Circadian distribution of sleep phases after major abdominal surgery
01 Jan 2008-BJA: British Journal of Anaesthesia (Oxford University Press)-Vol. 100, Iss: 1, pp 45-49
TL;DR: Patients have significantly increased REM sleep, LS, and reduced time awake during the daytime period after surgery compared with before surgery, suggesting disturbances in the circadian regulation of the sleep-wake cycle may be involved in the development of postoperative sleep disturbances.
Abstract: Background It is believed that the severely disturbed night-time sleep architecture after surgery is associated with increased cardiovascular morbidity with rebound of rapid eye movement (REM). The daytime sleep pattern of patients after major general surgery has not been investigated before. We decided to study the circadian distribution of sleep phases before and after surgery. Methods Eleven patients undergoing elective major abdominal surgery were included in the study. Continuous ambulatory polysomnographic monitoring was made 24 h before surgery and 36 h after surgery, thus including two nights after operation. Sleep was scored independently by two blinded observers and the recordings were reported as awake, light sleep (LS, stages I and II), slow wave sleep (SWS, stages III and IV), and REM sleep. Results There was significantly increased REM sleep ( P =0.046), LS ( P =0.020), and reduced time awake ( P =0.016) in the postoperative daytime period compared with the preoperative daytime period. Five patients had REM sleep during the daytime after surgery. Three of these patients did not have REM sleep during the preceding postoperative night. There was significantly reduced night-time REM sleep for two nights after surgery compared with before surgery ( P =0.001). Conclusions Patients have significantly increased REM sleep, LS, and reduced time awake during the daytime period after surgery compared with before surgery. Disturbances in the circadian regulation of the sleep–wake cycle may be involved in the development of postoperative sleep disturbances.
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TL;DR: In this article, the authors investigated the emotional and impulsive characteristics of problem gamblers and examined whether those who are adults, those who have more years of study or who work are less likely to have problem gambling.
Abstract: Background: Problem gambling could progressively grow in a period of isolation due to the COVID-19 pandemic to the possibility of gambling directly from home. Objectives: This pilot study highlights if the problem gambling, during a period of isolation such as that of COVID-19, can be explained by personality or sociodemographic characteristics, therefore it investigates the emotional and impulsive characteristics of problem gamblers and examines whether those who are adults, those who have more years of study or who work are less likely to have problem gambling. Methods: A total of 200 subjects completed an online survey to examine the associations between problem gambling, alexithymia, and impulsiveness. The standardized tools used were the South Oaks Gambling Screen (SOGS), the Toronto Alexithymia Scale (TAS-20), and the Barratt Impulsiveness Scale (BIS-11). Results: Problem gambling was positively correlated with male gender, TAS-20 total score, difficulty describing feelings, externally-oriented thinking, attentional, and nonplanning impulsiveness. Furthermore, there was a significant inverse correlation between higher SOGS scores and fewer years of study. Multivariate analysis showed that age, gender, years of study, BIS-11 total score, attentional impulsiveness, and nonplanning impulsiveness were predictors of gambling. Conclusions: The results of this exploratory research suggest that in a period characterized by a pandemic, problem gambling is associated with some personality and sociodemographic characteristics. Moreover, age, male gender, low levels of study and impulsive characteristics play a decisive role in problem gambling.
7 citations
TL;DR: In this paper , the effect of intraoperative esketamine infusion on incidence of sleep disturbance following gynecological laparoscopic surgery was examined in a randomized clinical trial, and the results showed that the infusion improved sleep quality.
Abstract: This randomized clinical trial examines the effect of intraoperative esketamine infusion on incidence of sleep disturbance following gynecological laparoscopic surgery.
7 citations
TL;DR: Main correlational findings showed in the CHD children’s group that parenting stress total scores were positive related to difficult parent-infant bedtime interactions both for mothers and fathers.
