Heng Zhong
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Shan Jiang
- Department of Pharmacology, School of Basic Medical Science, Fudan University, Shanghai, China
| | - Wei-Min Qu
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
- Department of Pharmacology, School of Basic Medical Science, Fudan University, Shanghai, China
| | - Zhi-Li Huang
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
- Department of Pharmacology, School of Basic Medical Science, Fudan University, Shanghai, China
| | - Chang-Rui Chen
- Department of Pharmacology, School of Basic Medical Science, Fudan University, Shanghai, China
- Chang-Rui Chen,
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20
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Martins HADL, Ribas VR, Dos Santos Ribas KH, da Fonseca Lins L, Mainieri AG. Case Report: Anomalous Experience in a Dissociative Identity and Borderline Personality Disorder. Front Psychiatry 2022; 13:662290. [PMID: 35923455 PMCID: PMC9339793 DOI: 10.3389/fpsyt.2022.662290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/03/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Dissociative identity disorder, formerly called multiple personality disorder, is a rupture of identity characterized by the presence of two or more distinct personality states, described in some cultures as an experience of possession. OBJECTIVE The case of a 30-year-old woman with dissociative identity disorder and borderline personality disorder associated with a previous history of anomalous experience was reported. CASE REPORT A 30-year-old woman who fulfilled the DSM-5 criteria for dissociative identity disorder and borderline personality disorder reported the presence of unusual sensory experiences (clairvoyance, premonitory dreams, clairaudience) since she was 5 years old. The patient told that for 12 months she presented episodes in which a "second self" took charge of her actions: she would then speak with a male voice, become aggressive, and require several people to contain her desire for destruction. After 3 months of religious follow-up, and accepting her unusual experiences and trance possessions as normal and natural, she had significant improvement. CONCLUSION When approaching DID and BPD patients, it is necessary to observe the anomalous phenomena (in the light of) closer to their cultural and religious contexts, to promote better results in the treatment of their disorders, which has not been explored in the treatment guide.
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21
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Mainieri G, Loddo G, Castelnovo A, Balella G, Cilea R, Mondini S, Manconi M, Provini F. EEG Activation Does Not Differ in Simple and Complex Episodes of Disorders of Arousal: A Spectral Analysis Study. Nat Sci Sleep 2022; 14:1097-1111. [PMID: 35698590 PMCID: PMC9188335 DOI: 10.2147/nss.s360120] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Disorders of arousal (DoA) are characterized by incomplete awakening from NREM sleep, with the admixture of both deep sleep and wake EEG activity. Previous observations suggested that changes in EEG activity could be detected in the seconds preceding DoA episodes. The aims of this work were to characterize the topography of EEG spectral changes prior to DoA episodes and to investigate whether or not behavioral complexity could be predicted by changes in EEG immediately preceding behavioral onsets. PATIENTS AND METHODS We collected 103 consecutive video-polysomnographic recordings of 53 DoA adult patients and classified all episodes as simple, rising and complex arousal movements. For each episode, a 5-second window preceding its motor onset ("pre-event") and a 60-second window from 2 to 3 minutes before the episodes ("baseline") were compared. Subsequently, a between-group comparison was performed for the pre-event of simpler versus the more complex episodes. RESULTS Spectral analysis over 325 DoA episodes showed an absolute significant increase prior to DoA episodes in all frequency bands excluding sigma, which displayed the opposite effect. In normalized maps, the increase was relatively higher over the central/anterior areas for both slow and fast frequency bands. No significant differences emerged from the comparison between simpler and more complex episodes. CONCLUSION Taken together, these results show that deep sleep and wake-like EEG rhythms coexist over overlapping areas before DoA episodes, suggesting an alteration of local sleep mechanisms. Episodes of different complexity are preceded by a similar EEG activation, implying that they possibly share a similar pathophysiology.
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Affiliation(s)
- Greta Mainieri
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Loddo
- Department of Primary Care, Azienda AUSL di Bologna, Bologna, Italy
| | - Anna Castelnovo
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.,University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Giulia Balella
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Rosalia Cilea
- Neurology Unit, "Morgagni-Pierantoni" Hospital, AUSL Romagna, Forlì, Italy
| | - Susanna Mondini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italia
| | - Mauro Manconi
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.,Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
| | - Federica Provini
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italia
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22
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Huang Z, Ling BWK. Sleeping stage classification based on joint quaternion valued singular spectrum analysis and ensemble empirical mode decomposition. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2021.103086] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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23
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Raduga M. Detecting lucid dreams only by submentalis electromyography. Sleep Med 2021; 88:221-230. [PMID: 34798438 DOI: 10.1016/j.sleep.2021.10.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 11/17/2022]
Abstract
Lucid dreams (LDs) occur when people become aware that they are dreaming. This phenomenon has a wide range of possible applications from the perspectives of psychology, training physical movements, and controlling computers while asleep, among others. However, research on LDs might lack efficiency because the standard LD verification protocol uses polysomnography (PSG), which requires an expensive apparatus and skilled staff. The standard protocol also may reduce LD-induction efficiency. The current study examines whether humans can send phasic signals through submentalis electromyography (EMG) during muscle atonia via pre-agreed chin movements (PACM). This ability would manifest both REM sleep and consciousness, which are the main features of LDs. In laboratory conditions volunteers were instructed to open their jaws three times while in an LD right after the standard verification protocol to achieve the research goal. Results: 4 of 5 volunteers proved to be in an LD using the standard protocol, and then all of them made PACM. The outcomes show that dream signals cannot be blocked in the submentalis area during muscle atonia. Also, this finding can be considered to develop a simplified, reliable LD protocol that needs only one EMG sensor. The cost of this protocol could be only a small percentage of the current protocol, making it more convenient for researchers and volunteers. It can also be used remotely by inbuilt in wearable gadgets. Considering PACM could speed up LD research and provide many discoveries and new opportunities. Also, it can be used in sleep paralysis studies.
