Academic literature on the topic 'Cyclic sleep'

Background/Objectives: Sleep has been shown to enhance creativity, but the reason for this enhancement is not entirely known. There are several different physiological states associated with sleep. In addition to rapid (REM) and non-rapid eye movement (NREM) sleep, NREM sleep can be broken down into Stages (1-4) that are characterized by the degree of EEG slow wave activity. In addition, during NREM sleep there are transient but cyclic alternating patterns (CAP) of EEG activity and these CAPs can also be divided into three subtypes (A1-A3) according to speed of the EEG waves. Differences in CAP ratios have been previously linked to cognitive performances. The purpose of this study was to learn the relationship CAP activity during sleep and creativity. Methods: The participants were 8 healthy young adults (4 women), who underwent 3 consecutive nights of polysomnographic recording and took the Abbreviated Torrance Test for Adults (ATTA) on the 2 and 3rd mornings after the recordings. Results: There were positive correlations between Stage 1 of NREM sleep and some measures of creativity such as fluency (R= .797; p=.029) and flexibility ( R=.43; p=.002), between Stage 4 of Non-REM sleep and originality (R= .779; p=.034) and a global measure of figural creativity (R= .758; p=.040). There was also a negative correlation between REM sleep and originality (R= -.827; p= .042) . During NREM sleep the CAP rate, which in young people is primarily the A1 subtype, also correlated with originality (R= .765; p =.038). Conclusions: NREM sleep is associated with low levels of cortical arousal and low cortical arousal may enhance the ability of people to access to the remote associations that are critical for creative innovations. In addition, A1 CAP activity reflects frontal activity and the frontal lobes are important for divergent thinking, also a critical aspect of creativity.

This thesis project is focused on systems of automatic analysis of sleep parameters and it is composed by two main parts: the first is focused on the process of creation of a software for the analysis of Cyclic Alternating Pattern (CAP) a particular parameter of sleep microstructure and the second part is focused on the use of automatic analysis of muscle activity during sleep. CAP is defined as periodic EEG activity of NREM sleep characterized by sequences of transient electrocortical events, that are distinct from the background electroencephalogram (EEG) activity and occurs at up to 1-minute intervals. CAP represents the microstructure of sleep, and its analysis gives fundamental information that are otherwise neglected with the analysis of sleep macrostructure (sleep staging) alone. CAP is considered a marker for the evaluation of sleep stability and its oscillatory presence is fundamental preservation of sleep stability through the night and in response to arousal stimuli. Analysis of CAP is a very time consuming procedure and it is still used mainly for research purpose rather than in the clinical practice. The development of a software for the analysis of CAP was the main focus of the work in collaboration with Micromed® (an international company for the manufacturing of hardware and software for neurophysiology based in Mogliano Veneto (TV)). During the months spent at Micromed® the PhD student worked with the software programmers and engineers for the creation and validation of the software, individuating all the clinical parameters from guidelines and verifying their correct application and the validity of the results. In the first part of this thesis all the creation process is described in detail. The second part of this thesis is focused on the automatic analysis of muscle EMG tone during both REM and NREM sleep. Muscle tone during sleep gradually diminishes throughout the different sleep stages reaching its minimum with REM muscle atonia. Evaluation of muscle tone during REM sleep is fundamental for the diagnosis of REM sleep Behavior Disorder (RBD) in which there is loss of muscle atonia during REM associated to dream enacting behavior. Muscle activity is measured in polysomnography (PSG) through the recording of different EMG channels. This activity is evaluated almost exclusively during REM sleep using a manual method of visual scoring that require high expertise is highly time consuming. A