1
|
Dawson A, Avraam J, Nicholas CL, Kay A, Thornton T, Feast N, Fridgant MD, O’Donoghue FJ, Trinder J, Jordan AS. Mechanisms underlying the prolonged activation of the genioglossus following arousal from sleep. Sleep 2024; 47:zsad202. [PMID: 37503934 PMCID: PMC10782491 DOI: 10.1093/sleep/zsad202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/17/2023] [Indexed: 07/29/2023] Open
Abstract
STUDY OBJECTIVES Transient arousal from sleep has been shown to elicit a prolonged increase in genioglossus muscle activity that persists following the return to sleep and which may protect against subsequent airway collapse. We hypothesized that this increased genioglossal activity following return to sleep after an arousal is due to persistent firing of inspiratory-modulated motor units (MUs) that are recruited during the arousal. METHODS Thirty-four healthy participants were studied overnight while wearing a nasal mask with pneumotachograph to measure ventilation and with 4 intramuscular genioglossus EMG electrodes. During stable N2 and N3 sleep, auditory tones were played to induce brief (3-15s) AASM arousals. Ventilation and genioglossus MUs were quantified before the tone, during the arousal and for 10 breaths after the return to sleep. RESULTS A total of 1089 auditory tones were played and gave rise to 239 MUs recorded across arousal and the return to sleep in 20 participants (aged 23 ± 4.2 years and BMI 22.5 ± 2.2 kg/m2). Ventilation was elevated above baseline during arousal and the first post-arousal breath (p < .001). Genioglossal activity was elevated for five breaths following the return to sleep, due to increased firing rate and recruitment of inspiratory modulated MUs, as well as a small increase in tonic MU firing frequency. CONCLUSIONS The sustained increase in genioglossal activity that occurs on return to sleep after arousal is primarily a result of persistent activity of inspiratory-modulated MUs, with a slight contribution from tonic units. Harnessing genioglossal activation following arousal may potentially be useful for preventing obstructive respiratory events.
Collapse
Affiliation(s)
- Andrew Dawson
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Joanne Avraam
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
- Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
- Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Amanda Kay
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Therese Thornton
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Nicole Feast
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Monika D Fridgant
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Fergal J O’Donoghue
- Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Faculty of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - John Trinder
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Amy S Jordan
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
- Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| |
Collapse
|
2
|
Avraam J, Dawson A, Nicholas CL, Fridgant MD, Fan FL, Kay A, Koay ZY, Greig R, O'Donoghue FJ, Trinder J, Jordan AS. The influence of alcohol on genioglossus single motor units in men and women during wakefulness. Exp Physiol 2023; 108:491-502. [PMID: 36533973 PMCID: PMC10103883 DOI: 10.1113/ep090580] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022]
Abstract
NEW FINDINGS What is the central question of this study? How does alcohol intake, which worsens obstructive sleep apnoea, alter motor control of the genioglossus muscle, an upper airway dilator, in healthy awake human volunteers, and does alcohol alter genioglossus muscle afterdischarge? What is the main finding and its importance? Alcohol consumption had a very minor effect on the activity of the genioglossus in healthy young individuals studied during wakefulness and did not alter afterdischarge, leaving open the possibility that alcohol worsens obstructive sleep apnoea via other mechanisms. ABSTRACT Alcohol worsens obstructive sleep apnoea (OSA). This effect is thought to be due to alcohol's depressant effect on upper airway dilator muscles such as the genioglossus, but how alcohol reduces genioglossal activity is unknown. The aim of this study was to investigate the effect of alcohol consumption on genioglossus muscle single motor units (MUs). Sixteen healthy individuals were studied on two occasions (alcohol: breath alcohol concentration ∼0.07% and placebo). They were instrumented with a nasal mask, four intramuscular genioglossal EMG electrodes, and an ear oximeter. They were exposed to 8-12 hypoxia trials (45-60 s of 10% O2 followed by one breath of 100% O2 ) while awake. MUs were sorted according to their firing patterns and quantified during baseline, hypoxia and recovery. For the alcohol and placebo conditions, global muscle activity (mean ± SD peak inspiratory EMG = 119.3 ± 44.1 and 126.5 ± 51.9 μV, respectively, P = 0.53) and total number of MUs recorded at baseline (68 and 67, respectively) were similar. Likewise, the peak discharge frequency did not differ between conditions (21.2 ± 4.28 vs. 22.4 ± 4.08 Hz, P = 0.09). There was no difference between conditions in the number (101 vs. 88, respectively) and distribution of MU classes during hypoxia, and afterdischarge duration was also similar. In this study, alcohol had a very minor effect on genioglossal activity and afterdischarge in these otherwise healthy young individuals studied while awake. If similar effects are observed during sleep, it would suggest that the worsening of OSA following alcohol may be related to increased upper airway resistance/nasal congestion or arousal threshold changes.
Collapse
Affiliation(s)
- Joanne Avraam
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
- Department of Respiratory and Sleep Medicine and Institute for Breathing and SleepAustin HealthHeidelbergVictoriaAustralia
| | - Andrew Dawson
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
| | - Christian L. Nicholas
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
- Department of Respiratory and Sleep Medicine and Institute for Breathing and SleepAustin HealthHeidelbergVictoriaAustralia
| | - Monika D. Fridgant
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
| | - Feiven Lee Fan
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
| | - Amanda Kay
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
| | - Zi Yi Koay
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
| | - Rachel Greig
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
| | - Fergal J. O'Donoghue
- Department of Respiratory and Sleep Medicine and Institute for Breathing and SleepAustin HealthHeidelbergVictoriaAustralia
- Faculty of MedicineUniversity of MelbourneParkvilleVictoriaAustralia
| | - John Trinder
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
| | - Amy S. Jordan
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
- Department of Respiratory and Sleep Medicine and Institute for Breathing and SleepAustin HealthHeidelbergVictoriaAustralia
| |
Collapse
|
3
|
Schenker MT, Theoswin PM, Qian H, Jordan AS, Nicholas CL, Felmingham KL. Sleep and day-to-day PTSD symptom variability: an ecological momentary assessment and actigraphy monitored study in trauma-exposed young adults. Eur J Psychotraumatol 2023; 14:2202058. [PMID: 37096587 PMCID: PMC10132228 DOI: 10.1080/20008066.2023.2202058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Disrupted sleep and post-traumatic stress disorder (PTSD) are bi-directionally linked and have been found to mutually reinforce each other on a day-to-day basis. However, most of the previous research has focused on subjective measures of sleep only. OBJECTIVE Here, we investigated the temporal relationship between sleep and PTSD symptoms using both subjective (sleep diary) and objective measures of sleep (actigraphy). METHODS Forty-one non-treatment seeking, trauma exposed young adults (age M = 24.68, SD = 8.15) with a range of PTSD symptom severities (PTSS, 0-53 on PCL-5) were recruited. Participants completed two surveys per day over four weeks to measure day-time PTSD symptoms (i.e. PTSS and number of intrusions) and night-time sleep subjectively, while wearing an actigraphy watch to measure sleep objectively. RESULTS Linear mixed models revealed that subjectively reported sleep disruptions were associated with elevated next-day PTSS and increasing number of intrusive memories both within and between participants. Similar results were found for daytime PTSD symptoms on night-time sleep. However, these associations were not found using objective sleep data. Exploratory moderator analyses including sex (male vs. female) found that these associations differed in strength between sexes but were generally in the same direction. DISCUSSION These results were in line with our hypothesis with regards to the sleep diary (subjective sleep), but not actigraphy (objective sleep). Several factors which have implications on both PTSD and sleep, such as the COVID-19 pandemic and/ or sleep-state misperception, may be potential reasons behind those discrepancies. However, this study had limited power and needs to be replicated in larger samples. Nonetheless, these results add to the current literature about the bi-directional relationship between sleep and PTSD and have clinical implications for treatment strategies.
Collapse
Affiliation(s)
- Maya T Schenker
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | | | - Hang Qian
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Amy S Jordan
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Kim L Felmingham
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| |
Collapse
|
4
|
Schenker MT, Ince S, Ney LJ, Hsu CMK, Zuj DV, Jordan AS, Nicholas CL, Felmingham KL. Sex differences in the effect of subjective sleep on fear conditioning, extinction learning, and extinction recall in individuals with a range of PTSD symptom severity. Behav Res Ther 2022; 159:104222. [PMID: 36327524 DOI: 10.1016/j.brat.2022.104222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 12/14/2022]
Abstract
Sleep has been found to play a key role in fear conditioning, extinction learning and extinction recall, and sleep disturbances are linked to many mental disorders including post-traumatic stress disorder (PTSD). Previous studies examining associations between sleep and fear or extinction processes primarily focused on objectively measured sleep architecture. Little research has so far focused on subjective sleep measures and particularly in clinical populations, which often experience subjectively poor sleep, including PTSD. Here we investigated whether subjective sleep disturbance, sleep onset latency, wake after sleep onset or sleep efficiency were related to fear conditioning, extinction learning or extinction recall in a large sample of individuals with a range of PTSD symptom severity (n = 248). Overall, we did not find that subjective sleep was associated with fear conditioning or extinction processes. However, exploratory analyses examining the moderating effect of sex found that shorter sleep onset latency and greater sleep efficiency were associated with improved extinction recall in women with higher PTSD symptom severity. This suggests that less time falling asleep and longer time asleep while in bed may be protective in highly symptomatic women against the commonly observed impaired extinction recall in PTSD. More studies are needed to explore sex-specific effects further.
Collapse
Affiliation(s)
- Maya T Schenker
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.
| | - Sevil Ince
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.
| | - Luke J Ney
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia; School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Chia-Ming K Hsu
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia.
| | - Daniel V Zuj
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia.
| | - Amy S Jordan
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.
| | - Kim L Felmingham
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia; School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia.
| |
Collapse
|
5
|
Jenkins CA, Tiley LCF, Lay I, Hartmann JA, Chan JKM, Nicholas CL. Comparing GENEActiv against Actiwatch-2 over Seven Nights Using a Common Sleep Scoring Algorithm and Device-Specific Wake Thresholds. Behav Sleep Med 2022; 20:369-379. [PMID: 34096407 DOI: 10.1080/15402002.2021.1924175] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Demonstrating inter-device reliability is essential to use devices interchangeably, and accurately integrate, interpret, or compare data from different actigraphs. Despite this, there is a paucity of comparative literature over a timeframe exceeding one night. The aims of this study were to determine an optimal wake threshold for GENEActiv and to evaluate the concordance between Actiwatch-2 and GENEActiv using a common algorithm (Phillips Respironics). Data were collected from 33 individuals (20 female) aged 20-35 years (M= 25.33, SD = 4.69) across a total 213 nights. Participants wore both devices simultaneously and continuously for seven days. The sleep parameters of interest were: total sleep time, sleep efficiency, sleep onset latency, and wake after sleep onset. Exploratory analyses of sensitivity, specificity, overall accuracy, mean bias, and paired samples t-tests indicated an optimal wake threshold of 115 for GENEActiv, compared with Actiwatch-2 at the 40 (medium, default) threshold. Using these thresholds, sensitivity, and overall accuracy of GENEActiv were both good (86% and 78%, respectively), however specificity was relatively low (40%). There were no significant inter-device differences for any sleep parameters, and all absolute mean biases were small. Overall, the findings from this study provide the first empirical evidence to support the reliability of GENEActiv against Actiwatch-2 over multiple nights using a common algorithm with device-specific wake thresholds.
Collapse
Affiliation(s)
- Claire A Jenkins
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Lucy C F Tiley
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Isabella Lay
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Jessica A Hartmann
- Orygen, Parkville, Australia.,Centre For Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Julia K M Chan
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia.,Institute for Breathing and Sleep, Heidelberg, Australia
| |
Collapse
|
6
|
Jenkins CA, Thompson KN, Nicholas CL, Hartmann JA, Chanen AM. Potential mechanisms underlying sleep disturbance in young people with borderline personality disorder features: an exploratory study. Borderline Personal Disord Emot Dysregul 2022; 9:10. [PMID: 35264240 PMCID: PMC8908552 DOI: 10.1186/s40479-022-00180-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/11/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Sleep disturbance is common among young people (15-25 years) with features of borderline personality disorder (BPD). However, the mechanisms underlying sleep disturbance in BPD remain unknown. Understanding these underlying processes is essential to guide the development of sleep-improvement interventions and to optimise their efficacy through identifying beneficial treatment targets. This exploratory study aimed to investigate potential underlying mechanisms to inform future hypotheses, research development, and provide insight into potential treatment targets to improve sleep in young people with BPD. This study explored the indirect roles of emotion regulation difficulties, depression, anxiety and stress in the relationship between BPD features and sleep disturbance in young people. METHODS Sleep was measured subjectively (self-report questionnaires) and objectively (10 days wrist actigraphy) in 40 young people with BPD features and 38 healthy young people. Participants also completed the Difficulties in Emotion Regulation Scale and the Depression, Anxiety and Stress Scale. RESULTS Mediation analyses revealed that impulse control difficulties, limited emotion regulation strategies and anxiety indirectly affected the relationship between group (BPD vs. healthy) and subjective sleep disturbance in young people. Lack of emotional awareness and anxiety contributed to associations between group and objectively longer time in bed and bedtime variability, respectively. CONCLUSIONS These preliminary findings suggest that targeting emotional dysregulation (impulse control, strategies, emotional awareness) and anxiety might be beneficial for improving sleep in this population.
