Thermoregulation, metabolism, and stages of sleep in cold-exposed men

Effect of quilt thermal resistance on bedding system and sleep thermal comfort

Ambient temperature and the bedding thermal resistance are two key factors affecting sleepers' thermal comfort. Six duvets with thermal resistance of 3.81, 5.12, 6.19, 7.81, 8.75 and 8.93 clo were included to investigate the effects of duvet thermal resistance on the sleep thermal comfort zone. Six males and six females were enrolled in a whole night sleep experiment, and the ambient temperature of the sleep room was adjusted to be thermally comfortable. Skin temperature, bed climate temperature and sleep stages were all acquired. Subjective evaluations including thermal perception and sleep quality were also assessed through questionnaires. The results indicated that increasing the thermal resistance of duvets widened the thermal comfort zone of ambient temperature, with the highest thermal resistance ranging from 8.2 to 17.7 °C and the lowest from 16.4 to 22.2 °C. The upper and lower temperature limits of the comfort zone did not significantly differ in their effect on sleep quality. The recommended bed climate temperature for comfortable sleep would be in the small range of 30-33 °C, and a good quality of sleep can be guaranteed in the scenario.

Objective sleep assessments for healthy people in environmental research: A literature review

To date, although many studies had focused on the impact of environmental factors on sleep, how to choose the proper assessment method for objective sleep quality was often ignored, especially for healthy subjects in bedroom environment. In order to provide methodological guidance for future research, this paper reviewed the assessments of objective sleep quality applied in environmental researches, compared them from the perspective of accuracy and interference, and statistically analyzed the impact of experimental type and subjects' information on method selection. The review results showed that, in contrast to polysomnography (PSG), the accuracy of actigraphy (ACT), respiratory monitoring-oxygen saturation monitoring (RM-OSM), and electrocardiograph (ECG) could reach up to 97%, 80.38%, and 79.95%, respectively. In terms of sleep staging, PSG and ECG performed the best, ACT the second, and RM-OSM the worst; as compared to single methods, mix methods were more accurate and better at sleep staging. PSG interfered with sleep a great deal, while ECG and ACT could be non-contact, and thus, the least interference with sleep was present. The type of experiment significantly influenced the choice of assessment method (p < 0.001), 85.3% of researchers chose PSG in laboratory study while 82.5% ACT in field study; moreover, PSG was often used in a relatively small number of young subjects, while ACT had a wide applicable population. In general, researchers need to pay more attention at selection of assessments in future studies, and this review can be used as a reliable reference for experimental design.

Nutrient timing and metabolic regulation symposium review from "Novel dietary approaches to appetite regulation, health and performance (2021)"

Daily (circadian) rhythms coordinate our physiology and behaviour with regular environmental changes. Molecular clocks in peripheral tissues (e.g. liver, skeletal muscle and adipose) give rise to rhythms in macronutrient metabolism, appetite regulation and the components of energy balance such that our bodies can align the periodic delivery of nutrients with ongoing metabolic requirements. The timing of meals both in absolute terms (i.e. relative to clock time) and in relative terms (i.e. relative to other daily events) is therefore relevant to metabolism and health. Experimental manipulation of feeding–fasting cycles can advance understanding of the effect of absolute and relative timing of meals on metabolism and health. Such studies have extended the overnight fast by regular breakfast omission and revealed that morning fasting can alter the metabolic response to subsequent meals later in the day, whilst also eliciting compensatory behavioural responses (i.e. reduced physical activity). Similarly, restricting energy intake via alternate‐day fasting also has the potential to elicit a compensatory reduction in physical activity, and so can undermine weight‐loss efforts (i.e. to preserve body fat stores). Interrupting the usual overnight fast (and therefore also the usual sleep cycle) by nocturnal feeding has also been examined and further research is needed to understand the importance of this period for either nutritional intervention or nutritional withdrawal. In summary, it is important for dietary guidelines for human health to consider nutrient timing (i.e. when we eat) alongside the conventional focus on nutrient quantity and nutrient quality (i.e. how much we eat and what we eat).

Effectiveness of a Cool Bed Linen for Thermal Comfort and Sleep Quality in Air-Conditioned Bedroom under Hot-Humid Climate

Comfort temperature and sleep quality involving 20 participants were determined in two cases: Case A (arbitrary, controlled air-conditioner setting) and Case B (adjustment of 3 °C higher than the setting of Case A with cool bed linen). Data of indoor thermal comfort and electricity consumption were collected every night throughout the measurement period. Questionnaires on thermal comfort and sleep quality were distributed twice a night for a duration of three nights for each case; the first night was for respondents’ adaptation and the following two nights were for measurement. The sleep quality of the respondents was objectively measured using a commercially available activity tracker. Results found that most respondents were thermally comfortable in both cases, with 39% lower energy consumption reported for Case B compared to Case A. The thermal conditions of Case B were found to be more tolerable than those of Case A. Most respondents reported to have a calm and satisfied sleep for both cases. Comfort temperature and Sleep Efficiency Index (SEI) were found to be maintained in both cases.

High and low ambient temperature at night and the prescription of hypnotics

STUDY OBJECTIVES

This study investigated the association between ambient nighttime temperature and sleep problems assessed by the prescription dose of sleeping pills in South Korean adults.

METHODS

We used the 2002-2015 National Health Insurance Service-National Sample Cohort. A total of 711,079 adults who were 20 years old or older were included, wherein 42,858 adults (~6%) had been prescribed hypnotic medications including zolpidem (N05CF02) and triazolam (N05CD05). Ambient temperature data was calculated as the mean highest temperature of nighttime (23:00-07:00) for every month from January to December. We combined the drug-prescribed date with the administrative districts-level daily nighttime temperature between 2002 and 2015.

RESULTS

We found that a non-linear, U-shaped relationship between nighttime temperature and hypnotic medication prescription. With an increase per 1°C temperature or an increase in a square per 1°C, the prescription dose of sleeping pills was significantly increased (both p < 0.05). At each 5°C nighttime temperature, subjects belonging to low (≤0°C and 0-5°C) or high (20-25°C and ≥25°C) temperature categories had significantly higher doses of sleeping pills than those at the reference temperature (10-15°C). Changes in nighttime temperature had a significant non-linear effect on the prescribed dosage of hypnotic medications for both adults (p < 0.0001) and the elderly (p = 0.0006).

CONCLUSION

We found that either a high or low nighttime temperature was significantly associated with a high daily dose of hypnotic medications in the Korean population.