Abstract: The aim of this study is to evaluate parental perceptions of parent-infant bedtime interactions and quality of sleep, after hospital discharge, in a group of children diagnosed at birth with congenital heart disease (CHD), as compared with the perceptions of parents in a control group of children who were healthy at birth. More specifically, we evaluated the associations between parental stress, parental perceptions of infant emotion regulation, and infants’ bedtime and sleep routines in each of the two groups. Fifty Italian intact two-parent families (23 boys) of toddlers ageing from 11 to 36 months (M= 23.42, SD=7.10) were recruited. 20 families of CHD children group were recruited from the Department of Cardiology at the Bambino Gesu Children’s Hospital in Rome, Italy; 30 families of the healthy children group were recruited from two childcare units. Parents completed Emotion Regulation Checklist (Shields & Cicchetti, 1997), Parent-Child Sleep Interaction Scale (PSIS; Alfano et al., 2013), Parent-Stress Index-Short Form (PSI-SF; Abidin, 1990) and ad-hoc semi-structured interview on child’s sleep quality. The independent-samples t-test evidenced that parents of healthy children reported significantly higher scores on children's emotion regulation compared with the CHD group Specifically CHD children and healthy children's emotion regulation reported both by mothers (respectively CHD children’s mothers: M= 26.11, SD= 2.9; healthy children’s mothers: M= 28.85, SD= 2.71; t(37) = 3.10, p= .004) and fathers (respectively CHD children’s fathers: M=25.76, SD= 2.79; healthy children’s fathers: M= 27.37, SD= 2.02; t(31)= 2.71, p= .010). Main correlational findings showed in the CHD children’s group that parenting stress total scores were positive related to difficult parent-infant bedtime interactions both for mothers ( r =.58, p < .01) and fathers ( r = .70, p < .01). Results show significant differences in emotion regulation between the two groups. The results of this research will show to the clinicians the aspects of parent-infant bedtime interactions to be addressed in parents of children with CHD.
7 citations
TL;DR: Wide limits of agreement preclude perioperative PG to be used as a diagnostic method; however, it may be useful to screen sedated surgical patients for OSA.
7 citations
Cites background from "Circadian distribution of sleep pha..."
...Recently, it was shown that anesthesiologists and surgeons fail to diagnose a significant number of OSA cases [9], despite high prevalence [2], and that more severe episodes of apnea in surgical patients is well-established [11,12]....
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...During the perioperative period, signs and symptoms of OSA may become more pronounced due to sleep impairment and use of sedative/analgesic medication [2,9,11,12]....
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TL;DR: Minimizing interruptions at night by clustering care, informing patients of scheduled interruptions, and increasing access to noise-reduction aids may improve sleep quality.
7 citations
References
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Book•
01 Jan 1968
11,993 citations
TL;DR: Techniques of recording, scoring, and doubtful records are carefully considered, and Recommendations for abbreviations, types of pictorial representation, order of polygraphic tracings are suggested.
Abstract: With the vast research interest in sleep and dreams that has developed in the past 15 years, there is increasing evidence of noncomparibility of scoring of nocturnal electroencephalograph-electroculograph records from different laboratories. In 1967 a special session on scoring criteria was held at the seventh annual meeting of the Association for the Psychophysiological Study of Sleep. Under the auspices of the UCLA Brain Information, an ad hoc committee composed of some of the most active current researchers was formed in 1967 to develop a terminology and scoring system for universal use. It is the results of the labors of this group that is now published under the imprimatur of the National Institutes of Health. The presentation is beautifully clear. Techniques of recording, scoring, and doubtful records are carefully considered. Recommendations for abbreviations, types of pictorial representation, order of polygraphic tracings are suggested.
8,001 citations
01 Jan 1968
3,002 citations
01 Jan 1968
2,439 citations
TL;DR: REM sleep is associated with profound sympathetic activation in normal subjects, possibly linked to changes in muscle tone and the hemodynamic and sympathetic changes during REM sleep could play a part in triggering ischemic events in patients with vascular disease.
Abstract: Background The early hours of the morning after awakening are associated with an increased frequency of events such as myocardial infarction and ischemic stroke. The triggering mechanisms for these events are not clear. We investigated whether autonomic changes occurring during sleep, particularly rapid-eye-movement (REM) sleep, contribute to the initiation of such events. Methods We measured blood pressure, heart rate, and sympathetic-nerve activity (using microneurography, which provides direct measurements of efferent sympathetic-nerve activity related to muscle blood vessels) in eight normal subjects while they were awake and while in the five stages of sleep. Results The mean (±SE) amplitude of bursts of sympathetic-nerve activity and levels of blood pressure and heart rate declined significantly (P<0.001), from 100 ±9 percent, 90 ±4 mm Hg, and 64 ±2 beats per minute, respectively, during wakefulness to 41 ±9 percent, 80 ±4 mm Hg, and 59 ±2 beats per minute, respectively, during stage 4 of non-REM sl...
1,378 citations