validated method developed by R. Ferri and co. allows automatic analysis of chin EMG activity through the calculation of Atonia index. Few studies evaluated muscle tone during NREM sleep, and little is known about the neurophysiology of muscle control. Manual methods would be difficult to apply to NREM sleep; the method developed by Ferri is capable to perform an analysis of muscle tone for all sleep stages. RBD is associated to neurodegenerative disorders, synucleinopathies such as Parkinson disease (PD), Multiple System Atrophy (MSA). MSA patients have a more severe loss of atonia during REM sleep compared to PD with RBD. Starting from the fortuitous observation of a prominent facial activity during NREM sleep, we decided to evaluate the facial activity recorded in vPSG in patients with PD, MSA and controls and to evaluate the muscle tone in both REM and NREM sleep using the automatic method for the calculation of atonia index. Our results showed that MSA have a more sustained muscle tone compared to healthy controls in all sleep stages and compared to PD in all NREM stages. Moreover a particular facial expression was noted to be significantly more frequent in MSA compared to PD. This results may help the differential diagnosis between PD and MSA. This is the first study to evaluate muscle tone during all sleep stages using Atonia index and this analysis may open to different perspectives for the understanding of REM behavior disorder and the mechanism underlying the control of muscle tone in NREM sleep

Objective: Amyotrophic lateral sclerosis (ALS) is a progressive and fatal neurodegenerative disease, associated with an almost exclusive involvement of upper and lower motor neurons, although autonomic impairment has also been described. Often patients affected by ALS complain of disturbed sleep and sudden death during sleep has been reported. To date, few overnight polysomnographic studies have been performed and a complete evaluation of autonomic nervous system (ANS) during sleep has never been performed before in ALS subjects. The aim of our study was to assess macro- and microstructure of sleep, detect any sleep disorders and evaluate cardiac ANS in a cohort of ALS patients, in order to better characterize the disease and identify novel strategies to improve quality of life and possibly prolong life expectancy. Methods: 23 patients affected by ALS (16M/7 F, age 26-79, mean 61) were compared to 15 healthy controls matched for age and sex. Each subject underwent a full-night videopolysomnography. Sleep staging was performed according to AASM criteria, assessment of sleep stability was made by means of both CAP detection and CPC (cardiopulmonary coupling), evaluation of ANS was made with assessment of HRV. Results: Compared to controls, ALS patients showed a significant reduction of sleep efficiency and of total sleep time, longer sleep latency than controls, together with an increased number of WASO, increased N1 sleep and decreased N2, N3 and REM sleep. Moreover patients showed a significant reduction of CAP rate mainly due to a significant reduction in phase A1 and A2. Compared to controls, patients showed significant reductions in: total HRV power during non-REM (p=0.005), LF in non-REM (p=0.01) and REM (p=0.003) sleep, and wake after sleep onset (WASO) (p=0.06) and also in HF during non-REM (p=0.04) and REM (p=0.05) sleep and WASO (p=0.03). CPC analysis showed the patients with the most advanced pathology, i.e. those with ALS-FRS<30, had the most unstable sleep patterns, with high percentage of LFC and low percentage of HFC (<4%). Interpretation: Our results confirm that sleep structure and stability of ALS patients is altered, and that there is a subclinical alteration of cardiac autonomic control in both sleep and wakefulness, with an impairment of both vagal and sympathetic systems. Moreover reduction of CAP rate, analogously to the reduction of HRV, may reflect an alteration of cortical circuits wich underlie to the organization of sleep and autonomic functions, which are strongly interconnected, that in these patients seem to be characterized by a marked rigidity, with poor reactivity and reduced adaptability to external or internal stimuli. These findings suggest the potential importance of assessment of autonomic nervous system and sleep in ALS, in conjunction with standard motor system evaluations.

