SLEEP

doi: 10.1093/sleep/14.6.477pmid: 1798878

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Okawa,, M.;Mishima,, K.;Hishikawa,, Y.;Hozumi,, S.;Hori,, H.;Takahashi,, K.

doi: 10.1093/sleep/14.6.478pmid: 1798879

Abstract Circadian rhythms in elderly patients with severe dementia and behavioral disorders such as wandering, agitation and/or delirium were examined. The subjects consisted of 24 patients with dementia (5 with senile dementia of Alzheimer's type and 19 with multi-infarct dementia), aged 56–89 (it = 75.5 ± 8.7) and 8 control patients without dementia or with dementia of slight degree, aged 65-81 (x = 75 ± 5.4). The sleep-wake state of the patients was judged every hour by nurses over periods of 1–4 mo and recorded in the form of a sleep diary. Oral temperature was recorded for 4–7 consecutive days. For the treatment of sleep-wake rhythm disorders, social interaction with nurses was encouraged in addition to drug therapy. The patients showed various types of sleep-wake disorders such as reversed day-night rhythm or irregular sleep-wake rhythm corresponding to a decreased amplitude ofthe sleepwake rhythm. Circadian rhythm of oral temperature was irregularly disturbed in 59.0% of the patients in the dementia group and in only 12.5% ofthe patients in the control group. The effects of treatment by enforcement of social interaction with nurses was effective in redUl:ing behavioral problems and sleep-wake rhythm disorder in 30.0% of the patients tested. However, body temperature rhythm disorganization remained after the treatment. These observations indicate that behavioral disorders such as delirium, agitation or wandering in patients with severe dementia might be closely related to disrupted biological rhythms of sleep-waking and the autonomic system (body temperature). Circadian rhythm, Sleep, Wake rhythm, Body temperature, Dementia, Social zeitgeber This content is only available as a PDF. © 1991 Association of Professional Sleep Societies

Ancoli-Israel,, Soni;Ancoli-Israel,, Soni;Kripke, Daniel, F.;Kripke, Daniel, F.;Klauber, Melville, R.;Mason, William, J.;Mason, William, J.;Fell,, Robert;Fell,, Robert;Kaplan,, Oscar

doi: 10.1093/sleep/14.6.486pmid: 1798880

Ancoli-Israel,, Sonia;Ancoli-Israel,, Sonia;Kripke, tDaniel, F.;Kripke, tDaniel, F.;Klauber, Melville, R.;Mason, William, J.;Mason, William, J.;Fell,, Robert;Fell,, Robert;Kaplan,, Oscar

doi: 10.1093/sleep/14.6.496pmid: 1798881

Kerkhofs,, Myriam;Linkowski,, Paul;Lucas,, Françoise;Mendelwicz,, Julien

doi: 10.1093/sleep/14.6.501pmid: 1798882

Abstract Alterations of nocturnal sleep have been widely described in affective disorders. However, little is known about putative daytime sleep and to what extent daytime sleep could interfere with nocturnal sleep. The goal ofthis study was to investigate 24-hr sleep patterns in 12 depressed patients hospitalized for a major depressive disorder and in 10 control subjects studied under the same experimental conditions. Patients and controls were free to sleep whenever they chose, and sleep recordings were performed using the Oxford Medilog System during 60 hr. Daytime sleep episodes were detected in 50% of the patients and in 60% of the controls. Patients took naps at various times of the day, whereas controls napped in the early afternoon, during the well-known “postlunch dip”. Thus daytime sleep prevalence was similar in both groups; however, the biphasic distribution of sleep observed in controls disappeared in the patients. Napping did not affect subsequent nocturnal sleep in either group. Depression, Sleep, Naps, 24-hr sleep This content is only available as a PDF. © 1991 Association of Professional Sleep Societies

Åkerstedt,, Torbjörn;Kecklund,, Göran

doi: 10.1093/sleep/14.6.507pmid: 1798883

Abstract Twenty rotating three-shift workers participated. Night and day sleep in connection with work on afternoon and night shifts, respectively, were recorded using 24-hour polysomnographic recording techniques. The procedure was repeated 2 years later. Both day and night sleep showed high significant correlations between years for rapid eye movement (REM) sleep, slow wave sleep (SWS-stages 3 + 4), total sleep time, slow wave energy, in the delta band (obtained via spectral analysis) and subjective sleep quality. Stage 2, stage I, percent waking, sleep latency, SWS latency and REM latency were not correlated across years. None ofthe variables showed a significant difference between years. It was concluded that core variables of sleep show considerable interindividual stability across time and that a 2-year exposure to rotating shift work does not affect sleep in experienced shift workers. Sleep, Shift work, Reliability, Variability, Spectral analysis, EEG This content is only available as a PDF. © 1991 Association of Professional Sleep Societies

Dawson,, Drew;Campbell, Scott, S.

