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Bressler S, Neely R, Yost RM, Wang D. A randomized controlled trial of alpha phase-locked auditory stimulation to treat symptoms of sleep onset insomnia. Sci Rep 2024; 14:13039. [PMID: 38844793 PMCID: PMC11156862 DOI: 10.1038/s41598-024-63385-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 05/28/2024] [Indexed: 06/09/2024] Open
Abstract
Sleep onset insomnia is a pervasive problem that contributes significantly to the poor health outcomes associated with insufficient sleep. Auditory stimuli phase-locked to slow-wave sleep oscillations have been shown to augment deep sleep, but it is unknown whether a similar approach can be used to accelerate sleep onset. The present randomized controlled crossover trial enrolled adults with objectively verified sleep onset latencies (SOLs) greater than 30 min to test the effect of auditory stimuli delivered at specific phases of participants' alpha oscillations prior to sleep onset. During the intervention week, participants wore an electroencephalogram (EEG)-enabled headband that delivered acoustic pulses timed to arrive anti-phase with alpha for 30 min (Stimulation). During the Sham week, the headband silently recorded EEG. The primary outcome was SOL determined by blinded scoring of EEG records. For the 21 subjects included in the analyses, stimulation had a significant effect on SOL according to a linear mixed effects model (p = 0.0019), and weekly average SOL decreased by 10.5 ± 15.9 min (29.3 ± 44.4%). These data suggest that phase-locked acoustic stimulation can be a viable alternative to pharmaceuticals to accelerate sleep onset in individuals with prolonged sleep onset latencies. Trial Registration: This trial was first registered on clinicaltrials.gov on 24/02/2023 under the name Sounds Locked to ElectroEncephalogram Phase For the Acceleration of Sleep Onset Time (SLEEPFAST), and assigned registry number NCT05743114.
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Affiliation(s)
- Scott Bressler
- Elemind Technologies, Inc., Cambridge, MA, USA
- Science and Research, Elemind Technologies, Inc., Cambridge, MA, 02139, USA
| | - Ryan Neely
- Elemind Technologies, Inc., Cambridge, MA, USA.
- Science and Research, Elemind Technologies, Inc., Cambridge, MA, 02139, USA.
| | - Ryan M Yost
- Elemind Technologies, Inc., Cambridge, MA, USA
- Science and Research, Elemind Technologies, Inc., Cambridge, MA, 02139, USA
| | - David Wang
- Elemind Technologies, Inc., Cambridge, MA, USA
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2
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Smith SK, Kafashan M, Rios RL, Brown EN, Landsness EC, Guay CS, Palanca BJA. Daytime dexmedetomidine sedation with closed-loop acoustic stimulation alters slow wave sleep homeostasis in healthy adults. BJA OPEN 2024; 10:100276. [PMID: 38571816 PMCID: PMC10990715 DOI: 10.1016/j.bjao.2024.100276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 02/29/2024] [Indexed: 04/05/2024]
Abstract
Background The alpha-2 adrenergic agonist dexmedetomidine induces EEG patterns resembling those of non-rapid eye movement (NREM) sleep. Fulfilment of slow wave sleep (SWS) homeostatic needs would address the assumption that dexmedetomidine induces functional biomimetic sleep states. Methods In-home sleep EEG recordings were obtained from 13 healthy participants before and after dexmedetomidine sedation. Dexmedetomidine target-controlled infusions and closed-loop acoustic stimulation were implemented to induce and enhance EEG slow waves, respectively. EEG recordings during sedation and sleep were staged using modified American Academy of Sleep Medicine criteria. Slow wave activity (EEG power from 0.5 to 4 Hz) was computed for NREM stage 2 (N2) and NREM stage 3 (N3/SWS) epochs, with the aggregate partitioned into quintiles by time. The first slow wave activity quintile served as a surrogate for slow wave pressure, and the difference between the first and fifth quintiles as a measure of slow wave pressure dissipation. Results Compared with pre-sedation sleep, post-sedation sleep showed reduced N3 duration (mean difference of -17.1 min, 95% confidence interval -30.0 to -8.2, P=0.015). Dissipation of slow wave pressure was reduced (P=0.02). Changes in combined durations of N2 and N3 between pre- and post-sedation sleep correlated with total dexmedetomidine dose, (r=-0.61, P=0.03). Conclusions Daytime dexmedetomidine sedation and closed-loop acoustic stimulation targeting EEG slow waves reduced N3/SWS duration and measures of slow wave pressure dissipation on the post-sedation night in healthy young adults. Thus, the paired intervention induces sleep-like states that fulfil certain homeostatic NREM sleep needs in healthy young adults. Clinical trial registration ClinicalTrials.gov NCT04206059.
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Affiliation(s)
- S. Kendall Smith
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Center on Biological Rhythms and Sleep, Washington University in St. Louis, St. Louis, MO, USA
| | - MohammadMehdi Kafashan
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Center on Biological Rhythms and Sleep, Washington University in St. Louis, St. Louis, MO, USA
| | - Rachel L. Rios
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Center on Biological Rhythms and Sleep, Washington University in St. Louis, St. Louis, MO, USA
| | - Emery N. Brown
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Eric C. Landsness
- Center on Biological Rhythms and Sleep, Washington University in St. Louis, St. Louis, MO, USA
- Department of Neurology, Division of Sleep Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Christian S. Guay
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ben Julian A. Palanca
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Center on Biological Rhythms and Sleep, Washington University in St. Louis, St. Louis, MO, USA
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Division of Biology and Biomedical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
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3
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Huwiler S, Carro-Domínguez M, Stich FM, Sala R, Aziri F, Trippel A, Ryf T, Markendorf S, Niederseer D, Bohm P, Stoll G, Laubscher L, Thevan J, Spengler CM, Gawinecka J, Osto E, Huber R, Wenderoth N, Schmied C, Lustenberger C. Auditory stimulation of sleep slow waves enhances left ventricular function in humans. Eur Heart J 2023; 44:4288-4291. [PMID: 37794725 PMCID: PMC10590124 DOI: 10.1093/eurheartj/ehad630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Affiliation(s)
- Stephanie Huwiler
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Manuel Carro-Domínguez
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Fabia M Stich
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Rossella Sala
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Florent Aziri
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Anna Trippel
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Tabea Ryf
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Susanne Markendorf
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Philipp Bohm
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Gloria Stoll
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Lily Laubscher
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Jeivicaa Thevan
- Institute of Clinical Chemistry, University Hospital Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Christina M Spengler
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
- Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich 8057, Switzerland
| | - Joanna Gawinecka
- Institute of Clinical Chemistry, University Hospital Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Elena Osto
- Institute of Clinical Chemistry, University Hospital Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Reto Huber
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich 8006, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich 8057, Switzerland
- Child Development Centre, University Children’s Hospital, University of Zurich, Zurich 8032, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital Zurich, University of Zurich, Zurich 8032, Switzerland
| | - Nicole Wenderoth
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich 8057, Switzerland
- Future Health Technologies, Singapore-ETH Center, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore 138602, Singapore
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Caroline Lustenberger
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich 8006, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich 8057, Switzerland
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4
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Kuo CF, Tsai CY, Cheng WH, Hs WH, Majumdar A, Stettler M, Lee KY, Kuan YC, Feng PH, Tseng CH, Chen KY, Kang JH, Lee HC, Wu CJ, Liu WT. Machine learning approaches for predicting sleep arousal response based on heart rate variability, oxygen saturation, and body profiles. Digit Health 2023; 9:20552076231205744. [PMID: 37846406 PMCID: PMC10576931 DOI: 10.1177/20552076231205744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/18/2023] Open
Abstract
Objective Obstructive sleep apnea is a global health concern, and several tools have been developed to screen its severity. However, most tools focus on respiratory events instead of sleep arousal, which can also affect sleep efficiency. This study employed easy-to-measure parameters-namely heart rate variability, oxygen saturation, and body profiles-to predict arousal occurrence. Methods Body profiles and polysomnography recordings were collected from 659 patients. Continuous heart rate variability and oximetry measurements were performed and then labeled based on the presence of sleep arousal. The dataset, comprising five body profiles, mean heart rate, six heart rate variability, and five oximetry variables, was then split into 80% training/validation and 20% testing datasets. Eight machine learning approaches were employed. The model with the highest accuracy, area under the receiver operating characteristic curve, and area under the precision recall curve values in the training/validation dataset was applied to the testing dataset and to determine feature importance. Results InceptionTime, which exhibited superior performance in predicting sleep arousal in the training dataset, was used to classify the testing dataset and explore feature importance. In the testing dataset, InceptionTime achieved an accuracy of 76.21%, an area under the receiver operating characteristic curve of 84.33%, and an area under the precision recall curve of 86.28%. The standard deviations of time intervals between successive normal heartbeats and the square roots of the means of the squares of successive differences between normal heartbeats were predominant predictors of arousal occurrence. Conclusions The established models can be considered for screening sleep arousal occurrence or integrated in wearable devices for home-based sleep examination.