Collapse
Affiliation(s)
- Claire A Jenkins
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.,Orygen, Melbourne, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Katherine N Thompson
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia
| | - Jessica A Hartmann
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Andrew M Chanen
- Orygen, Melbourne, Australia. .,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
| |
Collapse
|
7
|
Abstract
Sleep disturbance is commonly reported in young people with features of borderline personality disorder (BPD). Examining sleep quality and sleep-wake patterns in young people with features of BPD is essential to inform the development of sleep-improvement interventions. A scoping review was conducted according to the Joanna Briggs Institute methodology. The objectives were to map the literature regarding sleep in young people with features of BPD, highlight areas for further investigation, and provide methodological recommendations for future research. Seven data sets were included in the review. Young people with features of BPD had poorer objective and subjective sleep quality, disturbed sleep architecture (particularly rapid-eye-movement sleep), an increased vulnerability to delayed sleep phase syndrome, and more nightmares and dream anxiety, compared with healthy individuals. Future research should use both objective and subjective sleep measures, include clinical comparison groups, and focus specifically on young people with BPD.
Collapse
Affiliation(s)
- Claire A Jenkins
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia.,Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Katherine N Thompson
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia.,Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
| | - Andrew M Chanen
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
8
|
Wen CCY, Nicholas CL, Howard ME, Trinder J, Jordan AS. Understanding Sleepiness and Fatigue in Cabin Crew Using COVID-19 to Dissociate Causative Factors. Aerosp Med Hum Perform 2022; 93:50-53. [PMID: 35063056 DOI: 10.3357/amhp.5925.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES: Airline cabin crew experience high levels of fatigue and sleepiness. Whether these are solely related to their work schedules/jetlag or are in part related to individual factors is unknown. The COVID-19 pandemic has significantly disrupted the aviation industry and many cabin crew have been grounded. This provides a unique opportunity to assess the causes of fatigue and sleepiness in this population.METHODS: An online anonymous survey was distributed in April-June 2020 to cabin crew who were 1) flying, 2) grounded but doing alternative work, and 3) grounded, not working, or unemployed. The survey measured fatigue, sleepiness, and mental health. It also screened their risk for insomnia, depression, and shift work disorder and assessed drug and caffeine use.RESULTS: Collected were 409 valid responses: 45 currently flying; 35 grounded but doing alternate work; and 329 not working. On average, all three groups experienced normal levels of fatigue and sleepiness. The risk for major depressive disorder was 27.4%, with 59.5% of individuals reporting abnormal levels of anxiety. Caffeine intake and the use of drugs and alcohol to facilitate sleep were common, although not different between those currently flying vs. grounded.CONCLUSIONS: With reduced workloads or not flying, cabin crew reported lowered fatigue and sleepiness compared to prepandemic findings, along with reduced risk for major depressive disorder. However, a high occurrence of negative emotional states were reported, potentially related to the uncertainty surrounding the pandemic. This study suggests fatigue and sleepiness is primarily related to airline operational rather than personal variables.Wen CC-Y, Nicholas CL, Howard ME, Trinder J, Jordan AS. Understanding sleepiness and fatigue in cabin crew using COVID-19 to dissociate causative factors. Aerosp Med Hum Perform. 2022; 93(1):50-53.
Collapse
|
9
|
Jenkins CA, Thompson KN, Chanen AM, Hartmann JA, Nicol K, Nicholas CL. Subjective and objective sleep in young people with borderline personality disorder features. J Sleep Res 2021; 31:e13463. [PMID: 34409668 DOI: 10.1111/jsr.13463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/21/2021] [Accepted: 07/28/2021] [Indexed: 01/02/2023]
Abstract
Characterising sleep in young people (aged 15-25 years) with borderline personality disorder (BPD) features is crucial given the association between BPD features and sleep disturbance, negative consequences of poor sleep, and normative developmental sleep changes that occur in this age group. The present study aimed to characterise the sleep profile of young people with BPD to determine whether this profile is non-normative and specific to BPD. Participants were 96 young people (40 with BPD features, 38 healthy individuals, and 18 young people seeking help for mental health difficulties without BPD). Sleep was measured subjectively (self-report questionnaires) and objectively (10 days of actigraphy). Young people with BPD features reported poorer subjective sleep quality, greater insomnia symptoms and later chronotype than same-age healthy and clinical comparison groups. Young people with BPD features also displayed irregular sleep timing, later rise times, greater time in bed and longer sleep durations than healthy young people. Those with BPD features had superior sleep quality (greater sleep efficiency, less wake after sleep onset) and longer sleep durations than the clinical comparison group. Sleep profiles were similar across young people with BPD features with and without co-occurring depression. Overall, the findings revealed a subjective-objective sleep discrepancy and suggest that sleep-improvement interventions might be beneficial to improve subjective sleep in young people with BPD features.
Collapse
Affiliation(s)
- Claire A Jenkins
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia.,Orygen, Parkville, Victoria., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Katherine N Thompson
- Orygen, Parkville, Victoria., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrew M Chanen
- Orygen, Parkville, Victoria., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Jessica A Hartmann
- Orygen, Parkville, Victoria., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Katie Nicol
- Orygen, Parkville, Victoria., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia.,Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
| |
Collapse
|
10
|
Avraam J, Dawson A, Feast N, Fan FL, D Frigant M, Kay A, Koay ZY, Jia P, Greig R, Thornton T, Nicholas CL, O'Donoghue FJ, Trinder J, Jordan AS. After-Discharge in the Upper Airway Muscle Genioglossus Following Brief Hypoxia. Sleep 2021; 44:6208283. [PMID: 33822200 DOI: 10.1093/sleep/zsab084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/10/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Genioglossus after-discharge is thought to protect against pharyngeal collapse by minimising periods of low upper airway muscle activity. How genioglossus after-discharge occurs and which single motor units (SMUs) are responsible for the phenomenon are unknown. The aim of this study was to investigate genioglossal after-discharge. METHODS During wakefulness, after-discharge was elicited 8-12 times in healthy individuals with brief isocapnic hypoxia (45-60s of 10%O2 in N2) terminated by a single breath of 100% O2. Genioglossus SMUs were designated as firing solely, or at increased rate, during inspiration (Inspiratory phasic [IP] and inspiratory tonic [IT] respectively); solely, or at increased rate, during expiration (Expiratory phasic [EP] or expiratory tonic [ET] respectively) or firing constantly without respiratory modulation (Tonic). SMUs were quantified at baseline, the end of hypoxia, the hyperoxic breath and the following 8 normoxic breaths. RESULTS 210 SMU's were identified in 17 participants. Genioglossus muscle activity was elevated above baseline for 7 breaths after hyperoxia (p<0.001), indicating a strong after-discharge effect. After-discharge occurred due to persistent firing of IP and IT units that were recruited during hypoxia, with minimal changes in ET, EP or Tonic SMUs. The firing frequency of units that were already active changed minimally during hypoxia or the afterdischarge period (P>0.05). CONCLUSION That genioglossal after-discharge is almost entirely due to persistent firing of previously silent inspiratory SMUs provides insight into the mechanisms responsible for the phenomenon and supports the hypothesis that the inspiratory and expiratory/tonic motor units within the muscle have idiosyncratic functions.
Collapse
Affiliation(s)
- Joanne Avraam
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.,Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Andrew Dawson
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Nicole Feast
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Feiven Lee Fan
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Monika D Frigant
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Amanda Kay
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Zi Yi Koay
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Pingdong Jia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Rachel Greig
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Therese Thornton
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.,Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Fergal J O'Donoghue
- Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.,Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - John Trinder
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Amy S Jordan
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.,Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| |
Collapse
|
11
|
Wen CCY, Nicholas CL, Clarke-Errey S, Howard ME, Trinder J, Jordan AS. Health Risks and Potential Predictors of Fatigue and Sleepiness in Airline Cabin Crew. Int J Environ Res Public Health 2020; 18:ijerph18010013. [PMID: 33375088 PMCID: PMC7792809 DOI: 10.3390/ijerph18010013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 01/14/2023]
Abstract
Background: Aviation pilots and cabin crew regularly undertake shift work, and may experience circadian disruption, restricted sleep, sleepiness and impaired health. Research on aviation fatigue and sleepiness has focused on pilots, with less being known about cabin crew. This study aimed to identify likely predictors of fatigue, sleepiness, shift work disorder (SWD) and depression in cabin crew. Methods: An online anonymous survey was distributed to active cabin crew around the world. It measured sleepiness, fatigue, and screened for insomnia, depression and SWD. Information on individuals’ habits and work schedules were collected. Results: 930 valid responses were analysed. 63.5% of the sample had abnormal levels of fatigue and 46.9% experienced excessive daytime sleepiness. 68.0% were at risk for SWD, 57.7% screened positive for insomnia, and 40.0% for depression. Caffeine and use of alcohol and drugs for sleep were independently associated with insomnia and SWD (p < 0.05), whereas, type of route (international, domestic, both) and number of duty days per week predicted fatigue (p < 0.05). Conclusions: Cabin crew had a high prevalence of fatigue, sleepiness and elevated risk for SWD, insomnia and depression. Many cabin crew engaged in behaviours detrimental to good sleep hygiene, highlighting targets for future interventional studies.
Collapse
Affiliation(s)
- Candice C. Y. Wen
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC 3010, Australia; (C.L.N.); (M.E.H.); (J.T.); (A.S.J.)
- Correspondence:
| | - Christian L. Nicholas
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC 3010, Australia; (C.L.N.); (M.E.H.); (J.T.); (A.S.J.)
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC 3084, Australia
| | - Sandy Clarke-Errey
- Statistical Consulting Centre, University of Melbourne, Parkville, VIC 3010, Australia;
| | - Mark E. Howard
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC 3010, Australia; (C.L.N.); (M.E.H.); (J.T.); (A.S.J.)
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC 3084, Australia
| | - John Trinder
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC 3010, Australia; (C.L.N.); (M.E.H.); (J.T.); (A.S.J.)
| | - Amy S. Jordan
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC 3010, Australia; (C.L.N.); (M.E.H.); (J.T.); (A.S.J.)
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC 3084, Australia
| |
Collapse
|
12
|
Botchway EN, Godfrey C, Ryan NP, Hearps S, Nicholas CL, Anderson VA, Catroppa C. Sleep Disturbances in Young Adults with Childhood Traumatic Brain Injury: Relationship with Fatigue, Depression, and Quality of Life. Brain Inj 2020; 34:1579-1589. [PMID: 33054410 DOI: 10.1080/02699052.2020.1832704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study assessed the consequences of childhood traumatic brain injury (TBI) on sleep, fatigue, depression, and quality of life (QoL) outcomes and explored the relationships between these variables at 20 years following childhood TBI. PARTICIPANTS We followed up 54 young adults with mild, moderate, and severe TBI, and 13 typically developing control (TDC) participants, recruited at the time of TBI. METHODS Sleep was assessed with the Pittsburgh Sleep Quality Index and actigraphy. RESULTS At 20 years postinjury, results showed no significant difference between whole TBI group and TDC participants on subjective sleep quality; however, the moderate TBI group reported significantly poorer subjective sleep quality compared to those with severe TBI. Poorer subjective sleep was associated with increased symptoms of fatigue, depression, and poorer perceptions of General Health in the TBI group. Actigraphic sleep efficiency, fatigue, depression, and QoL outcomes were not significantly different between TBI and TDC or among TBI severity groups. CONCLUSIONS These preliminary findings underscore associations between subjective sleep disturbance, fatigue, depression, and QoL in this TBI sample, and mostly comparable outcomes in sleep, fatigue, depression, and QoL between the TBI and TDC groups. Further research is required to clarify these findings.