Muscle temperature is least altered during total sleep deprivation in rats

It has often been said that the brain is mostly benefitted from sleep. To understand the importance of sleep, extensive studies on other organs are too required. One such unexplored area is the understanding of muscle physiology during the sleep-wake cycle. Changes in muscle tone with different sleep phases are evident from the rapid eye movement sleep muscle atonia. There is variation in brain and body temperature during sleep stages, the brain temperature being higher during rapid eye movement sleep than slow-wave sleep. However, the change in muscle temperature with different sleep stages is not known. In this study, we have implanted pre-calibrated K-type thermocouples in the hypothalamus and the dorsal nuchal muscle, and a peritoneal transmitter to monitor the hypothalamic, muscle, and body temperature respectively in rats during 24 h sleep-wake cycle. The changes in muscle, body, and hypothalamic temperature during total sleep deprivation were also monitored. During normal sleep-wake stages, the temperature in the decreasing order was that of the hypothalamus, body, and muscle. Total sleep deprivation by gentle handling caused a significant increase in hypothalamic and body temperature, while there was least change in the muscle temperature. The circadian rhythm of the hypothalamic and body temperature in the sleep-deprived rats was disrupted, while the same was preserved in the muscle temperature. The results of our study show that muscle atonia during rapid eye movement sleep is a physiologically regulated thermally quiescent muscle state offering a conducive environment for muscle rest and repair.

Thermoregulation and Sleep: Functional Interaction and Central Nervous Control

Each of the wake-sleep states is characterized by specific changes in autonomic activity and bodily functions. The goal of such changes is not always clear. During non-rapid eye movement (NREM) sleep, the autonomic outflow and the activity of the endocrine system, the respiratory system, the cardiovascular system, and the thermoregulatory system seem to be directed at increasing energy saving. During rapid eye movement (REM) sleep, the goal of the specific autonomic and regulatory changes is unclear, since a large instability of autonomic activity and cardiorespiratory function is observed in concomitance with thermoregulatory changes, which are apparently non-functional to thermal homeostasis. Reciprocally, the activation of thermoregulatory responses under thermal challenges interferes with sleep occurrence. Such a double-edged and reciprocal interaction between sleep and thermoregulation may be favored by the fact that the central network controlling sleep overlaps in several parts with the central network controlling thermoregulation. The understanding of the central mechanism behind the interaction between sleep and thermoregulation may help to understand the functionality of thermoregulatory sleep-related changes and, ultimately, the function(s) of sleep. © 2021 American Physiological Society. Compr Physiol 11:1591-1604, 2021.

A field investigation of the thermal environment and adaptive thermal behavior in bedrooms in different climate regions in China

Sleep thermal environments substantially impact sleep quality. To study the sleep thermal environment and thermal comfort in China, this study carried out on-site monitoring of thermal environmental parameters in peoples' homes, including 166 households in five climate zones, for one year. A questionnaire survey on sleep thermal comfort and adaptive behavior was also conducted. The results showed that the indoor temperature for sleep in northern China was more than 4°C higher than that in southern China in winter, while the indoor temperatures for sleep were similar in summer. Furthermore, 70% of people were satisfied with their sleep thermal environment. Due to the use of air conditioning and window opening in various areas in summer, people were satisfied with their sleep thermal environments. Due to the lack of central heating in the southern region in winter, people feel cold and their sleep thermal environment needs further improvement. The bedding insulation in summer and winter in northern China was 1.83clo and 2.67clo, respectively, and in southern China was 2.21clo and 3.17clo, respectively. Both northern China and southern China used air conditioning only in summer. People in southern China opened their windows all year, while those in northern China opened their windows during the summer and transitional periods.

Effects of Changing Air Temperature at Different Sleep Stages on the Subjective Evaluation of Sleep Quality

The thermal environment in bedrooms is important for high-quality sleep. Studies confirm that, even during sleep, the human body remains sensitive to the ambient air temperature. This study assesses how changing indoor air temperatures at different sleep stages affects the subjective evaluation of sleep quality. We compare reports from two identical sleeping environments with different thermal control systems: an IoT-based control system that adjusts the indoor air temperature according to the sleep stage and a fixed control system that maintains a constant temperature throughout the night. Ten subjects participated in the experiments and completed a questionnaire about their sleep quality. Our results show that, overall, the subjects experienced better sleep in the room with the IoT-based control system than in the one with a fixed thermal control. The mean differences in sleep satisfaction levels between the two sleeping environments were generally statistically significant in favor of the room with the IoT-based thermal control. Our results thus illustrate the suitability of using the IoT to control the air conditioning in bedrooms to provide improved sleep quality.

Skin temperature, sleep, and vigilance

A large number of studies have shown a close association between the 24-hour rhythms in core body temperature and sleep propensity. More recently, studies have have begun to elucidate an intriguing association of sleep with skin temperature as well. The present chapter addresses the association of sleep and alertness with skin temperature. It discusses whether the association could reflect common underlying drivers of both sleep propensity and skin vasodilation; whether it could reflect efferents of sleep-regulating brain circuits to thermoregulatory circuits; and whether skin temperature could provide afferent input to sleep-regulating brain circuits. Sleep regulation and concomitant changes in skin temperature are systematically discussed and three parallel factors suggested: a circadian clock mechanism, a homeostatic hourglass mechanism, and a third set of sleep-permissive and wake-promoting factors that gate the effectiveness of signals from the clock and hourglass in the actual induction of sleep or maintenance of alert wakefulness. The chapter moreover discusses how the association between skin temperature and arousal can change with sleep deprivation and insomnia. Finally it addresses whether the promising laboratory findings on the effects of skin temperature manipulations on vigilance can be applied to improve sleep in everyday life.

Energy metabolism differs between sleep stages and begins to increase prior to awakening

PURPOSE

Human sleep is generally consolidated into a single prolonged period, and its metabolic consequence is to impose an extended period of fasting. Changes in sleep stage and homeostatic sleep drive following sleep onset may affect sleeping metabolic rate through cross talk between the mechanisms controlling energy metabolism and sleep. The purpose of this study was to isolate the effects of sleep stage and time after sleep onset on sleeping metabolic rate.

METHODS

The sleeping metabolic rate of 29 healthy adults was measured using whole room indirect calorimetry, during which polysomnographic recording of sleep was performed. The effects of sleep stage and time after sleep onset on sleeping metabolic rate were evaluated using a semi-parametric regression analysis. A parametric analysis was used for the effect of sleep stage and a non-parametric analysis was used for the effect of time.

RESULTS

Energy expenditure differed significantly between sleep stages: wake after sleep onset (WASO)>stage 2, slow wave sleep (SWS), and REM; stage 1>stage 2 and SWS; and REM>SWS. Similarly, carbohydrate oxidation differed significantly between sleep stages: WASO > stage 2 and SWS; and stage 1>SWS. Energy expenditure and carbohydrate oxidation decreased during the first half of sleep followed by an increase during the second half of sleep.

CONCLUSIONS

This study identified characteristic phenotypes in energy expenditure and carbohydrate oxidation indicating that sleeping metabolic rate differs between sleep stages.