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Affiliation(s)
- Chih-Fan Kuo
- School of Medicine, China Medical University, Taichung City, Taichung, Taiwan
- Artificial Intelligence Center, China Medical University Hospital, Taichung, Taiwan
- Department of Medical Education, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Wun-Hao Cheng
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Respiratory Therapy, Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wen-Hua Hs
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Arnab Majumdar
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Marc Stettler
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Yi-Chun Kuan
- Sleep Center, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
- Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
| | - Po-Hao Feng
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Chien-Hua Tseng
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Kuan-Yuan Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Jiunn-Horng Kang
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Cheng-Jung Wu
- Department of Otolaryngology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Wen-Te Liu
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Sleep Center, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
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5
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Ruch S, Schmidig FJ, Knüsel L, Henke K. Closed-loop modulation of local slow oscillations in human NREM sleep. Neuroimage 2022; 264:119682. [PMID: 36240988 DOI: 10.1016/j.neuroimage.2022.119682] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022] Open
Abstract
Slow-wave sleep is the deep non-rapid eye-movement (NREM) sleep stage that is most relevant for the recuperative function of sleep. Its defining property is the presence of slow oscillations (<2 Hz) in the scalp electroencephalogram (EEG). Slow oscillations are generated by a synchronous back and forth between highly active UP-states and silent DOWN-states in neocortical neurons. Growing evidence suggests that closed-loop sensory stimulation targeted at UP-states of EEG-defined slow oscillations can enhance the slow oscillatory activity, increase sleep depth, and boost sleep's recuperative functions. However, several studies failed to replicate such findings. Failed replications might be due to the use of conventional closed-loop stimulation algorithms that analyze the signal from one single electrode and thereby neglect the fact that slow oscillations vary with respect to their origins, distributions, and trajectories on the scalp. In particular, conventional algorithms nonspecifically target functionally heterogeneous UP-states of distinct origins. After all, slow oscillations at distinct sites of the scalp have been associated with distinct functions. Here we present a novel EEG-based closed-loop stimulation algorithm that allows targeting UP- and DOWN-states of distinct cerebral origins based on topographic analyses of the EEG: the topographic targeting of slow oscillations (TOPOSO) algorithm. We present evidence that the TOPOSO algorithm can detect and target local slow oscillations with specific, predefined voltage maps on the scalp in real-time. When compared to a more conventional, single-channel-based approach, TOPOSO leads to fewer but locally more specific stimulations in a simulation study. In a validation study with napping participants, TOPOSO targets auditory stimulation reliably at local UP-states over frontal, sensorimotor, and centro-parietal regions. Importantly, auditory stimulation temporarily enhanced the targeted local state. However, stimulation then elicited a standard frontal slow oscillation rather than local slow oscillations. The TOPOSO algorithm is suitable for the modulation and the study of the functions of local slow oscillations.
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Affiliation(s)
- Simon Ruch
- Institute for Neuromodulation and Neurotechnology, Department of Neurosurgery and Neurotechnology, University Hospital and University of Tuebingen, Otfried-Müller-Str. 45, Tübingen 72076, Germany; Cognitive Neuroscience of Memory and Consciousness, Institute of Psychology, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland.
| | - Flavio Jean Schmidig
- Cognitive Neuroscience of Memory and Consciousness, Institute of Psychology, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Leona Knüsel
- Cognitive Neuroscience of Memory and Consciousness, Institute of Psychology, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Katharina Henke
- Cognitive Neuroscience of Memory and Consciousness, Institute of Psychology, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
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6
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Debellemanière E, Pinaud C, Schneider J, Arnal PJ, Casson AJ, Chennaoui M, Galtier M, Navarrete M, Lewis PA. Optimising sounds for the driving of sleep oscillations by closed-loop auditory stimulation. J Sleep Res 2022; 31:e13676. [PMID: 35762085 PMCID: PMC9788124 DOI: 10.1111/jsr.13676] [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: 10/02/2021] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 12/30/2022]
Abstract
Recent studies have shown that slow oscillations (SOs) can be driven by rhythmic auditory stimulation, which deepens slow-wave sleep (SWS) and improves memory and the immune-supportive hormonal milieu related to this sleep stage. While different attempts have been made to optimise the driving of the SOs by changing the number of click stimulations, no study has yet investigated the impact of applying more than five clicks in a row. Likewise, the importance of the type of sounds in eliciting brain responses is presently unclear. In a study of 12 healthy young participants (10 females; aged 18-26 years), we applied an established closed-loop stimulation method, which delivered sequences of 10 pink noises, 10 pure sounds (B note of 247 Hz), 10 pronounced "a" vowels, 10 sham, 10 variable sounds, and 10 "oddball" sounds on the up phase of the endogenous SOs. By analysing area under the curve, amplitude, and event related potentials, we explored whether the nature of the sound had a differential effect on driving SOs. We showed that every stimulus in a 10-click sequence, induces a SO response. Interestingly, all three types of sounds that we tested triggered SOs. However, pink noise elicited a more pronounced response compared to the other sounds, which was explained by a broader topographical recruitment of brain areas. Our data further suggest that varying the sounds may partially counteract habituation.
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Affiliation(s)
- Eden Debellemanière
- Unité Fatigue et VigilanceInstitut de recherche biomédicale des armées (IRBA)Brétigny sur OrgeFrance,EA7330 VIFASOM, Hôtel DieuUniversité Paris 5 DescartesParisFrance,Research Team, DreemParisFrance
| | | | - Jules Schneider
- School of Biological Sciencesthe University of ManchesterManchesterUK,CUBRIC, Psychology DepartmentCardiff UniversityCardiffUK
| | | | - Alexander J. Casson
- School of Electrical and Electronic Engineeringthe University of ManchesterManchesterUK
| | - Mounir Chennaoui
- Unité Fatigue et VigilanceInstitut de recherche biomédicale des armées (IRBA)Brétigny sur OrgeFrance,EA7330 VIFASOM, Hôtel DieuUniversité Paris 5 DescartesParisFrance
| | | | - Miguel Navarrete
- School of Biomedical EngineeringUniversity of Los AndesBogotáColombia
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7
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Wilckens KA, Jeon B, Morris JL, Buysse DJ, Chasens ER. Effects of continuous positive airway pressure treatment on sleep architecture in adults with obstructive sleep apnea and type 2 diabetes. Front Hum Neurosci 2022; 16:924069. [PMID: 36177385 PMCID: PMC9513763 DOI: 10.3389/fnhum.2022.924069] [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: 04/20/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022] Open
Abstract
Obstructive sleep apnea (OSA) severely impacts sleep and has long-term health consequences. Treating sleep apnea with continuous positive airway pressure (CPAP) not only relieves obstructed breathing, but also improves sleep. CPAP improves sleep by reducing apnea-induced awakenings. CPAP may also improve sleep by enhancing features of sleep architecture assessed with electroencephalography (EEG) that maximize sleep depth and neuronal homeostasis, such as the slow oscillation and spindle EEG activity, and by reducing neurophysiological arousal during sleep (i.e., beta EEG activity). We examined cross-sectional differences in quantitative EEG characteristics of sleep, assessed with power spectral analysis, in 29 adults with type 2 diabetes treated with CPAP and 24 adults undergoing SHAM CPAP treatment (total n = 53). We then examined changes in spectral characteristics of sleep as the SHAM group crossed over to active CPAP treatment (n = 19). Polysomnography (PSG) from the CPAP titration night was used for the current analyses. Analyses focused on EEG frequencies associated with sleep maintenance and arousal. These included the slow oscillation (0.5–1 Hz), sigma activity (12–16 Hz, spindle activity), and beta activity (16–20 Hz) in F3, F4, C3, and C4 EEG channels. Whole night non-rapid eye movement (NREM) sleep and the first period of NREM spectral activity were examined. Age and sex were included as covariates. There were no group differences between CPAP and SHAM in spectral characteristics of sleep architecture. However, SHAM cross-over to active CPAP was associated with an increase in relative 12–16 Hz sigma activity across the whole night and a decrease in average beta activity across the whole night. Relative slow oscillation power within the first NREM period decreased with CPAP, particularly for frontal channels. Sigma and beta activity effects did not differ by channel. These findings suggest that CPAP may preferentially enhance spindle activity and mitigate neurophysiological arousal. These findings inform the neurophysiological mechanisms of improved sleep with CPAP and the utility of quantitative EEG measures of sleep as a treatment probe of improvements in neurological and physical health with CPAP.
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Affiliation(s)
- Kristine A Wilckens
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bomin Jeon
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jonna L Morris
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Daniel J Buysse
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Eileen R Chasens
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
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8
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Ngo HVV, Antony JW, Rasch B. Real-time stimulation during sleep: prior findings, novel developments, and future perspectives. J Sleep Res 2022; 31:e13735. [PMID: 36180062 DOI: 10.1111/jsr.13735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022]
Abstract
Real-time brain stimulation is a powerful technique that continues to gain importance in the field of sleep and cognition. In this special issue, we collected 14 articles about real-time stimulation during sleep, including one review, 12 research articles and one letter covering both human and rodent research from various fields. We hope this special issue sparks greater interest and inspires fellow sleep researchers and clinicians to develop new ideas in the exciting topic of real-time stimulation.