Collapse
Affiliation(s)
- Edith N Botchway
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Department of Psychology, Royal Children's Hospital , Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne , Melbourne, Australia
| | - Celia Godfrey
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Department of Psychology, Royal Children's Hospital , Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne , Melbourne, Australia
| | - Nicholas P Ryan
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Department of Psychology, Royal Children's Hospital , Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne , Melbourne, Australia.,Cognitive Neuroscience Unit, Deakin University , Geelong, Victoria, Australia
| | - Stephen Hearps
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Department of Psychology, Royal Children's Hospital , Parkville, Victoria, Australia
| | - Christian L Nicholas
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Melbourne School of Psychological Sciences, University of Melbourne , Melbourne, Australia.,Institute for Breathing and Sleep, Austin Health , Heidelberg, Victoria, Australia
| | - Vicki A Anderson
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Department of Psychology, Royal Children's Hospital , Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne , Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne , Melbourne, Australia
| | - Cathy Catroppa
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Department of Psychology, Royal Children's Hospital , Parkville, Victoria, Australia.,Melbourne School of Psychological Sciences, University of Melbourne , Melbourne, Australia
| |
Collapse
|
13
|
Ishkova A, Wilson DL, Howard ME, Walker SP, Barnes M, Nicholas CL, Jordan AS. The effect of body position on maternal cardiovascular function during sleep and wakefulness in late pregnancy. J Matern Fetal Neonatal Med 2020; 35:2545-2554. [PMID: 32669005 DOI: 10.1080/14767058.2020.1789583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION An association between the increased risk of late stillbirth and the maternal supine sleeping position has been recently established. The risk of stillbirth following supine sleep has been suspected to occur as a result of aortocaval compression by the gravid uterus. A number of studies conducted during wakefulness have reported compromised cardiovascular function during supine rest, as demonstrated by reductions in cardiac output, blood pressure and utero-placental blood flow. It remains unclear whether similar effects are also present during sleep, due to the presence of key sleep-specific changes in cardiovascular function. OBJECTIVE To investigate the changes in maternal cardiovascular function between the supine and left-lateral positions during wakefulness and non-rapid eye movement (NREM) sleep in late pregnancy. METHODS Twenty-nine women with a singleton pregnancy between 24.7 and 36.7 weeks' gestation participated in a single overnight sleep study. Physiological measures (blood pressure, heart rate, heart rate variability - HRV, and pulse arrival time - PAT) were measured and recorded throughout the night using standard polysomnography equipment and the Portapres Model-2 device. As the present study evaluated cardiovascular changes during natural rest and sleep in pregnancy, participants were not given explicit instructions on which position to adopt. Body position was continuously recorded using a position monitor and verified with video recording. RESULTS No changes in systolic, diastolic or mean arterial blood pressure were observed between the left-lateral and supine positions during wakefulness or sleep. However, heart rate was significantly higher in the supine position compared to the left during wakefulness (p= .03), with a similar trend present during sleep (p= .11). A significantly shorter PAT was measured in the supine position (compared to the left) during wakefulness (p= .01) and sleep (p= .01). No change in HRV measures was observed between the left and supine positions in either state. CONCLUSION Blood pressure did not appear to differ significantly between the left-lateral and supine positions during wakefulness and sleep. The lack of blood pressure differences may reflect elevated sympathetic activity during rest and sleep in the supine position (compared to the left), suggesting that some degree of compensation for aortocaval compression may still be possible during sleep.
Collapse
Affiliation(s)
- Anna Ishkova
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
| | - Danielle L Wilson
- Austin Health, Institute for Breathing and Sleep, Heidelberg, Australia.,Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Australia.,Department of Medicine, University of Melbourne, Parkville, Australia
| | - Mark E Howard
- Austin Health, Institute for Breathing and Sleep, Heidelberg, Australia.,Department of Medicine, University of Melbourne, Parkville, Australia
| | - Susan P Walker
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Maree Barnes
- Austin Health, Institute for Breathing and Sleep, Heidelberg, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia.,Austin Health, Institute for Breathing and Sleep, Heidelberg, Australia
| | - Amy S Jordan
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia.,Austin Health, Institute for Breathing and Sleep, Heidelberg, Australia
| |
Collapse
|
14
|
Diep C, Ftouni S, Manousakis JE, Nicholas CL, Drummond SPA, Anderson C. Acoustic slow wave sleep enhancement via a novel, automated device improves executive function in middle-aged men. Sleep 2020; 43:5613713. [PMID: 31691831 DOI: 10.1093/sleep/zsz197] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 05/21/2019] [Indexed: 02/06/2023] Open
Abstract
STUDY OBJECTIVES As slow-wave activity (SWA) is critical for cognition, SWA-enhancing technologies provide an exciting opportunity to improve cognitive function. We focus on improving cognitive function beyond sleep-dependent memory consolidation, using an automated device, and in middle-aged adults, who have depleted SWA yet a critical need for maximal cognitive capacity in work environments. METHODS Twenty-four healthy adult males aged 35-48 years participated in a randomized, double-blind, cross-over study. Participants wore an automated acoustic stimulation device that monitored real-time sleep EEG. Following an adaptation night, participants were exposed to either acoustic tones delivered on the up phase of the slow-wave (STIM) or inaudible "tones" during equivalent periods of stimulation (SHAM). An executive function test battery was administered after the experimental night. RESULTS STIM resulted in an increase in delta (0.5-4 Hz) activity across the full-night spectra, with enhancement being maximal at 1 Hz. SWA was higher for STIM relative to SHAM. Although no group differences were observed in any cognitive outcomes, due to large individual differences in SWA enhancement, higher SWA responders showed significantly improved verbal fluency and working memory compared with nonresponders. Significant positive associations were found between SWA enhancement and improvement in these executive function outcomes. CONCLUSIONS Our study suggests that (1) an automated acoustic device enhances SWA; (2) SWA enhancement improves executive function; (3) SWA enhancement in middle-aged men may be an important therapeutic target for enhancing cognitive function; and (4) there is a need to examine interindividual responses to acoustic stimulation and its effect on subsequent cognitive function. CLINICAL TRIAL REGISTRATION This study has been registered with the Australian New Zealand Clinical Trials Registry. "The efficacy of acoustic tones in slow-wave sleep enhancement and cognitive function in healthy adult males". https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371548&isReview=true. REGISTRATION ACTRN12617000399392.
Collapse
Affiliation(s)
- Charmaine Diep
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Notting Hill, Victoria, Australia
| | - Suzanne Ftouni
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Notting Hill, Victoria, Australia
| | - Jessica E Manousakis
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Institute for Breathing and Sleep, Austin Hospital, Melbourne, Victoria, Australia
| | - Sean P A Drummond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Clare Anderson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Notting Hill, Victoria, Australia
| |
Collapse
|
15
|
Cavuoto MG, Kinsella GJ, Ong B, Pike KE, Nicholas CL. Naturalistic Measurement of Sleep in Older Adults with Amnestic Mild Cognitive Impairment: Anxiety Symptoms Do Not Explain Sleep Disturbance. Curr Alzheimer Res 2020; 16:233-242. [PMID: 30827241 DOI: 10.2174/1567205016666190301104645] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/14/2018] [Accepted: 01/31/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sleep disturbance is prevalent in Alzheimer's disease (AD). In amnestic mild cognitive impairment (aMCI), the preclinical stage of AD, deterioration in sleep quality has also been reported. Consensus is lacking, however, regarding what aspects of sleep are characteristically affected, whether the setting of the sleep recordings impacts these findings, and whether anxiety may account for the differences. OBJECTIVE The current study aimed to address these knowledge gaps by obtaining comprehensive sleep measurement in aMCI within a naturalistic environment using in-home sleep recordings. METHODS 17 healthy older adults and twelve participants with aMCI wore an actiwatch for two weeks to objectively record habitual sleeping patterns and completed two nights of in-home polysomnography. RESULTS In aMCI, habitual sleep disturbances were evident on actigraphy including greater wake after sleep onset (p = .012, d = 0.99), fragmentation (p = .010, d = 1.03), and time in bed (p = .046, d = .76). Although not statistically significant, there was a large group effect on polysomnography with aMCI demonstrating less slow-wave-sleep than controls (p >.05, d = .0.83). Anxiety did not mediate the relationship between the group and sleep in this small study. CONCLUSIONS The results indicate that people with aMCI have poorer quality sleep than healthy controls, as indicated by greater sleep disruption and less slow-wave sleep, even in naturalistic settings. Additionally, anxiety symptoms do not mediate the relationship. Therefore, this research supports the view that sleep disturbance is likely to be indicative of neuropathological changes in aMCI rather than being attributed to psychological factors.
Collapse
Affiliation(s)
- Marina G Cavuoto
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia.,Department of Psychology, Caulfield Hospital, Caulfield, Victoria, Australia
| | - Glynda J Kinsella
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia.,Department of Psychology, Caulfield Hospital, Caulfield, Victoria, Australia
| | - Ben Ong
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Kerryn E Pike
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia.,Institute for Breathing & Sleep, Heidelberg, Victoria, Australia
| |
Collapse
|
16
|
Pittaway I, Ishkova A, Bean H, McCarthy S, Lay I, Avraam J, Dawson A, Thornton T, Nicholas CL, Trinder J, O'Donoghue FJ, Jackson ML, Jordan AS. Does Nasal Obstruction Induce Obstructive Sleep Apnea in Healthy Women? Nat Sci Sleep 2020; 12:347-355. [PMID: 32607034 PMCID: PMC7319502 DOI: 10.2147/nss.s254473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/11/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Obstructive sleep apnea (OSA) is less prevalent among women and is associated with different symptoms and consequences to OSA in men. The reasons for these differences are unknown and difficult to tease apart in clinical populations. If OSA could be temporarily induced in healthy men and women, the causes of some of these differences could be investigated. Nasal blocking has been used to induce OSA in healthy men but its effect in women has not been reported. PATIENTS AND METHODS A total of 14 healthy individuals (10 women) underwent in-laboratory diagnostic sleep studies on two occasions separated by a week. On one occasion, the nasal passages were blocked, whereas on the other occasion, participants slept naturally. In both conditions, a full-face mask was used to monitor respiratory events. Participants' self-reported sleepiness, mood and performance on a motor learning task were assessed in the evening and morning of both sleep studies. Furthermore, endothelial function and self-reported sleep quality were assessed in the morning following each study. RESULTS Nasal blockage induced OSA in healthy young (age=22±3 years) and slim (BMI=22.2±3.2 kg/m2) women (control AHI=2.0±2.6, blocked AHI=33.1±36.7 events/hr, p=0.02). One night of OSA was associated with poorer self-reported sleep quality (p<0.001) and increased self-reported snoring (p<0.04), choking and gasping during sleep (p<0.001) but was not associated with alterations in mood, neurocognitive or endothelial function on the following morning. CONCLUSION Nasal blockage induces OSA in healthy, young, and normal weight women. However, whether the induced OSA is representative of naturally occurring OSA and the technique useful for future studies is unclear.
Collapse
Affiliation(s)
- Islay Pittaway
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Anna Ishkova
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Helena Bean
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Stephanie McCarthy
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Isabella Lay
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Joanne Avraam
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Andrew Dawson
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Therese Thornton
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia.,Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC 3084, Australia
| | - John Trinder
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Fergal J O'Donoghue
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC 3084, Australia.,Department of Medicine, The University of Melbourne, Austin Hospital, Heidelberg, VIC 3084, Australia
| | - Melinda L Jackson
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC 3084, Australia.,Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3164, Australia
| | - Amy S Jordan
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia.,Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC 3084, Australia
| |
Collapse
|
17
|
Botchway EN, Godfrey C, Nicholas CL, Hearps S, Anderson V, Catroppa C. Objective sleep outcomes 20 years after traumatic brain injury in childhood. Disabil Rehabil 2019; 42:2393-2401. [PMID: 30945574 DOI: 10.1080/09638288.2019.1578422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To assess objective sleep outcomes and correlates in young adults with a history of childhood traumatic brain injury.Materials and methods: Participants included 45 young adults who sustained brain injury in childhood (mild = 12, moderate = 22, and severe = 11) and 13 typically developing control participants. Sleep was assessed with actigraphy and sleep diaries recorded over 14 consecutive days. Rates of good sleep (sleep efficiency ≥ 85%) and poor sleep (sleep efficiency < 85%) were also evaluated.Results: At 20-years postinjury, participants with traumatic brain injury and controls presented with similar outcomes across the objective sleep parameters (all p > 0.050) and rates of poor sleepers were also similar between these groups (p = 0.735): 67% and 77%, respectively. However, moderate and severe traumatic brain injury and female sex were associated with longer sleep duration.Conclusions: These findings provide preliminary insights into objective sleep outcome and associated factors in the very-long-term after childhood brain injuries. They also indicate the need to monitor sleep outcomes in young adults with and without traumatic brain injury.Implication for rehabilitationSustaining traumatic brain injury in childhood can impact on several functional domains including sleep.Sleep disturbances, particularly insomnia-related symptoms, are common in this population, with evidence of poor outcomes reported until adolescence postinjury, while outcomes beyond adolescence remain unexplored.In this first investigation of objective sleep outcomes in young adults with a history of childhood traumatic brain injury, we showed that insomnia-related symptoms are highly prevalent in both young adults with traumatic brain injury (67%) and healthy controls (77%).These findings suggest the need to routinely evaluate and treat sleep problem in young adults in general, irrespective of history of childhood traumatic brain injury.