The sleep architecture of Australian volunteer firefighters during a multi-day simulated wildfire suppression: Impact of sleep restriction and temperature

Wildland firefighting exposes personnel to combinations of occupational and environmental stressors that include physical activity, heat and sleep restriction. However, the effects of these stressors on sleep have rarely been studied in the laboratory, and direct comparisons to field scenarios remain problematic. The aim of this study was to examine firefighters' sleep during a three-day, four-night simulated wildfire suppression that included sleep restriction and physical activity circuits representative of firefighting wildfire suppression tasks in varied temperatures. Sixty-one volunteer firefighters (37.5±14.5 years of age, mean±SD) were assigned to one of three conditions: control (n=25; 8h sleep opportunities and 18-20°C), awake (n=25; 4h sleep opportunities and 18-20°C) or awake/hot (n=11; 4h sleep opportunities and 33-35°C during the day and 23-25°C during the night). Results demonstrated that amounts of N1, N2 and R sleep, TST, SOL and WASO declined, whilst sleep efficiency increased significantly in the awake and awake/hot conditions compared to the control condition. Results also demonstrated that SWS sleep remained relatively stable in the awake and awake/hot conditions compared to control values. Most importantly, no significant differences were found for any of the sleep measures between the awake and awake/hot conditions. Thus, working in hot daytime temperatures in combination with sleep restriction during the night did not affect patterns of sleep compared to working in temperate conditions in combination with sleep restriction during the night. However, the effects on sleep of high (>25°C) night-time temperatures with sleep restriction in addition to physical activity remains to be studied.

Effect of cardboard under a sleeping bag on sleep stages during daytime nap

Fourteen healthy male subjects slept from 13:30 to 15:30 under ambient temperature and relative humidity maintained at 15 °C and 60%, respectively. They slept under two conditions: in a sleeping bag on wooden flooring (Wood) and in a sleeping bag with corrugated cardboard between the bag and the flooring (CC). Polysomnography, skin temperature (Tsk), microclimate, bed climate, and subjective sensations were obtained. The number of awakenings in the CC had significantly decreased compared to that in the Wood. The mean, back, and thigh Tsk, and bed climate temperature were significantly higher in the CC than that in the Wood. Subjective thermal sensations were warmer in the CC than in the Wood. These results suggest that using corrugated cardboard under a sleeping bag may reduce cold stress, thereby decreasing the number of awakenings and increasing subjective warmth; the mean, back, and thigh Tsk; and bed climate temperature.

Effects of thermal environment on sleep and circadian rhythm

The thermal environment is one of the most important factors that can affect human sleep. The stereotypical effects of heat or cold exposure are increased wakefulness and decreased rapid eye movement sleep and slow wave sleep. These effects of the thermal environment on sleep stages are strongly linked to thermoregulation, which affects the mechanism regulating sleep. The effects on sleep stages also differ depending on the use of bedding and/or clothing. In semi-nude subjects, sleep stages are more affected by cold exposure than heat exposure. In real-life situations where bedding and clothing are used, heat exposure increases wakefulness and decreases slow wave sleep and rapid eye movement sleep. Humid heat exposure further increases thermal load during sleep and affects sleep stages and thermoregulation. On the other hand, cold exposure does not affect sleep stages, though the use of beddings and clothing during sleep is critical in supporting thermoregulation and sleep in cold exposure. However, cold exposure affects cardiac autonomic response during sleep without affecting sleep stages and subjective sensations. These results indicate that the impact of cold exposure may be greater than that of heat exposure in real-life situations; thus, further studies are warranted that consider the effect of cold exposure on sleep and other physiological parameters.

Sleep, vigilance, and thermosensitivity

The regulation of sleep and wakefulness is well modeled with two underlying processes: a circadian and a homeostatic one. So far, the parameters and mechanisms of additional sleep-permissive and wake-promoting conditions have been largely overlooked. The present overview focuses on one of these conditions: the effect of skin temperature on the onset and maintenance of sleep, and alertness. Skin temperature is quite well suited to provide the brain with information on sleep-permissive and wake-promoting conditions because it changes with most if not all of them. Skin temperature changes with environmental heat and cold, but also with posture, environmental light, danger, nutritional status, pain, and stress. Its effect on the brain may thus moderate the efficacy by which the clock and homeostat manage to initiate or maintain sleep or wakefulness. The review provides a brief overview of the neuroanatomical pathways and physiological mechanisms by which skin temperature can affect the regulation of sleep and vigilance. In addition, current pitfalls and possibilities of practical applications for sleep enhancement are discussed, including the recent finding of impaired thermal comfort perception in insomniacs.

Numerical studies on the microclimate around a sleeping person and the related thermal neutrality issues

This article reports on two numerical studies on the microclimate around, and the thermal neutrality of, a sleeping person in a space installed with a displacement ventilation system. The development of a sleeping computational thermal manikin (SCTM) placed in a space air-conditioned by a displacement ventilation system is first described. This is followed by reporting the results of the first numerical study on the microclimate around the SCTM, including air temperature and velocity distributions and the heat transfer characteristics. Then the outcomes of the other numerical study on the thermal neutrality of a sleeping person are presented, including the thermal neutrality for a naked sleeping person and the effects of the total insulation value of a bedding system on the thermal neutrality of a sleeping person. STATEMENT OF RELEVANCE: The thermal environment would greatly affect the sleep quality of human beings. Through developing a SCTM, the microclimate around a sleeping person has been numerically studied. The thermal neutral environment may then be predicted and contributions to improved sleep quality may be made.

Energy expenditure during sleep, sleep deprivation and sleep following sleep deprivation in adult humans

Sleep has been proposed to be a physiological adaptation to conserve energy, but little research has examined this proposed function of sleep in humans. We quantified effects of sleep, sleep deprivation and recovery sleep on whole-body total daily energy expenditure (EE) and on EE during the habitual day and nighttime. We also determined effects of sleep stage during baseline and recovery sleep on EE. Seven healthy participants aged 22 ± 5 years (mean ± s.d.) maintained ∼8 h per night sleep schedules for 1 week before the study and consumed a weight-maintenance diet for 3 days prior to and during the laboratory protocol. Following a habituation night, subjects lived in a whole-room indirect calorimeter for 3 days. The first 24 h served as baseline – 16 h wakefulness, 8 h scheduled sleep – and this was followed by 40 h sleep deprivation and 8 h scheduled recovery sleep. Findings show that, compared to baseline, 24 h EE was significantly increased by ∼7% during the first 24 h of sleep deprivation and was significantly decreased by ∼5% during recovery, which included hours awake 25-40 and 8 h recovery sleep. During the night time, EE was significantly increased by ∼32% on the sleep deprivation night and significantly decreased by ∼4% during recovery sleep compared to baseline. Small differences in EE were observed among sleep stages, but wakefulness during the sleep episode was associated with increased energy expenditure. These findings provide support for the hypothesis that sleep conserves energy and that sleep deprivation increases total daily EE in humans.