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Affiliation(s)
- Hong-Viet V Ngo
- Department of Psychology, University of Lübeck, Lübeck, Germany.,Center for Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
| | - James W Antony
- Department of Psychology and Child Development, California Polytechnic State University, San Luis Obispo, California, USA
| | - Björn Rasch
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
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9
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Koo-Poeggel P, Neuwerk S, Petersen E, Grasshoff J, Mölle M, Martinetz T, Marshall L. Closed-loop acoustic stimulation during an afternoon nap to modulate subsequent encoding. J Sleep Res 2022; 31:e13734. [PMID: 36123957 DOI: 10.1111/jsr.13734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 11/27/2022]
Abstract
Sleep is able to contribute not only to memory consolidation, but also to post-sleep learning. The notion exists that either synaptic downscaling or another process during sleep increase post-sleep learning capacity. A correlation between augmentation of the sleep slow oscillation and hippocampal activation at encoding support the contribution of sleep to encoding of declarative memories. In the present study, the effect of closed-loop acoustic stimulation during an afternoon nap on post-sleep encoding of two verbal (word pairs, verbal learning and memory test) and non-verbal (figural pairs) tasks and on electroencephalogram during sleep and learning were investigated in young healthy adults (N = 16). Closed-loop acoustic stimulation enhanced slow oscillatory and spindle activity, but did not affect encoding at the group level. Subgroup analyses and comparisons with similar studies lead us to the tentative conclusion that further parameters such as time of day and subjects' cognitive ability influenced responses to closed-loop acoustic stimulation.
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Affiliation(s)
- Ping Koo-Poeggel
- Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany.,Institute for Experimental and Clinical Pharmacology and Toxicology, University of Luebeck, Luebeck, Germany
| | - Soé Neuwerk
- Institute for Experimental and Clinical Pharmacology and Toxicology, University of Luebeck, Luebeck, Germany
| | - Eike Petersen
- Institute for Electrical and Engineering in Medicine, University of Luebeck, Luebeck, Germany.,DTU Compute, Technical University of Denmark, Denmark
| | - Jan Grasshoff
- Fraunhofer IMTE, Fraunhofer Research Institution for Individualized and Cell-Based Medical Engineering, Lübeck, Germany
| | - Matthias Mölle
- Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
| | - Thomas Martinetz
- Institute for Neuro- and Bioinformatics, University of Luebeck, Luebeck, Germany
| | - Lisa Marshall
- Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany.,Institute for Experimental and Clinical Pharmacology and Toxicology, University of Luebeck, Luebeck, Germany
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10
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Abstract
Over the past few decades, the importance of sleep has become increasingly recognized for many physiologic functions, including cognition. Many studies have reported the deleterious effect of sleep loss or sleep disruption on cognitive performance. Beyond ensuring adequate sleep quality and duration, discovering methods to enhance sleep to augment its restorative effects is important to improve learning in many populations, such as the military, students, age-related cognitive decline, and cognitive disorders.
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Affiliation(s)
- Roneil G Malkani
- Division of Sleep Medicine, Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, 710 North Lake Shore Drive, Suite 525, Chicago, IL 60611, USA; Jesse Brown Veterans Affairs Medical Center, Chicago, IL 60612, USA.
| | - Phyllis C Zee
- Division of Sleep Medicine, Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, 710 North Lake Shore Drive, Suite 520, Chicago, IL 60611, USA
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11
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Anderson C. Acoustic enhancement of slow wave sleep—timing and tone: “the details create the big picture”. Sleep 2022; 45:6672582. [DOI: 10.1093/sleep/zsac191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Clare Anderson
- School of Psychological Sciences and Turner Institute for brain and Mental Health, Monash University , Clayton 3800 , Australia
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12
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Besedovsky L, Cordi M, Wißlicen L, Martínez-Albert E, Born J, Rasch B. Hypnotic enhancement of slow-wave sleep increases sleep-associated hormone secretion and reduces sympathetic predominance in healthy humans. Commun Biol 2022; 5:747. [PMID: 35882899 PMCID: PMC9325885 DOI: 10.1038/s42003-022-03643-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 06/27/2022] [Indexed: 11/30/2022] Open
Abstract
Sleep is important for normal brain and body functioning, and for this, slow-wave sleep (SWS), the deepest stage of sleep, is assumed to be especially relevant. Previous studies employing methods to enhance SWS have focused on central nervous components of this sleep stage. However, SWS is also characterized by specific changes in the body periphery, which are essential mediators of the health-benefitting effects of sleep. Here we show that enhancing SWS in healthy humans using hypnotic suggestions profoundly affects the two major systems linking the brain with peripheral body functions, i.e., the endocrine and the autonomic nervous systems (ANS). Specifically, hypnotic suggestions presented at the beginning of a 90-min afternoon nap to promote subsequent SWS strongly increased the release of growth hormone (GH) and, to a lesser extent, of prolactin and aldosterone, and shifted the sympathovagal balance towards reduced sympathetic predominance. Thus, the hypnotic suggestions induced a whole-body pattern characteristic of natural SWS. Given that the affected parameters regulate fundamental physiological functions like metabolism, cardiovascular activity, and immunity, our findings open up a wide range of potential applications of hypnotic SWS enhancement, in addition to advancing our knowledge on the physiology of human SWS. The hypnotic enhancement of slow wave sleep, the deepest stage of sleep, goes beyond the central nervous system, causing changes at the level of the endocrine and the autonomic nervous systems.
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Affiliation(s)
- Luciana Besedovsky
- Institute of Medical Psychology, LMU Munich, Munich, Germany. .,Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany.
| | - Maren Cordi
- Department of Psychology, Division of Biopsychology and Methods, University of Fribourg, Fribourg, Switzerland
| | - Laura Wißlicen
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Estefanía Martínez-Albert
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Jan Born
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Björn Rasch
- Department of Psychology, Division of Biopsychology and Methods, University of Fribourg, Fribourg, Switzerland.
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13
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Grigg-Damberger MM, Foldvary-Schaefer N. Sleep Biomarkers Help Predict the Development of Alzheimer Disease. J Clin Neurophysiol 2022; 39:327-334. [PMID: 35239558 DOI: 10.1097/wnp.0000000000000818] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SUMMARY Middle-aged or older adults who self-report sleep-wake disorders are at an increased risk for incident dementia, mild cognitive impairment, and Alzheimer disease. Dementia in people with mild cognitive impairment and Alzheimer disease who complain of sleep-wake disorders progress faster than those without sleep-wake disorders. Removal of amyloid-beta and tau tangles occurs preferentially in non-rapid eye movement 3 sleep and fragmented or insufficient sleep may lead to accumulation of these neurotoxins even in preclinical stages. Selective atrophy in the medial temporal lobe on brain MRI has been shown to predict impaired coupling of slow oscillations and sleep spindles. Impaired slow wave-spindle coupling has been shown to correlate with impaired overnight memory consolidation. Whereas, a decrease in the amplitude of 0.6 to 1 Hz slow wave activity predicts higher cortical Aβ burden on amyloid PET scans. Overexpression of the wake-promoting neurotransmitter orexin may predispose patients with mild cognitive impairment and Alzheimer disease to increased wakefulness, decreasing time they need to clear from the brain the neurotoxic accumulation of amyloid-beta and especially tau. More research exploring these relationships is needed and continuing.
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14
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Translational Approaches to Influence Sleep and Arousal. Brain Res Bull 2022; 185:140-161. [PMID: 35550156 PMCID: PMC9554922 DOI: 10.1016/j.brainresbull.2022.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/27/2022] [Accepted: 05/03/2022] [Indexed: 12/16/2022]
Abstract
Sleep disorders are widespread in society and are prevalent in military personnel and in Veterans. Disturbances of sleep and arousal mechanisms are common in neuropsychiatric disorders such as schizophrenia, post-traumatic stress disorder, anxiety and affective disorders, traumatic brain injury, dementia, and substance use disorders. Sleep disturbances exacerbate suicidal ideation, a major concern for Veterans and in the general population. These disturbances impair quality of life, affect interpersonal relationships, reduce work productivity, exacerbate clinical features of other disorders, and impair recovery. Thus, approaches to improve sleep and modulate arousal are needed. Basic science research on the brain circuitry controlling sleep and arousal led to the recent approval of new drugs targeting the orexin/hypocretin and histamine systems, complementing existing drugs which affect GABAA receptors and monoaminergic systems. Non-invasive brain stimulation techniques to modulate sleep and arousal are safe and show potential but require further development to be widely applicable. Invasive viral vector and deep brain stimulation approaches are also in their infancy but may be used to modulate sleep and arousal in severe neurological and psychiatric conditions. Behavioral, pharmacological, non-invasive brain stimulation and cell-specific invasive approaches covered here suggest the potential to selectively influence arousal, sleep initiation, sleep maintenance or sleep-stage specific phenomena such as sleep spindles or slow wave activity. These manipulations can positively impact the treatment of a wide range of neurological and psychiatric disorders by promoting the restorative effects of sleep on memory consolidation, clearance of toxic metabolites, metabolism, and immune function and by decreasing hyperarousal.