Collapse
Affiliation(s)
- Edith N Botchway
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Celia Godfrey
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Christian L Nicholas
- Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.,Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
| | - Stephen Hearps
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| |
Collapse
|
18
|
Allocca G, Ma S, Martelli D, Cerri M, Del Vecchio F, Bastianini S, Zoccoli G, Amici R, Morairty SR, Aulsebrook AE, Blackburn S, Lesku JA, Rattenborg NC, Vyssotski AL, Wams E, Porcheret K, Wulff K, Foster R, Chan JKM, Nicholas CL, Freestone DR, Johnston LA, Gundlach AL. Validation of 'Somnivore', a Machine Learning Algorithm for Automated Scoring and Analysis of Polysomnography Data. Front Neurosci 2019; 13:207. [PMID: 30936820 PMCID: PMC6431640 DOI: 10.3389/fnins.2019.00207] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/22/2019] [Indexed: 12/14/2022] Open
Abstract
Manual scoring of polysomnography data is labor-intensive and time-consuming, and most existing software does not account for subjective differences and user variability. Therefore, we evaluated a supervised machine learning algorithm, SomnivoreTM, for automated wake–sleep stage classification. We designed an algorithm that extracts features from various input channels, following a brief session of manual scoring, and provides automated wake-sleep stage classification for each recording. For algorithm validation, polysomnography data was obtained from independent laboratories, and include normal, cognitively-impaired, and alcohol-treated human subjects (total n = 52), narcoleptic mice and drug-treated rats (total n = 56), and pigeons (n = 5). Training and testing sets for validation were previously scored manually by 1–2 trained sleep technologists from each laboratory. F-measure was used to assess precision and sensitivity for statistical analysis of classifier output and human scorer agreement. The algorithm gave high concordance with manual visual scoring across all human data (wake 0.91 ± 0.01; N1 0.57 ± 0.01; N2 0.81 ± 0.01; N3 0.86 ± 0.01; REM 0.87 ± 0.01), which was comparable to manual inter-scorer agreement on all stages. Similarly, high concordance was observed across all rodent (wake 0.95 ± 0.01; NREM 0.94 ± 0.01; REM 0.91 ± 0.01) and pigeon (wake 0.96 ± 0.006; NREM 0.97 ± 0.01; REM 0.86 ± 0.02) data. Effects of classifier learning from single signal inputs, simple stage reclassification, automated removal of transition epochs, and training set size were also examined. In summary, we have developed a polysomnography analysis program for automated sleep-stage classification of data from diverse species. Somnivore enables flexible, accurate, and high-throughput analysis of experimental and clinical sleep studies.
Collapse
Affiliation(s)
- Giancarlo Allocca
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.,Somnivore Pty. Ltd., Parkville, VIC, Australia
| | - Sherie Ma
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.,Somnivore Pty. Ltd., Parkville, VIC, Australia
| | - Davide Martelli
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.,Laboratory of Autonomic and Behavioral Physiology, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Matteo Cerri
- Laboratory of Autonomic and Behavioral Physiology, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Flavia Del Vecchio
- Laboratory of Autonomic and Behavioral Physiology, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Stefano Bastianini
- PRISM Laboratory, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giovanna Zoccoli
- PRISM Laboratory, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Roberto Amici
- Laboratory of Autonomic and Behavioral Physiology, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Stephen R Morairty
- Center for Neuroscience, Biosciences Division, SRI International, Menlo Park, CA, United States
| | - Anne E Aulsebrook
- School of BioSciences, The University of Melbourne, Parkville, VIC, Australia
| | - Shaun Blackburn
- School of Life Sciences, La Trobe University, Bundoora, VIC, Australia
| | - John A Lesku
- School of Life Sciences, La Trobe University, Bundoora, VIC, Australia.,Avian Sleep Group, Max Planck Institute for Ornithology, Seewiesen, Germany
| | - Niels C Rattenborg
- Avian Sleep Group, Max Planck Institute for Ornithology, Seewiesen, Germany
| | - Alexei L Vyssotski
- Institute of Neuroinformatics, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Emma Wams
- The Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Kate Porcheret
- The Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Katharina Wulff
- The Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Russell Foster
- The Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Julia K M Chan
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.,Institute of Breathing and Sleep, Austin Health, Heidelberg, VIC, Australia
| | - Dean R Freestone
- Department of Medicine, St. Vincent's Hospital, The University of Melbourne, Fitzroy, VIC, Australia
| | - Leigh A Johnston
- Biomedical Engineering, The University of Melbourne, Parkville, VIC, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrew L Gundlach
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.,Somnivore Pty. Ltd., Parkville, VIC, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
19
|
Botchway EN, Godfrey C, Anderson V, Nicholas CL, Catroppa C. Outcomes of Subjective Sleep–Wake Disturbances Twenty Years after Traumatic Brain Injury in Childhood. J Neurotrauma 2019; 36:669-678. [DOI: 10.1089/neu.2018.5743] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Edith N. Botchway
- Murdoch Children's Research Institute, Melbourne, Australia
- Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Celia Godfrey
- Murdoch Children's Research Institute, Melbourne, Australia
- Royal Children's Hospital, Melbourne, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, Melbourne, Australia
- Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Christian L. Nicholas
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, Melbourne, Australia
- Royal Children's Hospital, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| |
Collapse
|
20
|
Cori JM, Nicholas CL, Avraam J, Lee VV, Schembri R, Jackson ML, Jordan AS. The Effects of Experimental Sleep Fragmentation and Sleep Deprivation on the Response of the Genioglossus Muscle to Inspiratory Resistive Loads. J Clin Sleep Med 2018; 14:715-724. [PMID: 29734983 DOI: 10.5664/jcsm.7090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 12/13/2017] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Poor upper airway dilator muscle function may contribute to obstructive sleep apnea (OSA). Sleep deprivation reduces dilator muscle responsiveness, but sleep fragmentation, which is most characteristic of OSA, has not been assessed. This study compared the effects of sleep deprivation and fragmentation on dilator muscle responsiveness during wakefulness. METHODS Twenty-four healthy individuals (10 female) participated in two consecutive overnight polysomnography (PSG) sessions. The first was an adaptation PSG of normal sleep. The second was an experimental PSG, where participants were allocated to groups of either normal sleep, no sleep, or fragmented sleep. Inspiratory resistive loading assessment occurred the morning following each PSG. Four 10 cmH2O and four 20 cmH2O loads were presented in random order for 60 seconds while participants were awake and supine. Sleep (electroencephalogram, electrooculogram, electromyogram [EMG]), intramuscular genioglossus activity (EMGGG), and ventilation were measured throughout the loading sessions. RESULTS Five controls, seven sleep deprivation participants, and seven sleep fragmentation participants provided data. Contrary to expectations, neither EMGGG nor ventilation showed significant interaction effects (group × session × load) during resistive loading. There was a main effect of load, with peak EMGGG (mean % max ± standard error) significantly higher for the 20 cmH2O load (4.1 ± 0.6) than the 10 cmH2O load (3.3 ± 0.6) across both sessions and all groups. Similar results were observed for peak inspiratory flow, duty cycle, and mask pressure. CONCLUSIONS Upper airway function was not affected by 1 night of no sleep or poor-quality sleep. This raises doubt as to whether fragmented sleep in OSA increases disorder severity via reduced upper airway dilator responses.
Collapse
Affiliation(s)
- Jennifer M Cori
- Institute for Breathing and Sleep and Austin Health, Heidelberg, Victoria, Australia
| | - Christian L Nicholas
- Institute for Breathing and Sleep and Austin Health, Heidelberg, Victoria, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Joanne Avraam
- Institute for Breathing and Sleep and Austin Health, Heidelberg, Victoria, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - V Vien Lee
- Institute for Breathing and Sleep and Austin Health, Heidelberg, Victoria, Australia.,School of Health & Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Rachel Schembri
- Institute for Breathing and Sleep and Austin Health, Heidelberg, Victoria, Australia.,School of Health & Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Melinda L Jackson
- Institute for Breathing and Sleep and Austin Health, Heidelberg, Victoria, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.,School of Health & Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Amy S Jordan
- Institute for Breathing and Sleep and Austin Health, Heidelberg, Victoria, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
21
|
Sletten TL, Ftouni S, Nicholas CL, Magee M, Grunstein RR, Ferguson S, Kennaway DJ, O'Brien D, Lockley SW, Rajaratnam SMW. Randomised controlled trial of the efficacy of a blue-enriched light intervention to improve alertness and performance in night shift workers. Occup Environ Med 2017. [PMID: 28630378 DOI: 10.1136/oemed-2016-103818] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Night workers often experience high levels of sleepiness due to misalignment of the sleep-wake cycle from the circadian pacemaker, in addition to acute and chronic sleep loss. Exposure to light, in particular short wavelength light, can improve alertness and neurobehavioural performance. This randomised controlled trial examined the efficacy of blue-enriched polychromatic light to improve alertness and neurobehavioural performance in night workers. DESIGN Participants were 71 night shift workers (42 males; 32.8±10.5 years) who worked at least 6 hours between 22:00 and 08:00 hours. Sleep-wake logs and wrist actigraphy were collected for 1-3 weeks, followed by 48-hour urine collection to measure the circadian 6-sulphatoxymelatonin (aMT6s) rhythm. On the night following at least two consecutive night shifts, workers attended a simulated night shift in the laboratory which included subjective and objective assessments of sleepiness and performance. Workers were randomly assigned for exposure to one of two treatment conditions from 23:00 hours to 07:00 hours: blue-enriched white light (17 000 K, 89 lux; n=36) or standard white light (4000 K, 84 lux; n=35). RESULTS Subjective and objective sleepiness increased during the night shift in both light conditions (p<0.05, ηp2=0.06-0.31), but no significant effects of light condition were observed. The 17 000 K light, however, did improve subjective sleepiness relative to the 4000 K condition when light exposure coincided with the time of the aMT6s peak (p<0.05, d=0.41-0.60). CONCLUSION This study suggests that, while blue-enriched light has potential to improve subjective sleepiness in night shift workers, further research is needed in the selection of light properties to maximise the benefits. TRIAL REGISTRATION NUMBER The Australian New Zealand Clinical Trials Registry ACTRN12610000097044 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=320845&isReview=true).
Collapse
Affiliation(s)
- Tracey L Sletten
- Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,CRC for Alertness, Safety and Productivity, Clayton, Victoria, Australia
| | - Suzanne Ftouni
- Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,CRC for Alertness, Safety and Productivity, Clayton, Victoria, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Michelle Magee
- Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,CRC for Alertness, Safety and Productivity, Clayton, Victoria, Australia
| | - Ronald R Grunstein
- CRC for Alertness, Safety and Productivity, Clayton, Victoria, Australia.,Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia.,Department of Respiratory & Sleep Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Sally Ferguson
- Appleton Institute, Central Queensland University, Wayville, South Australia, Australia
| | - David J Kennaway
- Robinson Research Institute, School of Medicine, Discipline of Obstetrics and Gynaecology, University of Adelaide, Adelaide, South Australia, Australia
| | - Darren O'Brien
- Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia.,Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
| | - Steven W Lockley
- Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,CRC for Alertness, Safety and Productivity, Clayton, Victoria, Australia.,Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Shantha M W Rajaratnam
- Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,CRC for Alertness, Safety and Productivity, Clayton, Victoria, Australia.,Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
22
|
Raniti MB, Allen NB, Schwartz O, Waloszek JM, Byrne ML, Woods MJ, Bei B, Nicholas CL, Trinder J. Sleep Duration and Sleep Quality: Associations With Depressive Symptoms Across Adolescence. Behav Sleep Med 2017; 15:198-215. [PMID: 26744783 DOI: 10.1080/15402002.2015.1120198] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study explored whether short sleep duration and sleep quality mediate the relationship between age and depressive symptoms. For comparison, we also explored whether depressive symptoms mediate the relationship between age and short sleep duration and sleep quality. The sample comprised 741 adolescents (63.5% female, mean age 15.78 years, range 11.92-19.67 years) in grades 7-12 from 11 secondary schools in metropolitan Melbourne, Australia. Students completed the Pittsburgh Sleep Quality Index (PSQI) and Center for Epidemiologic Studies Depression Scale (CES-D). Path analyses suggested that short sleep duration significantly mediated the relationship between age and depressive symptoms. Poor sleep quality also significantly mediated this relationship when sleep quality was defined by subjective judgement, but not sleep disturbance, sleep efficiency, or sleep onset latency. Depressive symptoms significantly mediated the relationship between age and short sleep duration and sleep quality (subjective judgement, sleep disturbance, sleep efficiency, and sleep onset latency). These findings suggest that the population-wide increase in depressive symptoms across adolescence is partially mediated by sleep-related developmental changes. They also highlight the importance of examining specific sleep problems when investigating the relationship between sleep and mood in this age group.
