Showing papers on "Non-rapid eye movement sleep published in 1981"
TL;DR: Fifty children and adolescents with obstructive sleep apnea syndrome and related breathing disorders during sleep are reviewed; the most common presenting complaint was excessive daytime somnolence; hyperactivity and antisocial behavior also were cited frequently.
Abstract: Fifty children and adolescents with obstructive sleep apnea syndrome and related breathing disorders during sleep are reviewed. Subjects were subdivided according to whether their breathing irregularity was secondary to a medical problem (group I) or was the primary complaint (group II). The most common presenting complaint was excessive daytime somnolence; hyperactivity and antisocial behavior also were cited frequently. In 20% of cases, substantial personality changes were reported. Clinical symptoms included failure to thrive, abnormal weight for age, acute cardiac or cardiorespiratory failure, hypertension, and frequent upper airway infections. Continuous, heavy snoring was reported in all cases; disrupted nocturnal sleep, sleep walking, nightmares, and enuresis were common. All subjects, and 22 control patients, were monitored polygraphically during sleep for at least one night. Nocturnal sleep in the reported population was severely disrupted. A complete disappearance of stage 3 NREM sleep was noted in 86% of cases; REM sleep was decreased less. The management of these cases is reviewed. Eight patients received permanent tracheostomies. Thirty children had tonsillectomy and/or adenoidectomy (three later required tracheostomy). Non-surgical approaches also were used, particularly in group 1. Follow-up on these cases to date is presented.
439 citations
TL;DR: The effect of sleep state on ventilation and the mechanics of breathing was studied in nine normal adolescents by use of a respiratory inductive plethysmograph and surface electromyogram electrodes.
Abstract: The effect of sleep state on ventilation and the mechanics of breathing was studied in nine normal adolescents by use of a respiratory inductive plethysmograph and surface electromyogram electrodes. Minute ventilation was state dependent (P less than 0.01), decreasing by a mean of 8% from wakefulness to nonrapid-eye-movement (NREM) sleep and increasing 4% from NREM to rapid-eye-movement (REM) sleep. These changes were caused by changes in respiratory rate. Tidal volume (VT) was not affected by sleep state (P greater than 0.10). The pattern of breathing during wakefulness was similar to that of REM sleep. During NREM sleep intercostal and diaphragmatic muscle activity increased by a mean of 34% and 11%, respectively, as compared with wakefulness, indicating an increase in the respiratory work load. This was accompanied by a substantial increase in rib cage contribution to VT. REM sleep was associated with a marked decrease in intercostal muscle activity (P less than 0.05) and a diminished rib cage contribution; VT was maintained due to a mean increase of 34% in diaphragmatic muscle activity (P less than 0.05).
268 citations
TL;DR: All-night electroencephalographic (EEG) sleep data were examined a function of age in normal control subjects and hospitalized, unmedicated depressed patients with primary affective illness to find that depressed patients had a greater Sleep Latency, Early Morning Awake time, Intermittent AwakeTime, Duration and REM Density of the first REM period, and average REM D density for the night.
Abstract: All-night electroencephalographic (EEG) sleep data were examined as a function of age in normal control subjects and hospitalized, unmedicated depressed patients with primary affective illness. By analysis of variance, Total Sleep time, Delta Sleep, Sleep Efficiency, Rapid Eye Movement (REM) Sleep, and REM Latency decreased as a function of age, whereas Early Morning Awake time and Intermittent Awake time increase. Compared with normal controls, after the effects of age were covaried out, depressed patients had a greater Sleep Latency, Early Morning Awake time, Intermittent Awake time, Duration and REM Density of the first REM period, and average REM Density for the night, as well as less Sleep Efficiency, less Delta Sleep, and shorter REM Latency. Early Morning Awake time increased with age in depressive but not in normals.
215 citations
TL;DR: Five patients between the ages of 7 and 74 years presented with nocturnal episodes characterized by coarse, often violent movements of the limbs and by a tonic phase of variable duration, indicating a distinct nosological entity whose pathophysiology is not yet understood.
