Aircraft noise effects on sleep: a systematic comparison of EEG awakenings and automatically detected cardiac activations.
TL;DR: An algorithm for the automatic identification of cardiac activations associated with cortical arousals, which uses heart rate information derived from a single electrocardiogram (ECG) channel, may be used as estimates for EEG awakenings.
Abstract: OBJECTIVES: Polysomnography is the gold standard for investigating noise effects on sleep, but data collection and analysis are sumptuous and expensive. We recently developed an automatic algorithm for the identification of cardiac activations associated with cortical arousals, which uses heart rate information derived from a single electrocardiogram (ECG) channel (Basner et al. 2007a). We hypothesized that cardiac arousals can be used as estimates for EEG awakenings. METHODS: Polysomnographic EEG awakenings and automatically detected cardiac activations were systematically compared using laboratory data of 112 subjects (47 male, mean ± SD age 37.9 ± 13 years), 985 nights and 23,855 aircraft noise events (ANEs). RESULTS: The overall agreement was higher in control (81.9 %) compared to noise nights (76.4 %). However, if corrected for chance expected agreement according to Landis and Koch (1977), agreement was higher in noise (к=0.60) compared to control nights (к=0.33), representing “moderate to substantial” and “fair” agreement respectively. The probability of automatically detected cardiac arousals increased monotonously with increasing maximum sound pressure levels of ANEs, exceeding the probability of EEG awakenings by up to 18.1 %. If spontaneous reactions were taken into account, exposure-response curves were practically identical for EEG awakenings and cardiac arousals. CONCLUSIONS: Automatically detected cardiac arousals can be used as estimates for EEG awakenings. This inexpensive, objective, and non-invasive method facilitates large scale field studies on the effects of traffic noise on sleep. More investigations are needed to further validate the ECG algorithm in the field and to investigate interindividual differences in its ability to predict EEG awakenings.
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TL;DR: It is proposed that brain disorders and abnormal sleep have a common mechanistic origin and that many co-morbid pathologies that are found in brain disease arise from a destabilization of sleep mechanisms.
Abstract: Sleep and circadian rhythm disruption are frequently observed in patients with psychiatric disorders and neurodegenerative disease. The abnormal sleep that is experienced by these patients is largely assumed to be the product of medication or some other influence that is not well defined. However, normal brain function and the generation of sleep are linked by common neurotransmitter systems and regulatory pathways. Disruption of sleep alters sleep-wake timing, destabilizes physiology and promotes a range of pathologies (from cognitive to metabolic defects) that are rarely considered to be associated with abnormal sleep. We propose that brain disorders and abnormal sleep have a common mechanistic origin and that many co-morbid pathologies that are found in brain disease arise from a destabilization of sleep mechanisms. The stabilization of sleep may be a means by which to reduce the symptoms of--and permit early intervention of--psychiatric and neurodegenerative disease.
864 citations
TL;DR: In this article, the effects of air, road and rail traffic noise on sleep and recuperation were investigated for 11 consecutive nights, which included eight noise exposure nights and one noise-free control night.
Abstract: Study Objectives: Traffic noise disturbs sleep and may impair recuperation. There is limited information on single and combined effects of air, road and rail traffic noise on sleep and recuperation.
Design: Repeated measures
Setting: Polysomnographic laboratory study
Participants: 72 healthy subjects, mean ± standard deviation 40 ± 13 years, range 18-71 years, 32 male
Interventions: Exposure to 40, 80, or 120 rail, road, and/or air traffic noise events
Measurements and Results: Subjects were investigated for 11 consecutive nights, which included eight noise exposure nights and one noise-free control night. Noise effects on sleep structure and continuity were subtle, even in nights with combined exposure, most likely due to habituation and an increase in arousal thresholds both within and across nights. However, cardiac arousals did not habituate across nights. Noise exposure significantly affected subjective assessments of sleep quality and recuperation, whereas objective performance was unaffected, except for a small increase in mean PVT reaction time (+4 ms, adjusted P 3 kHz) noise event components.