Collapse
Affiliation(s)
- Monika B Raniti
- a Melbourne School of Psychological Sciences , University of Melbourne , Parkville , Victoria , Australia
| | - Nicholas B Allen
- a Melbourne School of Psychological Sciences , University of Melbourne , Parkville , Victoria , Australia.,b Department of Psychology , University of Oregon , Eugene , Oregon
| | - Orli Schwartz
- a Melbourne School of Psychological Sciences , University of Melbourne , Parkville , Victoria , Australia
| | - Joanna M Waloszek
- a Melbourne School of Psychological Sciences , University of Melbourne , Parkville , Victoria , Australia
| | - Michelle L Byrne
- a Melbourne School of Psychological Sciences , University of Melbourne , Parkville , Victoria , Australia.,b Department of Psychology , University of Oregon , Eugene , Oregon
| | - Michael J Woods
- a Melbourne School of Psychological Sciences , University of Melbourne , Parkville , Victoria , Australia
| | - Bei Bei
- a Melbourne School of Psychological Sciences , University of Melbourne , Parkville , Victoria , Australia.,c School of Psychological Sciences , Monash University , Clayton , Victoria , Australia
| | - Christian L Nicholas
- a Melbourne School of Psychological Sciences , University of Melbourne , Parkville , Victoria , Australia
| | - John Trinder
- a Melbourne School of Psychological Sciences , University of Melbourne , Parkville , Victoria , Australia
| |
Collapse
|
23
|
Burns AC, Sletten TL, Magee M, Hawi Z, Nicholas CL, Saxena R, Ftouni S, Grunstein R, Kennaway D, Ferguson S, Lockley SW, Rajaratnam SW, Cain SW. 0029 BDNF VAL66MET POLYMORPHISM IMPACTS ALERTNESS AND PERFORMANCE IN SHIFT WORKERS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
24
|
Hicks A, Cori JM, Jordan AS, Nicholas CL, Kubin L, Semmler JG, Malhotra A, McSharry DGP, Trinder JA. Mechanisms of the deep, slow-wave, sleep-related increase of upper airway muscle tone in healthy humans. J Appl Physiol (1985) 2017; 122:1304-1312. [PMID: 28255086 DOI: 10.1152/japplphysiol.00872.2016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/14/2017] [Accepted: 02/23/2017] [Indexed: 12/21/2022] Open
Abstract
Upper airway muscle activity is reportedly elevated during slow-wave sleep (SWS) when compared with lighter sleep stages. To uncover the possible mechanisms underlying this elevation, we explored the correlation between different indices of central and reflex inspiratory drive, such as the changes in airway pressure and end-expiratory CO2 and the changes in the genioglossus (GG) and tensor palatini (TP) muscle activity accompanying transitions from the lighter N2 to the deeper N3 stage of non-rapid eye movement (NREM) sleep in healthy young adult men. Forty-six GG and 38 TP continuous electromyographic recordings were obtained from 16 men [age: 20 ± 2.5 (SD) yr; body mass index: 22.5 ± 1.8 kg/m2] during 32 transitions from NREM stages N2 to N3. GG but not TP activity increased following transition into N3 sleep, and the increase was positively correlated with more negative airway pressure, increased end-tidal CO2, increased peak inspiratory flow, and increased minute ventilation. None of these correlations was statistically significant for TP. Complementary GG and TP single motor unit analysis revealed a mild recruitment of GG units and derecruitment of TP units during the N2 to N3 transitions. These findings suggest that, in healthy individuals, the increased GG activity during SWS is driven primarily by reflex stimulation of airway mechanoreceptors and central chemoreceptors.NEW & NOTEWORTHY The characteristic increase in the activity of the upper airway dilator muscle genioglossus during slow-wave sleep (SWS) in young healthy individuals was found to be related to increased stimulation of airway mechanoreceptors and central chemoreceptors. No evidence was found for the presence of a central SWS-specific drive stimulating genioglossus activity in young healthy individuals. However, it remains to be determined whether a central drive exists in obstructive sleep apnea patients.
Collapse
Affiliation(s)
- Amelia Hicks
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer M Cori
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Amy S Jordan
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Christian L Nicholas
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Leszek Kubin
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John G Semmler
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Atul Malhotra
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of California at San Diego, San Diego, California; and
| | - David G P McSharry
- School of Medicine and Medical Science, University College Dublin and Mater Misericordiae University Hospital, Dublin, Ireland
| | - John A Trinder
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia;
| |
Collapse
|
25
|
Avraam J, Bourke R, Trinder J, Nicholas CL, Brazzale D, O’Donoghue FJ, Rochford PD, Jordan AS. The effect of body mass and sex on the accuracy of respiratory magnetometers for measurement of end-expiratory lung volumes. J Appl Physiol (1985) 2016; 121:1169-1177. [DOI: 10.1152/japplphysiol.00571.2016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/04/2016] [Accepted: 10/04/2016] [Indexed: 12/31/2022] Open
Abstract
Respiratory magnetometers are increasingly being used in sleep studies to measure changes in end-expiratory lung volume (EELV), including in obese obstructive sleep apnea patients. Despite this, the accuracy of magnetometers has not been confirmed in obese patients nor compared between sexes. Thus we compared spirometer-measured and magnetometer-estimated lung volume and tidal volume changes during voluntary end-expiratory lung volume changes of 1.5, 1, and 0.5 l above and 0.5 l below functional respiratory capacity in supine normal-weight [body mass index (BMI) < 25 kg/m] and healthy obese (BMI > 30 kg/m) men and women. Two different magnetometer calibration techniques proposed by Banzett et al. [Banzett RB, Mahan ST, Garner DM, Brughera A, Loring SH. J Appl Physiol (1985) 79: 2169–2176, 1995] and Sackner et al. [Sackner MA, Watson H, Belsito AS, Feinerman D, Suarez M, Gonzalez G, Bizousky F, Krieger B. J Appl Physiol (1985) 66: 410–420, 1989] were assessed. Across all groups and target volumes, magnetometers overestimated spirometer-measured EELV by ~65 ml (<0.001) with no difference between techniques (0.07). The Banzett method overestimated the spirometer EELV change in normal-weight women for all target volumes except +0.5 l, whereas no differences between mass or sex groups were observed for the Sackner technique. The variability of breath-to-breath measures of EELV was significantly higher for obese compared with nonobese subjects and was higher for the Sackner than Banzett technique. On the other hand, for tidal volume, both calibration techniques underestimated spirometer measurements (<0.001), with the underestimation being more marked for the Banzett than Sackner technique (0.03), in obese than normal weight (<0.001) and in men than in women (0.003). These results indicate that both body mass and sex affect the accuracy of respiratory magnetometers in measuring EELV and tidal volume.
Collapse
Affiliation(s)
- Joanne Avraam
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; and
| | - Rosie Bourke
- Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; and
| | - John Trinder
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Christian L. Nicholas
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; and
| | - Danny Brazzale
- Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; and
| | - Fergal J. O’Donoghue
- Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; and
- Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Peter D. Rochford
- Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; and
| | - Amy S. Jordan
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- Department of Respiratory and Sleep Medicine and Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; and
| |
Collapse
|
26
|
Jenkins LM, Andrewes DG, Nicholas CL, Drummond KJ, Moffat BA, Phal PM, Desmond P. Emotional reactivity following surgery to the prefrontal cortex. J Neuropsychol 2016; 12:120-141. [DOI: 10.1111/jnp.12110] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 07/06/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Lisanne M. Jenkins
- Melbourne School of Psychological Sciences; The University of Melbourne; Parkville Victoria Australia
| | - David G. Andrewes
- Psychiatry Department; Melbourne Neuropsychiatry Centre; The University of Melbourne; Parkville Victoria Australia
| | - Christian L. Nicholas
- Melbourne School of Psychological Sciences; The University of Melbourne; Parkville Victoria Australia
| | - Katharine J. Drummond
- Department of Neurosurgery; The Royal Melbourne Hospital; Parkville Victoria Australia
- Melbourne Brain Centre; The University of Melbourne; Parkville Victoria Australia
| | - Bradford A. Moffat
- Melbourne Brain Centre; The University of Melbourne; Parkville Victoria Australia
| | - Pramit M. Phal
- Department of Radiology; The University of Melbourne, Royal Melbourne Hospital; Parkville Victoria Australia
| | - Patricia Desmond
- Department of Radiology; The University of Melbourne, Royal Melbourne Hospital; Parkville Victoria Australia
| |
Collapse
|
27
|
Cavuoto MG, Ong B, Pike KE, Nicholas CL, Bei B, Kinsella GJ. Better Objective Sleep Quality in Older Adults with High Subjective Memory Decline. J Alzheimers Dis 2016; 53:943-53. [DOI: 10.3233/jad-160187] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Marina G. Cavuoto
- School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Ben Ong
- School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Kerryn E. Pike
- School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Christian L. Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
- Institute for Breathing & Sleep, Heidelberg, VIC, Australia
| | - Bei Bei
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia
- Centre for Women’s Mental Health, Royal Women’s Hospital, Melbourne, VIC, Australia
| | - Glynda J. Kinsella
- School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
- Caulfield Hospital, Caulfield, VIC, Australia
| |
Collapse
|
28
|
Cavuoto MG, Ong B, Pike KE, Nicholas CL, Bei B, Kinsella GJ. Objective but not subjective sleep predicts memory in community-dwelling older adults. J Sleep Res 2016; 25:475-85. [PMID: 26868539 DOI: 10.1111/jsr.12391] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 12/12/2015] [Indexed: 12/13/2022]
Abstract
Research on the relationship between habitual sleep patterns and memory performance in older adults is limited. No previous study has used objective and subjective memory measures in a large, older-aged sample to examine the association between sleep and various domains of memory. The aim of this study was to examine the association between objective and subjective measures of sleep with memory performance in older adults, controlling for the effects of potential confounds. One-hundred and seventy-three community-dwelling older adults aged 65-89 years in Victoria, Australia completed the study. Objective sleep quality and length were ascertained using the Actiwatch 2 Mini-Mitter, while subjective sleep was measured using the Pittsburgh Sleep Quality Index. Memory was indexed by tests of retrospective memory (Hopkins Verbal Learning Test - Revised), working memory (n-back, 2-back accuracy) and prospective memory (a habitual button pressing task). Compared with normative data, overall performance on retrospective memory function was within the average range. Hierarchical regression was used to determine whether objective or subjective measures of sleep predicted memory performances after controlling for demographics, health and mood. After controlling for confounds, actigraphic sleep indices (greater wake after sleep onset, longer sleep-onset latency and longer total sleep time) predicted poorer retrospective (∆R(2) = 0.05, P = 0.016) and working memory (∆R(2) = 0.05, P = 0.047). In contrast, subjective sleep indices did not significantly predict memory performances. In community-based older adults, objectively-measured, habitual sleep indices predict poorer memory performances. It will be important to follow the sample longitudinally to determine trajectories of change over time.