Abstract: Five patients between the ages of 7 and 74 years presented with nocturnal episodes characterized by coarse, often violent movements of the limbs and by a tonic phase of variable duration. Seizures recurred every night or almost every night during slow wave (NREM) sleep and were not associated with electroencephalographic (EEG) abnormalities. Interictal EEGs were normal during both sleep and wakefulness. Carbamazepine treatment was effective in all patients. Uniform clinical behavior and EEG patterns indicate a distinct nosological entity whose pathophysiology is not yet understood.
214 citations
TL;DR: There were no marked differences in the sleep loss response of young adolescents as compared to published reports of sleep loss in older subjects.
Abstract: Effects of one night's sleep loss on nocturnal sleep, performance, and sleepiness were evaluated in 12 subjects (8 boys, 4 girls) whose ages ranged from 11.7 to 14.6 years. The magnitude and direction of sleep stage changes after sleep loss were comparable to similar findings in older subjects. Performance test decrements occurred for two measures during sleep deprivation. The performance decrements appeared to be related to episodes of sleep during the performance tests. Subjective measures of sleepiness showed a significant increase during sleep loss, with a complete recovery to basal levels after one night of sleep. The subjective ratings of sleepiness during sleep loss also showed a marked short-term dependence on preceding activity levels. Multiple sleep latency tests showed a marked reduction of sleep onset latency from 0530 throughout the day of sleep loss. In contrast to the subjective measures, sleep latency test scores did not vary with activity levels during sleep loss and did not recover to basal levels until the afternoon of the first recovery day. In general, there were no marked differences in the sleep loss response of young adolescents as compared to published reports of sleep loss in older subjects.
202 citations
TL;DR: The authors studied 104 dreams obtained from 14 subjects and quantified the formal aspects of the subjects' dream experiences by the following categories: movement in dreams, sensation, affect, dream bizarreness, and dream lucidity to show consistent with and supportive of the activation-synthesis hypothesis.
Abstract: The authors studied 104 dreams obtained from 14 subjects and quantified the formal aspects of the subjects' dream experiences by the following categories: movement in dreams, sensation, affect, dream bizarreness, and dream lucidity. Their results are compared with the predictions of the activation-synthesis hypothesis, which postulates that the characteristic formal aspects of dreams correspond to characteristic aspects of physiological activation during REM sleep. Although further experimental work is needed, the authors show that their results are consistent with and supportive of the activation-synthesis hypothesis.
167 citations
TL;DR: Sleep recordings were carried out on athletes on four successive nights after completing a 92-kilometer road race and significant increases in total sleep time and slow-wave sleep were found.
Abstract: Sleep recordings were carried out on athletes on four successive nights after completing a 92-kilometer road race. Significant increases in total sleep time and slow-wave sleep were found after this metabolic stress. The results show a definite exercise effect on sleep and support sleep-restoration hypotheses.
151 citations
TL;DR: A consecutive series of 100 sleep apnea free patients with the complaint of excessive daytime somnolence (EDS) were evaluated and significant differences in sleep latency during MSLT and NPSG testing were found between different EDS diagnostic groups of non-narcoleptic patients.
Abstract: A consecutive series of 100 sleep apnea free patients with the complaint of excessive daytime somnolence (EDS) were evaluated; data from medical histories, physical examination, personality inventories, and polysomnography [nocturnal polysomnography (NPSG) and daytime multiple sleep latency testing (MSLT)] were tabulated. Significant differences were found between narcoleptic and non-narcoleptic patients in a number of parameters, including EDS severity, mean sleep latency on MSLT, sleep latency on NPSG, latency to REM sleep at night, number of REM sleep at night, number of REM sleep segments throughout the night, the total number of nocturnal myoclonic jerks (as well as the number occurring per hour of NREM and REM sleep), and the number of arousals and wake periods preceded by a myoclonic jerk. Significant differences in sleep latency during MSLT and NPSG testing were found between different EDS diagnostic groups of non-narcoleptic patients. The majority of patients in the MSLT group with long sleep latencies were in the diagnostic groups of EDS associated with psychophysiological and/or psychiatric problems or with drug abuse; patients with a diagnosis of idiopathic central nervous system hypersomnia or EDS associated with disturbed nocturnal sleep formed the majority of the MSLT group with short sleep latencies. The non-narcoleptic patients in a MSLT group with short sleep latencies had significantly shorter sleep latencies at night, more sleep cycles, higher sleep efficiency, and earlier REM sleep than patients with long sleep latencies.