Conclusions: Road, rail, and air traffic noise differentially affect objective and subjective assessments of sleep. Differences in the degree of noise-induced sleep fragmentation between traffic modes were explained by the specific spectral and temporal composition of noise events, indicating potential targets for active and passive noise control. Field studies are needed to validate our findings in a setting with higher ecologic validity.
231 citations
TL;DR: It is argued that an understanding of the mechanistic overlap between SCRD and schizophrenia will ultimately lead to novel treatment approaches, which will not only ameliorate SCRD in schizophrenia patients, but also will improve their broader health problems and overall quality of life.
Abstract: Sleep and circadian rhythm disruption (SCRD) and schizophrenia are often co-morbid. Here, we propose that the co-morbidity of these disorders stems from the involvement of common brain mechanisms. We summarise recent clinical evidence that supports this hypothesis, including the observation that the treatment of SCRD leads to improvements in both the sleep quality and psychiatric symptoms of schizophrenia patients. Moreover, many SCRD-associated pathologies, such as impaired cognitive performance, are routinely observed in schizophrenia. We suggest that these associations can be explored at a mechanistic level by using animal models. Specifically, we predict that SCRD should be observed in schizophrenia-relevant mouse models. There is a rapidly accumulating body of evidence which supports this prediction, as summarised in this review. In light of these emerging data, we highlight other models which warrant investigation, and address the potential challenges associated with modelling schizophrenia and SCRD in rodents. Our view is that an understanding of the mechanistic overlap between SCRD and schizophrenia will ultimately lead to novel treatment approaches, which will not only ameliorate SCRD in schizophrenia patients, but also will improve their broader health problems and overall quality of life.
99 citations
Cites background from "Aircraft noise effects on sleep: a ..."
...…2001; Killgore et al. 2008; Randazzo et al. 1998) Impaired motor performance (Kahol et al. 2008; Pilcher and Huffcutt 1996) Dissociation (Lynn et al. 2012) Drowsiness, micro-sleeps and unintended sleep (Basner et al. 2008a, b; Philip and Akerstedt 2006; Pilcher et al. 2000; Scott et al. 2007)....
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TL;DR: Nocturnal vibration has a negative impact on sleep and that the impact increases with greater vibration amplitude, therefore, it is necessary to define levels that protect residents against sleep disruptive vibrations that may arise from night time railway freight traffic.
Abstract: Background
A substantial increase in transportation of goods on railway may be hindered by public fear of increased vibration and noise leading to annoyance and sleep disturbance. As the majority of freight trains run during night time, the impact upon sleep is expected to be the most serious adverse effect. The impact of nocturnal vibration on sleep is an area currently lacking in knowledge. We experimentally investigated sleep disturbance with the aim to ascertain the impact of increasing vibration amplitude.
97 citations
Cites background from "Aircraft noise effects on sleep: a ..."
...Events perceived in such a way perhaps then have a large influence on subjective sleep quality, as has been proposed previously [45]....
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TL;DR: Nocturnal freight train noise exposure in Germany was associated with increased awakening probabilities exceeding those for aircraft noise and contrasting the findings of many annoyance surveys and annoyance ratings of the study.
81 citations
References
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15 Mar 2007-Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
TL;DR: It was concluded that the scoring of EEG arousals has added much to the authors' understanding of the sleep process but that significant work on the neurophysiology of arousal needs to be done.