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24
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Chen CR, Zhong YH, Jiang S, Xu W, Xiao L, Wang Z, Qu WM, Huang ZL. Dysfunctions of the paraventricular hypothalamic nucleus induce hypersomnia in mice. eLife 2021; 10:69909. [PMID: 34787078 PMCID: PMC8631797 DOI: 10.7554/elife.69909] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/16/2021] [Indexed: 12/19/2022] Open
Abstract
Hypersomnolence disorder (HD) is characterized by excessive sleep, which is a common sequela following stroke, infection, or tumorigenesis. HD is traditionally thought to be associated with lesions of wake-promoting nuclei. However, lesions of a single wake-promoting nucleus, or even two simultaneously, did not exert serious HD. Therefore, the specific nucleus and neural circuitry for HD remain unknown. Here, we observed that the paraventricular nucleus of the hypothalamus (PVH) exhibited higher c-fos expression during the active period (23:00) than during the inactive period (11:00) in mice. Therefore, we speculated that the PVH, in which most neurons are glutamatergic, may represent one of the key arousal-controlling centers. By using vesicular glutamate transporter 2 (vglut2Cre) mice together with fiber photometry, multichannel electrophysiological recordings, and genetic approaches, we found that PVHvglut2 neurons were most active during wakefulness. Chemogenetic activation of PVHvglut2 neurons induced wakefulness for 9 hr, and photostimulation of PVHvglut2→parabrachial complex/ventral lateral septum circuits immediately drove transitions from sleep to wakefulness. Moreover, lesioning or chemogenetic inhibition of PVHvglut2 neurons dramatically decreased wakefulness. These results indicate that the PVH is critical for arousal promotion and maintenance.
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Affiliation(s)
- Chang-Rui Chen
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Yu-Heng Zhong
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Shan Jiang
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Wei Xu
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Lei Xiao
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Zan Wang
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Wei-Min Qu
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Zhi-Li Huang
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
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25
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Zhong YH, Jiang S, Qu WM, Zhang W, Huang ZL, Chen CR. Saikosaponin a promotes sleep by decreasing neuronal activities in the lateral hypothalamus. J Sleep Res 2021; 31:e13484. [PMID: 34510626 DOI: 10.1111/jsr.13484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/20/2021] [Accepted: 08/30/2021] [Indexed: 11/27/2022]
Abstract
Insomnia is one of the most prevalent sleep disorders, which imparts tremendous societal and economic impact. However, the present pharmacotherapy is greatly limited by adverse effects, so it is necessary to explore new drugs for the treatment of insomnia. Radix Bupleuri (RB) has been widely used in traditional Chinese medicine for >2000 years; it has many pharmacological effects, including sedation and anticonvulsant properties. The present study investigated the effects of saikosaponin a (SSa), an active component of RB, on sleep and locomotion. Male C57BL/6j mice received intraperitoneal injections of SSa at three different dosages (0.625, 1.25, and 2.5 mg/kg). Sleep parameters were analysed by electroencephalography and electromyography. The open-field test was used to measure locomotor activities. Our present results showed that SSa treatment significantly increased the duration of non-rapid eye movement sleep and shortened sleep latency in a dose-dependent manner. A high dose of SSa (2.5 mg/kg) also decreased locomotor activities. Moreover, by measuring c-Fos expression and the calcium signal in the lateral hypothalamus (LH), we found that SSa treatment decreased neuronal activity in the LH. In conclusion, SSa might be the sleep-promoting component in RB and its mechanism may be related to the modulation of neuronal activity in the LH.
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Affiliation(s)
- Yu-Heng Zhong
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Shan Jiang
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Wei-Min Qu
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Wen Zhang
- Department of Integrative Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhi-Li Huang
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Chang-Rui Chen
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
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26
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Kanagasundram S. Quetiapine-induced sleep-related eating disorder: A case report. Clin Case Rep 2021; 9:e04168. [PMID: 34194765 PMCID: PMC8222754 DOI: 10.1002/ccr3.4168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/31/2021] [Indexed: 12/20/2022] Open
Abstract
This is the first case report of two depressed Malay females prescribed quetiapine, the first patient developed sleep related eating disorder (SRED) on 200 mg per day and the second patient at 50 mg per day. Both resolved with discontinuation of the drug. Assessment for SRED should be done at every follow up.
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27
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Mainieri G, Maranci JB, Champetier P, Leu-Semenescu S, Gales A, Dodet P, Arnulf I. Are sleep paralysis and false awakenings different from REM sleep and from lucid REM sleep? A spectral EEG analysis. J Clin Sleep Med 2021; 17:719-727. [PMID: 33283752 DOI: 10.5664/jcsm.9056] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To determine the polysomnography characteristics during sleep paralysis, false awakenings, and lucid dreaming (which are states intermediate to rapid eye movement [REM] sleep and wake but exceptionally observed in sleep laboratory). METHODS In 5 participants, we captured 5 episodes of sleep paralysis (2 time marked with the ocular left-right-left-right code normally used to signal lucid dreaming, 1 time marked by an external noise, and 2 retrospectively reported) and 2 episodes of false awakening. The sleep coding (using 3-second mini-epochs) and spectral electroencephalography analysis were compared during these episodes and normal REM sleep as well as wakefulness in the same 4 of 5 participants and vs lucid REM sleep in 4 other patients with narcolepsy. RESULTS During episodes of sleep paralysis, 70.8% of mini-epochs contained theta electroencephalography rhythm (vs 89.7% in REM sleep and 21.2% in wakefulness), 93.8% contained chin muscle atonia (vs 89.7% in REM sleep and 33.3% in wakefulness), and 6.9% contained rapid eye movements (vs 11.9% in REM sleep and 8.1% in wakefulness). The electroencephalography spectrum during sleep paralysis was intermediate between wakefulness and REM sleep in the alpha, theta, and delta frequencies, whereas the beta frequencies were not different between sleep paralysis and normal REM sleep. The power spectrum during false awakening followed the same profile as in sleep paralysis. CONCLUSIONS The predominant theta electroencephalography rhythm during sleep paralysis and false awakenings (with rare and lower alpha rhythm) suggests that the brain during sleep paralysis is not in an awake but in a dreaming state.