147 citations
TL;DR: Results from the present study suggest that the decrease in raphe unit activity during REM sleep is largely a concomitant of the atonia which characterizes that state of the organism.
140 citations
TL;DR: Children appear to be able to tolerate a single night of restricted sleep, although they do not recover as rapidly as adult subjects.
Abstract: Sleep, performance, and sleepiness were evaluated in nine (6 girls, 3 boys) children (ages 11 to 13.2 yr.) with a view toward determining whether children are more sensitive to sleep restriction th...
138 citations
TL;DR: The increases in VO2 and the absence of marked changes in vasomotor tone during REM sleep in the cold were unexpected and possibly indicate that REM sleep is not as thermally disruptive in humans as in other mammals.
Abstract: Electrophysiological stages of sleep, oxygen consumption (VO2), and skin (Tsk) and rectal (Tre) temperatures were recorded from six virtually naked male subjects exposed to ambient temperatures (Ta) of 21, 24, 29, 34, and 37 degrees C. VO2 increased during sleep as a whole as Ta departed from thermoneutrality (29 degrees C) and was significantly greater during rapid-eye-movement (REM) sleep than during adjacent nonrapid-eye-movement (NREM) periods at low and high Ta but not at 29 degrees C. Tsk showed small but significant increases during REM sleep at 29, 34, and 37 degrees C, but Tre did not change during REM sleep at any Ta. Shivering was present during wakefulness at 21 and 24 degrees C but occurred only occasionally during stages 1 and 2 sleep at 21 degrees C. The increases in VO2 and the absence of marked changes in vasomotor tone during REM sleep in the cold were unexpected and possibly indicate that REM sleep is not as thermally disruptive in humans as in other mammals.
TL;DR: Somnograms obtained from recently abstinent chronic alcoholics reveal gross disruption succinctly described as "fractured" sleep, which persists after as much as 21 mo of abstinence.
Abstract: Somnograms obtained from recently abstinent chronic alcoholics reveal gross disruption succinctly described as "fractured" sleep. Sleep onset is delayed and the rhythmic properties of the sleep pattern are markedly disturbed with numerous brief arousals and changes of sleep stage. Excessive stage 1 and stage rapid eye movement sleep are present while the high voltage slow wave sleep is markedly reduced or absent. With continued sobriety (9 mo or more) the sleep stage percentages tend to return to normal levels, but the disruption of the sleep pattern persists after as much as 21 mo of abstinence.
Journal Article•
TL;DR: Findings from animal studies indicate an increase in non-REM sleep following exercise, and several proposals for human research are made, and further aspects of the topic of body restitution and human sleep function are discussed.
TL;DR: It is concluded that the sleep apnea syndrome was the presenting manifestation of hypothyroidism in this patient and was solely responsible for his symptoms and disability.