The worm Caenorhabditis elegans is a well-studied model organism in numerous aspects of its biology. This small free living nematode has less than 1,000 cells, but shows clear conservation in both signaling and behavior to mammals in aspects of appetite control. This is of importance to humans, where failure of appetite control is a major factor in the unprecedented obesity epidemic that we see today. In general, worm behavior reflects its internal nutritional state and the availability and quality of food. Specifically, worms show a behavioral state that mimics aspects of the mammalian behavioral satiety sequence, which has been termed satiety quiescence. We have used locomotion tracking and Hidden Markov Model analysis to identify worm behavioral state over time, finding quiescence along with the established worm locomotive behaviors roaming and dwelling. Using this analysis as well as more conventional cell biology and genetic approaches we have further investigated satiety signaling pathways. We have found that the neuron ASI is a major center of integration of signals regarding the internal nutritional state of the worms as well as the nutritional content of its environment. Our results show that cGMP causes levels of the TGFβ ligand to be increased in fasted worms, which is then released and binds to its receptor on the RIM and RIC neurons. This signaling connects nutritional state to behavioral response, promoting the sleep-like behavioral state satiety quiescence. Additionally, we have begun a candidate approach examining several other groups of signaling molecules for potential roles in satiety quiescence signaling including cannabinoids, multidrug resistance proteins, and neuropeptides. The result of this investigation is a better understanding of mechanisms of satiety quiescence signaling as well as a new tool that provides highly quantitative, unbiased, and automated data to aid in our ongoing work.

Introdução: O Padrão Alternante Cíclico (“CAP”, do inglês - Cyclic Alternating Pattern) é um ritmo fisiológico do sono NREM, que corresponde aos períodos de ativação cíclica expressos por eventos fásicos do sono. O aumento na expressão de taxa do CAP tem sido considerado uma medida de instabilidade e fragmentação do sono. O CAP representa uma condição favorável para a ocorrência de descargas interictais e/ou ictais. A modulação do CAP em pacientes com Epilepsia do Lobo Temporal (ELT) não está bem definida. Objetivos: Analisar a expressão do CAP em pacientes com ELT e comparar com o grupo de controle. Selecionar o grupo de pacientes sem distúrbios do sono que possam influenciar a organização do sono. Métodos: Foi realizado estudo transversal com grupo de controle de comparação. A seleção foi pareada em sexo e idade entre pacientes com ELT e o grupo de controle, obedecendo aos critérios de inclusão e exclusão. Os parâmetros do sono e CAP foram analisados em 13 pacientes com ELT (6 do sexo masculino e 7 do sexo feminino; idade média: 33,8 ± 8,5 anos) e 13 indivíduos sadios (8 do sexo masculino e 5 do sexo feminino; idade média: 26,1 ± 9,2 anos), os quais não apresentaram distúrbios do sono. A comparação dos dois grupos foi realizada através do “teste t” de Student e confirmada pelo “teste U” de Mann-Whitney. Resultados: Os pacientes com ELT apresentaram aumento na taxa de CAP (44,02 ± 5,23 % versus 31,83 ± 3 %; p<0,001) e maior duração do tempo de CAP (133,77 ± 15,56 min. versus 99,38 ± 9,6 min.; p<0,001) em relação aos indivíduos sadios. Não houve diferença na média da duração da fase A (9,27 ± 1,15 seg. versus 8,7 ± 0,61 seg.; p<0,131), e a média da duração da fase B não atingiu diferença significativa (22,92 ± 1,71 seg. versus 21,54 ± 1,78 seg.; p<0,054) entre os dois grupos. A comparação dos parâmetros de sono e de CAP dentro de cada grupo, mostrou não haver diferença entre os gêneros. A análise estatística dos parâmetros do sono em pacientes com ELT evidenciou uma diferença significativa das seguintes variáveis: menor latência ao sono (5,8 ± 2,4 min. versus 14,2 ± 7,6 min.; p=0,002); aumento do número da troca