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Affiliation(s)
- Greta Mainieri
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France.,Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania Via S. Sofia 78, Italy
| | - Jean-Baptiste Maranci
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France.,Sorbonne University, Paris, France.,Paris Brain Institute, Paris, France
| | - Pierre Champetier
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France.,Paris Brain Institute, Paris, France.,Ecole Normale Supérieure Paris-Saclay, Université Paris-Saclay, France
| | | | - Ana Gales
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France
| | - Pauline Dodet
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France
| | - Isabelle Arnulf
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France.,Sorbonne University, Paris, France.,Paris Brain Institute, Paris, France
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A method based on cardiopulmonary coupling analysis for sleep quality assessment with FPGA implementation. Artif Intell Med 2021; 112:102019. [PMID: 33581831 DOI: 10.1016/j.artmed.2021.102019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/06/2020] [Accepted: 01/10/2021] [Indexed: 11/22/2022]
Abstract
The relevance of sleep quality examination for clinical diagnosis is increasing with the discovery of new relationships with several diseases and the overall wellness. This assessment is commonly performed by conducting interviews with the subjects, evaluating the self-report and psychological variables. However, this approach has a major constraint since the subject is a poor self-observer of sleep behaviors. To address this issue, a method based on the examination of a physiological signal was developed. Specifically, the single-lead electrocardiogram signal was examined to estimate the cardiopulmonary coupling between the electrocardiogram derived respiration signal and the normal-to-normal sinus interbeat interval series. A one dimensional array was created from the coupling signal and was fed to a convolutional neural network to estimate the sleep quality. The age-related cyclic alternating pattern rate percentages in healthy subjects was considered as the classification reference. An accuracy of 91 % was attained by the developed model, with an area under the receiver operating characteristic curve of 97 %. The performance is in the upper range of the reported performance by the works presented in the state of the art, advocating the relevance of the proposed method. The model was implemented in a small field programmable gate array board. Hence, a home monitoring device was created, composed of a processing unit, a sensing module and a display unit. The device is resilient, easy to self-assemble and operate, and can conceivably be employed for clinical analysis.
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Ontology-Based Decision Support Tool for Automatic Sleep Staging Using Dual-Channel EEG Data. Symmetry (Basel) 2020. [DOI: 10.3390/sym12111921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Sleep staging has attracted significant attention as a critical step in auxiliary diagnosis of sleep disease. To avoid subjectivity of doctor’s manual sleep staging, and to realize scientific management of massive physiological data, an ontology-based decision support tool is proposed. The tool implements an automated procedure for sleep staging using dual-channel electroencephalogram (EEG) signals. First of all, it encodes EEG features, sleep-related concepts and other contextual information to “EEG-Sleep ontology”. Secondly, a rule-set is constructed based on a data mining technique. Finally, the first two steps are processed in a reasoning engine which is automatically assign each 30 s epoch (segment) sleep stage to one of five possible sleep stages: WA, NREM1, NREM2, SWS and REM. The rule set is obtained using EEG data taken from the Sleep-EDF database [EXPANDED] according to the random forest algorithm (RF), we prove that the performance of the proposed method with 89.12% accuracy, and 0.81 Kappa statistics is superior to other algorithms such as Bayesian network, C4.5, support vector machine, and multilayer perceptron. Additionally, our proposed approach improved performance when compared to other studies using a small subset of the Sleep-EDF database [EXPANDED].
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A detection method for latent circadian rhythm sleep-wake disorder. EBioMedicine 2020; 62:103080. [PMID: 33166792 PMCID: PMC7653065 DOI: 10.1016/j.ebiom.2020.103080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Individuals with typical circadian rhythm sleep-wake disorders (CRSWDs) have a habitual sleep timing that is desynchronized from social time schedules. However, it is possible to willfully force synchronisation against circadian-driven sleepiness, which causes other sleep problems. This pathology is distinguishable from typical CRSWDs and is referred to here as latent CRSWD (LCRSWD). Conventional diagnostic methods for typical CRSWDs are insufficient for detecting LCRSWD because sufferers have an apparently normal habitual sleep timing. METHODS We first evaluated the reliability of circadian phase estimation based on clock gene expression using hair follicles collected at three time points without sleep interruption. Next, to identify detection criteria for LCRSWD, we compared circadian and sleep parameters according to estimated circadian phases, at the group and individual level, between subjects with low and high Pittsburgh Sleep Quality Index (PSQI) scores. To validate the reliability of identified detection criteria, we investigated whether the same subjects could be reproducibly identified at a later date and whether circadian amelioration resulted in sleep improvement. FINDINGS We successfully validated the reliability of circadian phase estimation at three time points and identified potential detection criteria for individuals with LCRSWD attributed to delayed circadian-driven sleepiness. In particular, a criterion based on the interval between the times of the estimated circadian phase of clock gene expression and getting out of bed on work or school days was promising. We also successfully confirmed the reproducibility of candidate screening and sleep improvement by circadian amelioration, supporting the reliability of the detection criteria. INTERPRETATION Although several limitations remain, our present study demonstrates a promising prototype of a detection method for LCRSWD attributed to delayed circadian-driven sleepiness. More extensive trials are needed to further validate this method. FUNDING This study was supported mainly by JSPS, Japan.