Abstract: A 58-yr-old man with hypothyroidism and sleep apnea syndrome was studied to determine the cause of the nocturnal obstructive apnea and oxygen desaturation. Control studies showed free thyroxine (T4) concentration of 0.7 ng/dl (normal, 0.8 to 2.3 ng/dl), and thyroid-stimulating hormone of 32 microIU/ml (normal, less than 12 microIU/ml). Weight, pulmonary function, arterial blood gases, minute ventilation to carbon dioxide production ratio (VE/VCO2), and the ventilatory response to exercise (delta VE/delta VCO2) were normal. Episodes of obstructive apnea (4 per hour during non-REM (NREM) and 10 per hour during REM) and oxygen desaturation (9 per hour during NREM and 11 per hour during REM) were common during sleep. Oxygen saturation ranged between 72 and 99% and 70 and 97% during NREM and REM sleep, respectively. Medroxyprogesterone acetate (MPA) therapy for 4 wk caused a reduction in awake PaCO2 (38 to 33 mm Hg), and an increase in VE/VCO2 (17%), mouth occlusion pressure (50%), and AVE/VCO2 (23%). During sleep, apneas were completely eliminated and only one episode of oxygen desaturation occurred. L-thyroxine therapy for 2 months after a placebo period caused an awake isocapnic hyperpnea with no change in PaCO2 and VE/VCO2 despite a 23% increase in VE. Mouth occlusion pressure increased 37% but delta VE/delta VCO2 was unchanged. Obstructive apnea and oxygen desaturation during sleep were completely eliminated with L-thyroxine. The patient noted completed relief of symptoms with both MPA and L-thyroxine. We concluded that the sleep apnea syndrome was the presenting manifestation of hypothyroidism in this patient and was solely responsible for his symptoms and disability.
TL;DR: The findings support the suggestion that by 6 months of age REM storms express dysfunction or delay in the development of central inhibitory feedback controls for sleep organization and phasic sleep-related activities.
Abstract: Intense rapid eye movements (REM) during sleep were investigated as a possible indication of delay in the neurodevelopment of infants. The rate of occurrence of REM storms was determined by monitoring the sleep of 15 normal, first-born infants during weeks 2 through 5 and at 3, 6, 12 months. The amount of REM within each 10-second interval of active sleep was rated on a four-point scale based on frequency and intensity of eye movements. When the babies were 12 months old, the Bayley Scales of Mental Development were administered. A significant negative correlation was found between the frequency of REM storms of 14 subjects was also studied. The negative correlation was confirmed. The findings support the suggestion that by 6 months of age REM storms express dysfunction or delay in the development of central inhibitory feedback controls for sleep organization and phasic sleep-related activities.
TL;DR: It is concluded that pineal AVT is physiologically involved in the induction and/or circadian organization of REM sleep.
TL;DR: In a group of 15 depressed patients, REM latencies in morning and afternoon naps were similar to the shortened REM onset at night, and the data suggest that responders to tricyclic treatment tend to be poor sleepers during daytime naps.
Abstract: Continued interest in rapid eye movement (REM) sleep abnormalities in depression stimulated comparative studies on daytime naps versus nighttime sleep. In a group of 15 depressed patients, REM latencies in morning and afternoon naps were similar to the shortened REM onset at night. Although REM latency did not vary across the three times, the propensity for REM sleep appeared to be greater in the morning nap than in the afternoon nap and the early portion of nocturnal sleep. Finally, the data suggest that responders to tricyclic treatment tend to be poor sleepers during daytime naps.
TL;DR: Polygraphic findings during spontaneous nocturnal sleep of 2 patients suffering from Shy-Drager syndrome are reported, with significant reductions of rapid eye movement (REM) stage and, in 1 patient, also of deep non-REM (NREM; stages 3-4) were found.
Abstract: Polygraphic findings during spontaneous nocturnal sleep of 2 patients suffering from Shy-Drager syndrome are reported. In both patients, total sleep time was reduced--sleep latency and awakening periods during the night being increased. Considerable reductions of rapid eye movement (REM) stage and, in 1 patient, also of deep non-REM (NREM; stages 3-4) were found. No apneas were recorded. In normal subjects, systemic systolic and diastolic pressure decreases during all the sleep stages; in our patients, arterial pressure values rose progressively during NREM sleep stages and showed a further increase in REM sleep. In all the sleep stages, sudden phasic swings of systemic arterial pressure were observed.
TL;DR: The self-management treatment program was designed to teach patients skills for identifying and modifying environmental, behavioral, physiological, and cognitive conditions related to poor sleep.