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15
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Lustenberger C, Ferster ML, Huwiler S, Brogli L, Werth E, Huber R, Karlen W. Auditory deep sleep stimulation in older adults at home: a randomized crossover trial. COMMUNICATIONS MEDICINE 2022; 2:30. [PMID: 35603302 PMCID: PMC9053232 DOI: 10.1038/s43856-022-00096-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Auditory stimulation has emerged as a promising tool to enhance non-invasively sleep slow waves, deep sleep brain oscillations that are tightly linked to sleep restoration and are diminished with age. While auditory stimulation showed a beneficial effect in lab-based studies, it remains unclear whether this stimulation approach could translate to real-life settings. Methods We present a fully remote, randomized, cross-over trial in healthy adults aged 62-78 years (clinicaltrials.gov: NCT03420677). We assessed slow wave activity as the primary outcome and sleep architecture and daily functions, e.g., vigilance and mood as secondary outcomes, after a two-week mobile auditory slow wave stimulation period and a two-week Sham period, interleaved with a two-week washout period. Participants were randomized in terms of which intervention condition will take place first using a blocked design to guarantee balance. Participants and experimenters performing the assessments were blinded to the condition. Results Out of 33 enrolled and screened participants, we report data of 16 participants that received identical intervention. We demonstrate a robust and significant enhancement of slow wave activity on the group-level based on two different auditory stimulation approaches with minor effects on sleep architecture and daily functions. We further highlight the existence of pronounced inter- and intra-individual differences in the slow wave response to auditory stimulation and establish predictions thereof. Conclusions While slow wave enhancement in healthy older adults is possible in fully remote settings, pronounced inter-individual differences in the response to auditory stimulation exist. Novel personalization solutions are needed to address these differences and our findings will guide future designs to effectively deliver auditory sleep stimulations using wearable technology.
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Affiliation(s)
- Caroline Lustenberger
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich and ETH Zurich, Zurich, Switzerland
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
| | - M. Laura Ferster
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Stephanie Huwiler
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Luzius Brogli
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Institute of Biomedical Engineering, Universität Ulm, Ulm, Germany
| | - Esther Werth
- Neuroscience Center Zurich (ZNZ), University of Zurich and ETH Zurich, Zurich, Switzerland
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Reto Huber
- Neuroscience Center Zurich (ZNZ), University of Zurich and ETH Zurich, Zurich, Switzerland
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
- Child Development Centre, University Children’s Hospital, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Walter Karlen
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Institute of Biomedical Engineering, Universität Ulm, Ulm, Germany
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16
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Navarrete M, Arthur S, Treder MS, Lewis PA. Ongoing neural oscillations predict the post-stimulus outcome of closed loop auditory stimulation during slow-wave sleep. Neuroimage 2022; 253:119055. [PMID: 35276365 DOI: 10.1016/j.neuroimage.2022.119055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/26/2022] [Accepted: 03/01/2022] [Indexed: 10/18/2022] Open
Abstract
Large slow oscillations (SO, 0.5-2 Hz) characterise slow-wave sleep and are crucial to memory consolidation and other physiological functions. Manipulating slow oscillations may enhance sleep and memory, as well as benefitting the immune system. Closed-loop auditory stimulation (CLAS) has been demonstrated to increase the SO amplitude and to boost fast sleep spindle activity (11-16 Hz). Nevertheless, not all such stimuli are effective in evoking SOs, even when they are precisely phase locked. Here, we studied what factors of the ongoing activity patterns may help to determine what oscillations to stimulate to effectively enhance SOs or SO-locked spindle activity. Hence, we trained classifiers using the morphological characteristics of the ongoing SO, as measured by electroencephalography (EEG), to predict whether stimulation would lead to a benefit in terms of the resulting SO and spindle amplitude. Separate classifiers were trained using trials from spontaneous control and stimulated datasets, and we evaluated their performance by applying them to held-out data both within and across conditions. We were able to predict both when large SOs occurred spontaneously, and whether a phase-locked auditory click effectively enlarged them with good accuracy for predicting the SO trough (∼70%) and SO peak values (∼80%). Also, we were able to predict when stimulation would elicit spindle activity with an accuracy of ∼60%. Finally, we evaluate the importance of the various SO features used to make these predictions. Our results offer new insight into SO and spindle dynamics and may suggest techniques for developing future methods for online optimization of stimulation.
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Affiliation(s)
- Miguel Navarrete
- Cardiff University Brain Research Imaging Center (CUBRIC), School of Psychology, Cardiff University, Maindy Rd, Cardiff CF24 4HQ, UK.
| | - Steven Arthur
- School of Computer Science and Informatics, Cardiff University, Queen's Buildings, 5 The Parade, Roath, Cardiff CF24 3AA, UK
| | - Matthias S Treder
- School of Computer Science and Informatics, Cardiff University, Queen's Buildings, 5 The Parade, Roath, Cardiff CF24 3AA, UK
| | - Penelope A Lewis
- Cardiff University Brain Research Imaging Center (CUBRIC), School of Psychology, Cardiff University, Maindy Rd, Cardiff CF24 4HQ, UK.
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17
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Johnson JM, Durrant SJ, Law GR, Santiago J, Scott EM, Curtis F. The effect of slow-wave sleep and rapid eye-movement sleep interventions on glycaemic control: a systematic review and meta-analysis of randomised controlled trials. Sleep Med 2022; 92:50-58. [DOI: 10.1016/j.sleep.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/04/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
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18
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Gomez-Merino D, Drogou C, Debellemaniere E, Erblang M, Dorey R, Guillard M, Van Beers P, Thouard M, Masson R, Sauvet F, Leger D, Bougard C, Arnal PJ, Rabat A, Chennaoui M. Strategies to Limit Cognitive Impairments under Sleep Restriction: Relationship to Stress Biomarkers. Brain Sci 2022; 12:brainsci12020229. [PMID: 35203992 PMCID: PMC8869873 DOI: 10.3390/brainsci12020229] [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] [Received: 12/10/2021] [Revised: 01/29/2022] [Accepted: 02/04/2022] [Indexed: 02/01/2023] Open
Abstract
Adding relaxation techniques during nap or auditory stimulation of EEG slow oscillation (SO) during nighttime sleep may limit cognitive impairments in sleep-deprived subjects, potentially through alleviating stress-releasing effects. We compared daytime sleepiness, cognitive performances, and salivary stress biomarker responses in 11 volunteers (aged 18–36) who underwent 5 days of sleep restriction (SR, 3 h per night, with 30 min of daily nap) under three successive conditions: control (SR-CT), relaxation techniques added to daily nap (SR-RT), and auditory stimulation of sleep slow oscillations (SO) during nighttime sleep (SR-NS). Test evaluation was performed at baseline (BASE), the fifth day of chronic SR (SR5), and the third and fifth days after sleep recovery (REC3, REC5, respectively). At SR5, less degradation was observed for percentage of commission errors in the executive Go–noGo inhibition task in SR-RT condition compared to SR-CT, and for sleepiness score in SR-NS condition compared both to SR-CT and SR-RT. Beneficial effects of SR-RT and SR-NS were additionally observed on these two parameters and on salivary α-amylase (sAA) at REC3 and REC5. Adding relaxation techniques to naps may help performance in inhibition response, and adding nocturnal auditory stimulation of SO sleep may benefit daytime sleepiness during sleep restriction with persistent effects during recovery. The two strategies activated the autonomic nervous system, as shown by the sAA response.
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Affiliation(s)
- Danielle Gomez-Merino
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223 Bretigny-sur-Orge, France; (C.D.); (E.D.); (M.E.); (R.D.); (M.G.); (P.V.B.); (F.S.); (C.B.); (A.R.)
- VIgilance FAtigue SOMmeil et Santé Publique, Université de Paris, 75004 Paris, France;
- Correspondence: (D.G.-M.); (M.C.)
| | - Catherine Drogou
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223 Bretigny-sur-Orge, France; (C.D.); (E.D.); (M.E.); (R.D.); (M.G.); (P.V.B.); (F.S.); (C.B.); (A.R.)
- VIgilance FAtigue SOMmeil et Santé Publique, Université de Paris, 75004 Paris, France;
| | - Eden Debellemaniere
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223 Bretigny-sur-Orge, France; (C.D.); (E.D.); (M.E.); (R.D.); (M.G.); (P.V.B.); (F.S.); (C.B.); (A.R.)
- VIgilance FAtigue SOMmeil et Santé Publique, Université de Paris, 75004 Paris, France;
- Dreem SAS, 75009 Paris, France;
| | - Mégane Erblang
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223 Bretigny-sur-Orge, France; (C.D.); (E.D.); (M.E.); (R.D.); (M.G.); (P.V.B.); (F.S.); (C.B.); (A.R.)
- VIgilance FAtigue SOMmeil et Santé Publique, Université de Paris, 75004 Paris, France;
| | - Rodolphe Dorey
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223 Bretigny-sur-Orge, France; (C.D.); (E.D.); (M.E.); (R.D.); (M.G.); (P.V.B.); (F.S.); (C.B.); (A.R.)
- VIgilance FAtigue SOMmeil et Santé Publique, Université de Paris, 75004 Paris, France;
| | - Mathias Guillard
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223 Bretigny-sur-Orge, France; (C.D.); (E.D.); (M.E.); (R.D.); (M.G.); (P.V.B.); (F.S.); (C.B.); (A.R.)
- VIgilance FAtigue SOMmeil et Santé Publique, Université de Paris, 75004 Paris, France;
| | - Pascal Van Beers
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223 Bretigny-sur-Orge, France; (C.D.); (E.D.); (M.E.); (R.D.); (M.G.); (P.V.B.); (F.S.); (C.B.); (A.R.)
- VIgilance FAtigue SOMmeil et Santé Publique, Université de Paris, 75004 Paris, France;
| | | | - Robin Masson
- Ecole du Val de Grace, 75005 Paris, France; (M.T.); (R.M.)
| | - Fabien Sauvet
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223 Bretigny-sur-Orge, France; (C.D.); (E.D.); (M.E.); (R.D.); (M.G.); (P.V.B.); (F.S.); (C.B.); (A.R.)