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NREM sleep arousal-related disorders reflect cognitive impairment in Parkinson's disease. Sleep Med 2020; 75:491-496. [PMID: 33011475 DOI: 10.1016/j.sleep.2020.08.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/12/2020] [Accepted: 08/31/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Sleep disorders and cognitive impairment are frequently reported in Parkinson's disease (PD) as non-motor disabling symptoms. While it is known that REM sleep Behaviour Disorder (RBD) in PD is associated with motor and cognitive decline, little is known about the neurobiological significance of NREM sleep arousal-related disorders. OBJECTIVES to evaluate the cognitive and clinical correlates of arousal-related disorders in PD. METHODS Clinical data and video-polysomnography were analysed from one hundred-seventy consecutive subjects with PD. Based on the neuropsychological assessment, the subjects were divided into three groups: no cognitive impairment (PD; n = 58), mild cognitive impairment (PD-MCI; n = 58) and overt dementia (PDD; n = 54). RESULTS Arousal-related disorders by history were reported in 32.9% of the subjects: 10.3% PD, 31.6% PD-MCI and 59.3% PDD (p = 0.001). Video-PSG captured arousal-related disorders in 1.7% PD, 21.2% MCI-PD and 35.6% PDD (p = 0.001). Arousal-related disorders and RBD were recorded in the same night in 7.7% PD, 9.8% MCI-PD and 15.6% PDD (p = 0.04). Patients with arousal-related disorders captured at V-PSG have a longer disease duration (p = 0.003), higher UPDRS score (p = 0.039), longer duration of treatment with levodopa (p = 0.017) and dopamine agonists (p = 0.018), worse H&Y staging (p = 0.001), lower MMSE score (p = 0.019) and more frequently hallucinations (p = 0.004). In multivariate analysis, cognitive impairment significantly increases the risk of arousal-related disorders (OR 3.387-95% CI 1.395-8.220, p = 0.007). CONCLUSION Arousal-related disorders appear to be a marker of cognitive decline in PD. Recognizing arousal-related disorders should make clinicians aware of a possible cognitive decline in PD and eventually modify the therapeutic approach.
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Raduga M, Kuyava O, Sevcenko N. Is there a relation among REM sleep dissociated phenomena, like lucid dreaming, sleep paralysis, out-of-body experiences, and false awakening? Med Hypotheses 2020; 144:110169. [PMID: 32795836 DOI: 10.1016/j.mehy.2020.110169] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 11/16/2022]
Abstract
During REM sleep we normally experience dreams. However, there are other less common REM sleep phenomena, like lucid dreaming (LD), false awakening (FA), sleep paralysis (SP), and out of body experiences (OBE). LD occurs when one is conscious during dreaming, and FA occurs when one is dreaming but believes that has woken up. SP is characterized by skeletal muscle atonia and occurs mainly during awakening or falling asleep. OBE is the subjective sensation of 'leaving the physical body'. Since all these phenomena happen during REM sleep, their frequency is probably connected. The goal of this research is to explore how these phenomena are connected to each other in terms of frequency. We surveyed 974 people on the streets of Moscow and found significant correlations between the phenomena. Of those surveyed, 88% have experienced at least one of the phenomena of interest (i.e., LD, OBE, FA, and SP), which appeared to be closely correlated to each other. Furthermore, 43% of respondents stated that they often experience at least one of these phenomena. We found that the recurrence of these phenomena correlated with sleep duration and dream recall frequency. The results of the survey provide better understanding of the nature of REM sleep dissociative phenomena. Cross-correlations between REM sleep dissociated phenomena, like lucid dreaming, sleep paralysis, out-of-body experiences, and false awakening, revealed by a survey.
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Du Y, Jiang J, Ng CH, Wu L, Zhang P, Xi C, Lai J, Xu Y, Hu S, Wang Z. Vortioxetine improves rapid eye movement sleep behavior disorder: A case report. Medicine (Baltimore) 2020; 99:e21003. [PMID: 32590816 PMCID: PMC7329003 DOI: 10.1097/md.0000000000021003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Rapid eye movement sleep behavior disorder (RBD) is a kind of sleep disturbance characterized by a loss of normal paralysis of REM sleep with dream enactment behavior during REM sleep. The pharmacotherapy options for treating RBD are limited and the use of antidepressants remains controversial. Further, the role of vortioxetine in RBD has not been evaluated so far. PATIENT CONCERNS A 72-year-old woman presented with recurrent peculiar behaviors such as shouting, punching, kicking or even walking around her bedroom during sleep for over 3 years. DIAGNOSIS Clinical examinations and polysomnography indicated the diagnosis of RBD. INTERVENTIONS The patient received treatment with paroxetine and melatonin for 1 year and then paroxetine was discontinued and vortioxetine was initiated in a daily dose of 10 mg. OUTCOMES Treatment with paroxetine and melatonin for one year was ineffective. A trial of vortioxetine 10 mg per day over 3 months resulted in significant clinical improvement. LESSONS To our knowledge, this is the first reported case of effective treatment of RBD with vortioxetine. Well-designed studies with large samples are needed to verify the clinical benefits.