Metabolic rate and fuel utilization during sleep assessed by whole-body indirect calorimetry

The purpose of this study was to examine metabolic rate and substrate oxidation during sleep in relation to time of sleep and sleep stage. Twelve male subjects free from sleep-disordered breathing slept for 469 +/- 8.7 (mean +/- SE) minutes until natural awakening in a whole-body indirect calorimeter, and polysomnographic documentation of sleep was recorded. Energy expenditure decreased during the first half of the night, reached a nadir (a 35% decrease), and remained relatively stable until awakening. Similarly, fat oxidation decreased from the onset of sleep. On the other hand, carbohydrate oxidation showed no remarkable changes from the onset of sleep but began to increase before awakening. Because distribution of sleep stages is not uniform throughout the night, with rapid-eye-movement (REM) sleep tending to appear later in the sleep, effect of sleep stage on energy metabolism was isolated by analysis of covariance with time as a covariate. Subsequent comparison of metabolic rate by 1-way analysis of variance with Bonferroni post hoc analysis revealed that energy expenditure during REM sleep was significantly greater than that during sleep stages 2 and 3/4 (stage 2, 25.248 +/- 0.961; stage 3/4, 24.825 +/- 0.935; REM, 25.712 +/- 0.928 kcal kg(-1) fat-free mass d(-1)). Carbohydrate oxidation during REM sleep was significantly greater than that during sleep stage 3/4 (stage 3/4, 12.229 +/- 1.071; REM, 13.986 +/- 1.291 kcal kg(-1) fat-free mass d(-1)). Respiration quotient was statistically different among sleep stages, but Bonferroni post hoc analysis failed to identify significant differences (stage 2, 0.850 +/- 0.010; stage 3/4, 0.846 +/- 0.011; REM, 0.861 +/- 0.013). The increases in energy expenditure and carbohydrate oxidation during REM sleep are consistent with a notion that changes in energy metabolism in brain are manifested as small fluctuations in whole-body energy metabolism during sleep.

Algorithm for transient response of whole body indirect calorimeter: deconvolution with a regularization parameter

A whole body indirect calorimeter provides accurate measurement of energy expenditure over long periods of time, but it has limitations to assess its dynamic changes. The present study aimed to improve algorithms to compute O2 consumption and CO2 production by adopting a stochastic deconvolution method, which controls the relative weight of fidelity to the data and smoothness of the estimates. The performance of the new algorithm was compared with that of other algorithms (moving average, trends identification, Kalman filter, and Kalman smoothing) against validation tests in which energy metabolism was evaluated every 1 min. First, an in silico simulation study, rectangular or sinusoidal inputs of gradually decreasing periods (64, 32, 16, and 8 min) were applied, and samples collected from the output were corrupted with superimposed noise. Second, CO2 was infused into a chamber in gradually decreasing intervals and the CO2 production rate was estimated by algorithms. In terms of recovery, mean square error, and correlation to the known input signal in the validation tests, deconvolution performed better than the other algorithms. Finally, as a case study, the time course of energy metabolism during sleep, the stages of which were assessed by a standard polysomnogram, was measured in a whole body indirect calorimeter. Analysis of covariance revealed an association of energy expenditure with sleep stage, and energy expenditure computed by deconvolution and Kalman smoothing was more closely associated with sleep stages than that based on trends identification and the Kalman filter. The new algorithm significantly improved the transient response of the whole body indirect calorimeter.

Effects of low ambient temperature on heart rate variability during sleep in humans

The effects of cold exposure on heart rate variability (HRV) during sleep were examined. Eight male subjects slept under three different conditions: 3 degrees C, 50-80% relative humidity (RH) [3]; 10 degrees C, 50% RH [10]; and 17 degrees C 50% RH [17]. No significant differences were observed in HRV during rapid eye movement sleep (REM) and wakefulness. The ratio of the low frequency (LF) to high frequency component (HF) of HRV (LF/HF) significantly differed among the conditions during stage 2 and slow wave sleep (SWS) that decreased as the ambient temperature decreased. The normalized LF [LF/(LF + HF)] significantly decreased in 3 and 10 than in 17 during SWS. In low ambient temperature, predominant cardiac parasympathetic activity during stage 2 with no significant difference during REM and wakefulness may cause variations in HRV at transition from stage 2 to REM and wakefulness. These results may partly explain the peak in adverse cardiac events during winter.

Sleep under extreme environments: Effects of heat and cold exposure, altitude, hyperbaric pressure and microgravity in space

Human sleep is sensitive to the individual's environment. The present review examines current knowledge of human sleep patterns under different environments: heat exposure, cold exposure, altitude, high pressure and microgravity in space. Heat exposure has two effects. In people living in temperate conditions, moderate heat loads (hot bath, sauna) prior to sleep provoke a delayed reaction across time (diachronic reaction) whereby slow-wave sleep (SWS) augments in the following night (neurogenic adaptive pathway). Melanoids and Caucasians living in the Sahel dry tropical climate experience diachronic increases in SWS throughout seasonal acclimatization. Such increases are greater during the hot season, being further enhanced after daytime exercise. On the contrary, when subjects are acutely exposed to heat, diachronic decreases in total sleep time and SWS occur, being often accompanied by synchronic (concomitant) diminution in REM sleep. Stress hormones increase. Nocturnal cold exposure provokes a synchronic decrease in REM sleep along with an activation of stress hormones (synchronic somatic reaction). SWS remains undisturbed as it still occurs at the beginning of the night before nocturnal body cooling. Altitude and high pressure are deleterious to sleep, especially in non-acclimatized individuals. In their controlled environment, astronauts can sleep well in microgravity. Exercise-induced sleep changes help to understand environmental effects on sleep: well-tolerated environmental strains may improve sleep through a neurogenic adaptive pathway; when this "central" adaptive pathway is overloaded or bypassed, diachronic and synchronic sleep disruptions occur.

Evidence in female rhesus monkeys (Macaca mulatta) that nighttime caloric intake is not associated with weight gain

OBJECTIVE

To evaluate the hypothesis that nighttime consumption of calories leads to an increased propensity to gain weight.

RESEARCH METHODS AND PROCEDURES

Sixteen female rhesus monkeys (Macaca mulatta) were ovariectomized and placed on a high-fat diet to promote weight gain, and we examined whether monkeys that ate a high percentage of calories at night were more likely to gain weight than monkeys that ate the majority of calories during the day.

RESULTS

Within 6 weeks post-ovariectomy, calorie intake and body weight increased significantly (129 +/- 14%, p = 0.04; 103 +/- 0.91%, p = 0.02, respectively). Subsequent placement on high-fat diet led to further significant increases in calorie intake and body weight (368 +/- 56%, p = 0.001; 113 +/- 4.0%, p = 0.03, respectively). However, there was no correlation between the increase in calorie intake and weight gain (p = 0.34). Considerable individual variation existed in the percentage of calories consumed at night (6% to 64% total daily caloric intake). However, the percentage of calorie intake occurring at night was not correlated with body weight (r = 0.04; p = 0.87) or weight gain (r = 0.07; p = 0.79) over the course of the study. Additionally, monkeys that showed the greatest nighttime calorie intake did not gain more weight (p = 0.94) than monkeys that showed the least nighttime calorie intake.

