SLEEP

Ryan,, Thomas;Mlynczak,, Stanislaw;Erickson,, Tim;Man, S. F., Paul;Man, Godfrey C., W.

doi: 10.1093/sleep/12.3.201pmid: N/A

Abstract We measured oxygen consumption (VO2) in eight normal male volunteers during sleep, using the ventilated-hood method. Data were collected over 28 subject-nights. There was an overnight trend of gradually decreasing VO2 in the first 4 h, followed by a rise toward the morning. The minimum VO2 was 7.9% lower than that in the first hour. To examine the influence of sleep stages on the VO2 , we compared the VO2 of a sleep stage (an overnight average of all epochs in that stage) with that of other stages. The results show that VO2 values in stages awake and 1 are significantly higher than all other stages. Stage rapid eye movement (REM) is significantly lower than stage 2, but stages 3 and 4 are not different from each other or from stages REM and 2. We also compared VO2 of sleep stages that occurred close to each other (within the same hour). VO2 in awake stage is again significantly higher than in all other stages, and stage 2 is higher than stages 3 and 4. However, no difference is found between stage 1 and stages 2, 3 and REM, nor is there any difference between REM and stages 2 and 3. The discrepancy between close-stage comparison and overnight-average comparison can be accounted for by the variation in VO2 of an individual stage with the time of night. Although there is a variation in time distribution of the stages overnight, this factor influences the overnight trend of VO2 in a minor fashion only. Oxygen consumption, Sleep stage This content is only available as a PDF. © 1989 Association of Professional Sleep Societies

Berry, David T., R.;Phillips, Barbara, A.;Cook, Yvette, R.;Schmitt, Frederick, A.;Honeycutt, Nancy, A.;Edwards, Carolyn, L.;Lamb, David, G.;Magan, Laura, K.;Allen, Rebecca, S.

doi: 10.1093/sleep/12.3.211pmid: 2740692

Summary: We studied the waking medical, sleep, and psychological status of 28 healthy older persons who had undergone nocturnal polysomnography and daytime assessment approximately I-year earlier. In a previous report based on this sample, we found that sleep-disordered breathing (SDB) indices were not related to concurrent measurements of daytime functioning. However, in the present study, we observed relationships between the original SDB indices and several measures of cardiopulmonary functioning obtained I year later. At follow-up, subjects with originally high levels of SDB had significantly higher systolic blood pressure and poorer pulmonary function test results, were more likely to report irregular heartbeats in the previous year, and had experienced more disruptive snoring than the remaining subjects. When combined with other recent data, these results raise the possibility that SDB exerts an insidious pathological influence on the health and daytime functioning of otherwise healthy older persons. Sleep, Sleep apnea, Aging, Hypertension This content is only available as a PDF. © 1989 Association of Professional Sleep Societies

Aubert-Tulkens,, G.;Culée,, C.;Rodenstein,, D.O.

doi: 10.1093/sleep/12.3.216pmid: 2662343

Summary: Two male patients [aged 53 and 54 years; body mass index (BMI) of 36.8 and 34.4 kg/m2] presented with severely symptomatic sleep apnea syndrome. Polysomnographic recording showed sleep fragmentation, diminution of stages III and IV and continuous sleep-related disordered breathing with mixed and obstructive apneas and hypopneas, and snoring. Apnea index (number of apneas per sleep-hour) was 73 and 30, respectively. These abnormalities were reversed by nasal continuous positive airway pressure (nCPAP). Home treatment with nCPAP associated with hypocaloric diet was started. Six months later, all symptoms had disappeared and BMI was 29 and 29.2 kg/m2, respectively. Polygraphic recordings without nCP AP showed regular breathing in all sleep stages, which were stable and normally abundant. Therapy has been discontinued and clinical and polygraphic data have remained normal for up to 6 and 11 months, respectively. Sleep apnea syndrome, nCPAP, Weight loss This content is only available as a PDF. © 1989 Association of Professional Sleep Societies

Hirshkowitz,, Max;Karacan,, Ismet;Gurakar,, Ahmet;Williams, Robert, L.