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Affiliation(s)
- Yanli Du
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine, Hangzhou, China
| | - Jiajun Jiang
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine, Hangzhou, China
| | - Chee H. Ng
- Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lingling Wu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine, Hangzhou, China
| | - Peifen Zhang
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine, Hangzhou, China
| | - Caixi Xi
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine, Hangzhou, China
| | - Jianbo Lai
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- The Key Laboratory of Mental Disorder's Management of Zhejiang Province, No. 79, Qingchun Road
- Brain Research Institute of Zhejiang University, Hangzhou, China
| | - Yi Xu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- The Key Laboratory of Mental Disorder's Management of Zhejiang Province, No. 79, Qingchun Road
- Brain Research Institute of Zhejiang University, Hangzhou, China
| | - Shaohua Hu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- The Key Laboratory of Mental Disorder's Management of Zhejiang Province, No. 79, Qingchun Road
- Brain Research Institute of Zhejiang University, Hangzhou, China
| | - Zheng Wang
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- The Key Laboratory of Mental Disorder's Management of Zhejiang Province, No. 79, Qingchun Road
- Brain Research Institute of Zhejiang University, Hangzhou, China
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Mendonça F, Mostafa SS, Morgado-Dias F, Ravelo-García AG. An Oximetry Based Wireless Device for Sleep Apnea Detection. SENSORS 2020; 20:s20030888. [PMID: 32046102 PMCID: PMC7039040 DOI: 10.3390/s20030888] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 01/29/2020] [Accepted: 02/03/2020] [Indexed: 11/16/2022]
Abstract
Sleep related disorders can severely disturb the quality of sleep. Among these disorders, obstructive sleep apnea (OSA) is highly prevalent and commonly undiagnosed. Polysomnography is considered to be the gold standard exam for OSA diagnosis. Even though this multi-parametric test provides highly accurate results, it is time consuming, labor-intensive, and expensive. A non-invasive and easy to self-assemble home monitoring device was developed to address these issues. The device can perform the OSA diagnosis at the patient’s home and a specialized technician is not required to supervise the process. An automatic scoring algorithm was developed to examine the blood oxygen saturation signal for a minute-by-minute OSA assessment. It was performed by analyzing statistical and frequency-based features that were fed to a classifier. Afterward, the ratio of the number of minutes classified as OSA to the time in bed in minutes was compared with a threshold for the global (subject-based) OSA diagnosis. The average accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve for the minute-by-minute assessment were, respectively, 88%, 80%, 91%, and 0.86. The subject-based accuracy was 95%. The performance is in the same range as the best state of the art methods for the models based only on the blood oxygen saturation analysis. Therefore, the developed model has the potential to be employed in clinical analysis.
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Affiliation(s)
- Fábio Mendonça
- Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal;
- ITI/Larsys/Madeira Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Correspondence: (F.M.); (F.M.-D.); Tel.: +351-291-721-006 (F.M.)
| | - Sheikh Shanawaz Mostafa
- Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal;
- ITI/Larsys/Madeira Interactive Technologies Institute, 9020-105 Funchal, Portugal;
| | - Fernando Morgado-Dias
- ITI/Larsys/Madeira Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Faculty of Exact Sciences and Engineering, University of Madeira, 9000-082 Funchal, Portugal
- Correspondence: (F.M.); (F.M.-D.); Tel.: +351-291-721-006 (F.M.)
| | - Antonio G. Ravelo-García
- ITI/Larsys/Madeira Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Institute for Technological Development and Innovation in Communications, Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain
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Chen F, Chen G, Chen Z, Zhang Z, Zhang P, Luo D, Li K, Hou Y, Xing W, Shi P, Yuan X. Guizhi Gancao Longgu Muli decoction for insomnia: A protocol for a systematic review. Medicine (Baltimore) 2020; 99:e19198. [PMID: 32118720 PMCID: PMC7478409 DOI: 10.1097/md.0000000000019198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Insomnia is a prevalent and bothersome disorder of sleep initiation and maintenance. Although efficacious treatments for insomnia have been available for decades, they all have their own limitations. Guizhi Gancao Longgu Muli Decoction (GGLMD), a popular complementary and alternative therapy, has been widely applied to treat insomnia in some Asian countries for centuries. Yet no systematic reviews have comprehensively assessed the efficacy and safety of GGLMD as a treatment for insomnia. METHODS A comprehensive search up to November, 2019 will be conducted in the following electronic databases: the Cochrane Library, Embase, PubMed, Web of Science, the Chinese National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature Database (CBM), the Chinese Scientific Journal Database (VIP), and the Wanfang Database. The primary outcomes will be sleep quality including Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG). Stata 15 will be used for data analysis as well. RESULTS This study will provide the current evidence of insomnia treated with GGLMD from the several points including PSQI and PSG. CONCLUSION The consequence of this summary will furnish proof to evaluate if GGLMD is effective in the treatment of insomnia. ETHICS AND DISSEMINATION Without personal information involved, ethical approval and informed consent form is no need. The review will be submitted to a peer-reviewed journal prospectively to spread our findings. PROSPERO REGISTRATION NUMBER PROSPERO CRD42018118336.
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Affiliation(s)
- Fangying Chen
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine
| | - Guoming Chen
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ziyin Chen
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhaoping Zhang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Peng Zhang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dongqiang Luo
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Keyi Li
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yingyue Hou
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wanli Xing
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Peiyu Shi
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xueya Yuan
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine
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Abstract
For many decades, sleep researchers have sought to determine which species 'have' rapid eye movement (REM) sleep. In doing so, they relied predominantly on a template derived from the expression of REM sleep in the adults of a small number of mammalian species. Here, we argue for a different approach that focuses less on a binary decision about haves and have nots, and more on the diverse expression of REM sleep components over development and across species. By focusing on the components of REM sleep and discouraging continued reliance on a restricted template, we aim to promote a richer and more biologically grounded developmental-comparative approach that spans behavioral, physiological, neural, and ecological domains.