de estágios com média de 91,1 ± 25,7 versus 68,2 ± 12,8; p=0,008; menor duração de estágio IV (30,8 ± 14,8 min. versus 51,4 ± 12,5 min.; p=0,001); maior percentual do estágio III (7,7 ± 2,8% versus 5,7 ± 1,7%; p=0,035); menor percentual do estágio IV (7,9 ± 4% versus 12,9 ± 3,3%; p=0,002) em pacientes com ELT, comparando com o grupo de controle. A análise dos despertares breves demonstrou em pacientes com ELT: maior número de despertares breves em sono (66,5 ± 20 versus 41,8 ± 9; p=0,001); maior número de despertares breves em sono NREM (52,9 ± 19,6 versus 31 ± 9,5; p=0,002); maior duração total de despertares breves em sono (549,1 ± 170,3 seg. versus 357,2 ± 88,5 seg.; p=0,002); maior duração total de despertares breves em sono NREM (436,8 ± 165,7 seg. versus 271,9 ± 95,2 seg.; p=0,006); aumento do índice de despertar breve em sono (10,2 ± 2,9 versus 6,3 ± 1,7; p=0,001); aumento do índice de despertar breve em sono NREM (10,3 ± 3,4 versus 6 ± 2; p=0,001). Não houve diferença significativa de número (13,6 ± 5,6 versus 10,8 ± 3,7; p=0,149), duração total (112,3 ± 48,3 seg. versus 85,3 ± 25,2 seg.; p=0,091) e índice de despertar breve (9,7 ± 3,8 versus 7,4 ± 2,4; p=0,075) em sono REM entre os dois grupos. Todos os pacientes comELT tiveram uma eficiência do sono normal e similar ao grupo de controle (90,4 ± 2,9 % versus 90,6 ± 2,9 %). Conclusões: Os pacientes com ELT apresentam aumento da taxa de CAP e da duração de tempo de CAP em relação ao grupo controle, demonstrando um aumento na instabilidade e fragmentação do sono. O aumento na expressão da taxa de CAP, alterações nos parâmetros de fragmentação e descontinuidade do sono, expressos pelo aumento de número, duração e índice de despertares breves em sono NREM e o número de mudanças de estágios, associados à eficiência normal do sono em nosso grupo de pacientes com ELT, podem sugerir que o CAP tem um papel na modulação do sono. A fragmentação e a instabilidade do sono em pacientes com ELT, provavelmente, ocorrem devido à própria epilepsia e podem refletir a interação do foco epiléptico com os sistemas responsáveis pela manutenção e estabilidade de sono.<br>Introduction: Cyclic Alternating Pattern (“CAP”) is a NREM sleep physiological rhythm corresponding to periods of cyclical activation expressed by phasic events of sleep. The increase in the CAP rate expression has been considered a measure for sleep instability and fragmentation. CAP offers a favorable condition for interictal and/or ictal discharges. The CAP modulation in patients with Temporal Lobe Epilepsy (TLE) is not well defined. Objectives: Analyze the CAP expression in patients with TLE comparing it with a control group. Select the group of patients without sleep disorders which may interfere with sleep organization. Methods: A transversal study was conducted with a comparing control group. The selection was paired on gender and age between patients with TLE and the control group, in accordance with inclusion and exclusion criteria. The sleep parameters and CAP were analyzed in 13 patients (6 males and 7 females; mean age: 33,8 ± 8,5 years) and 13 healthy individuals (8 males and 5 females; mean age: 26,1 ± 9,2 years) who did not present sleep disorders. The comparison of the two groups was made through Student’s t-test and was confirmed by the Mann-Whitney U test. Results: Patients with TLE showed an increase in the CAP rate (44,02 ± 5,23% versus 31,83 ± 3%; p<0,001) and CAP time was longer (133,77 ± 15,56 min. versus 99,38 ± 9,6 min.; p<0,001) as compared to healthy individuals. There was no difference in the duration average of stage A (9,27 ± 1,15 sec. versus 8,7 ± 0,61 sec.; p<0,131), and the duration average of stage B did not show a significant difference (22,92 ± 1,71 sec. versus 21,54 ± 1,78 sec.; p<0,054) between both groups. The comparison of sleep parameters and CAP within the group showed that there is no difference between the genders. The statistical analysis of sleep parameters in patients with TLE showed a significant difference in the following variables: lower sleep latency (5,8 ± 2,4 