Abstract: The reliability and validity of EEG arousals and other types of arousal are reviewed. Brief arousals during sleep had been observed for many years, but the evolution of sleep medicine in the 1980s directed new attention to these events. Early studies at that time in animals and humans linked brief EEG arousals and associated fragmentation of sleep to daytime sleepiness and degraded performance. Increasing interest in scoring of EEG arousals led the ASDA to publish a scoring manual in 1992. The current review summarizes numerous studies that have examined scoring reliability for these EEG arousals. Validity of EEG arousals was explored by review of studies that empirically varied arousals and found deficits similar to those found after total sleep deprivation depending upon the rate and extent of sleep fragmentation. Additional data from patients with clinical sleep disorders prior to and after effective treatment has also shown a continuing relationship between reduction in pathology-related arousals and improved sleep and daytime function. Finally, many suggestions have been made to refine arousal scoring to include additional elements (e.g., CAP), change the time frame, or focus on other physiological responses such as heart rate or blood pressure changes. Evidence to support the reliability and validity of these measures is presented. It was concluded that the scoring of EEG arousals has added much to our understanding of the sleep process but that significant work on the neurophysiology of arousal needs to be done. Additional refinement of arousal scoring will provide improved insight into sleep pathology and recovery.
177 citations
TL;DR: Changes in pulse transit time (and to a lesser extent pulse rate) are sensitive markers of EEG arousal and should be useful to include when monitoring sleep and its disorders, particularly since pulse Transit time recorders can easily be made portable for home use.
Abstract: 1. Obstructive sleep apnoea and its variants often provoke hundreds of short arousals that lead to the most important symptom, disabling hypersomnolence. The measurement of sleep in these conditions requires the documentation of these short arousals and this is conventionally done by manual inspection of the sleeping EEG, a laborious procedure. 2. Other markers of 'arousal', that are easier to measure and document, include several cardiovascular signals that change as part of the orienting reflex: pulse rate rise, blood pressure rise, skin vasoconstriction, for example. 3. Pulse transit time (measured as the interval from the ECG R-wave until the arrival of the pulse pressure wave at the periphery, about 250 ms) varies inversely with blood pressure and provides a beat-to-beat estimation of blood pressure changes. 4. In eight normal subjects we have assessed the relationship between transient EEG arousals of different length (provoked by external stimuli) and changes in both pulse transit time and heart rate. 5. Significant falls in pulse transit time occurred in response to external stimuli [15.1 (SEM 1.4) ms], indicating a rise in blood pressure, and were significant even when there was no discernible change in the EEG [9.9 (SEM 2.6) ms]. Significant changes in heart rate also occurred [10.3 (SEM 1.2) beats/min], but were slightly less sensitive than changes in pulse transit time. 6. Changes in pulse transit time (and to a lesser extent pulse rate) are sensitive markers of EEG arousal. As such they should be useful to include when monitoring sleep and its disorders, particularly since pulse transit time recorders can easily be made portable for home use.
174 citations
TL;DR: The Institute of Aerospace Medicine at the German Aerospace Center (DLR) investigated the influence of nocturnal aircraft noise on sleep in polysomnographic laboratory and field studies between 1999 and 2004 and established noise protection zones directly related to the effects of noise onSleep.
Abstract: The Institute of Aerospace Medicine at the German Aerospace Center (DLR) investigated the influence of nocturnal aircraft noise on sleep in polysomnographic laboratory and field studies between 1999 and 2004. The results of the field studies were used by the Regional Council of Leipzig (Germany) for the establishment of a noise protection plan in the official approval process for the expansion of Leipzig/Halle airport. Methods and results of the DLR field study are described in detail. Special attention is given to the dose-response relationship between the maximum sound pressure level of an aircraft noise event and the probability to wake up, which was used to establish noise protection zones directly related to the effects of noise on sleep. These protection zones differ qualitatively and quantitatively from zones that are solely based on acoustical criteria. The noise protection plan for Leipzig/Halle airport is presented and substantiated: (1) on average, there should be less than one additional awakening induced by aircraft noise, (2) awakenings recalled in the morning should be avoided as much as possible, and (3) aircraft noise should interfere as little as possible with the process of falling asleep again. Issues concerned with the representativeness of the study sample are discussed.
157 citations
"Aircraft noise effects on sleep: a ..." refers background in this paper
...An event-related analysis establishes a direct temporal association between the occurrence of an ANE and the reaction of the investigated subject (Basner et al 2006, Ollerhead et al 1992, Passchier-Vermeer et al 2002)....