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Affiliation(s)
- Mark S Blumberg
- Department of Psychological and Brain Sciences, Iowa Neuroscience Institute, University of Iowa, Iowa City, IA 52242, USA.
| | - John A Lesku
- School of Life Sciences, La Trobe University, Melbourne 3086, Australia
| | - Paul-Antoine Libourel
- Neurosciences Research Center of Lyon, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1 Neurocampus, 95 Boulevard Pinel, 69675 BRON, France
| | - Markus H Schmidt
- Department of Neurology, Bern University Hospital (Inselspital), University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland; Ohio Sleep Medicine Institute, 4975 Bradenton Avenue, Dublin, OH 43017, USA
| | - Niels C Rattenborg
- Avian Sleep Group, Max Planck Institute for Ornithology, Haus 5, Seewiesen 82319, Germany.
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Garbarino S, Lanteri P, Feeling NR, Jarczok MN, Quintana DS, Koenig J, Sannita WG. Circadian Rhythms, Sleep, and the Autonomic Nervous System. J PSYCHOPHYSIOL 2020. [DOI: 10.1027/0269-8803/a000236] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, Polyclinic Hospital San Martino IRCCS, University of Genova, Italy
| | - Paola Lanteri
- Department of Medical and Surgery, Neuroscience, Rehabilitation – Continuity of Care, Neurophysiology Center, Institute G. Gaslini, Genova, Italy
| | - Nicole R. Feeling
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Marc N. Jarczok
- Clinic for Psychosomatic Medicine and Psychotherapy, Ulm University, Germany
| | - Daniel S. Quintana
- Brain and Mind Centre, Central Clinical School, Sydney Medical School, University of Sydney, Camperdown, Australia
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, University of Oslo, Norway
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Germany
| | - Walter G. Sannita
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, Polyclinic Hospital San Martino IRCCS, University of Genova, Italy
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Lynn SJ, Maxwell R, Merckelbach H, Lilienfeld SO, Kloet DVHVD, Miskovic V. Dissociation and its disorders: Competing models, future directions, and a way forward. Clin Psychol Rev 2019; 73:101755. [DOI: 10.1016/j.cpr.2019.101755] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 06/20/2019] [Accepted: 07/15/2019] [Indexed: 12/18/2022]
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Castelnovo A, Lopez R, Proserpio P, Nobili L, Dauvilliers Y. NREM sleep parasomnias as disorders of sleep-state dissociation. Nat Rev Neurol 2019; 14:470-481. [PMID: 29959394 DOI: 10.1038/s41582-018-0030-y] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Non-rapid eye movement (NREM) sleep parasomnias (or NREM parasomnias) are fascinating disorders with mysterious neurobiological substrates. These conditions are common and often severe, with social, personal and forensic implications. The NREM parasomnias include sleepwalking, sleep terrors and confusional arousals - collectively termed disorders of arousal (DOAs) - as well as less well-known entities such as sleep-related sexual behaviours and eating disorders. Affected patients can exhibit waking behaviours arising abruptly out of NREM sleep. Although the individual remains largely unresponsive to the external environment, their EEG shows both typical sleep-like and wake-like features, and they occasionally report dreaming afterwards. Therefore, these disorders offer a unique natural model to explore the abnormal coexistence of local sleep and wake brain activity and the dissociation between behaviour and various aspects of consciousness. In this article, we critically review major findings and updates on DOAs, focusing on neurophysiological studies, and offer an overview of new clinical frontiers and promising future research areas. We advocate a joint effort to inform clinicians and the general public about the management and follow-up of these conditions. We also strongly encourage collaborative multicentre studies to add more objective polysomnographic criteria to the current official diagnostic definitions and to develop clinical practice guidelines, multidisciplinary research approaches and evidence-based medical care.
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Affiliation(s)
- Anna Castelnovo
- Center for Sleep and Consciousness, Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.,Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland
| | - Régis Lopez
- Reference National Center for Narcolepsy-Hypersomnia, Sleep Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France
| | - Paola Proserpio
- Claudio Munari Center for Epilepsy Surgery, Niguarda Hospital, Milan, Italy
| | - Lino Nobili
- Claudio Munari Center for Epilepsy Surgery, Niguarda Hospital, Milan, Italy. .,Department of Neuroscience, DINOGMI, University of Genoa, Genoa, Italy.
| | - Yves Dauvilliers
- Reference National Center for Narcolepsy-Hypersomnia, Sleep Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.
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40
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Dvir H, Kantelhardt JW, Zinkhan M, Pillmann F, Szentkiralyi A, Obst A, Ahrens W, Bartsch RP. A Biased Diffusion Approach to Sleep Dynamics Reveals Neuronal Characteristics. Biophys J 2019; 117:987-997. [PMID: 31422824 DOI: 10.1016/j.bpj.2019.07.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/20/2019] [Accepted: 07/19/2019] [Indexed: 01/10/2023] Open
Abstract
We propose a biased diffusion model of accumulated subthreshold voltage fluctuations in wake-promoting neurons to account for stochasticity in sleep dynamics and to explain the occurrence of brief arousals during sleep. Utilizing this model, we derive four neurophysiological parameters related to neuronal noise level, excitability threshold, deep-sleep threshold, and sleep inertia. We provide the first analytic expressions for these parameters, and we show that there is good agreement between empirical findings from sleep recordings and our model simulation results. Our work suggests that these four parameters can be of clinical importance because we find them to be significantly altered in elderly subjects and in children with autism.