min. versus 14,2 ± 7,6 min.; p=0,002); increase in the number of stage shifts with an average of (91,1 ± 25,7 versus 68,2 ± 12,8; p=0,008); lower duration of the stage IV (30,8 ± 14,8 min. versus 51,4 ± 12,5 min.; p=0,001); higher percentage of the stage III (7,7 ± 2,8% versus 5,7 ± 1,7%; p=0,035); lower percentage of the stage IV (7,9 ± 4% versus 12,9 ± 3,3%; p=0,002) in patients with TLE as compared to the control group. The analysis of arousals in patients with TLE showed: a higher number of arousals during sleep (66,5 ± 20 versus 41,8 ± 9; p=0,001); a higher number of arousals during NREM sleep (52,9 ± 19,6 versus 31 ± 9,5; p=0,002); a longer total duration of arousals during sleep (549,1 ± 170,3 sec. versus 357,2 ± 88,5 sec.; p=0,002); a longer total duration of arousals during NREM sleep (436,8 ± 165,7 sec. versus 271,9 ± 95,2 sec.; p=0,006); an increase of arousal index during sleep (10,2 ± 2,9 versus 6,3 ± 1,7; p=0,001); an increase of arousal index during NREM sleep (10,3 ± 3,4 versus 6 ± 2; p=0,001). There was not a significant difference in number (13,6 ± 5,6 versus 10,8 ± 3,7; p=0,149), total duration (112,3 ± 48,3 sec. versus 85,3 ± 25,2 sec.; p=0,091) and arousal index (9,7 ± 3,8 versus 7,4 ± 2,4; p=0,075) during REM sleep between the two groups. All patients with TLE showed a sleep efficiency that is normal and similar to the control group (90,4 ± 2,9% versus 90,6 ± 2,9%).Conclusions: Patients with TLE showed an increase in CAP rate and a longer CAP duration in relation to the control group, demonstrating an increase in the instability and fragmentation of sleep. The increase in the CAP rate expression, alterations in the parameters of sleep fragmentation and discontinuity that as expressed by increase in the number, duration, arousal index during NREM sleep and number of stage shifts, associated with normal sleep efficiency in our group of patients with TLE may suggest that CAP may have influence in the modulation of sleep. Sleep fragmentation and instability in patients with TLE may occur probably due to epilepsy itself, reflecting the interaction of the epileptic foci with the systems responsible for the maintenance and stability of sleep.

Introdução: A enurese noturna (EN) é considerada como a eliminação de urina no período noturno, de forma involuntária, em indivíduos com cinco ou mais anos de idade em pelo menos duas noites no mês até todas as noites. EN pode ser do tipo monossintomática, quando ocorre na ausência de outros sintomas, ou não monossintomática, na presença de sintomas de vesicais diurnos. Apesar de historicamente conhecida com uma desordem psiquiátrica, a EN monossintomática está incluída na Classificação Internacional dos Transtornos de 2012 como uma parassonia podendo ocorrer em qualquer fase do sono, porém predominantemente no sono não REM. Está comumente associada a hiperatividade vesical, produção excessiva de urina e falha em acordar após o enchimento vesical. Apesar de ocorrer no sono, a avaliação do sono pelos padrões usuais falhou em encontrar justificativa para este processo patológico. A análise da microestrutura do sono é uma ferramenta mais refinada e precisa que pode auxiliar na busca do mecanismo neurofisiológico que justifica este processo. Objetivo: Analisar os padrões de microarquitetura de sono atrvés do Padrão alternante Cíclico (CAP) nas crianças com EN monossintomática para melhor compreensão das bases neurofisiológicas da EN. Metodologia: Trinta e seis crianças sendo, 22 enuréticos e 14 controles com idade variando entre sete e 17 anos de idade, que satisfizeram os critérios de inclusão, foram submetidas a triagem clínica e laboratorial, avaliados quanto aos aspectos do sono, com uso de diários de sono, das escalas de Berlin, Sleep Scale for Children (SDSC) e Escala de Sonolência de Epworth e posteriormente submetidos ao de estudo polissonográfico completo de noite inteira, com a avaliação do CAP. Resultados: As escalas de sonolência e de Berlin não evidenciaram anormalidades, o SDSC evidenciou apneia em 11/22 (50%), hiperidrose em 2/22 (9%) e transtorno da transição