DISCUSSION

These results show that eating at night is not associated with an increased propensity to gain weight, suggesting that individuals trying to lose weight should not rely on decreasing evening calorie intake as a primary strategy for promoting weight loss.

Effects of an electric blanket on sleep stages and body temperature in young men

The aim of this study was to investigate any effects of electric blanket on sleep stages and body temperature. Nine male subjects slept under two conditions: using the electric blanket (HB); and not using the electric blanket (C). The ambient condition was controlled at 3 degrees C relative humidity 50-80%. Electroencephalography, electrooculography (EOG) and electromyography, rectal temperature, skin temperature and microclimate temperature and humidity were recorded continuously through the night. Body weight was measured before and after sleep. The amount of stage 1 and number of stage 1 and rapid eye movement sleep decreased in HB compared to C. No significant difference was observed in other sleep stages. Rectal temperature was higher in HB compared to C. The thigh, leg and foot skin temperature was higher in HB than C. The microclimate temperature of the foot area was higher in HB compared to C. No significant difference was observed in whole body sweat loss between the conditions. These results suggest that use of an electric blanket under low ambient temperature may decrease cold stress to support sleep stability and thermoregulation during sleep.

Effects of partial humid heat exposure during different segments of sleep on human sleep stages and body temperature

The effects of partial humid heat exposure applied at different segments of sleep on sleep stages and body temperature were examined. In the first experiment, eight male subjects slept under 26 degrees C 50% (26) and 26 degrees C for the first 3 h and 45 min followed by a 30-min transition to the conditions of 32 degrees C 80%, which was maintained for the final 3 h and 45 min (26-32). Wakefulness increased significantly over the last 4 h under 26-32 compared to 26. Mean skin temperature and clothing microclimate temperature (Tcm) were significantly higher during the last 3 h and 45 min, while rectal temperature (Tre) was higher during the last 3 h under 26-32 than in 26. In the second experiment, eight male subjects slept under 26 degrees C 50% (26) and 32 degrees C 80% for the first 3 h and 45 min followed by a 30-min transition to 26, which was then maintained for the last 3 h and 45 min (32-26). Wakefulness increased both in first and during the last 4 h, and slow wave sleep (SWS) decreased in the first 4 h under 32-26 compared to 26. Mean Tsk was significantly higher during the first 4:15 h. Tcm decreased in 32-26 compared to 26 just after the 30-min transition due to cooling effects. Tre was higher during the first 5 h under 32-26 compared to 26. These results suggest that humid heat exposure during the initial segment of sleep may be more disruptive to sleep stage distribution, Tre decline, and maintenance of Tcm than the same exposure during the later sleep segments.

Single and Sequential REM sleep episodes in humans: a phylogenetic left-over?

The occurrence of REM sleep in the rat appears to be under the control of either sleep related processes and homeostatic regulation of physiological variables. With respect to this, it has been observed that in this species REM sleep may occur in the form of two types of episodes, Single and Sequential episodes, which are supposed to play a different functional role. Since it is possible to distinguish Single and Sequential REM sleep episodes also in human beings, the aim of this pilot study was to asses whether a sleep deprivation may differently affect these two types of REM episodes. The sleep deprivation was induced in young human subjects by a progressive restriction of sleep within the same night period. Seventy-two PSG tracing belonging to six subjects have been analyzed. The results show that sleep deprivation does not significantly affect the relative occurrence of Single and Sequential REM sleep episodes, suggesting that in human beings these two types of REM episodes might not have a different functional role.

A definition of internal constancy and homeostasis in the context of non-equilibrium thermodynamics

The constancy of the internal environment, internal homeostasis, and its stability are necessary conditions for the survival of a biological system within its environment. These have never been clearly defined. For this purpose nonequilibrium thermodynamics is taken as a reference, and the essential principles of equilibrium, reversibility, stationary steady state and stability (Lyapounov, asymptotic, local and global), are briefly illustrated. On this basis, internal homeostasis describes a stationary state of nonequilibrium, the actual state of rest, X(t), resulting from the relation X(t) = Xs + x(t), between a time-independent steady state of reference (Xs), and time-dependent fluctuations of the state variables, x(t). In humans, two resting spontaneous homeostatic states are: (1) the conscious state of quiet wakefulness, during which time-dependent variables display bounded oscillations around the mean time-independent steady state level, this conscious state being thus stable in the sense of Lyapounov, and (2) the unconscious stable state of non-rapid eye movement sleep, in which the time-dependent variables would approach the lowest spontaneously attainable time-independent state asymptotically, sleep becoming a globally stable and attractive state. Exercise may be described as a non-resting, unstable active state far away from equilibrium and hibernation is a resting, time-independent steady state very near equilibrium. The range between sleep and exercise is neurohumorally regulated. For spontaneously stable states to occur, slowing of the metabolic rate, withdrawal of the sympathetic drive and reinforcement of the vagal tone to the heart and circulation are required, thus confirming that the parasympathetic division of the autonomic nervous system is the main controller of homeostasis.

Skin sympathetic nerve function during sleep--a study with effector responses

We investigated the effector-organ activities corresponding to skin sympathetic nerve activity (SSNA) during sleep in eight healthy adult volunteers. The following parameters of SSNA were recorded during night sleep: the spontaneous skin vasoconstriction and skin blood flow volume, by laser Doppler flowmetry; sweating, by the ventilated capsule method; and the galvanic skin response (GSR). Fluctuations of sweating and GSR were mainly observed on the dorsal side of the hand during night sleep. The frequency of GSR and sweat rate on the dorsal side of the hand were significantly lower during REM sleep than during NREM sleep. The frequency of spontaneous skin vasoconstriction was higher and blood flow was lower during REM sleep than during NREM sleep. These results indicate that sweating and blood flow in the skin are differentially regulated depending on the sleep stage. Our results also suggest that the sleep-regulating system is closely linked to thermoregulation, which is controlled by the sympathetic nervous system.