Abstract: Three controlled case studies are presented to demonstrate the application of behavioral self-management to two subtypes of sleep-maintenance insomnia. Patient 1 suffered from brief but frequent arousals to wakefulness and to NREM Stage 1 sleep. Patient 2 suffered from brief but frequent arousals and extended minutes awake after sleep onset. Patient 3 suffered from an extended latency to sleep onset and also extended minutes awake after sleep onset. The self-management treatment program was designed to teach these patients skills for identifying and modifying environmental, behavioral, physiological, and cognitive conditions related to poor sleep. Results are documented using home and laboratory all-night sleep recordings during treatment and at 3 and 12 months following the end of treatment.
TL;DR: It is concluded that self-signaled arousals deserve consideration in clinical analyses in which reports of arousals are a part of the reported sleep disturbance.
Abstract: We studied the relationship between electroencephalographic (EEG)-defined awakenings and subjects' awareness of them at the time of their occurrence in 40 men (mean age, 55.3 years). The subjects used a push-button device to signal wakefulness during an evening's sleep in the laboratory; continuous EEG and electro-oculograms were also made. Results were as follows (after eliminating data for 12 nonresponders): 52% of the responses occurred during EEG-defined wakefulness (stage 0), 12% in a sleep stage that was followed immediately by stage 0, and 36% in a sleep stage not followed by stage 0. However, analysis of the last finding indicated that 73% of these responses were associated with at least 4-6 sec of preceding alpha activity. Thus, signals in the absence of EEG criteria were actually less than 10% of the total recorded. Signals of wakefulness were closely associated with the onset of EEG-defined wakefulness (and 84% of the signals occurred within 4 sec to 1 min of the EEG period). We conclude that self-signaled arousals deserve consideration in clinical analyses in which reports of arousals are a part of the reported sleep disturbance.
TL;DR: Body movements during sleep were examined in eight non-eventful preterm babies and two full-term babies using the polygraphic methods including superficial EMG and revealed a decrease of St or GPM, GM and LPM, which may indicate the differences of maturational changes in the different part of CNS.
Abstract: Body movements during sleep were examined in eight non-eventful preterm babies and two full-term babies using the polygraphic methods including superficial EMG. Typical movements in quiet sleep were startle (St) or generalized phasic movement (GPM) and increased tonic activity in chin muscles. In active sleep, instead of total simultaneous patterns observed in quiet sleep, more un-coordinated and localized movements such as generalized movement (GM), localized tonic movement (LTM), localized phasic movement (LPM) and clonic movement (CM) occurred. Longitudinal study of movements revealed a decrease of St or GPM, GM and LPM. LTM did not decrease with increasing conceptional age. The differences of decreasing tendency among these movements may indicate the differences of maturational changes in the different part of CNS.
TL;DR: The occurrence of epileptic activity was shown to be significantly more frequent amongst women and those who developed epilepsy at a younger age and for practical purposes it is recommended that for those patients whose wake EEGs are free from epilepsyptic activity, a sleep EEG—possibly drug-induced—should be recorded.
Abstract: The purpose of the study was to investigate whether the sleep EEG after sleep deprivation has a stronger provocative effect than the drug-induced sleep EEG. For this purpose a sleep EEG, induced by 2 mg/kg body weight of promazine hydrochloride, was recorded. On the following day a sleep EEG of the same patient was recorded after sleep deprivation of 24--26 h. If only patients whose wake EEGs were free from epileptic activity are considered, the rate of provocation was 58%. As epileptic activity could be recorded even in the sleep EEG without sleep deprivation in 45%, the advantage gained by recording a sleep EEG after sleep deprivation (52%) is only relatively small. The occurrence of epileptic activity was shown to be significantly more frequent amongst women and those who developed epilepsy at a younger age. For practical purposes it is recommended that for those patients whose wake EEGs are free from epileptic activity, a sleep EEG--possibly drug-induced--should be recorded. Only in instances where epileptic activity can not then be recorded should a wake EEG after sleep deprivation be carried out, and followed immediately, if necessary, by a sleep EEG.
TL;DR: EEG sleep stage measures were obtained on younger subjects (18-22 years) and older subjects (40-50 years) at 9 a.m. after 2 nights of sleep loss and showed sharply reduced latencies and increased stage 4 sleep.