vigília-sono, do despertar e do início e manutenção de sono em 1/22 (4,5%) cada. A análise da estrutura do sono mostrou maiores números de despertares (p < 0,001) e de sono N2 (p=0,0025) além de maior quantidade de sono N3 (p < 0,0001) do que nos controles. A microestrutura do sono evidenciou aumento da fase A1 (p=0,05), porém de forma mais contundente, redução das fases A2 e A3 (p < 0,0001), mesmo com a taxa de CAP igual à dos controles normais.Conclusão: Crianças com EN possuem sono com comorbidades (avaliado pelo SDSC) e menos fases CAP A2 e A3, significando uma redução no seu mecanismo de despertar e que ainda não havia sido demonstrado num estudo de PSG com análise das variáveis comuns. Este é o primeiro estudo que demonstra tal fenômeno<br>Introduction: Nocturnal enuresis (NE) is defined as the lack of nocturnal urine control, in individuals with five or more years old for at least two nights in a month, but up to every night. EN can be monosymptomatic (ENM), when it occurs in the absence of other symptoms or non monosymptomatic in the presence of diurnal renal symptoms. Although historically known as a psychiatric disorder, ENM is included in the International Classification of Sleep Disorders 2012 as a parasomnia. It can occur at any sleep stage but predominantly in non-REM sleep. EN is commonly associated to bladder hyperactivity, excessive urine production and/or failure to wake up after bladder filling. Despite the occurrence in sleep, standard sleep evaluation has failed to find abnormalities. The analysis of sleep microstructure is a refined and more accurate tool that can help find the neurophysiological mechanism underlying this process. Purpose: To evaluate sleep microarchitecture through Clyclic Altenating Pattern (CAP) analysis in children with monosymptomatic NE and provide a better understanding of the neurophysiological basis of EN. Methods: After IRB approval, 36 children, 22 with NE and 14 controls aged between seven and 17 years old who met the inclusion criteria were submitted to clinical and laboratory screening, evaluated for aspects of sleep, using sleep logs, Berlin Questionnaire (BQ), Sleep Scale for Children (SDSC) and Epworth Sleepiness Scale (ESS) and submitted to a full polysomnographic study, with evaluation of CAP. Results: ESS and BQ evidenced no abnormalities, the SDSC showed mild sleep apnea in 11/22 (50%), hyperhidrosis in 2/22 (9%) and disorder of the sleep-wake transition, awakening and initiation and maintenance sleep in 1/22 (4.5%) each. Analysis of sleep macrostructure showed higher numbers of awakenings (p < 0.001) and N2 sleep (p = 0.0025) as well as greater amount of sleep N3 (p < 0.0001) when compared to controls. Sleep microstructure showed an increase in A1 phase (p = 0.05), and reduction of A2 and A3 (p < 0.0001). CAP rate was the same for both enuretic and controls. Conclusion: Children with EN may present sleep comorbidities (measured by SDSC) and less A2 and A3 CAP phases, meaning a reduction in its wake regulation. This is the first study to acknowledge this phenomenon

Thesis (M.S. in Human Systems Integration)--Naval Postgraduate School, December 2009.<br>Thesis Advisor(s): Miller, Nita Lewis. Second Reader: McCauley, Michael E. "December 2009." Description based on title screen as viewed on January 26, 2010. Author(s) subject terms: Sleep Efficiency, Sleeping Surface, Acceleration, Motion Effects on Sleep, Actigraphy, Sleep Quality, Shipboard Sleep. Includes bibliographical references (p. 83-87). Also available in print.

A four week investigation of the cognitive and physiological effects that polyphasic sleep had on a human subject. The subject was put onto Uberman’s sleep schedule and took cognitive tests for four weeks measuring memory, concentration and problem solving skills. Additionally weight, food intake, and dreams were recorded. After two weeks exercise one hour of anaerobic exercise was introduced. From the data recorded there was no significant variance in cognitive ability due to change of sleep pattern yet there was a noticeable weight change.