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Affiliation(s)
- Hila Dvir
- Department of Physics, Bar-Ilan University, Ramat-Gan, Israel.
| | - Jan W Kantelhardt
- Institute of Physics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Melanie Zinkhan
- Institute of Clinical Epidemiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Frank Pillmann
- Department of Psychiatry and Psychotherapy, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Andras Szentkiralyi
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Anne Obst
- Department of Internal Medicine B, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Ronny P Bartsch
- Department of Physics, Bar-Ilan University, Ramat-Gan, Israel.
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41
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Rattenborg NC, van der Meij J, Beckers GJL, Lesku JA. Local Aspects of Avian Non-REM and REM Sleep. Front Neurosci 2019; 13:567. [PMID: 31231182 PMCID: PMC6560081 DOI: 10.3389/fnins.2019.00567] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/17/2019] [Indexed: 12/12/2022] Open
Abstract
Birds exhibit two types of sleep that are in many respects similar to mammalian rapid eye movement (REM) and non-REM (NREM) sleep. As in mammals, several aspects of avian sleep can occur in a local manner within the brain. Electrophysiological evidence of NREM sleep occurring more deeply in one hemisphere, or only in one hemisphere – the latter being a phenomenon most pronounced in dolphins – was actually first described in birds. Such asymmetric or unihemispheric NREM sleep occurs with one eye open, enabling birds to visually monitor their environment for predators. Frigatebirds primarily engage in this form of sleep in flight, perhaps to avoid collisions with other birds. In addition to interhemispheric differences in NREM sleep intensity, the intensity of NREM sleep is homeostatically regulated in a local, use-depended manner within each hemisphere. Furthermore, the intensity and temporo-spatial distribution of NREM sleep-related slow waves varies across layers of the avian hyperpallium – a primary visual area – with the slow waves occurring first in, and propagating through and outward from, thalamic input layers. Slow waves also have the greatest amplitude in these layers. Although most research has focused on NREM sleep, there are also local aspects to avian REM sleep. REM sleep-related reductions in skeletal muscle tone appear largely restricted to muscles involved in maintaining head posture. Other local aspects of sleep manifest as a mixture of features of NREM and REM sleep occurring simultaneously in different parts of the neuroaxis. Like monotreme mammals, ostriches often exhibit brainstem-mediated features of REM sleep (muscle atonia and REMs) while the hyperpallium shows EEG slow waves typical of NREM sleep. Finally, although mice show slow waves in thalamic input layers of primary sensory cortices during REM sleep, this is not the case in the hyperpallium of pigeons, suggesting that this phenomenon is not a universal feature of REM sleep. Collectively, the local aspects of sleep described in birds and mammals reveal that wakefulness, NREM sleep, and REM sleep are not always discrete states.
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Affiliation(s)
- Niels C Rattenborg
- Avian Sleep Group, Max Planck Institute for Ornithology, Seewiesen, Germany
| | | | - Gabriël J L Beckers
- Cognitive Neurobiology and Helmholtz Institute, Utrecht University, Utrecht, Netherlands
| | - John A Lesku
- School of Life Sciences, La Trobe University, Melbourne, VIC, Australia
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Stefani A, Holzknecht E, Högl B. Clinical neurophysiology of REM parasomnias. HANDBOOK OF CLINICAL NEUROLOGY 2019; 161:381-396. [DOI: 10.1016/b978-0-444-64142-7.00062-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Sleep talking: A viable access to mental processes during sleep. Sleep Med Rev 2018; 44:12-22. [PMID: 30594004 DOI: 10.1016/j.smrv.2018.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 11/05/2018] [Accepted: 12/03/2018] [Indexed: 02/08/2023]
Abstract
Sleep talking is one of the most common altered nocturnal behaviours in the whole population. It does not represent a pathological condition and consists in the unaware production of vocalisations during sleep. Although in the last few decades we have experienced a remarkable increase in knowledge about cognitive processes and behavioural manifestations during sleep, the literature regarding sleep talking remains dated and fragmentary. We first provide an overview of historical and recent findings regarding sleep talking, and we then discuss the phenomenon in the context of mental activity during sleep. It is shown that verbal utterances, reflecting the ongoing dream content, may represent the unique possibility to access the dreamlike mental experience directly. Furthermore, we discuss such phenomena within a cognitive theoretical framework, considering both the atypical activation of psycholinguistic circuits during sleep and the implications of verbal 'replay' of recent learning in memory consolidation. Despite current knowledge on such a common experience being far from complete, an in-depth analysis of sleep talking episodes could offer interesting opportunities to address fundamental questions on dreaming or information processing during sleep. Further systematic polysomnographic and neuroimaging investigations are expected to shed new light on the manifestation of the phenomenon and related aspects.