- VIgilance FAtigue SOMmeil et Santé Publique, Université de Paris, 75004 Paris, France;
| | - Damien Leger
- VIgilance FAtigue SOMmeil et Santé Publique, Université de Paris, 75004 Paris, France;
- Centre du Sommeil et de la Vigilance, APHP, Hôpital Hôtel-Dieu, 75004 Paris, France
| | - Clément Bougard
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223 Bretigny-sur-Orge, France; (C.D.); (E.D.); (M.E.); (R.D.); (M.G.); (P.V.B.); (F.S.); (C.B.); (A.R.)
- VIgilance FAtigue SOMmeil et Santé Publique, Université de Paris, 75004 Paris, France;
| | | | - Arnaud Rabat
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223 Bretigny-sur-Orge, France; (C.D.); (E.D.); (M.E.); (R.D.); (M.G.); (P.V.B.); (F.S.); (C.B.); (A.R.)
- VIgilance FAtigue SOMmeil et Santé Publique, Université de Paris, 75004 Paris, France;
| | - Mounir Chennaoui
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223 Bretigny-sur-Orge, France; (C.D.); (E.D.); (M.E.); (R.D.); (M.G.); (P.V.B.); (F.S.); (C.B.); (A.R.)
- VIgilance FAtigue SOMmeil et Santé Publique, Université de Paris, 75004 Paris, France;
- Correspondence: (D.G.-M.); (M.C.)
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19
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Henao D, Navarrete M, Juez JY, Dinh H, Gómez R, Valderrama M, Le Van Quyen M. Auditory closed‐loop stimulation on sleep slow oscillations using in‐ear EEG sensors. J Sleep Res 2022; 31:e13555. [DOI: 10.1111/jsr.13555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 11/30/2022]
Affiliation(s)
- David Henao
- Department of Biomedical Engineering Universidad de Los Andes Bogotá D.C. Colombia
| | - Miguel Navarrete
- Department of Biomedical Engineering Universidad de Los Andes Bogotá D.C. Colombia
- Cardiff University Brain Research Imaging Centre (CUBRIC) School of Psychology Cardiff University Cardiff UK
| | - José Yesith Juez
- Department of Biomedical Engineering Universidad de Los Andes Bogotá D.C. Colombia
| | | | - Rodrigo Gómez
- Department of Biomedical Engineering Universidad de Los Andes Bogotá D.C. Colombia
| | - Mario Valderrama
- Department of Biomedical Engineering Universidad de Los Andes Bogotá D.C. Colombia
| | - Michel Le Van Quyen
- Laboratoire d’Imagerie Biomédicale (LIB) Inserm U1146/Sorbonne Université UMCR2/UMR7371 CNRS Paris France
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20
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Krugliakova E, Skorucak J, Sousouri G, Leach S, Snipes S, Ferster ML, Da Poian G, Karlen W, Huber R. Boosting Recovery During Sleep by Means of Auditory Stimulation. Front Neurosci 2022; 16:755958. [PMID: 35185455 PMCID: PMC8847378 DOI: 10.3389/fnins.2022.755958] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
Sufficient recovery during sleep is the basis of physical and psychological well-being. Understanding the physiological mechanisms underlying this restorative function is essential for developing novel approaches to promote recovery during sleep. Phase-targeted auditory stimulation (PTAS) is an increasingly popular technique for boosting the key electrophysiological marker of recovery during sleep, slow-wave activity (SWA, 1-4 Hz EEG power). However, it is unknown whether PTAS induces physiological sleep. In this study, we demonstrate that, when applied during deep sleep, PTAS accelerates SWA decline across the night which is associated with an overnight improvement in attentional performance. Thus, we provide evidence that PTAS enhances physiological sleep and demonstrate under which conditions this occurs most efficiently. These findings will be important for future translation into clinical populations suffering from insufficient recovery during sleep.
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Affiliation(s)
- Elena Krugliakova
- Child Development Centre and Children’s Research Centre, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jelena Skorucak
- Child Development Centre and Children’s Research Centre, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Georgia Sousouri
- Child Development Centre and Children’s Research Centre, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Sven Leach
- Child Development Centre and Children’s Research Centre, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sophia Snipes
- Child Development Centre and Children’s Research Centre, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Maria Laura Ferster
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Giulia Da Poian
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Walter Karlen
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Reto Huber
- Child Development Centre and Children’s Research Centre, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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21
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Diep C, Ftouni S, Drummond SPA, Garcia‐Molina G, Anderson C. Heart rate variability increases following automated acoustic slow wave sleep enhancement. J Sleep Res 2022; 31:e13545. [DOI: 10.1111/jsr.13545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Charmaine Diep
- School of Psychological Sciences Turner Institute for Brain and Mental Health Monash University Clayton Victoria Australia
- Cooperative Research Centre for Alertness, Safety and Productivity Notting Hill Victoria Australia
| | - Suzanne Ftouni
- School of Psychological Sciences Turner Institute for Brain and Mental Health Monash University Clayton Victoria Australia
- Cooperative Research Centre for Alertness, Safety and Productivity Notting Hill Victoria Australia
| | - Sean P. A. Drummond
- School of Psychological Sciences Turner Institute for Brain and Mental Health Monash University Clayton Victoria Australia
| | - Gary Garcia‐Molina
- Department of Psychiatry University of Wisconsin‐Madison Madison Wisconsin USA
| | - Clare Anderson
- School of Psychological Sciences Turner Institute for Brain and Mental Health Monash University Clayton Victoria Australia
- Cooperative Research Centre for Alertness, Safety and Productivity Notting Hill Victoria Australia
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22
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Whitehurst LN, Subramoniam A, Krystal A, Prather AA. Links between the brain and body during sleep: implications for memory processing. Trends Neurosci 2022; 45:212-223. [PMID: 35074220 DOI: 10.1016/j.tins.2021.12.007] [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: 08/09/2021] [Revised: 11/30/2021] [Accepted: 12/21/2021] [Indexed: 10/19/2022]
Abstract
Sleep is intimately related to memory processes. The established view is that the transformation of experiences into long-term memories is linked to sleep-related CNS function. However, there is increasing evidence that the autonomic nervous system (ANS), long recognized to modulate cognition during waking, can impact memory processing during sleep. Here, we review human research that examines the role of autonomic activity and sleep in memory formation. We argue that autonomic activity during sleep may set the stage for the CNS dynamics associated with sleep and memory stability and integration. Further, we consider how the link between ANS activity and polysomnographic markers of sleep may help elucidate both healthy and pathological cognitive aging in humans.
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Affiliation(s)
| | | | - Andrew Krystal
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Aric A Prather
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
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Stich FM, Huwiler S, D'Hulst G, Lustenberger C. The Potential Role of Sleep in Promoting a Healthy Body Composition: Underlying Mechanisms Determining Muscle, Fat, and Bone Mass and Their Association with Sleep. Neuroendocrinology 2022; 112:673-701. [PMID: 34348331 DOI: 10.1159/000518691] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/22/2021] [Indexed: 11/19/2022]
Abstract
Sleep plays an essential role in human life. While sleep is a state elicited by the brain, its vital role reaches beyond maintaining brain health. Unhealthy sleeping habits have been associated with increased risk for inflammation, obesity, or diabetes. Evidence is emerging that sleep guides processes playing an important role in promoting the regulation of endocrine function involved in tissue regeneration and tissue remodelling. Thereby, sleep presumably is a critical factor contributing to the balance of core body tissues: bone, fat, and muscle mass. Given the increasing prevalence of various chronic diseases and comorbidities due to unhealthy lifestyle choices, sleep could be a key target to promote a healthy body composition up until old age. Here, we review the potential role of sleep and its underlying brain oscillations in body core tissues turnover. Specifically, we discuss potential underlying mechanisms linking sleep to body composition, both during rest and under challenging conditions. Among other described pathways, we highlight the possible role of the growth hormone that was found to be involved in the homeostasis of all core body tissues and has been strongly linked to brain activity dominating deep sleep, the so-called slow waves. Finally, we formulate important questions to be addressed in future research on the effect of sleep on body composition and specifically emphasize the importance of intervention studies to move from correlative to causal evidence.
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Affiliation(s)
- Fabia M Stich
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Stephanie Huwiler
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Gommaar D'Hulst
- Laboratory of Exercise and Health, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Caroline Lustenberger
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
- Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland
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24
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Stanyer EC, Baniqued PDE, Awais M, Kouara L, Davies AG, Killan EC, Mushtaq F. The impact of acoustic stimulation during sleep on memory and sleep architecture: A meta-analysis. J Sleep Res 2021; 31:e13385. [PMID: 34850995 DOI: 10.1111/jsr.13385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 04/12/2021] [Accepted: 04/19/2021] [Indexed: 11/28/2022]
Abstract
The relationship between sleep and cognition has long been recognized, with slow-wave sleep thought to play a critical role in long-term memory consolidation. Recent research has presented the possibility that non-invasive acoustic stimulation during sleep could enhance memory consolidation. Herein, we report a random-effects model meta-analysis examining the impact of this intervention on memory and sleep architecture in healthy adults. Sixteen studies were identified through a systematic search. We found a medium significant effect of acoustic stimulation on memory task performance (g = 0.68, p = .031) in young adults <35 years of age, but no statistically significant effect in adults >35 years of age (g = -0.83, p = .223). In young adults, there was a large statistically significant effect for declarative memory tasks (g = 0.87, p = .014) but no effect for non-declarative tasks (g = -0.25, p = .357). There were no statistically significant differences in polysomnography-derived sleep architecture values between sham and stimulation conditions in either young or older adults. Based on these results, it appears that acoustic stimulation during sleep may only be an effective intervention for declarative memory consolidation in young adults. However, the small number of studies in this area, their small sample sizes, the short-term nature of most investigations and the high between-studies heterogeneity highlight a need for high-powered and long-term experiments to better elucidate, and subsequently maximise, any potential benefits of this novel approach.