Assessing sleeping energy expenditure in children using heart-rate monitoring calibrated against open-circuit indirect calorimetry: a pilot study

Total energy expenditure (EE) can be assessed in children by the heart-rate (HR) monitoring technique calibrated against open-circuit indirect calorimetry (IC). In this technique, sleeping EE is usually estimated as the lowest value of a 30 min resting EE measurement x 0 x 90 to give an average for the total sleeping period. However, sleeping is a dynamic process in which sleeping EE is modulated by the effect of factors such as body movement and different sleep stages. The aim of the present study was to determine a new method to improve the sleeping EE measurement by taking into account body movements during sleep. Twenty-four non-obese children participated in the present study. All subjects passed through a calibration period. HR and EE measured by IC were simultaneously collected during resting, the postprandial period, and during different levels of activity. Different methods for computing sleeping EE (resting with different breakpoints ('flex point' HR with linear regression or 'inflection point' (IP) HR with the third order polynomial regression equation (P3)) were compared with EE measured for least 2.0 h in eight sleeping children. The best method of calculation was then tested in sixteen children undergoing HR monitoring and with a body movement detector. In a subset of eight children undergoing simultaneous sleeping EE measurement by IC and HR, the use of the equation resting when HR<IP and P3 when HR>IP during the sleeping period gave the lowest difference (1 (sd 5.4) %) compared with other methods (linear or polynomial regressions). The new formula was tested in an independent subset of sixteen other children. The difference between sleeping EE computed with the formula resting and sleeping EE computed with resting when HR<IP and the P3 equation when HR>IP during sleeping periods was significant (13 (sd 5.9) %) only for active sleeping subjects (n 6 of 16 subjects). The correlation between the difference in the results from the two methods of calculation and body movements was close (r 0.63, P<0.005, Spearman test) as well as computed sleeping EE (Spearman test, r 0.679, P<0.001), indicating that this new method is reliable for computing sleeping EE with HR monitoring if children are moving during sleep and improves the total EE assessment.

Sleeping metabolic rate in relation to body mass index and body composition

OBJECTIVES

To determine whether patterns of sleeping metabolic rate (SMR) are altered in obesity. Specifically to determine the relationship between changes in SMR and body weight, body mass index (BMI, kg/m(2)), and fat-free mass (FFM); and to compare resting metabolic rate (RMR) with SMR during different periods of sleep.

SUBJECTS

Eighteen healthy, pre-menopausal, obese (BMI >30, n=9) and non-obese (BMI <30, n=9), female subjects (six Caucasians and 12 African-Americans), with an average age of 36 y (range 22-45).

MEASUREMENTS

Total energy expenditure (TEE or 24 h EE), metabolic rate (MR), SMR (minimum, average and maximum) and resting metabolic rate (RMR) or resting energy expenditure (REE) measured by human respiratory chamber, and external mechanical work measured by a force platform within the respiratory chamber. Physical activity index (PAL) was derived as TEE/REE. Body composition was determined by dual-energy X-ray absorptiometry (DXA).

RESULTS

SMR decreased continuously during sleep and reached its lowest point just before the subject was awakened in the morning by the research staff. Although averages for RMR and SMR were similar, RMR was lower than SMR at the beginning of the sleeping period and higher than SMR in the morning hours. The rate of decrease in SMR was faster with increasing body weight (-0.829, P<0.0001), BMI (correlation factor -0.896, P<0.0001) and FFM (-0.798, P=0.001). The relationship between the slope of SMR decrease and BMI (y=-5 x 10(-6)x(2)+0.0002x-0.0028) is highly significant, with a P-value of <0.0001 and r(2) value of 0.9622.

CONCLUSIONS

The rate of decline in metabolic rate during sleep is directly related to body weight, BMI and FFM. Average SMR tends to be lower than RMR in obese subjects and higher than RMR in non-obese subjects.

Ultradian oscillations in cranial thermoregulation and electroencephalographic slow-wave activity during sleep are abnormal in humans with annual winter depression

The level of core body, and presumably brain temperature during sleep varies with clinical state in patients with seasonal affective disorder (SAD), becoming elevated during winter depression and lowered during clinical remission induced by either light treatment or summer. During sleep, brain temperatures are in part determined by the level of brain cooling activity, which may be reflected by facial skin temperatures. In many animals, the level of brain cooling activity oscillates across the NREM-REM sleep cycle. Facial skin temperatures during sleep in patients with winter depression are abnormally low and uncorrelated with rectal temperatures, although their relationship to EEG-defined sleep stages remains unknown. We therefore measured the sleep EEG, core body and facial skin temperatures in 23 patients with winter depression and 23 healthy controls, and tested the hypothesis that ultradian oscillations in facial skin temperatures exist in humans and are abnormal in patients with winter depression. We found that facial skin temperatures oscillated significantly across the NREM-REM sleep cycle, and were again significantly lower and uncorrelated with rectal temperatures in patients with winter depression. Mean slow-wave activity and NREM episode duration were significantly greater in patients with winter depression, whereas the intraepisodic dynamics of slow-wave activity were normal in patients with winter depression. These results suggest that brain cooling activity oscillates in an ultradian manner during sleep in humans and is reduced during winter depression, and provide additional support for the hypothesis that brain temperatures are elevated during winter depression.

Effects of temperature on sleep in the developing rat

In altricial species, such as humans and rats, much of the development of autonomic systems occurs postnatally. Consequently, vulnerabilities exist early in postnatal development when immature autonomic functions are challenged by external factors such as variations in ambient temperature (Ta). Ta profoundly influences sleep/wake state structure in adult animals and humans, and exposure to excessive warmth has been implicated as a risk factor in sudden infant death syndrome. To better understand the relationship between temperature and sleep during development, we investigated the effect of Ta variation on sleep/wake state structure and sleep intensity in developing rats. In this experiment, sleep intensity was measured by the intensity of slow-wave activity during slow-wave sleep. Neonatal Long-Evans hooded rat pups were surgically prepared for chronic sleep/wake state and brain temperature (Tbr) recording. Two-hour recordings of sleep/wake state and Tbr were obtained from rats on postnatal day 12 (P12), P14, P16, P18, and P20 at a Ta of either 28.0-30.0, 33.0-35.0, or 38.0-40.0 degrees C. Ta significantly influenced sleep/wake state structure but had little, if any, effect on sleep intensity in developing rats.

Neural-mechanical coupling of breathing in REM sleep

During rapid-eye-movement (REM) sleep the ventilatory response to airway occlusion is reduced. Possible mechanisms are reduced chemosensitivity, mechanical impairment of the chest wall secondary to the atonia of REM sleep, or phasic REM events that interrupt or fractionate ongoing diaphragm electromyogram (EMG) activity. To differentiate between these possibilities, we studied three chronically instrumented dogs before, during, and after 15-20 s of airway occlusion during non-REM (NREM) and phasic REM sleep. We found that 1) for a given inspiratory time the integrated diaphragm EMG (Di) was similar or reduced in REM sleep relative to NREM sleep; 2) for a given Di in response to airway occlusion and the hyperpnea following occlusion, the mechanical output (flow or pressure) was similar or reduced during REM sleep relative to NREM sleep; 3) for comparable durations of airway occlusion the Di and integrated inspiratory tracheal pressure tended to be smaller and more variable in REM than in NREM sleep, and 4) significant fractionations (caused visible changes in tracheal pressure) of the diaphragm EMG during airway occlusion in REM sleep occurred in approximately 40% of breathing efforts. Thus reduced and/or erratic mechanical output during and after airway occlusion in REM sleep in terms of flow rate, tidal volume, and/or pressure generation is attributable largely to reduced neural activity of the diaphragm, which in turn is likely attributable to REM effects, causing reduced chemosensitivity at the level of the peripheral chemoreceptors or, more likely, at the central integrator. Chest wall distortion secondary to the atonia of REM sleep may contribute to the reduced mechanical output following airway occlusion when ventilatory drive is highest.