Journal Article•
TL;DR: Polysomnographic recordings allow the recognition of three normal sleep stages: wakefulness, NREM and REM sleep, and the benzodiazepines are the most frequently prescribed hypnotics.
Abstract: Polysomnographic recordings allow the recognition of three normal sleep stages: wakefulness, NREM and REM sleep. There are quantitative changes in these stages from childhood to old age. Most characteristic are progressive decreases in total sleep time, stage 4 NREM sleep and REM sleep. Insomnia can be defined as an alteration of both the quantity and quality of sleep. It can be associated with psychophysiological factors, psychiatric disorders, use of drugs and alcohol, sleep apnea, sleep-related myoclonus and restless legs, medical, toxic and environmental conditions, or REM sleep interruptions. At present, the benzodiazepines are the most frequently prescribed hypnotics. Their efficacy has been evaluated in the sleep laboratory and by means of sleep questionnaires (clinical studies). Their derivatives are grouped according to their pharmacokinetic profiles as short acting (triazolam), intermediate acting (flunitrazepam) and long acting (flurazepam). At the EEG level these compounds induce an increase in fast frequencies and in the number of sleep spindles. Slow wave activity is markedly decreased. All of the derivatives effectively and significantly induce and maintain sleep. Total sleep time increase is related to an imcrement of stage 2 sleep while REM sleep and stages 3 + 4 sleep are consistently reduced. Triazolam withdrawal is followed by a rebound insomnia. In contrast, under the same circumstances, flurazepam has a carry-over effect.
TL;DR: The hypothesis that REM sleep-induced depression of CO2 sensitivity develops in the neonatal monkey with advancing postconceptual age is supported.
Abstract: To determine the independent effects of sleep state, gestational age, and postnatal age on eucapnic ventilation and steady-state CO2 sensitivity, nine premature (146 +/- 3 days) and eight full-term (168 +/- 2 days) monkeys, Macaca nemestrina, from accurately timed conceptions were studied serially over the first 3 wk of life Minute volume (VE)/kg,tidal volume (VT)/kg, and respiratory frequency were quantitated during rapid-eye-movement sleep (REM) and nonrapid-eye-movement sleep (NREM)in room air and when animals were breathing varied concentrations of cO2 in 21% O2 Eucapnic VE/kg and CO2 sensitivity [(deltaVE/kg)/delta PaCO2] increased progressively with advancing postnatal age during NREM sleep in grouped term and premature animals CO2 sensitivity was not significantly different between REM and NREM sleep except in full-term animals at the highest postconceptual age studied (189 +/- 2 days) when [(delta VE/kg)/delta PaCO2] was lower in REM sleep than in NREM sleep (209 +/- 54 vs 301 +/- 71 mlmin-1kg-1Torr-1; P less than 005, paired-t test) Gestational age had no measurable effect on eucapnic ventilation or CO2 sensitivity These results support the hypothesis that REM sleep-induced depression of CO2 sensitivity develops in the neonatal monkey with advancing postconceptual age
TL;DR: The evolution of slow EEG activities (delta rhythms) and their topographical distribution during 31 night sleep records of 27 control subjects whose ages ranged from 1 month to 27 years are concerned, suggesting hypotheses about the importance of NREM sleep in developmental processes.
TL;DR: In two adolescent and two adult patients with Kleine-Levin syndrome, polygraphic sleep recording performed during somnolent and non-somnolENT periods revealed various forms of abnormal breathing patterns during sleep.
TL;DR: The pineal indole melatonin, injected into the third ventricle of unanesthetized cats, induced NREM sleep within 11-15 min and suppressed REM sleep for about 3 hr, supporting the hypothesis that melatonin represents the releasing hormone for pineal arginine vasotocin.
TL;DR: Terminal sleep following delirium tremens probably consists of recovery sleep from sleep deprivation caused by DT and disturbances of consciousness, which regularly occur in the former, but not in the latter.