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Affiliation(s)
- Emily C Stanyer
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, West Yorkshire, UK.,Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paul Dominick E Baniqued
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, West Yorkshire, UK.,School of Mechanical Engineering, Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, West Yorkshire, UK
| | - Muhammad Awais
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, West Yorkshire, UK.,Department of Computer Science, Edgehill University, Ormskirk, Lancashire, UK
| | - Layla Kouara
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, West Yorkshire, UK
| | - Andrew G Davies
- Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, West Yorkshire, UK
| | - Edward C Killan
- Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, West Yorkshire, UK
| | - Faisal Mushtaq
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, West Yorkshire, UK
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25
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Mikutta C, Wenke M, Spiegelhalder K, Hertenstein E, Maier JG, Schneider CL, Fehér K, Koenig J, Altorfer A, Riemann D, Nissen C, Feige B. Co-ordination of brain and heart oscillations during non-rapid eye movement sleep. J Sleep Res 2021; 31:e13466. [PMID: 34467582 PMCID: PMC9285890 DOI: 10.1111/jsr.13466] [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: 03/03/2021] [Revised: 05/26/2021] [Accepted: 07/23/2021] [Indexed: 12/25/2022]
Abstract
Oscillatory activities of the brain and heart show a strong variation across wakefulness and sleep. Separate lines of research indicate that non‐rapid eye movement (NREM) sleep is characterised by electroencephalographic slow oscillations (SO), sleep spindles, and phase–amplitude coupling of these oscillations (SO–spindle coupling), as well as an increase in high‐frequency heart rate variability (HF‐HRV), reflecting enhanced parasympathetic activity. The present study aimed to investigate further the potential coordination between brain and heart oscillations during NREM sleep. Data were derived from one sleep laboratory night with polysomnographic monitoring in 45 healthy participants (22 male, 23 female; mean age 37 years). The associations between the strength (modulation index [MI]) and phase direction of SO–spindle coupling (circular measure) and HF‐HRV during NREM sleep were investigated using linear modelling. First, a significant SO–spindle coupling (MI) was observed for all participants during NREM sleep, with spindle peaks preferentially occurring during the SO upstate (phase direction). Second, linear model analyses of NREM sleep showed a significant relationship between the MI and HF‐HRV (F = 20.1, r2 = 0.30, p < 0.001) and a tentative circular‐linear correlation between phase direction and HF‐HRV (F = 3.07, r2 = 0.12, p = 0.056). We demonstrated a co‐ordination between SO–spindle phase–amplitude coupling and HF‐HRV during NREM sleep, presumably related to parallel central nervous and peripheral vegetative arousal systems regulation. Further investigating the fine‐graded co‐ordination of brain and heart oscillations might improve our understanding of the links between sleep and cardiovascular health.
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Affiliation(s)
- Christian Mikutta
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland.,Privatklinik Meiringen, Meiringen, Switzerland
| | - Marion Wenke
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Elisabeth Hertenstein
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Jonathan G Maier
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Carlotta L Schneider
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Kristoffer Fehér
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Andreas Altorfer
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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26
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Sousouri G, Krugliakova E, Skorucak J, Leach S, Snipes S, Ferster ML, Da Poian G, Karlen W, Huber R. Neuromodulation by means of phase-locked auditory stimulation affects key marker of excitability and connectivity during sleep. Sleep 2021; 45:6347149. [PMID: 34373925 DOI: 10.1093/sleep/zsab204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/15/2021] [Indexed: 11/12/2022] Open
Abstract
The propagating pattern of sleep slow waves (high-amplitude oscillations < 4.5 Hz) serves as a blueprint of cortical excitability and brain connectivity. Phase-locked auditory stimulation is a promising tool for the modulation of ongoing brain activity during sleep; however, its underlying mechanisms remain unknown. Here, eighteen healthy young adults were measured with high-density electroencephalography (hd-EEG) in three experimental conditions; one with no stimulation, one with up- and one with down-phase stimulation; ten participants were included in the analysis. We show that up-phase auditory stimulation on a right prefrontal area locally enhances cortical involvement and promotes traveling by increasing the propagating distance and duration of targeted small-amplitude waves. On the contrary, down-phase stimulation proves more efficient at perturbing large-amplitude waves and interferes with ongoing traveling by disengaging cortical regions and interrupting high synchronicity in the target area as indicated by increased traveling speed. These results point out to different underlying mechanisms mediating the effects of up- and down-phase stimulation and highlight the strength of traveling analysis as a sensitive and informative method for the study of connectivity and cortical excitability alterations.
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Affiliation(s)
- Georgia Sousouri
- Child Development Centre and Children's Research Centre, University Children's Hospital Zürich, University of Zurich, Zurich, Switzerland
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Elena Krugliakova
- Child Development Centre and Children's Research Centre, University Children's Hospital Zürich, University of Zurich, Zurich, Switzerland
| | - Jelena Skorucak
- Child Development Centre and Children's Research Centre, University Children's Hospital Zürich, University of Zurich, Zurich, Switzerland
| | - Sven Leach
- Child Development Centre and Children's Research Centre, University Children's Hospital Zürich, University of Zurich, Zurich, Switzerland
| | - Sophia Snipes
- Child Development Centre and Children's Research Centre, University Children's Hospital Zürich, University of Zurich, Zurich, Switzerland
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Maria Laura Ferster
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Giulia Da Poian
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Walter Karlen
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Reto Huber
- Child Development Centre and Children's Research Centre, University Children's Hospital Zürich, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zürich, Zurich, Switzerland
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27
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Real-Time Excitation of Slow Oscillations during Deep Sleep Using Acoustic Stimulation. SENSORS 2021; 21:s21155169. [PMID: 34372405 PMCID: PMC8347755 DOI: 10.3390/s21155169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 11/20/2022]
Abstract
Slow-wave synchronous acoustic stimulation is a promising research and therapeutic tool. It is essential to clearly understand the principles of the synchronization methods, to know their performances and limitations, and, most importantly, to have a clear picture of the effect of stimulation on slow-wave activity (SWA). This paper covers the mentioned and currently missing parts of knowledge that are essential for the appropriate development of the method itself and future applications. Artificially streamed real sleep EEG data were used to quantitatively compare the two currently used real-time methods: the phase-locking loop (PLL) and the fixed-step stimulus in our own implementation. The fixed-step stimulation method was concluded to be more reliable and practically applicable compared to the PLL method. The sleep experiment with chronic insomnia patients in our sleep laboratory was analyzed in order to precisely characterize the effect of sound stimulation during deep sleep. We found that there is a significant phase synchronization of delta waves, which were shown to be the most sensitive metric of the effect of acoustic stimulation compared to commonly used averaged signal and power analyses. This finding may change the understanding of the effect and function of the SWA stimulation described in the literature.
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28
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Chen P, Sattari N, Whitehurst LN, Mednick SC. Age-related losses in cardiac autonomic activity during a daytime nap. Psychophysiology 2021; 58:e13701. [PMID: 33048396 PMCID: PMC8041919 DOI: 10.1111/psyp.13701] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 12/12/2022]
Abstract
In healthy, young individuals, a reduction in cardiovascular output and a shift from sympathetic to parasympathetic (vagal) dominance is observed from wake into stages of nocturnal and daytime sleep. This cardiac autonomic profile, measured by heart rate variability (HRV), has been associated with significant benefits for cardiovascular health. Aging is associated with decreased nighttime sleep quality and lower parasympathetic activity during both sleep and resting. However, it is not known whether age-related dampening of HRV extends to daytime sleep, diminishing the cardiovascular benefits of naps in the elderly. Here, we investigated this question by comparing the autonomic activity profile between young and older healthy adults during a daytime nap and a similar period of wakefulness (quiet wake; QW). For each condition, from the electrocardiogram (ECG), we obtained beat-to-beat HRV intervals (RR), root mean square of successive differences between adjacent heart-beat-intervals (RMSSD), high-frequency (HF), low-frequency (LF) power, and total power (TP), HF normalized units (HFnu ), and the LF/HF ratio. As previously reported, young subjects showed a parasympathetic dominance during NREM, compared with REM, prenap rest, and WASO. Moreover, older, compared to younger, adults showed significantly lower vagally mediated HRV (measured by RMSSD, HF, HFnu ) during NREM. Interestingly, however, no age-related differences were detected during prenap rest or QW. Altogether, our findings suggest a sleep-specific reduction in parasympathetic modulation that is unique to NREM sleep in older adults.