Collapse
Affiliation(s)
- Marina G Cavuoto
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Ben Ong
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Kerryn E Pike
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia.,Institute for Breathing & Sleep, Heidelberg, Victoria, Australia
| | - Bei Bei
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Centre for Women's Health, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Glynda J Kinsella
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia.,Caulfield Hospital, Caulfield, Victoria, Australia
| |
Collapse
|
29
|
Waloszek JM, Woods MJ, Byrne ML, Nicholas CL, Bei B, Murray G, Raniti M, Allen NB, Trinder J. Nocturnal indicators of increased cardiovascular risk in depressed adolescent girls. J Sleep Res 2015; 25:216-24. [DOI: 10.1111/jsr.12360] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 09/24/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Joanna M. Waloszek
- Melbourne School of Psychological Sciences; The University of Melbourne; Melbourne Vic. Australia
| | - Michael J. Woods
- Melbourne School of Psychological Sciences; The University of Melbourne; Melbourne Vic. Australia
| | - Michelle L. Byrne
- Melbourne School of Psychological Sciences; The University of Melbourne; Melbourne Vic. Australia
| | - Christian L. Nicholas
- Melbourne School of Psychological Sciences; The University of Melbourne; Melbourne Vic. Australia
| | - Bei Bei
- Melbourne School of Psychological Sciences; The University of Melbourne; Melbourne Vic. Australia
- School of Psychological Sciences; Monash University; Melbourne Vic. Australia
| | - Greg Murray
- Psychological Sciences and Statistics; Swinburne University of Technology; Hawthorn Vic. Australia
| | - Monika Raniti
- Melbourne School of Psychological Sciences; The University of Melbourne; Melbourne Vic. Australia
| | - Nicholas B. Allen
- Melbourne School of Psychological Sciences; The University of Melbourne; Melbourne Vic. Australia
- Department of Psychology; University of Oregon; Eugene OR USA
| | - John Trinder
- Melbourne School of Psychological Sciences; The University of Melbourne; Melbourne Vic. Australia
| |
Collapse
|
30
|
Ftouni S, Sletten TL, Nicholas CL, Kennaway DJ, Lockley SW, Rajaratnam SMW. Ocular Measures of Sleepiness Are Increased in Night Shift Workers Undergoing a Simulated Night Shift Near the Peak Time of the 6-Sulfatoxymelatonin Rhythm. J Clin Sleep Med 2015; 11:1131-41. [PMID: 26094925 DOI: 10.5664/jcsm.5086] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 05/10/2015] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVE The study examined the relationship between the circadian rhythm of 6-sulphatoxymelatonin (aMT6s) and ocular measures of sleepiness and neurobehavioral performance in shift workers undergoing a simulated night shift. METHODS Twenty-two shift workers (mean age 33.4, SD 11.8 years) were tested at approximately the beginning (20:00) and the end (05:55) of a simulated night shift in the laboratory. At the time point corresponding to the end of the simulated shift, 14 participants were classified as being within range of 6-sulphatoxymelatonin (aMT6s) acrophase--defined as 3 hours before or after aMT6s peak--and 8 were classified as outside aMT6s acrophase range. Participants completed the Karolinska Sleepiness Scale (KSS) and the auditory psychomotor vigilance task (aPVT). Waking electroencephalography (EEG) was recorded and infrared reflectance oculography was used to collect ocular measures of sleepiness: positive and negative amplitude/velocity ratio (PosAVR, NegAVR), mean blink total duration (BTD), the percentage of eye closure (%TEC), and a composite score of sleepiness levels (Johns Drowsiness Scale; JDS). RESULTS Participants who were tested within aMT6s acrophase range displayed higher levels of sleepiness on ocular measures (%TEC, BTD, PosAVR, JDS), objective sleepiness (EEG delta power frequency band), subjective ratings of sleepiness, and neurobehavioral performance, compared to those who were outside aMT6s acrophase range. CONCLUSIONS The study demonstrated that objective ocular measures of sleepiness are sensitive to circadian rhythm misalignment in shift workers.
Collapse
Affiliation(s)
- Suzanne Ftouni
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Tracey L Sletten
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Christian L Nicholas
- Sleep Research Laboratory, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - David J Kennaway
- Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Steven W Lockley
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts.,Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Shantha M W Rajaratnam
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts.,Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
31
|
Woods MJ, Nicholas CL, Semmler JG, Chan JKM, Jordan AS, Trinder J. Common drive to the upper airway muscle genioglossus during inspiratory loading. J Neurophysiol 2015; 114:2883-92. [PMID: 26378207 DOI: 10.1152/jn.00738.2014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 09/14/2015] [Indexed: 12/14/2022] Open
Abstract
Common drive is thought to constitute a central mechanism by which the efficiency of a motor neuron pool is increased. This study tested the hypothesis that common drive to the upper airway muscle genioglossus (GG) would increase with increased respiratory drive in response to an inspiratory load. Respiration, GG electromyographic (EMG) activity, single-motor unit activity, and coherence in the 0-5 Hz range between pairs of GG motor units were assessed for the 30 s before an inspiratory load, the first and second 30 s of the load, and the 30 s after the load. Twelve of twenty young, healthy male subjects provided usable data, yielding 77 pairs of motor units: 2 Inspiratory Phasic, 39 Inspiratory Tonic, 15 Expiratory Tonic, and 21 Tonic. Respiratory and GG inspiratory activity significantly increased during the loads and returned to preload levels during the postload periods (all showed significant quadratic functions over load trials, P < 0.05). As hypothesized, common drive increased during the load in inspiratory modulated motor units to a greater extent than in expiratory/tonic motor units (significant load × discharge pattern interaction, P < 0.05). Furthermore, this effect persisted during the postload period. In conclusion, common drive to inspiratory modulated motor units was elevated in response to increased respiratory drive. The postload elevation in common drive was suggestive of a poststimulus activation effect.
Collapse
Affiliation(s)
- Michael J Woods
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia; and
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia; and
| | - John G Semmler
- School of Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Julia K M Chan
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia; and
| | - Amy S Jordan
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia; and
| | - John Trinder
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia; and
| |
Collapse
|
32
|
Cavuoto MG, Ong B, Pike KE, Nicholas CL, Kinsella GJ. Naturalistic prospective memory in older adults: Predictors of performance on a habitual task. Neuropsychol Rehabil 2015; 27:744-758. [DOI: 10.1080/09602011.2015.1074590] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Marina G. Cavuoto
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Ben Ong
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Kerryn E. Pike
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Christian L. Nicholas
- Sleep Research Laboratory, Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Glynda J. Kinsella
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
- Caulfield Hospital, Melbourne, Australia
| |
Collapse
|
33
|
Cavuoto MG, Ong B, Pike KE, Nicholas CL, Kinsella GJ. P4‐126: The relationship between objective and subjective measures of sleep and memory performance (retrospective, prospective, and working memory) in older adults. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.1832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Ben Ong
- La Trobe UniversityMelbourneAustralia
| | | | | | | |
Collapse
|
34
|
Kubin L, Jordan AS, Nicholas CL, Cori JM, Semmler JG, Trinder J. Crossed motor innervation of the base of human tongue. J Neurophysiol 2015; 113:3499-510. [PMID: 25855691 DOI: 10.1152/jn.00051.2015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/06/2015] [Indexed: 12/15/2022] Open
Abstract
Muscle fibers of the genioglossus (GG) form the bulk of the muscle mass at the base of the tongue. The motor control of the tongue is critical for vocalization, feeding, and breathing. Our goal was to assess the patterns of motor innervation of GG single motor units (SMUs) in humans. Simultaneous monopolar recordings were obtained from four sites in the base of the tongue bilaterally at two antero-posterior levels from 16 resting, awake, healthy adult males, who wore a face mask with airway pressure and airflow sensors. We analyzed 69 data segments in which at least one lead contained large action potentials generated by an SMU. Such potentials served as triggers for spike-triggered averaging (STA) of signals recorded from the other three sites. Spontaneous activity of the SMUs was classified as inspiratory modulated, expiratory modulated, or tonic. Consistent with the antero-posterior orientation of GG fibers, 44 STAs (77%) recorded ipsilateral to the trigger yielded sharp action potentials with a median amplitude of 52 μV [interquartile range (IQR): 25-190] that were time shifted relative to the trigger by about 1 ms. Notably, 48% of recordings on the side opposite to the trigger also yielded sharp action potentials. Of those, 17 (29%) had a median amplitude of 63 μV (IQR: 39-96), and most were generated by tonic SMUs. Thus a considerable proportion of GG muscle fibers receive a crossed motor innervation. Crossed innervation may help ensure symmetry and stability of tongue position and movements under normal conditions and following injury or degenerative changes affecting the tongue.
Collapse
Affiliation(s)
- Leszek Kubin
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia;
| | - Amy S Jordan
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | | | - Jennifer M Cori
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - John G Semmler
- School of Medical Sciences, University of Adelaide, Adelaide, Australia
| | - John Trinder
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| |
Collapse
|
35
|
Waloszek JM, Byrne ML, Woods MJ, Nicholas CL, Bei B, Murray G, Raniti M, Allen NB, Trinder J. Early physiological markers of cardiovascular risk in community based adolescents with a depressive disorder. J Affect Disord 2015; 175:403-10. [PMID: 25678173 DOI: 10.1016/j.jad.2015.01.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 01/07/2015] [Accepted: 01/08/2015] [Indexed: 01/25/2023]
Abstract
BACKGROUND Depression is recognised as an independent cardiovascular risk factor in adults. Identifying this relationship early on in life is potentially important for the prevention of cardiovascular disease (CVD). This study investigated whether clinical depression is associated with multiple physiological markers of CVD risk in adolescents from the general community. METHODS Participants aged 12-18 years were recruited from the general community and screened for depressive symptoms. Individuals with high and low depressive symptoms were administered a diagnostic interview. Fifty participants, 25 with a current depressive episode and 25 matched healthy controls, subsequently completed cardiovascular assessments. Variables assessed were automatic brachial and continuous beat-to-beat finger arterial blood pressure, heart rate, vascular functioning by pulse amplitude tonometry following reactive hyperaemia and pulse transit time (PTT) at rest. Blood samples were collected to measure cholesterol, glucose and glycohaemoglobin levels and an index of cumulative risk of traditional cardiovascular risk factors was calculated. RESULTS Depressed adolescents had a significantly lower reactive hyperaemia index and shorter PTT, suggesting deterioration in vascular integrity and structure. Higher fasting glucose and triglyceride levels were also observed in the depressed group, who also had higher cumulative risk scores indicative of increased engagement in unhealthy behaviours and higher probability of advanced atherosclerotic lesions. LIMITATIONS The sample size and number of males who completed all cardiovascular measures was small. CONCLUSIONS Clinically depressed adolescents had poorer vascular functioning and increased CVD risk compared to controls, highlighting the need for early identification and intervention for the prevention of CVD in depressed youth.
Collapse
Affiliation(s)
- Joanna M Waloszek
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia.
| | - Michelle L Byrne
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia.
| | - Michael J Woods
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia.
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia.
| | - Bei Bei
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia; School of Psychological Sciences, Monash University, Victoria 3800, Australia.
| | - Greg Murray
- Psychological Sciences and Statistics, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia.
| | - Monika Raniti
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia.
| | - Nicholas B Allen
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia; Department of Psychology, University of Oregon, Eugene, OR 97405, USA.
| | - John Trinder
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia.
| |
Collapse
|
36
|
Chan JKM, Trinder J, Colrain IM, Nicholas CL. The acute effects of alcohol on sleep electroencephalogram power spectra in late adolescence. Alcohol Clin Exp Res 2015; 39:291-9. [PMID: 25597245 DOI: 10.1111/acer.12621] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 10/27/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Alcohol's effect on sleep electroencephalogram (EEG) power spectra during late adolescence is of interest given that this age group shows both dramatic increases in alcohol consumption and major sleep-related developmental changes in quantitative EEG measures. This study examined the effect of alcohol on sleep EEG power spectra in 18- to 21-year-old college students. METHODS Participants were 24 (12 female) healthy 18- to 21-year-old social drinkers. Participants underwent 2 conditions: presleep alcohol and placebo, followed by standard polysomnography with comprehensive EEG recordings. RESULTS After alcohol, mean breath alcohol concentration at lights-out was 0.084%. Interaction effects indicated simultaneous increases in frontal non-rapid eye movement sleep (NREM) delta (p = 0.031) and alpha (p = 0.005) power in the first sleep cycles following alcohol consumption which was most prominent at frontal scalp sites (p < 0.001). A decrease in sigma power (p = 0.001) was also observed after alcohol. CONCLUSIONS As hypothesized, alcohol increased slow wave sleep-related NREM delta power. However, there was a simultaneous increase in frontal alpha power. Results suggest that alcohol may exert an arousal influence which may compete with the sleep maintenance influence of increased delta activity. The phenomenon is similar to, or the same as, alpha-delta sleep which has been associated with the presence of disruptive stimuli during sleep. This may have negative implications for the impact of presleep alcohol consumption on sleep and consequent daytime functioning.
Collapse
Affiliation(s)
- Julia K M Chan
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | | | | | | |
Collapse
|
37
|
Jordan AS, Cori JM, Dawson A, Nicholas CL, O'Donoghue FJ, Catcheside PG, Eckert DJ, McEvoy RD, Trinder J. Arousal from sleep does not lead to reduced dilator muscle activity or elevated upper airway resistance on return to sleep in healthy individuals. Sleep 2015; 38:53-9. [PMID: 25325511 DOI: 10.5665/sleep.4324] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 05/23/2014] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES To compare changes in end-tidal CO2, genioglossus muscle activity and upper airway resistance following tone-induced arousal and the return to sleep in healthy individuals with small and large ventilatory responses to arousal. DESIGN Observational study. SETTING Two sleep physiology laboratories. PATIENTS OR PARTICIPANTS 35 men and 25 women with no medical or sleep disorders. INTERVENTIONS Auditory tones to induce 3-s to 15-s cortical arousals from sleep. MEASUREMENTS AND RESULTS During arousal from sleep, subjects with large ventilatory responses to arousal had higher ventilation (by analytical design) and tidal volume, and more marked reductions in the partial pressure of end-tidal CO2 compared to subjects with small ventilatory responses to arousal. However, following the return to sleep, ventilation, genioglossus muscle activity, and upper airway resistance did not differ between high and low ventilatory response groups (Breath 1 on return to sleep: ventilation 6.7±0.4 and 5.5±0.3 L/min, peak genioglossus activity 3.4%±1.0% and 4.8%±1.0% maximum, upper airway resistance 4.7±0.7 and 5.5±1.0 cm H2O/L/s, respectively). Furthermore, dilator muscle activity did not fall below the pre-arousal sleeping level and upper airway resistance did not rise above the pre-arousal sleeping level in either group for 10 breaths following the return to sleep. CONCLUSIONS Regardless of the magnitude of the ventilatory response to arousal from sleep and subsequent reduction in PETCO2, healthy individuals did not develop reduced dilator muscle activity nor increased upper airway resistance, indicative of partial airway collapse, on the return to sleep. These findings challenge the commonly stated notion that arousals predispose to upper airway obstruction.