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...Although there is still debate, awakenings are usually considered an adequate indicator of noise-induced sleep disturbances for several reasons (Basner et al 2006, Ollerhead et al 1992)....
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TL;DR: The noncontact method for the ambulant measurement of basic sleep physiology parameters in humans, particularly for field studies involving sleep research and sleep disturbances, has been found to be adequate, especially for automated and unattended sleep-data collection over long periods of time.
Abstract: We describe a noncontact method for the ambulant measurement of basic sleep physiology parameters in humans, particularly for field studies involving sleep research and sleep disturbances. This method traces the body movements, respiration, and heart action of a person at rest or asleep on a bed, using four high-resolution force sensors installed under the bedposts. The recoil movement of the body at each heartbeat, known as the cardioballistic effect, as well as the lifting and lowering of the thorax, while breathing, causes very small shifts of the center of gravity of the bed and the subject. These shifts are reflected in the altering force distributions across the four sensors. Cardiac and respiratory parameters and the subject’s movement activity can be calculated from the sensor signals. Neither electrodes nor other kinds of transducers are in direct contact with the subject, which is the main advantage of this technique over conventional methods. Laboratory experiments were carried out to estimate validity and practicability. The method has been found to be adequate, especially for automated and unattended sleep-data collection over long periods of time.
146 citations
TL;DR: Cardiac responses did not habituate to traffic noise within the night and may therefore play a key role in promoting traffic noise induced cardiovascular disease, more likely for responses accompanied by awakenings than for situations without awakenings.
Abstract: TRANSIENT EXCITATIONS OF THE CENTRAL AND OF THE AUTONOMIC NERVOUS SYSTEM WITH A COMMON ORIGIN IN THE BRAINSTEM OCCUR FREQUENTLY and spontaneously (with no obvious reason) during normal sleep. Cortical arousals, which might lead to sleep stage changes or awakenings, are usually accompanied by autonomic arousals. As the reverse is not true, the latter may occur alone.1,2 Autonomic arousals are transient elevations of the sympathetic tone. They encompass increases of ventilation, of systolic and diastolic blood pressure, and of peripheral resistance; but they but are most often indicated by alterations of heart rate (HR). These cardiac arousals start to increase well before the visually detectable onset of cortical arousals.1–3 Their extent and patterns vary with the duration of the cortical arousals. With cortical arousals lasting up to 10 s, cardiac arousals are typically biphasic: an initial acceleration is followed by a deceleration below the baseline. The baseline is then regained after a gradual increase 15–30 s after stimulus onset.1,3–5 With longer lasting arousals the deceleration becomes gradually flatter, thus leading to a monophasic elevation of heart rate.1,4–5
Similar alterations are evoked by various external stimuli, in particular by acoustic stimuli.6–8 Research in this area was usually performed with artificial sounds, mostly with tones of up to 4 kHz and durations up to 5 s.6–12 The extents and the patterns of these responses were analyzed in detail and were shown to depend at least on stimulus intensity and on the sleep stage at the time of stimulation.
Traffic noises are a major cause of extrinsic sleep disturbances with after effects on mood, performance, and health.13 Despite this, cardiac responses to traffic noise have only occasionally been studied.14–17 A detailed analysis of these responses was performed only for sonic booms, which evoked the typical biphasic cardiac arousals described above.18
This paper deals with the cardiac responses of 24 persons to noises from aircraft, rail, and road vehicles during sleep in the laboratory. It investigates possible influences of acoustical parameters, time of night and momentary sleep stage. Such an analysis is highly relevant as numerous residents living in the vicinity of airports, along busy streets, and along railway tracks are permanently exposed to these noises while sleeping. Long-term exposure to these noises is assumed to contribute to the genesis of cardiovascular diseases.19
122 citations
"Aircraft noise effects on sleep: a ..." refers background in this paper
...Although there is still debate, awakenings are usually considered an adequate indicator of noise induced sleep disturbances (Basner et al. 2006; Griefahn et al. 2008; Ollerhead et al. 1992)....
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