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Affiliation(s)
- Pin‐Chun Chen
- Department of Cognitive ScienceUniversity of CaliforniaIrvineCAUSA
- Department of StatisticsUniversity of CaliforniaIrvineCAUSA
| | - Negin Sattari
- Department of Cognitive ScienceUniversity of CaliforniaIrvineCAUSA
| | | | - Sara C. Mednick
- Department of Cognitive ScienceUniversity of CaliforniaIrvineCAUSA
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29
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Navarrete M, Schneider J, Ngo HVV, Valderrama M, Casson AJ, Lewis PA. Examining the optimal timing for closed-loop auditory stimulation of slow-wave sleep in young and older adults. Sleep 2021; 43:5686285. [PMID: 31872860 PMCID: PMC7294407 DOI: 10.1093/sleep/zsz315] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/13/2019] [Indexed: 11/23/2022] Open
Abstract
Study Objectives Closed-loop auditory stimulation (CLAS) is a method for enhancing slow oscillations (SOs) through the presentation of auditory clicks during sleep. CLAS boosts SOs amplitude and sleep spindle power, but the optimal timing for click delivery remains unclear. Here, we determine the optimal time to present auditory clicks to maximize the enhancement of SO amplitude and spindle likelihood. Methods We examined the main factors predicting SO amplitude and sleep spindles in a dataset of 21 young and 17 older subjects. The participants received CLAS during slow-wave-sleep in two experimental conditions: sham and auditory stimulation. Post-stimulus SOs and spindles were evaluated according to the click phase on the SOs and compared between and within conditions. Results We revealed that auditory clicks applied anywhere on the positive portion of the SO increased SO amplitudes and spindle likelihood, although the interval of opportunity was shorter in the older group. For both groups, analyses showed that the optimal timing for click delivery is close to the SO peak phase. Click phase on the SO wave was the main factor determining the impact of auditory stimulation on spindle likelihood for young subjects, whereas for older participants, the temporal lag since the last spindle was a better predictor of spindle likelihood. Conclusions Our data suggest that CLAS can more effectively boost SOs during specific phase windows, and these differ between young and older participants. It is possible that this is due to the fluctuation of sensory inputs modulated by the thalamocortical networks during the SO.
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Affiliation(s)
- Miguel Navarrete
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Jules Schneider
- School of Biological Sciences, University of Manchester, Manchester, UK
| | - Hong-Viet V Ngo
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Mario Valderrama
- Department of Biomedical Engineering, University of Los Andes, Bogotá, Colombia
| | - Alexander J Casson
- School of Electrical and Electronic Engineering, University of Manchester, Manchester, UK
| | - Penelope A Lewis
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
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30
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Guay CS, Labonte AK, Montana MC, Landsness EC, Lucey BP, Kafashan M, Haroutounian S, Avidan MS, Brown EN, Palanca BJA. Closed-Loop Acoustic Stimulation During Sedation with Dexmedetomidine (CLASS-D): Protocol for a Within-Subject, Crossover, Controlled, Interventional Trial with Healthy Volunteers. Nat Sci Sleep 2021; 13:303-313. [PMID: 33692642 PMCID: PMC7939493 DOI: 10.2147/nss.s293160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/10/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The relative power of slow-delta oscillations in the electroencephalogram (EEG), termed slow-wave activity (SWA), correlates with level of unconsciousness. Acoustic enhancement of SWA has been reported for sleep states, but it remains unknown if pharmacologically induced SWA can be enhanced using sound. Dexmedetomidine is a sedative whose EEG oscillations resemble those of natural sleep. This pilot study was designed to investigate whether SWA can be enhanced using closed-loop acoustic stimulation during sedation (CLASS) with dexmedetomidine. METHODS Closed-Loop Acoustic Stimulation during Sedation with Dexmedetomidine (CLASS-D) is a within-subject, crossover, controlled, interventional trial with healthy volunteers. Each participant will be sedated with a dexmedetomidine target-controlled infusion (TCI). Participants will undergo three CLASS conditions in a multiple crossover design: in-phase (phase-locked to slow-wave upslopes), anti-phase (phase-locked to slow-wave downslopes) and sham (silence). High-density EEG recordings will assess the effects of CLASS across the scalp. A volitional behavioral task and sequential thermal arousals will assess the anesthetic effects of CLASS. Ambulatory sleep studies will be performed on nights immediately preceding and following the sedation session. EEG effects of CLASS will be assessed using linear mixed-effects models. The impacts of CLASS on behavior and arousal thresholds will be assessed using logistic regression modeling. Parametric modeling will determine differences in sleepiness and measures of sleep homeostasis before and after sedation. RESULTS The primary outcome of this pilot study is the effect of CLASS on EEG slow waves. Secondary outcomes include the effects of CLASS on the following: performance of a volitional task, arousal thresholds, and subsequent sleep. DISCUSSION This investigation will elucidate 1) the potential of exogenous sensory stimulation to potentiate SWA during sedation; 2) the physiologic significance of this intervention; and 3) the connection between EEG slow-waves observed during sleep and sedation.
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Affiliation(s)
- Christian S Guay
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Alyssa K Labonte
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Michael C Montana
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Eric C Landsness
- Department of Neurology, Division of Sleep Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Brendan P Lucey
- Department of Neurology, Division of Sleep Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - MohammadMehdi Kafashan
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Simon Haroutounian
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Michael S Avidan
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Emery N Brown
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ben Julian A Palanca
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Division of Biology and Biomedical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
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31
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Fehér KD, Wunderlin M, Maier JG, Hertenstein E, Schneider CL, Mikutta C, Züst MA, Klöppel S, Nissen C. Shaping the slow waves of sleep: A systematic and integrative review of sleep slow wave modulation in humans using non-invasive brain stimulation. Sleep Med Rev 2021; 58:101438. [PMID: 33582581 DOI: 10.1016/j.smrv.2021.101438] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 10/14/2020] [Accepted: 11/10/2020] [Indexed: 01/19/2023]
Abstract
The experimental study of electroencephalographic slow wave sleep (SWS) stretches over more than half a century and has corroborated its importance for basic physiological processes, such as brain plasticity, metabolism and immune system functioning. Alterations of SWS in aging or pathological conditions suggest that modulating SWS might constitute a window for clinically relevant interventions. This work provides a systematic and integrative review of SWS modulation through non-invasive brain stimulation in humans. A literature search using PubMed, conducted in May 2020, identified 3220 studies, of which 82 fulfilled inclusion criteria. Three approaches have been adopted to modulate the macro- and microstructure of SWS, namely auditory, transcranial electrical and transcranial magnetic stimulation. Our current knowledge about the modulatory mechanisms, the space of stimulation parameters and the physiological and behavioral effects are reported and evaluated. The integration of findings suggests that sleep slow wave modulation bears the potential to promote our understanding of the functions of SWS and to develop new treatments for conditions of disrupted SWS.
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Affiliation(s)
- Kristoffer D Fehér
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Marina Wunderlin
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Jonathan G Maier
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Elisabeth Hertenstein
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Carlotta L Schneider
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Christian Mikutta
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland; Privatklinik Meiringen, Meiringen, Switzerland
| | - Marc A Züst
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland.
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32
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Neurostimulation techniques to enhance sleep and improve cognition in aging. Neurobiol Dis 2020; 141:104865. [DOI: 10.1016/j.nbd.2020.104865] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/16/2020] [Accepted: 04/02/2020] [Indexed: 01/09/2023] Open
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Fröhlich F, Lustenberger C. Neuromodulation of sleep rhythms in schizophrenia: Towards the rational design of non-invasive brain stimulation. Schizophr Res 2020; 221:71-80. [PMID: 32354662 PMCID: PMC7316586 DOI: 10.1016/j.schres.2020.04.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 02/01/2023]
Abstract
Brain function critically depends on oscillatory synchronization of neuronal populations both during wake and sleep. Originally, neural oscillations have been discounted as an epiphenomenon. More recently, specific deficits in the structure of brain oscillations have been linked to psychiatric diseases. For example, schizophrenia is hallmarked by abnormalities in different brain oscillations. Key sleep rhythms during NEM sleep such as sleep spindles, which are implicated in memory consolidation and are related to cognitive functions, are strongly diminished in these patients compared to healthy controls. To date, it remains unclear whether these reductions in sleep oscillations are causal for the functional impairments observed in schizophrenia. The application of non-invasive brain stimulation permits the causal examination of brain network dynamics and will help to establish the causal association of sleep oscillations and symptoms of schizophrenia. To accomplish this, stimulation paradigms that selectively engage specific network targets such as sleep spindles or slow waves are needed. We propose that the successful development and application of these non-invasive brain stimulation approaches will require rational design that takes network dynamics and neuroanatomical information into account. The purpose of this article is to prepare the grounds for the next steps towards such rational design of non-invasive stimulation, with a special focus on electrical and auditory stimulation. First, we briefly summarize the deficits in network dynamics during sleep in schizophrenia. Then, we discuss today's and tomorrow's non-invasive brain stimulation modalities to engage these network targets.
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Affiliation(s)
- Flavio Fröhlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Caroline Lustenberger
- Neural Control of Movement Lab, Institute of Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland.