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Ma J, Li S, Jiang F, Jin X, Zhang Y, Yan C, Tian Y, Shen X, Li F. Relationship between sleep patterns, sleep problems, and childhood enuresis. Sleep Med 2018; 50:14-20. [DOI: 10.1016/j.sleep.2018.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/06/2018] [Accepted: 05/07/2018] [Indexed: 01/18/2023]
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Fang Y, Kang X, Feng X, Zhao D, Song D, Li P. Conditional effects of mindfulness on sleep quality among clinical nurses: the moderating roles of extraversion and neuroticism. PSYCHOL HEALTH MED 2018; 24:481-492. [DOI: 10.1080/13548506.2018.1492731] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Yueyan Fang
- School of Nursing, Shandong University, Jinan, Shandong, P.R. China
| | - Xiaofei Kang
- School of Nursing, Shandong University, Jinan, Shandong, P.R. China
| | - Xiujuan Feng
- School of Nursing, Shandong University, Jinan, Shandong, P.R. China
| | - Di Zhao
- School of Nursing, Shandong University, Jinan, Shandong, P.R. China
| | - Donghua Song
- Operating Room, Shandong Tumor Hospital and Institute, Jinan, Shandong, P.R. China
| | - Ping Li
- School of Nursing, Shandong University, Jinan, Shandong, P.R. China
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Development of an Algorithm to Identify Patients with Physician-Documented Insomnia. Sci Rep 2018; 8:7862. [PMID: 29777125 PMCID: PMC5959894 DOI: 10.1038/s41598-018-25312-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 04/17/2018] [Indexed: 01/09/2023] Open
Abstract
We developed an insomnia classification algorithm by interrogating an electronic medical records (EMR) database of 314,292 patients. The patients received care at Massachusetts General Hospital (MGH), Brigham and Women’s Hospital (BWH), or both, between 1992 and 2010. Our algorithm combined structured variables (such as International Classification of Diseases 9th Revision [ICD-9] codes, prescriptions, laboratory observations) and unstructured variables (such as text mentions of sleep and psychiatric disorders in clinical narrative notes). The highest classification performance of our algorithm was achieved when it included a combination of structured variables (billing codes for insomnia, common psychiatric conditions, and joint disorders) and unstructured variables (sleep disorders and psychiatric disorders). Our algorithm had superior performance in identifying insomnia patients compared to billing codes alone (area under the receiver operating characteristic curve [AUROC] = 0.83 vs. 0.55 with 95% confidence intervals [CI] of 0.76–0.90 and 0.51–0.58, respectively). When applied to the 314,292-patient population, our algorithm classified 36,810 of the patients with insomnia, of which less than 17% had a billing code for insomnia. In conclusion, an insomnia classification algorithm that incorporates clinical notes is superior to one based solely on billing codes. Compared to traditional methods, our study demonstrates that a classification algorithm that incorporates physician notes can more accurately, comprehensively, and quickly identify large cohorts of insomnia patients.
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A systematic review of variables associated with sleep paralysis. Sleep Med Rev 2018; 38:141-157. [DOI: 10.1016/j.smrv.2017.05.005] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 05/29/2017] [Accepted: 05/30/2017] [Indexed: 11/19/2022]
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Dvir H, Elbaz I, Havlin S, Appelbaum L, Ivanov PC, Bartsch RP. Neuronal noise as an origin of sleep arousals and its role in sudden infant death syndrome. SCIENCE ADVANCES 2018; 4:eaar6277. [PMID: 29707639 PMCID: PMC5916514 DOI: 10.1126/sciadv.aar6277] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/08/2018] [Indexed: 06/08/2023]
Abstract
In addition to regular sleep/wake cycles, humans and animals exhibit brief arousals from sleep. Although much is known about consolidated sleep and wakefulness, the mechanism that triggers arousals remains enigmatic. Here, we argue that arousals are caused by the intrinsic neuronal noise of wake-promoting neurons. We propose a model that simulates the superposition of the noise from a group of neurons, and show that, occasionally, the superposed noise exceeds the excitability threshold and provokes an arousal. Because neuronal noise decreases with increasing temperature, our model predicts arousal frequency to decrease as well. To test this prediction, we perform experiments on the sleep/wake behavior of zebrafish larvae and find that increasing water temperatures lead to fewer and shorter arousals, as predicted by our analytic derivations and model simulations. Our findings indicate a previously unrecognized neurophysiological mechanism that links sleep arousals with temperature regulation, and may explain the origin of the clinically observed higher risk for sudden infant death syndrome with increased ambient temperature.
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Affiliation(s)
- Hila Dvir
- Department of Physics, Bar-Ilan University, Ramat Gan, Israel
| | - Idan Elbaz
- The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
- The Leslie and Susan Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Shlomo Havlin
- Department of Physics, Bar-Ilan University, Ramat Gan, Israel
| | - Lior Appelbaum
- The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
- The Leslie and Susan Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Plamen Ch. Ivanov
- Keck Laboratory for Network Physiology, Department of Physics, Boston University, Boston, MA 02215, USA
- Harvard Medical School and Division of Sleep Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Institute of Solid State Physics, Bulgarian Academy of Sciences, Sofia, Bulgaria
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Automatic sleep staging based on ECG signals using hidden Markov models. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2015:530-3. [PMID: 26736316 DOI: 10.1109/embc.2015.7318416] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study is designed to investigate the feasibility of automatic sleep staging using features only derived from electrocardiography (ECG) signal. The study was carried out using the framework of hidden Markov models (HMMs). The mean, and SD values of heart rates (HRs) computed from each 30-second epoch served as the features. The two feature sequences were first detrended by ensemble empirical mode decomposition (EEMD), formed as a two-dimensional feature vector, and then converted into code vectors by vector quantization (VQ) method. The output VQ indexes were utilized to estimate parameters for HMMs. The proposed model was tested and evaluated on a group of healthy individuals using leave-one-out cross-validation. The automatic sleep staging results were compared with PSG estimated ones. Results showed accuracies of 82.2%, 76.0%, 76.1% and 85.5% for deep, light, REM and wake sleep, respectively. The findings proved that HRs-based HMM approach is feasible for automatic sleep staging and can pave a way for developing more efficient, robust, and simple sleep staging system suitable for home application.
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