Collapse
Affiliation(s)
- Amy S Jordan
- University of Melbourne, Parkville VIC, Australia: Institute for Breathing and Sleep, Heidelberg VIC, Australia
| | - Jennifer M Cori
- University of Melbourne, Parkville VIC, Australia: Institute for Breathing and Sleep, Heidelberg VIC, Australia
| | - Andrew Dawson
- University of Melbourne, Parkville VIC, Australia: : Institute for Breathing and Sleep, Heidelberg VIC, Australia
| | | | - Fergal J O'Donoghue
- University of Melbourne, Parkville VIC, Australia: Institute for Breathing and Sleep, Heidelberg VIC, Australia
| | - Peter G Catcheside
- Adelaide Institute for Sleep Health, Daw Park, SA, Australia: Flinders University, Bedford Park SA, Australia
| | - Danny J Eckert
- Neuroscience Research Australia (NeuRA) and the University of New South Wales, Randwick NSW, Australia
| | - R Doug McEvoy
- Adelaide Institute for Sleep Health, Daw Park, SA, Australia: Flinders University, Bedford Park SA, Australia
| | - John Trinder
- University of Melbourne, Parkville VIC, Australia
| |
Collapse
|
38
|
de Zambotti M, Baker FC, Sugarbaker DS, Nicholas CL, Trinder J, Colrain IM. Poor autonomic nervous system functioning during sleep in recently detoxified alcohol-dependent men and women. Alcohol Clin Exp Res 2014; 38:1373-80. [PMID: 24575956 DOI: 10.1111/acer.12384] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 01/12/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND Alcoholism is considered an important risk factor for cardiovascular (CV) disease. Autonomic nervous system (ANS) function is a major indicator of CV health. Sleep is a suitable model to investigate ANS activity free from wake-related confounders. We investigated nighttime ANS functioning, and the relation between ANS activity and severity of alcohol dependence in chronic alcoholism. METHODS Fourteen recently abstaining alcoholics (age: 42.0 ± 9.0 years, 7 women) and 16 age- and sex-matched controls (age: 45.2 ± 9.1 years, 8 women) underwent a night of standard clinical polysomnography, including electrocardiographic recording. Time- and frequency-domain spectral analysis of heart rate variability (HRV) was performed across hours of the night and during artifact-free epochs of stable sleep and wakefulness (presleep wakefulness, rapid-eye-movement [REM], and non-REM sleep). RESULTS Alcoholics had a poorer subjective and objective sleep quality compared to controls. Across the night, alcoholic men and women had elevated heart rate, reduced total HRV, that is, lower standard deviation of normal-to-normal interbeat intervals, and reduced high frequency (HF) activity (assessed by the HF power and by the square root of the mean squared of successive heart period differences). This ANS pattern was most apparent at the beginning of the night. None of the ANS measures was associated with lifetime alcohol consumption or duration of alcohol dependence. CONCLUSIONS Our results show that ANS functioning is disrupted during the night, even in undisturbed sleep periods, indicating poor CV functioning in recently detoxified alcohol-dependent men and women.
Collapse
|
39
|
Trinder J, Jordan AS, Nicholas CL. Discharge properties of upper airway motor units during wakefulness and sleep. Progress in Brain Research 2014; 212:59-75. [DOI: 10.1016/b978-0-444-63488-7.00004-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
40
|
Abstract
Alcohol acts as a sedative that interacts with several neurotransmitter systems important in the regulation of sleep. Acute administration of large amounts of alcohol prior to sleep leads to decreased sleep-onset latency and changes in sleep architecture early in the night, when blood alcohol levels are high, with subsequent disrupted, poor-quality sleep later in the night. Alcohol abuse and dependence are associated with chronic sleep disturbance, lower slow-wave sleep, and more rapid-eye-movement sleep than normal, that last long into periods of abstinence and may play a role in relapse. This chapter outlines the evidence for acute and chronic alcohol effects on sleep architecture and sleep electroencephalogram, evidence for tolerance with repeated administration, and possible underlying neurochemical mechanisms for alcohol's effects on sleep. Also discussed are sex differences as well as effects of alcohol on sleep homeostasis and circadian regulation. Evidence for the role of sleep disruption as a risk factor for developing alcohol dependence is discussed in the context of research conducted in adolescents. The utility of sleep-evoked potentials in the assessment of the effects of alcoholism on sleep and the brain and in abstinence-mediated recovery is also outlined. The chapter concludes with a series of questions that need to be answered to determine the role of sleep and sleep disturbance in the development and maintenance of problem drinking and the potential beneficial effects of the treatment of sleep disorders for maintenance of abstinence in alcoholism.
Collapse
Affiliation(s)
- Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Vic., Australia.
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Vic., Australia
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
41
|
de Zambotti M, Nicholas CL, Colrain IM, Trinder JA, Baker FC. Autonomic regulation across phases of the menstrual cycle and sleep stages in women with premenstrual syndrome and healthy controls. Psychoneuroendocrinology 2013; 38:2618-27. [PMID: 23850226 PMCID: PMC3812396 DOI: 10.1016/j.psyneuen.2013.06.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 06/07/2013] [Accepted: 06/08/2013] [Indexed: 11/24/2022]
Abstract
To investigate the influence of menstrual cycle phase and the presence of severe premenstrual symptoms on cardiac autonomic control during sleep, we performed heart rate variability (HRV) analysis during stable non-rapid eye movement (NREM) and REM sleep in 12 women with severe premenstrual syndrome and 14 controls in the mid-follicular, mid-luteal, and late-luteal phases of the menstrual cycle. Heart rate was higher, along with lower high frequency (HF) power, reflecting reduced vagal activity, and a higher ratio of low frequency (LF) to high frequency power, reflecting a shift to sympathetic dominance, in REM sleep compared with NREM sleep in both groups of women. Both groups of women had higher heart rate during NREM and REM sleep in the luteal phase recordings compared with the mid-follicular phase. HF power in REM sleep was lowest in the mid-luteal phase, when progesterone was highest, in both groups of women. The mid-luteal phase reduction in HF power was also evident in NREM sleep in control women but not in women with PMS, suggesting some impact of premenstrual syndrome on autonomic responses to the hormone environment of the mid-luteal phase. In addition, mid-luteal phase progesterone levels correlated positively with HF power and negatively with LF/HF ratio in control women in NREM sleep and with the LF/HF ratio during REM sleep in both groups of women. Our findings suggest the involvement of female reproductive steroids in cardiac autonomic control during sleep in women with and without premenstrual syndrome.
Collapse
Affiliation(s)
- Massimiliano de Zambotti
- Human Sleep Research Program, SRI International, 333 Ravenswood Avenue, Menlo Park, CA 94025, USA
| | - Christian L. Nicholas
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Ian M. Colrain
- Human Sleep Research Program, SRI International, 333 Ravenswood Avenue, Menlo Park, CA 94025, USA
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - John A. Trinder
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Fiona C. Baker
- Human Sleep Research Program, SRI International, 333 Ravenswood Avenue, Menlo Park, CA 94025, USA
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
42
|
Bei B, Allen NB, Nicholas CL, Dudgeon P, Murray G, Trinder J. Actigraphy-assessed sleep during school and vacation periods: a naturalistic study of restricted and extended sleep opportunities in adolescents. J Sleep Res 2013; 23:107-17. [PMID: 23992480 DOI: 10.1111/jsr.12080] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 07/13/2013] [Indexed: 12/01/2022]
Abstract
School-related sleep restriction in adolescents has been identified by studies comparing weekday and weekend sleep. This study compared weekday and vacation sleep to assess restricted and extended sleep opportunities. One-hundred and forty-six adolescents (47.3% male) aged 16.2 ± 1.0 years (M ± SD) from the general community wore an actigraph continuously for 4 weeks: the last week of a school term (Time-E), the following 2-week vacation, and the first week of the next term. Self-reported sleep was assessed for each of the three time intervals, and chronotype was assessed using the Morningness-Eveningness Questionnaire at Time-E. Daily actigraphy bedtime, rise-time, time-in-bed, total sleep time, sleep onset latency, sleep efficiency, and % wake after sleep onset were analysed using latent growth curve modelling. The removal of school-related sleep restriction was associated with an abrupt delay in sleep timing and increase in sleep duration. Subsequently, bedtime and rise-time showed further linear delays throughout the vacation, while changes in time-in-bed were non-significant. Sleep onset latency increased linearly, peaking in the middle of the second vacation week. Across the first vacation week, total sleep time and sleep efficiency linearly decreased, while % wake after sleep onset increased. These changes stabilized during the second vacation week. Older age and eveningness were associated with later bedtime and rise-time, whilst females had longer time-in-bed, total sleep time and sleep onset latency. Compared with school days, sleep during the vacation was characterized by later timing, longer duration, lower quality and greater variability. Recovery from school-related sleep restriction appeared to be completed within the 2 weeks of naturalistic extended sleep.
Collapse
Affiliation(s)
- Bei Bei
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Vic., Australia
| | | | | | | | | | | |
Collapse
|
43
|
Trinder J, Woods M, Nicholas CL, Chan JK, Jordan AS, Semmler JG. Motor unit activity in upper airway muscles genioglossus and tensor palatini. Respir Physiol Neurobiol 2013; 188:362-9. [DOI: 10.1016/j.resp.2013.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 06/11/2013] [Accepted: 06/17/2013] [Indexed: 10/26/2022]
|
44
|
Chan JKM, Trinder J, Andrewes HE, Colrain IM, Nicholas CL. The acute effects of alcohol on sleep architecture in late adolescence. Alcohol Clin Exp Res 2013; 37:1720-8. [PMID: 23800287 DOI: 10.1111/acer.12141] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 02/09/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Alcohol consumption is prevalent in late adolescence; however, little is known about its effect on sleep in this group. In mature adults, alcohol decreases sleep onset latency (SOL) and sleep efficiency (SE) and increases wake after sleep onset (WASO). It also increases slow wave sleep (SWS) and decreases rapid eye movement (REM) sleep in the first half of the night, with the inverse occurring in the second half. Alcohol's effect on sleep during late adolescence is of interest given that this age group shows both dramatic increases in alcohol consumption and significant developmental changes in the central nervous system. This study examined the effect of alcohol on sleep architecture in women and men aged 18 to 21 years and whether previously reported sleep architecture effects may have been as an artificial result of changes to sleep cycle length. METHODS Twenty-four (12 women) healthy 18- to 21-year-old light social drinkers (19.1 ± 1.0 years) underwent 2 conditions: presleep alcohol (target breath alcohol concentration [BAC] 0.10%) and placebo-administered under controlled conditions, followed by standard polysomnography. RESULTS In the alcohol condition, mean BAC at lights out was 0.084 ± 0.016%. Time in bed, total sleep time, and SOL (all p > 0.05) did not differ between conditions. However, there was less REM (p = 0.011) and more stage-2 sleep (p = 0.035) in the alcohol condition. Further, alcohol increased SWS (p = 0.02) and decreased REM sleep (p < 0.001) in the first half of the night and disrupted sleep in the second half, with increased WASO (interaction: p = 0.034), and decreased SE (p = 0.04) and SWS (p = 0.01) and no REM sleep rebound in the second half of the night (p = 0.262). Additionally, alcohol had no effect on sleep cycle length (p = 0.598). CONCLUSIONS The results were broadly consistent with the adult literature with the novel extension that half night sleep architecture effects could not be attributed to changes in sleep cycle length. However, alcohol did not reduce SOL, or result in a REM rebound following reduced REM in the first half of the night. The results suggest that the effects of alcohol on sleep are modified by sleep's prevailing developmental stage.
