Non-rapid eye movement sleep

About: Non-rapid eye movement sleep is a research topic. Over the lifetime, 8661 publications have been published within this topic receiving 389465 citations. The topic is also known as: NREM.

Drug Treatment of REM Sleep Behavior Disorder: the Use of Drug Therapies Other Than Clonazepam

Abstract: REM sleep behavior disorder (RBD) is characterized by loss of the normal muscle atonia during REM sleep with abnormal motor behaviors that lead to sleep disruption.1 Sleep related injury is common, usually as a result of enactment of violent or unpleasant dreams. The condition usually affects elderly males.2 RBD can occur alone as the idiopathic form or in association with other neurological diseases, in particular the α-synucleinopathies such as Parkinson disease or dementia with Lewy bodies. Up to two-thirds of men > 50 years thought to have idiopathic RBD will go on to develop a neurodegenerative condition,3 and some studies have described subtle cognitive, olfactory, and visual abnormalities in patients with RBD.4,5 Patients with narcolepsy can have RBD as part of their REM sleep dyscontrol. There is also an association with a number of medications, particularly selective serotonin reuptake inhibitors. There is an association with periodic limb movements of sleep (PLMS), and at least 75% of patients have PLMS during NREM sleep, although these often do not cause arousal. RBD tends to progress over time and spontaneous remissions are very rare, although it may subside during the late stages of a neurodegenerative disorder. By definition, the condition either causes injury or has the potential to cause injury to the patient or others and, as such, usually requires treatment. The benefit of clonazepam in this group was reported in the first publication on RBD in 1986.6 Subsequent studies have also reported the effective use of clonazepam and described the drug as well tolerated and effective in the majority of patients. Since then it has become the standard first-line therapy.7 Smaller case control studies have suggested melatonin is also effective but there have been no reports describing the efficacy of any of the newer hypnotic medications. Clonazepam can cause daytime sedation, confusion in the elderly, increased risk of falls, and exacerbation of existing sleep apnea. These side effects may be more prominent in an aging population and those with associated neurodegenerative conditions. A number of our patients within the Respiratory Support and Sleep Centre in Papworth did not tolerate clonazepam or did not find it effective, which prompted the use of other therapies, most commonly shorter acting hypnotics. In a number of cases these drugs were better tolerated and equally effective at treating symptoms. In this retrospective case notes review, we report the effective long-term use of a number of novel agents in treating RBD and carefully review the side effects of clonazepam in our patients.

NREM sleep with low-voltage EEG in the rat.

Abstract: NREM sleep in the rat has traditionally been defined by electroencephalographic (EEG) amplitudes above those of wakefulness (W) and paradoxical sleep (PS); we refer to this high-amplitude NREM sleep as "HS." We have found that approximately 5% of total time is occupied by episodes in which EEG amplitude is low, distinguishing it from HS; theta amplitude is low, distinguishing it from PS; and electromyographic (EMG) amplitude is low, distinguishing it from W. We have called these low-EEG, low-theta, low-EMG episodes "low-amplitude sleep" (LS). Three studies are done to elucidate additional characteristics of LS. Polygraphically scored 30-s epochs were matched with independent classifications of rat behavior as W, NREM, or PS; 87% of polygraphically scored LS epochs were matched with NREM sleep behavior. Response thresholds to noxious stimuli were lowest in W, intermediate and similar in LS and HS, and highest in PS. The incidence of PGO-type (ponto-geniculo-occipital) waves in W, HS, and LS were all very low in comparison with rates in PS. Thus, LS and HS exhibited similarly quiescent spontaneous behavior, similar intermediate response thresholds, and similar low rates of PGO-type activity. Accordingly, we have proposed that LS, along with HS, is an NREM sleep stage.

Psychological stress is associated with heightened physiological arousal during NREM sleep in primary insomnia.

Abstract: The objective of this study was to evaluate cross-sectional relationships among symptoms of psychological stress, sleep, and physiological arousal during non-rapid eye movement (NREM) sleep in a sample of 30 patients with chronic, primary insomnia (mean age, 30.2 years, 60% female). Study measures included indexes of subjective stress, visually scored sleep, and physiological arousal during NREM sleep: quantitative electroencephalogram (QEEG) and quantitative electrocardiogram (QEKG) measures. Psychological stress was more strongly related to indexes of physiological arousal during NREM sleep than to visually scored measures of sleep. Higher levels of perceived stress were associated with decreased EEG delta power (rho = -0.50, p < .01) and increased EEG beta power (rho = 0.38, p < .05). Increased frequency of stress-related avoidance behaviors was associated with decreased EKG high-frequency power (rho = -0.46, p < .05). Although QEEG measures were significantly correlated with sleep maintenance (QEEG delta power rho = 0.45, p < .01; QEEG beta power rho = -0.54, p < .01) and time spent in delta sleep (QEEG delta power rho = 0.65, p < .001; QEEG beta power rho = -0.65, p < .001), QEKG measures were unrelated to visually scored measures of sleep. Perceived stress and stress-related avoidance behaviors were associated with multiple indexes of physiological arousal during NREM sleep in patients with chronic, primary insomnia.

Stress and neonatal sleep.

Abstract: Routine circumcision, done without anesthesia in the newborn nursery, was usually followed by prolonged nonrapid eye movement (NREM) sleep. Since this form of sleep has been described as a low point on an arousal continuum, we consider its increase to be consistent with a theory of conservation-with