doi: 10.1093/sleep/12.3.223pmid: 2740693

Summary: Sleep-related respiratory pattern was evaluated in 175 hypertensive and 110 normotensive men, none of whom reported difficulties in initiating or maintaining sleep. Patients were grouped according to sexual status (complaint of erectile problems), hypertension treatment status (treated or untreated), and blood pressure (diastolic <90 or ≥90). The prevalence of sleep apnea, apnea index, duration of the longest episode of apnea, and penile rigidity were tabulated. The group with elevated blood pressure, persistent even with antihypertensive drug therapy, had the most sleep apnea. The treated hypertensive men with controlled blood pressure had significantly less apnea than those whose blood pressure remained high. Untreated hypertensive groups, however, did not differ from normotensive groups with respect to apnea. Evidence of abnormal sleep-related respiratory activity was found in both hypertensive and normotensive groups with erectile problems. Interestingly, penile rigidity was significantly lower for hypertensive men with erectile complaints than for normotensive men with erectile complaints. There was also a small, but significant, negative correlation between apnea index and penile rigidity among men with erectile complaints. These results indicate that sexual status is an important consideration in the diagnosis of hypertension and sleep apnea. Moreover, these data suggest an interrelationship among hypertension, erectile dysfunction, and sleep apnea. Hypertension, Sleep apnea, Impotence, Erectile dysfunction, Sleep disorders This content is only available as a PDF. © 1989 Association of Professional Sleep Societies

Gadoth,, Natan;Costeff,, Hanan;Harel,, Shaul;Lavie,, Peretz

doi: 10.1093/sleep/12.3.233pmid: 2740694

Summary: The structure of sleep and number of body movements (BMS) and periodic leg movements during sleep (PMS). were studied in three unrelated girls suffering from L-DOPA responsive hereditary dystonia with marked diurnal fluctuation and in their 11 healthy, close relatives. All three girls had an increased number of BMS during rapid eye movement (REM) sleep. Five of the six parents and three siblings had abnormal PMS. One pair of parents had BMS similar to those of their affected daughter. The occurrence of BMS and PMS in the families studied may indicate a common mechanism for both. Because-familial PMS is quite rare in its pure form, and this type of dystonia is also rarely encountered, the occurrence of BMS and PMS in members of these families may imply a causative relation between these two sleep-related motor phenomena. Sleep, Body movements, Dystonia, Periodic phenomena This content is only available as a PDF. © 1989 Association of Professional Sleep Societies

Pressman, Mark, R.;Fry, June, M.

doi: 10.1093/sleep/12.3.239pmid: 2740695

Summary: Autonomic nervous system (ANS) measures have been used frequently as measures of activation or arousal. However, their relationship to standard measures of alertness-the Multiple Sleep Latency Test (MSL T) and Stanford Sleepiness Scale (SSS}-and to the quantity and quality of prior sleep has not been determined. In this study, the direct pupil light reflex (PLR) was measured with the MSL T and SSS to determine how ANS activity varies with daytime sleepiness and how all three measures were related to prior nocturnal sleep in a group of patients with obstructive sleep apnea. When the effects of age and time of day were partialed out, PLR data suggest that increased sleepiness as measured by MSL T is significantly correlated with increased parasympathetic activity (r = − 0.60, p < 0.01) and not with decreased sympathetic activity (r = −0.24, not significant). These partial correlations were significantly different (p < 0.05). Increased sleepiness as measured by the SSS was significantly correlated with decreased sympathetic activity (r = − 0.46, p < 0.05) and not with increased parasympathetic activity (r = −0.00, not significant). These partial correlations were significantly different (p < 0.02). In the group of sleep apnea patients, the PLR suggests that increased number of apneas and hypopneas (sleep fragmentation) was significantly correlated with both decreased sympathetic activity and increased parasympathetic activity. These findings suggest that ANS activity is related to daytime sleepiness and to the quality of prior sleep. Sleepiness, Pupil light reflex, Autonomic nervous system, Sleep This content is only available as a PDF. © 1989 Association of Professional Sleep Societies