Collapse
Affiliation(s)
- Julia K M Chan
- Melbourne School of Psychological Sciences , The University of Melbourne, Parkville, Vic., Australia
| | | | | | | | | |
Collapse
|
45
|
Bei B, Byrne ML, Ivens C, Waloszek J, Woods MJ, Dudgeon P, Murray G, Nicholas CL, Trinder J, Allen NB. Pilot study of a mindfulness-based, multi-component, in-school group sleep intervention in adolescent girls. Early Interv Psychiatry 2013; 7:213-20. [PMID: 22759744 DOI: 10.1111/j.1751-7893.2012.00382.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 04/07/2012] [Indexed: 11/29/2022]
Abstract
AIM Existing literature links poor sleep and anxiety symptoms in adolescents. This pilot study aimed to develop a practical method through which a program to improve sleep could reach adolescents in need and to examine the feasibility of a mindfulness-based, multi-component group sleep intervention using sleep and anxiety as outcome measures. METHODS Sixty-two grade 9 students (aged 13-15) at a girls' school were screened with the Pittsburgh Sleep Quality Index (PSQI) and Spence Children's Anxiety Scale (SCAS). Ten participants with self-reported poor sleep were enrolled into a six-session program based on Bootzin & Stevens, with added stress/anxiety-specific components. Sessions covered key aspects of basic mindfulness concepts and practice, sleep hygiene, sleep scheduling, evening/daytime habits, stimulus control, skills for bedtime worries and healthy attitudes to sleep. Treatment changes were measured by pre-post scores on the PSQI, SCAS and 7-day actigraphy-measured sleep. RESULTS The program demonstrated high acceptability, with a completion rate of 90%. Based on effect-size analysis, participants showed significant improvement on objective sleep onset latency (SOL), sleep efficiency and total sleep time; actigraphy data also showed significantly earlier bedtime, rise time and smaller day-to-day bedtime variation. Post-intervention global PSQI scores were significantly lower than that of pre-intervention, with significant improvement in subjective SOL, sleep quality and sleep-related daytime dysfunction. There were small improvements on some subscales of the SCAS, but change on its total score was minimal. CONCLUSIONS A mindfulness-based, multi-component, in-school group sleep intervention following brief screening is feasible, and has the potential to improve sleep. Its impact on anxiety needs further investigation.
Collapse
Affiliation(s)
- Bei Bei
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Cori JM, Nicholas CL, Baptista S, Huynh I, Rochford PD, O'Donoghue FJ, Trinder JA, Jordan AS. Inspiratory-resistive loading increases the ventilatory response to arousal but does not reduce genioglossus muscle activity on the return to sleep. J Appl Physiol (1985) 2012; 113:909-16. [DOI: 10.1152/japplphysiol.00608.2012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Arousals from sleep are thought to predispose to obstructive sleep apnea by causing hyperventilation and hypocapnia, which reduce airway dilator muscle activity on the return to sleep. However, prior studies of auditory arousals have not resulted in reduced genioglossus muscle activity [GG-electromyogram (EMG)], potentially because airway resistance prior to arousal was low, leading to a small ventilatory response to arousal and minimal hypocapnia. Thus we aimed to increase the ventilatory response to arousal by resistive loading prior to auditory arousal and determine whether reduced GG-EMG occurred on the return to sleep. Eighteen healthy young men and women were recruited. Subjects were instrumented with a nasal mask with a pneumotachograph, an epiglottic pressure catheter, and intramuscular GG-EMG electrodes. Mask CO2 levels were monitored. Three- to 15-s arousals from sleep were induced with auditory tones after resting breathing (No-Load) or inspiratory-resistive loading (Load; average 8.4 cmH2O·l−1·s−1). Peak minute ventilation following arousal was greater after Load than No-Load (mean ± SE; 8.0 ± 0.6 vs. 7.4 ± 0.6 l/min, respectively). However, the nadir end tidal partial pressure of CO2 did not differ between Load conditions (43.1 ± 0.6 and 42.8 ± 0.5 mmHg, respectively), and no period of reduced GG activity occurred following the return to sleep (GG-EMG baseline, minimum after Load and No-Load = 2.9 ± 1.2%, 3.1 ± 1.3%, and 3.0 ± 1.3% max, respectively). These findings indicate that the hyperventilation, which occurs following tone-induced arousal, is appropriate for the prevailing level of respiratory drive, because loading did not induce marked hypocapnia or lower GG muscle activity on the return to sleep. Whether similar findings occur following obstructive events in patients remains to be determined.
Collapse
Affiliation(s)
- Jennifer M. Cori
- Department of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Christian L. Nicholas
- Department of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Shaira Baptista
- Department of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Ivan Huynh
- Department of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Peter D. Rochford
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; and
| | - Fergal J. O'Donoghue
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; and
- Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - John A. Trinder
- Department of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Amy S. Jordan
- Department of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; and
| |
Collapse
|
47
|
Nicholas CL, Jordan AS, Heckel L, Worsnop C, Bei B, Saboisky JP, Eckert DJ, White DP, Malhotra A, Trinder J. Discharge patterns of human tensor palatini motor units during sleep onset. Sleep 2012; 35:699-707. [PMID: 22547896 PMCID: PMC3321429 DOI: 10.5665/sleep.1834] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Upper airway muscles such as genioglossus (GG) and tensor palatini (TP) reduce activity at sleep onset. In GG reduced muscle activity is primarily due to inspiratory modulated motor units becoming silent, suggesting reduced respiratory pattern generator (RPG) output. However, unlike GG, TP shows minimal respiratory modulation and presumably has few inspiratory modulated motor units and minimal input from the RPG. Thus, we investigated the mechanism by which TP reduces activity at sleep onset. DESIGN The activity of TP motor units were studied during relaxed wakefulness and over the transition from wakefulness to sleep. SETTING Sleep laboratory. PARTICIPANTS Nine young (21.4 ± 3.4 years) males were studied on a total of 11 nights. INTERVENTION Sleep onset. MEASUREMENTS AND RESULTS Two TP EMGs (thin, hooked wire electrodes), and sleep and respiratory measures were recorded. One hundred twenty-one sleep onsets were identified (13.4 ± 7.2/subject), resulting in 128 motor units (14.3 ± 13.0/subject); 29% of units were tonic, 43% inspiratory modulated (inspiratory phasic 18%, inspiratory tonic 25%), and 28% expiratory modulated (expiratory phasic 21%, expiratory tonic 7%). There was a reduction in both expiratory and inspiratory modulated units, but not tonic units, at sleep onset. Reduced TP activity was almost entirely due to de-recruitment. CONCLUSIONS TP showed a similar distribution of motor units as other airway muscles. However, a greater proportion of expiratory modulated motor units were active in TP and these expiratory units, along with inspiratory units, tended to become silent over sleep onset. The data suggest that both expiratory and inspiratory drive components from the RPG are reduced at sleep onset in TP.
Collapse
Affiliation(s)
| | - Amy S. Jordan
- School of Psychological Science, University of Melbourne, Parkville, Australia
| | - Leila Heckel
- School of Psychological Science, University of Melbourne, Parkville, Australia
| | - Christopher Worsnop
- School of Psychological Science, University of Melbourne, Parkville, Australia
| | - Bei Bei
- School of Psychological Science, University of Melbourne, Parkville, Australia
| | - Julian P. Saboisky
- Division of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston MA
| | - Danny J. Eckert
- Division of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston MA
| | - David P. White
- Division of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston MA
| | - Atul Malhotra
- Division of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston MA
| | - John Trinder
- School of Psychological Science, University of Melbourne, Parkville, Australia
| |
Collapse
|
48
|
Baker FC, Sassoon SA, Kahan T, Palaniappan L, Nicholas CL, Trinder J, Colrain IM. Perceived poor sleep quality in the absence of polysomnographic sleep disturbance in women with severe premenstrual syndrome. J Sleep Res 2012; 21:535-45. [PMID: 22417163 DOI: 10.1111/j.1365-2869.2012.01007.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Women with severe premenstrual syndrome report sleep-related complaints in the late-luteal phase, but few studies have characterized sleep disturbances prospectively. This study evaluated sleep quality subjectively and objectively using polysomnographic and quantitative electroencephalographic measures in women with severe premenstrual syndrome. Eighteen women with severe premenstrual syndrome (30.5 ± 7.6 years) and 18 women with minimal symptoms (controls, 29.2 ± 7.3 years) had polysomnographic recordings on one night in each of the follicular and late-luteal phases of the menstrual cycle. Women with premenstrual syndrome reported poorer subjective sleep quality when symptomatic in the late-luteal phase compared with the follicular phase (P < 0.05). However, there were no corresponding changes in objective sleep quality. Women with premenstrual syndrome had more slow-wave sleep and slow-wave activity than controls at both menstrual phases (P < 0.05). They also had higher trait-anxiety, depression, fatigue and perceived stress levels than controls at both phases (P < 0.05) and mood worsened in the late-luteal phase. Both groups showed similar menstrual-phase effects on sleep, with increased spindle frequency activity and shorter rapid eye movement sleep episodes in the late-luteal phase. In women with premenstrual syndrome, a poorer subjective sleep quality correlated with higher anxiety (r = -0.64, P = 0.005) and more perceived nighttime awakenings (r = -0.50, P = 0.03). Our findings show that women with premenstrual syndrome perceive their sleep quality to be poorer in the absence of polysomnographically defined poor sleep. Anxiety has a strong impact on sleep quality ratings, suggesting that better control of mood symptoms in women with severe premenstrual syndrome may lead to better subjective sleep quality.
Collapse
Affiliation(s)
- Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA.
| | | | | | | | | | | | | |
Collapse
|
49
|
Colrain IM, Sullivan EV, Rohlfing T, Baker FC, Nicholas CL, Padilla ML, Chanraud S, Pitel AL, Pfefferbaum A. Independent contributions of cortical gray matter, aging, sex and alcoholism to K-complex amplitude evoked during sleep. Sleep 2011; 34:787-95. [PMID: 21629367 DOI: 10.5665/sleep.1050] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES The amplitude of the N550 component derived from the averaged evoked K-complex decreases with normal aging and with alcoholism. The study was designed to determine whether these declines are related to the extent of cortical or subcortical shrinkage. SETTING Research sleep laboratory and MR imaging facility PARTICIPANTS 26 abstinent long-term alcoholic men, 14 abstinent long-term alcoholic women, 18 control men, and 22 control women. MEASUREMENTS AND RESULTS MRI data collected at 3T were analyzed from alcoholic and control men and women previously reported to have significantly different evoked delta activity during sleep. Segmented and parcellated MRI data collected at 3T were compared between these groups and evaluated for correlation with evoked K-complex amplitude measured at FP1, Fz, FCz, Cz, CPz, and Pz. Cortical gray matter and regional subcortical tissue volumes entered as predictors into stepwise multiple regression identified cortical gray matter as a unique significant predictor of evoked K-complex at all sites. Age added independent variance at 5 of the 6 sites, while alcoholism and sex added independent variance at frontal sites only. CONCLUSIONS These data support recent intracranial studies showing cortical generation of K-complexes by indicating that cortical, but not subcortical volume contributes to K-complex amplitude. Establishing the extent of the relation between cortical volume and K-complex amplitude provides a mechanistic understanding of sleep compromise clinically relevant to normal aging, alcoholism, and likely other conditions affecting cortical volume and integrity.
Collapse
Affiliation(s)
- Ian M Colrain
- Human Sleep Research Program, SRI International, Menlo Park, CA 94025, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Yang JSC, Nicholas CL, Nixon GM, Davey MJ, Anderson V, Walker AM, Trinder J, Horne RSC. EEG spectral analysis of apnoeic events confirms visual scoring in childhood sleep disordered breathing. Sleep Breath 2011; 16:491-7. [PMID: 21567337 DOI: 10.1007/s11325-011-0530-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 03/31/2011] [Accepted: 05/04/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE This study compared electroencephalogram (EEG) spectral analysis with standard visual scoring to assess the validity of clinical classification of arousals at respiratory event termination in children with obstructive sleep apnoea (OSA). METHODS Twenty children (six M/14 F) aged 7-12 years, diagnosed with moderate to severe OSA participated in this study. Overnight polysomnography was performed, and sleep stages and arousals visually scored using clinical paediatric measures. The EEG was spectrally analysed in six 5-s epochs across respiratory events, namely two consecutive 5-s epochs pre-event onset and a 5s epoch post-event onset, 5-s before event termination, and two contiguous 5-s epochs post-event termination. EEG spectral power distribution was compared across respiratory events visually categorised as full cortical arousals, subcortical activations, or non-arousals using specialised software (Sleep Research System 5.0). RESULTS There was no difference in power spectra between events in REM and NREM sleep and these were combined. There was a statistically significant fall from pre-arousal baseline values in delta and theta spectral power at respiratory event terminations associated with cortical arousals only. No change in power was detected at respiratory event terminations associated with subcortical activations or non-arousals. CONCLUSIONS The lack of significant EEG spectral power changes at respiratory event terminations not associated with visually identified cortical arousals indicates undetected micro-arousals are not present. The results support the validity of clinical classifications of arousals at respiratory event termination.
Collapse
Affiliation(s)
- Joel S C Yang
- The Ritchie Centre, Monash Institute of Medical Research, Monash University, Level 5, Monash Medical Centre, 246 Clayton Rd, Clayton, Melbourne, Victoria, Australia
| | | | | | | | | | | | | | | |
Collapse
|