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35
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Garcia-Molina G, Tsoneva T, Neff A, Salazar J, Bresch E, Grossekathofer U, Pastoor S, Aquino A. Hybrid in-phase and continuous auditory stimulation significantly enhances slow wave activity during sleep. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:4052-4055. [PMID: 31946762 DOI: 10.1109/embc.2019.8857678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Recent evidence has shown that enhancing slow-wave activity (SWA) during sleep has positive effects on cognitive, metabolic, and autonomic function. We have developed a consumer, integrated device that automatically detects sleep stages from a single electroencephalogram (EEG) signal and delivers auditory stimulation in a closed-loop manner. The stimulation was delivered in 15-auditory tone blocks separated from each other by at least 15 seconds. The first tone in a block was synchronized to the up-state of a detected slow-wave while subsequent ones were separated from each other by a constant 1-second inter-tone interval. The system was tested in a study involving 22 participants and SWA enhancement (average 45.8%; p=0.0027) was found in 19/22 participants.
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Regan MD, Flynn-Evans EE, Griko YV, Kilduff TS, Rittenberger JC, Ruskin KJ, Buck CL. Shallow metabolic depression and human spaceflight: a feasible first step. J Appl Physiol (1985) 2020; 128:637-647. [PMID: 31999524 DOI: 10.1152/japplphysiol.00725.2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Synthetic torpor is an induced state of deep metabolic depression (MD) in an organism that does not naturally employ regulated and reversible MD. If applied to spaceflight crewmembers, this metabolic state may theoretically mitigate numerous biological and logistical challenges of human spaceflight. These benefits have been the focus of numerous recent articles where, invariably, they are discussed in the context of hypothetical deep MD states in which the metabolism of crewmembers is profoundly depressed relative to basal rates. However, inducing these deep MD states in humans, particularly humans aboard spacecraft, is currently impossible. Here, we discuss shallow MD as a feasible first step toward synthetic torpor during spaceflight and summarize perspectives following a recent NASA-hosted workshop. We discuss methods to safely induce shallow MD (e.g., sleep and slow wave enhancement via acoustic and photoperiod stimulation; moderate sedation via dexmedetomidine), which we define as an ~20% depression of metabolic rate relative to basal levels. We also discuss different modes of shallow MD application (e.g., habitual versus targeted, whereby shallow MD is induced routinely throughout a mission or only under certain circumstances, respectively) and different spaceflight scenarios that would benefit from its use. Finally, we propose a multistep development plan toward the application of synthetic torpor to human spaceflight, highlighting shallow MD's role. As space agencies develop missions to send humans further into space than ever before, shallow MD has the potential to confer health benefits for crewmembers, reduce demands on spacecraft capacities, and serve as a testbed for deeper MD technologies.
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Affiliation(s)
- Matthew D Regan
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Erin E Flynn-Evans
- Fatigue Countermeasures Laboratory, Human Systems Integration Division, NASA Ames Research Center, Moffett Field, California
| | - Yuri V Griko
- Countermeasure Development Laboratory, Space Biosciences Division, NASA Ames Research Center, Moffett Field, California
| | - Thomas S Kilduff
- Biosciences Division, Center for Neuroscience, SRI International, Menlo Park, California
| | - Jon C Rittenberger
- Guthrie Robert Packer Hospital Emergency Medicine Program, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania
| | - Keith J Ruskin
- Department of Anesthesia and Critical Care, University of Chicago, Chicago, Illinois
| | - C Loren Buck
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona
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Forouzanfar M, Baker FC, Colrain IM, de Zambotti M. Electroencephalographic Slow-Wave Activity During Sleep in Different Phases of Blood Pressure and Respiration Oscillations. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:2564-2567. [PMID: 31946420 DOI: 10.1109/embc.2019.8857490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sleep is characterized by dynamic coupling between central (CNS) and peripheral autonomic (ANS) nervous systems. However, further research is needed to better understand the multiple interactions occurring among electroencephalographic (EEG) features and respiratory and cardiovascular (CV) outputs modulated by the ANS during sleep. Here, we developed new methods to study EEG slow-wave activity (SWA) during non-rapid eye movement (NREM) sleep with respect to the phases of peripheral oscillations. EEG, respiration, and continuous blood pressure signals recorded from 20 participants were analyzed. Digital filters, designed to decompose the signals into different frequency bands, and the Hilbert transform were applied to estimate the instantaneous phases and frequencies of the peripheral oscillations. The peripheral oscillations were categorized into four phases representing up and down states. EEG delta power (synchronized SWA) was computed and compared across these phases during NREM sleep. Results show that EEG delta power is higher during down phases of slow and respiratory frequency components of blood pressure and during up phases of respiration, suggestive of CNS-ANS coupling during NREM sleep. The developed techniques provide the preliminary framework to further analyze and interpret complex interactions between cortical and cardiac oscillations and their synchrony.
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Abstract
Given the critical role of sleep, particularly sleep slow oscillations, sleep spindles, and hippocampal sharp wave ripples, in memory consolidation, sleep enhancement represents a key opportunity to improve cognitive performance. Techniques such as transcranial electrical and magnetic stimulation and acoustic stimulation can enhance slow oscillations and sleep spindles and potentially improve memory. Targeted memory reactivation in sleep may enhance or stabilize memory consolidation. Each technique has technical considerations that may limit its broader clinical application. Therefore, neurostimulation to enhance sleep quality, in particular sleep slow oscillations, has the potential for improving sleep-related memory consolidation in healthy and clinical populations.
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Affiliation(s)
- Roneil G Malkani
- Division of Sleep Medicine, Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine. 710 North Lake Shore Drive, Suite 525, Chicago, IL 60611, USA.
| | - Phyllis C Zee
- Division of Sleep Medicine, Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine. 710 North Lake Shore Drive, Suite 520, Chicago, IL 60611, USA
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Effect of Closed-Loop Vibration Stimulation on Heart Rhythm during Naps. SENSORS 2019; 19:s19194136. [PMID: 31554268 PMCID: PMC6806257 DOI: 10.3390/s19194136] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/18/2019] [Accepted: 09/21/2019] [Indexed: 11/16/2022]
Abstract
Sleep plays a primary function for health and sustains physical and cognitive performance. Although various stimulation systems for enhancing sleep have been developed, they are difficult to use on a long-term basis. This paper proposes a novel stimulation system and confirms its feasibility for sleep. Specifically, in this study, a closed-loop vibration stimulation system that detects the heart rate (HR) and applies −n% stimulus beats per minute (BPM) computed on the basis of the previous 5 min of HR data was developed. Ten subjects participated in the evaluation experiment, in which they took a nap for approximately 90 min. The experiment comprised one baseline and three stimulation conditions. HR variability analysis showed that the normalized low frequency (LF) and LF/high frequency (HF) parameters significantly decreased compared to the baseline condition, while the normalized HF parameter significantly increased under the −3% stimulation condition. In addition, the HR density around the stimulus BPM significantly increased under the −3% stimulation condition. The results confirm that the proposed stimulation system could influence heart rhythm and stabilize the autonomic nervous system. This study thus provides a new stimulation approach to enhance the quality of sleep and has the potential for enhancing health levels through sleep manipulation.
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Bender AM, Van Dongen HPA, Roll JM, Layton ME. Sleep disturbance and daytime sleepiness in cigarette smokers attempting to quit without treatment. Sleep Biol Rhythms 2019. [DOI: 10.1007/s41105-019-00235-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Papalambros NA, Weintraub S, Chen T, Grimaldi D, Santostasi G, Paller KA, Zee PC, Malkani RG. Acoustic enhancement of sleep slow oscillations in mild cognitive impairment. Ann Clin Transl Neurol 2019; 6:1191-1201. [PMID: 31353857 PMCID: PMC6649400 DOI: 10.1002/acn3.796] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 04/26/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Slow-wave activity (SWA) during sleep is reduced in people with amnestic mild cognitive impairment (aMCI) and is related to sleep-dependent memory consolidation. Acoustic stimulation of slow oscillations has proven effective in enhancing SWA and memory in younger and older adults. In this study we aimed to determine whether acoustic stimulation during sleep boosts SWA and improves memory performance in people with aMCI. METHODS Nine adults with aMCI (72 ± 8.7 years) completed one night of acoustic stimulation (stim) and one night of sham stimulation (sham) in a blinded, randomized crossover study. Acoustic stimuli were delivered phase-locked to the upstate of the endogenous sleep slow-waves. Participants completed a declarative recall task with 44 word-pairs before and after sleep. RESULTS During intervals of acoustic stimulation, SWA increased by >10% over sham intervals (P < 0.01), but memory recall increased in only five of the nine patients. The increase in SWA with stimulation was associated with improved morning word recall (r = 0.78, P = 0.012). INTERPRETATION Acoustic stimulation delivered during slow-wave sleep over one night was effective for enhancing SWA in individuals with aMCI. Given established relationships between SWA and memory, a larger or more prolonged enhancement may be needed to consistently improve memory in aMCI.
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Affiliation(s)
- Nelly A. Papalambros
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinois
- Center for Circadian and Sleep MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of MedicineChicagoIllinois
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Tammy Chen
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinois
- Center for Circadian and Sleep MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Daniela Grimaldi
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinois
- Center for Circadian and Sleep MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Giovanni Santostasi
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinois
- DeepWave TechnologiesEncinitasCalifornia
| | - Ken A. Paller
- Department of PsychologyNorthwestern UniversityEvanstonIllinois
| | - Phyllis C. Zee
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinois
- Center for Circadian and Sleep MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Roneil G. Malkani
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinois
- Center for Circadian and Sleep MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
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