Fluctuations of rectal and tympanic temperatures with changes of ambient temperature during night sleep

Many studies have demonstrated a decline in core temperature during slow wave sleep (SWS) in animals and humans. However, there are few studies that have investigated core temperature fluctuation during rapid eye movement sleep (REM) at different ambient temperatures. This study examined the effects on core temperature of continuous hot or cold exposure during sleep. Ten male subjects were exposed to hot and cold stress from 00 h to 1:00 h, when SWS is most predominant, and from 5:00 h to 7:00 h, when REM is predominant. Rectal temperature (Tr) and tympanic temperature (Tt) were monitored for 3 days, and polysomnographies (PSG) were recorded from 23:00 h to 7:00 h. The experiments lasted 3 weeks for each subject, over 2 consecutive nights each week (including an adaptation night and an experimental night). On the experimental night, subjects were exposed to hot (29 degrees C) or cold (21 degrees C) ambience. The core temperature fluctuation under the hot or cold ambience were compared with under the thermoneutral ambience. Under hot ambience, Tr declined significantly in the first 2 hours of sleep, but Tt did not change. In the last 2 hours, both Tr and Tt were significantly elevated. Under cold ambience, both Tr and Tt declined significantly in the first 2 hours. However, in the last 2 hours, neither Tr not Tt showed any change. The result that Tr and Tt rose in hot ambience during the last 2 hours when REM is predominant suggests that body temperature during REM is influenced by ambient temperature.

Lack of effect of sleep on energy expenditure and physiologic measures in critically ill burn patients

OBJECTIVE

Energy expenditure measurements, performed while patients are in standardized resting conditions, are often used as an indicator of care by which to evaluate the adequacy of nutrition support regimens. Little attention has been directed toward examining potential errors incurred by deriving daily energy needs based on a single 15- to 20-minute measurement. This study was designed to differentiate energy expenditure during periods of sleep (defined as time spent in any of the standard sleep stages) and wakefulness in pediatric burn patients.

DESIGN

Twenty-four-hour indirect calorimetry, polysomnography, and physiologic assessments (mean arterial pressure, heart rate, body temperature, oxygen saturation, and respiratory rate) were conducted simultaneously in 14 patients, who were thermally injured and tracheally intubated, for a total of 45 24-hour intervals.

SUBJECTS

Mean age of the patients was 10.8+/-1.2 years. Mean total body surface area of the injury was 55.7+/-4.7%, and mean full-thickness burn was 48.8+/-6.0%.

STATISTICAL ANALYSES PERFORMED

A nested general linear analysis of variance model was used to evaluate the association between sleep, wakefulness, and energy needs; adjustments were made for postburn day and multiple test runs per patient.

RESULTS

On average, subjects slept 699+/-46 minutes/day. They experienced a large number of awakenings from sleep (mean=53+/-6.3 awakenings per 24 hours). Patients had mean energy expenditure of 2,529+/-396 kcal/day while awake and 2,360+/-291 kcal/day while asleep, and these mean values did not differ significantly. No differences in physiologic measurements during the awake and sleep states were found.

APPLICATIONS

There appears to be little difference in the metabolism of seriously injured burn patients while asleep and while awake. The study deemphasizes the importance of performing indirect calorimetry at rest in critically ill pediatric burn patients, and it supports the extrapolation of daily energy expenditure from a 15- to 20-minute steady-state measurement obtained during either sleep or wakefulness.

Body temperature regulation in the newborn infant: interaction with sleep and clinical implications

Thermoregulation in newborn infant differs from that of adult. Comparisons between sleep stages show that, during rapid eye movements (REM) sleep, the impairment of thermoregulatory responses in adult is not observed in newborn. Both behavioral and autonomic temperature regulations are always operative in the range of air temperatures usually imposed. The interaction between sleep and thermoregulation seems to be less important in newborns than in adults, suggesting that sleep processes are well protected, reducing the probability of occurrence of central dysfunction. According to the model describing thermoregulation during sleep on the basis of changes in the hierarchical dominance of brain structures, either the influence of diencephalic structures is never depressed in REM sleep or the functional autonomy of the rhombencephalon is still relevant in the immature encephalon of the newborn. The thermoregulatory model also allows understanding of inter-individual differences in thermoregulation and levels of thermoneutrality. An attempt has also been made to learn the role of heat stroke in the production of sudden infant death syndrome when body heat loss is hampered.

Energy conservation and sleep

Phylogenetic and ontogenetic associations between sleep and endothermy are consistent with the hypothesis that sleep evolved in conjunction with endothermy to offset the high energetic cost of endothermy. The electrophysiological and thermoregulatory continuum of slow wave sleep, circadian torpor and hibernation substantiates a primordial link between sleep and energy conservation. Sleep constitutes a circadian and circannual rhythm of hypometabolic adaptation to biospheric energy cycles that is usually entrained through light-mediated suppression of melatonin secretion. When energy stores decline, energy is conserved by lowering Tb proportionally during sleep or by increasing the daily duration of sleep.

Relationship between sleep stages and metabolic rate in humans

Differences in sleeping metabolic rate (SMR) among subjects may be related to different levels of energy expenditure associated with sleep stages. The relationship between energy expenditure and sleep stages was investigated overnight in 29 subjects (14 Caucasians and 15 Pima Indians, 18 males and 11 females; mean +/- SD, 31 +/- 7 yr, 83 +/- 26 kg, 27 +/- 11% fat). Sleep stages were determined by electroencephalogram recording, whereas energy expenditure was measured in a 1,000-liter Plexiglas sleep box constructed around a bed as a fast-response open-circuit indirect calorimeter. Eighty-five percent of the interindividual variability in SMR was explained by differences in fat-free mass, fat mass, age, sex, and race (r2 = 0.85). The intra-individual variance in SMR over time was related to sleep stages and to clock time. Within subjects, SMR in stage 3 was significantly lower than in stage 2 (-39 +/- 18 kcal/day; P < 0.05) and rapid eye movement sleep (-51 +/- 23 kcal/day; P < 0.05). Also, sleep stages were associated with different respiratory quotients. Because sleep stages are associated with only small differences in energy metabolism, our results suggest that sleep stages play a minor role in the variance of SMR among subjects. However, the duration of sleep may contribute to the variability of 24-h energy expenditure.