doi: 10.1093/sleep/14.6.511pmid: 1798884

Abstract Many of the health and safety problems reported by shift workers result from the chronic sleep deprivation associated with shorter, fragmented daytime sleep. This reduction in the quality and duration of sleep has been attributed to a change in the phase relationship between the work period and the circadian system, timing the propensity for sleep and wakefulness. This study examined the extent to which appropriately timed exposure to bright light would accelerate the circadian readjustment of physiological parameters thought to contribute to impaired performance in shift workers. A control (n = 7) and treatment group (n = 6) underwent a 3-day transition to simulated night work. The treatment group received a single 4-hour pulse of bright light (6,000 lux) between 2400 and 0400 hours on the first night shift and dim light < 200 lux) for the remainder of the study. The control group received dim light throughout. By the third night shift, the phase position of the core body temperature rhythm for the treatment group had delayed by 5-6 hours whereas the control group had delayed by only 2–3 hours. When compared to the control group, the greater delay in core temperature rhythm for the treatment group was associated with significantly higher alertness across the night shift and improved sleep quality during the day. By the third day sleep, mean sleep efficiency in the treatment group was not significantly different from normal night sleep. Similarly, onshift alertness was improved relative to the control group. The treatment group did not show the typical decline in alertness observed in the control group between 0300 and 0700 hours. These data indicate that a single 4-hour pulse of bright light between midnight and 0400 hours is effective in ameliorating the sleep and alertness problems associated with transition to night shift. Shift work, Bright light, Body temperature, Alertness, Sleep EEG This content is only available as a PDF. © 1991 Association of Professional Sleep Societies

Liistro,, G.;Stănescu, D., C.;Stănescu, D., C.;Veriter,, C.;Rodenstein, D., O.;Aubert-Tulkens,, G.

doi: 10.1093/sleep/14.6.517pmid: 1798885

Abstract We measured respiratory mechanical characteristics during sleep in five heavy, nonapneic snorers (HS) and in five obstructive sleep apnea (OSA) patients. In two HS and in two OSA patients we obtained lateral pharyngeal cineradiographic images during sleep while snoring. Flow limitation preceded all snores in both HS and OSA. Pattern of snoring, hysteresis and temporal relationship between supraglottic pressure (Psg) and fiow rate were different in HS and OSA. Maximal fiow during snoring was less (p < 0.05) in OSA (0.18 ± 0.07 liter/second) than in HS (0.36 ± 0.06 liter/second). Linear supraglottic resistance during inspiratory snoring was higher, though not significantly, in OSA patients (7.11 ± 3.01 cm H20/liter/second) than in HS (4.80 ± 2.83 cm H20/liter/second). We conclude that: 1) Snoring is characterized by high frequency oscillations of the soft palate, pharyngeal walls, epiglottis and tongue. 2) Flow limitation appears to be a sine qua non for snoring during sleep. 3) The pattern of snoring is different in OSA and HS. 4) Pharyngeal size during snoring is probably larger in HS than in OSA patients. Snoring, Pharynx, Upper airway, Sleep, Flow limitation, Mechanics of breathing, Obstructive sleep apnea This content is only available as a PDF. © 1991 American Sleep Disorders Association and Sleep Research Society

Raetz, Sheryl, L.;Richard, Christopher, A.;Garfinkel,, Alan;Harper, Ronald, M.

doi: 10.1093/sleep/14.6.526pmid: 1798886

Abstract Traditional assessment of cardiac R-R intervals during sleep-wake states uses summary statistics such as mean and interquartile range. Such summary statistics are less able to provide information about instantaneous or dynamic aspects of beat-to-beat control. We examined state-dependent beat-to-beat patterning by plotting each cardiac R-R interval against the previous interval (Poincare plots). This procedure provides an indication of the probability of occurrence of one interval from its predecessor and allows assessment of dynamic properties of RR interval variation. Cardiac R-R intervals were determined over 5-12-minute periods of wakefulness (A W), quiet sleep (QS) and rapid eye movement sleep (REM) from six cats; each interval was plotted on the y-axis against the previous value on the x-axis resulting in an RRn+1 vs. RRn plot. These plots provided evidence that the correlation between an interval and its successor was greater in REM than in QS, even though the overall range was greater in REM. The results suggest that short-term cardiac control during REM may be influenced by more closely regulated mechanisms than suggested by classic concepts. Cat, Heart rate variability, Poincaré, Nonlinear dynamics, R-R interval This content is only available as a PDF. © 1991 American Sleep Disorders Association and Sleep Research Soci,:ty

Babkoff,, Harvey;Caspy,, Tamir;Hishikawa,, Y.;Mikulincer,, Mario

doi: 10.1093/sleep/14.6.534pmid: 1798887

Abstract Computerized self-report sleepiness scale:s were administered before and after cognitive testing in a 72-hour sleep deprivation study. The cognitive test battery was administered every 2 hours and took approximately 1-1.25 hours. Two computerized measures of subjective sleepiness were used, one a visual analog scale, the other a Hebrew version of the Stanford sleepiness scale. The results indicated that both accumulated sleep loss, circadian and ultradian (2 cycles/day) factors were significant in determining subjective estimates of sleepiness. The extent of the differences between subjective sleepiness ratings before cognitive testing and after testing was dependent upon the phase of the circadian cycle. These differences were greatest at approximately 0200—0600 hours and least around 1000 hours. A second low point occurred at 1800-2000 hours. Analysis by complex demodulation of the individual subjects' sleepiness rating curves indicated that the amount of variance accounted for by the circadian component increased significantly after cognitive testing. Sleepiness, Sleep deprivation, Circadian rhythmicity, Cognitive performance This content is only available as a PDF. © 1991 American Sleep Disorders Association and Sleep Research Society