Salín-Pascual, Rafael, J.;Nieto-Caraveo,, Amado;Roldán-Roldán,, Gabriel;Huerto-Delgadillo,, Lourdes;Granados-Fuentes,, Daniel

doi: 10.1093/sleep/12.3.246pmid: 2740696

Summary: Rapid eye movement sleep (REMS) deprivation is believed to alter the sensitivity of various neurotransmitter systems. In the present article, we studied 20 healthy volunteers divided into three groups. Group A attended the sleep laboratory for three nights: acclimatization, a baseline night, and one night of physostigmine infusion. Group B attended for eight nights; acclimatization, baseline, four nights of REMS deprivation, and two recovery nights. With the exception of the first recovery night, when group C volunteers were administered physostigmine, group C's schedule was identical to group B's. The infusions received by group A and C were composed of 1.0 mg of physostigmine, dissolved in 100 ml of saline solution. These were administered 5 min after sleep onset and thereafter every hour, except when the subjects were either awake or in REMS. All of the subjects receiving the cholinomimetic infusion were given a peripheral anticholinergic. Group A experienced a great number of awakenings with a decrease in REMS percentage. Group B recovery occurred over two nights, with an increase in the average length of REMS. Group C exhibited maximum REMS rebound on the first recovery night with an increased number of REMS episodes, as well as significant reductions in the first REMS latency. Our findings suggest that physostigmine alters REMS rebound following REMS deprivation. REM sleep deprivation, Physostigmine, Cholinergic, Depression This content is only available as a PDF. © 1989 Association of Professional Sleep Societies

Aldrich, Michael, S.;Rogers, Ann, E.

doi: 10.1093/sleep/12.3.254pmid: 2740697

Summary: A middle-aged woman with narcolepsy developed a pronounced exacerbation of cataplexy within 3 days of beginning treatment for hypertension with prazosin, an α1-adrenoceptor antagonist. At times, episodes of cataplexy were virtually continuous (status cataplecticus), and there was only partial amelioration with tricyclic antidepressants. Cataplexy improved when prazosin was discontinued. These findings are similar to the reported effects of prazosin on cataplexy in narcoleptic dogs; they support a role for altered α1-adrenoceptor function in narcolepsy. Narcolepsy, Cataplexy, Prazosin, α1-Adrenoceptor, Monoamines This content is only available as a PDF. © 1989 Association of Professional Sleep Societies

Watanabe,, Hiroki;Azuma,, Yuji

doi: 10.1093/sleep/12.3.257pmid: N/A

Summary A classification system of enuresis was proposed based on the overnight simultaneous electroencephalographic (EEG) and cystometric (CM) monitoring of 204 cases. The classification types proposed were as follows: (a) Type I (125 cases, 61%). The first bladder contraction (FBC) in CM is noticed on cystometrogram (CMG) during Stage 4 sleep when the bladder is full. An evidence of arousals in EEG appears and EEG changes to a Stage 1 or 2 sleep pattern; however, enuresis occurs without waking. (b) Type IIa (22 cases, 11%). FBC is noticed as in Type I, but no EEG response is observed; enuresis occurs. (c) Type lIb (57 cases, 28%). An uninhibited contraction of the bladder is observed on CMG only during sleep (not on awakening). No change in either FBC or EEG is found, but enuresis occurs. It is expected that new methods of treatment for enuresis will be developed based on this classification system. Cystometry, Electroencephalography, overnight monitoring This content is only available as a PDF. © 1989 Association of Professional Sleep Societies

Hoppenbrouwers,, Toke;Hodgman,, Joan;Arakawa,, Kazuko;Sterman, M., B.

doi: 10.1093/sleep/12.3.265pmid: N/A

Summary Twenty-five subsequent siblings of infants who died of Sudden Infant Death Syndrome (SIDS) underwent 12-h overnight polygraphic recordings during the first week of life and at 1, 2, 3, 4, and 6 months of age. The polygraphic tracings from these infants were compared with those from 25 infants without a family history of SIDS. One dozen sleep and waking parameters were examined including state transition probabilities, the ratio between quiet sleep (QS) and active sleep (AS), the incidence and duration of sustained states and the stability of an infant's sleep and waking during the first half year of life. Variability within and between infants was marked with a reduction of variability in measures of QS at 3 months and of AS at 4 months of age. The similarities between subsequent siblings of SIDS and control infants far outweighted the differences. However, subsequent siblings exhibited a tendency, once asleep, to remain asleep longer than controls. This finding was observed in a comparison of 20 infants in each group. When five infants were added to each group, infants in both groups tended to awaken equally from QS, but once in AS the subsequent siblings tended to-proceed into QS instead of awaken as the controls did. Sleep, Sudden Infant Death Syndrome (SIDS), Polysomnography This content is only available as a PDF. © 1989 Association of Professional Sleep Societies