The effects of two different kinds of quilt on human core temperature during night sleep

Effects of two kinds of quilt with different thermal insulation properties between the upper and lower halves on human core temperature during night sleep were compared at an ambient temperature of 16 degrees C and a relative humidity of 50% in five healthy adult women. One quilt has a thick part (110 mm) in the upper half and a thin part (63 mm) in the lowest half (Quilt A), and the other has a thin part (63 mm) in the upper half and a thick part (110 mm) in the lower half (Quilt B). Subjects, wearing shirts with half-sleeves and breeches, slept on a bed with sleeping mat, being fully covered by either Quilt A or Quilt B from 22:00 to 06:00. The major finding was that rectal temperature fell more quickly in Quilt B after retiring at 22:00, being kept at a lower level during one third of the whole night. We suggest that the reduced level of rectal temperature in Quilt B might be ascribed to lower thermal insulation in the upper half side of the Quilt B and partly to different core-peripheral blood redistribution in the lower extremities between the two kinds of quilt. Rapid fall and lowered level rectal temperature in Quilt B might be of significance for ease in sleep onset and sleep depth.

Rectal temperature changes during sleep state transitions in term and preterm neonates at postconceptional term ages

Mean rectal temperatures in neonates were investigated during sleep state transitions as assessed by visually analyzed electroencephalographic-polygraphic recordings. Continuous 3-hour studies were obtained on 3 term and 5 preterm infants at postconceptional term ages using a 24-channel computerized monitoring system. In the study, 1,461 min were assigned an EEG state by traditional criteria. Mean rectal temperature measurements were tabulated for each minute of sleep. Data were analyzed both as 1,461 consecutive minutes of sleep, and as 28 complete ultradian neonatal sleep cycles. Exploratory analyses were performed using t tests, Mann-Whitney U tests, and one-way analysis of variance. Decreases in mean rectal temperatures followed a transition from active to quiet sleep for only the term group. The preterm group had higher temperatures at sleep onset than the term group and demonstrated no changes during state transitions. Higher temperatures were maintained in the preterm group during both active and quiet sleep (i.e., 36.7 degrees C versus 36.4 degrees C, P = .02) when 28 complete cycles of sleep were compared and during the transition when 658 min of active sleep were compared to 617 min of quiet sleep. These findings are preliminary; however, the phenomenon of state-dependent changes in mean rectal temperature in neonates based on electroencephalographic sleep is unreported. Higher mean rectal temperatures during active sleep and altered temperature responses during transition to quiet sleep in the preterm infant suggest altered brain function because of the preterm infant's adaptation to the extrauterine experience.

Assessment of hypothermia with a new "tympanic" thermometer

OBJECTIVE

Rapid and accurate core temperature measurement is vitally important in trauma patients, especially in those with accidental hypothermia. We tested a new aural thermometer to measure "tympanic" temperatures and assessed its accuracy during normothermic and hypothermic cardiopulmonary bypass.

METHODS

Tympanic, esophageal, and blood temperatures were compared in 10 patients undergoing open-heart surgery. In addition, the stability and reaction time of the tympanic thermometer was evaluated in 5 volunteers in a cold room, with and without facial fanning.

RESULTS

We observed a good linear correlation between tympanic and esophageal (r = 0.96) and blood (r = 0.81) temperature measurements during normothermia and hypothermia. There was no evidence of iatrogenic ear lesions in any of the patients. In the cold-room tests, stability was excellent and the time for adjustment of tympanic temperature measurement was about 2 min (with and without facial fanning).

CONCLUSION

The new tympanic thermoprobe is a simple, fast, and reliable device for measuring core temperature. The device was designed particularly for, and may be useful for, patients suffering from accidental hypothermia.

Peripheral thermal responsivity to facial cooling during sleep

A recently developed technique for examining thermal sensitivity during sleep was used to assess whether skin and core temperature responses to thermal stimulation were altered by sleep state. The technique was designed to probe thermal responsivity without altering core body temperature or inducing awakening. Twenty-seven young men and women were studied during a sleep deprivation night and a sleep night three nights later. Cold water stimulation of the face alternated with an equal period of rewarming across a 40-min cycle throughout the night. Skin temperature from the finger and rectal temperature were continuously assessed. Sleep continuity and architecture were largely uninfluenced by the thermal stimulation. Finger skin temperature decreased during cold facial stimulation in both sleep and waking states. Skin temperature changes during sleep were approximately one-fifth the magnitude of those during waking. Core temperature was minimally influenced. REM sleep was associated with a greater amplitude decrease in finger temperature than was non-REM (NREM) sleep. The results support the utility of the technique as a probe of thermal responsivity during sleep and suggest a reduction of thermal responsivity during sleep and, more tentatively, an altered responsivity during REM versus NREM sleep.

Human slow wave sleep: a review and appraisal of recent findings, with implications for sleep functions, and psychiatric illness

Recent findings concerning human slow wave sleep (hSWS-stages 3 + 4; delta EEG activity) are critically reviewed. Areas covered include the significance of the first hSWS cycle; hSWS in extended sleep; relationship between hSWS, prior wakefulness and sleep loss; hSWS influence on sleep length; problems with hSWS deprivation; influence of the circadian rhythm; individual differences in hSWS, especially, age, gender and constitutional variables such as physical fitness and body composition. Transient increases in hSWS can be produced by increasing both the quality and quantity of prior wakefulness, with an underlying mechanism perhaps relating to the waking level of brain metabolism. Whilst there may also be thermoregulatory influences on hSWS, hypotheses that energy conservation and brain cooling are major roles for hSWS are debatable. hSWS seems to offer some form of cerebral recovery, with the prefrontal cortex being particularly implicated. The hSWS characteristics of certain forms of major psychiatric disorders may well endorse this prefrontal link.

Selective SWS suppression does not affect the time course of core body temperature in men

In eight healthy middle-aged men, sleep and core body temperature were recorded under baseline conditions, during all-night SWS suppression by acoustic stimulation, and during undisturbed recovery sleep. SWS suppression resulted in a marked reduction of sleep stages 3 and 4 but did not affect the time course of core body temperature. These data suggest that sleep stages 3 and 4 of nonREM sleep (i.e. SWS) do not play a major role in the regulation of core body temperature in humans.

A brain-warming function for REM sleep

During REM sleep, arterial blood flow, neuronal firing rates, metabolism, and temperature increase in many parts of the CNS. Eye muscle tone also increases, and the eyes exhibit bursts of rapid movements. If one of the functions of sleep is to conserve energy, then it is curious that energy is so conspicuously expended in the vicinity of the CNS during REM sleep. The author hypothesizes that homeotherms use REM sleep to produce heat in order to maintain a high, stable temperature in a restricted CNS core during sleep. The fact that several of the active features of REM sleep heat the CNS, and the fact that REM sleep propensity increases when core temperature physiologically decreases, seem consistent with the hypothesis that REM sleep is a regulated mechanism for warming the CNS.

Circasemidian sleep propensity and the phase-amplitude maintenance model of human sleep/wake regulation

Evidence for circasemidian sleep/wake regulation is briefly reviewed with respect to protocols used to quantify sleep propensity. Existing models of sleep/wake regulation are examined in view of their ability to accommodate data which demonstrate an afternoon sleep period. Finally, a modelling approach is briefly outlined which emphasizes the maintenance of the phase and amplitude characteristics of the circadian rhythm of body (and brain) temperature and predicts the circasemidian phenomena.