Greatest changes in objective sleep architecture during COVID-19 lockdown in night-owls with increased REM sleep

Abstract Study Objectives The Covid-19 pandemic has had dramatic effects on society and people’s daily habits. In this observational study we recorded objective data on sleep macro- and microarchitecture repeatedly over several nights before and during the Covid-19 government-imposed lockdown. The main objective was to evaluate changes in patterns of sleep duration and architecture during home confinement using the pre-confinement period as a control. Methods Participants were regular users of a sleep-monitoring headband that records, stores, and automatically analyses physiological data in real time, equivalent to polysomnography. We measured: sleep onset duration (SOD), total sleep time (TST), duration of sleep stages (N2, N3 and REM), and sleep continuity. Via the user’s smartphone application participants filled-in questionnaires on how lockdown changed working hours, eating behaviour, and daily-life at home. They also filled-in the Insomnia Severity Index, reduced Morningness-Eveningness Questionnaire and Hospital Anxiety and Depression Scale questionnaires allowing us to create selected sub-groups. Results The 599 participants were mainly men (71%) of median age 47 [IQR: 36;59]. Compared to before lockdown, during lockdown individuals slept more overall (mean +3·83 min; SD: ±1.3), had less deep sleep (N3), more light sleep (N2) and longer REM sleep (mean +3·74 min; SD: ±0.8). They exhibited less week-end specific changes, suggesting less sleep restriction during the week. Changes were most pronounced in individuals reporting eveningness preferences, suggesting relative sleep deprivation in this population and exacerbated sensitivity to societal changes. Conclusions This unique dataset should help us understand the effects of lockdown on sleep architecture and on our health.

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Abstract P417: Relationship Between Blood Pressure Variability and Sleep Architecture

Circulation ◽

10.1161/circ.141.suppl_1.p417 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Xiaoyue Liu ◽

Jeongok G Logan ◽

Younghoon Kwon ◽

Jennifer Lobo ◽

Hyojung Kang ◽

...

Keyword(s):

Blood Pressure ◽

Eye Movement ◽

Rem Sleep ◽

Sleep Time ◽

Sleep Architecture ◽

Sleep Stages ◽

Apnea Hypopnea Index ◽

Rapid Eye Movement ◽

Sleep Studies ◽

The Relationship

Introduction: Blood pressure (BP) variability (BPV) is a novel marker for cardiovascular disease (CVD) independent of high BP. Sleep architecture represents the structured pattern of sleep stages consisting of rapid eye movement (REM) and non-rapid eye movement (NREM), and it is an important element in the homeostatic regulation of sleep. Currently, little is known regarding whether BPV is linked to sleep stages. Our study aimed to examine the relationship between sleep architecture and BPV. Methods: We analyzed in-lab polysomnographic studies collected from individuals who underwent diagnostic sleep studies at a university hospital from 2010 to 2017. BP measures obtained during one year prior to the sleep studies were included. BPV was computed using the coefficient of variation for all individuals who had three or more systolic and diastolic BP data. We conducted linear regression analysis to assess the relationship of systolic BPV (SBPV) and diastolic BPV (DBPV) with the sleep stage distribution (REM and NREM sleep time), respectively. Covariates that can potentially confound the relationships were adjusted in the models, including age, sex, race/ethnicity, body mass index, total sleep time, apnea-hypopnea index, mean BP, and history of medication use (antipsychotics, antidepressants, and antihypertensives) during the past two years before the sleep studies. Results: Our sample (N=3,565; male = 1,353) was racially and ethnically diverse, with a mean age 54 ± 15 years and a mean BP of 131/76 ± 13.9/8.4 mmHg. Among the sleep architecture measures examined, SBPV showed an inverse relationship with REM sleep time after controlling for all covariates ( p = .033). We subsequently categorized SBPV into four quartiles and found that the 3 rd quartile (mean SBP SD = 14.9 ± 2.1 mmHg) had 3.3 fewer minutes in REM sleep compared to the 1 st quartile ( p = .02). However, we did not observe any relationship between DBPV and sleep architecture. Conclusion: Greater SBPV was associated with lower REM sleep time. This finding suggests a possible interplay between BPV and sleep architecture. Future investigation is warranted to clarify the directionality, mechanism, and therapeutic implications.

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Glucocorticoid Replacement Is Permissive for Rapid Eye Movement Sleep and Sleep Consolidation in Patients with Adrenal Insufficiency1

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.85.11.6965 ◽

2000 ◽

Vol 85 (11) ◽

pp. 4201-4206

Author(s):

Diego GarcÍa-Borreguero ◽

Thomas A. Wehr ◽

Oscar Larrosa ◽

Juan J. Granizo ◽

Donna Hardwick ◽

...

Keyword(s):

Rem Sleep ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Stages ◽

Sleep Regulation ◽

Double Blind ◽

Rem Latency ◽

Sleep Parameters ◽

Sleep Consolidation ◽

Permissive Role

There is a well described temporal relation between hormonal secretion and sleep phase, with hormones of the hypothalamic-pituitary-adrenal (HPA) axis possibly playing a role in determining entry into and duration of different sleep stages. In this study sleep features were studied in primary Addison’s patients with undetectable levels of cortisol treated in a double blind, randomized, cross-over fashion with either hydrocortisone or placebo supplementation. We found that REM latency was significantly decreased in Addison’s patients when receiving hydrocortisone at bedtime, whereas REM sleep time was increased. There was a trend toward an increase in the percentage of time in REM sleep and the number of REM sleep episodes. Waking time after sleep onset was increased, whereas no differences were observed between the two conditions when total sleep time or specific non-REM sleep parameters were evaluated. Our results suggest that in Addison’s patients, cortisol plays a positive, permissive role in REM sleep regulation and may help to consolidate sleep. These effects may be mediated either directly by the central effects of glucocorticoids and/or indirectly through CRH and/or ACTH.

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Variations in Elite Female Soccer Players' Sleep, and Associations With Perceived Fatigue and Soccer Games

Frontiers in Sports and Active Living ◽

10.3389/fspor.2021.694537 ◽

2021 ◽

Vol 3 ◽

Author(s):

Frode Moen ◽

Maja Olsen ◽

Gunvor Halmøy ◽

Maria Hrozanova

Keyword(s):

Respiration Rate ◽

Rem Sleep ◽

Sleep Onset ◽

Sleep Time ◽

Self Report ◽

Ultra Wideband ◽

Soccer Players ◽

Sleep Stages ◽

Sleep Onset Latency ◽

Time In Bed

The current study investigated the associations between female perceived fatigue of elite soccer players and their sleep, and the associations between the sleep of players and soccer games. The sample included 29 female elite soccer players from the Norwegian national soccer team with a mean age of ~26 years. Perceived fatigue and sleep were monitored over a period of 124 consecutive days. In this period, 12.8 ± 3.9 soccer games per player took place. Sleep was monitored with an unobtrusive impulse radio ultra-wideband Doppler radar (Somnofy). Perceived fatigue was based on a self-report mobile phone application that detected daily experienced fatigue. Multilevel analyses of day-to-day associations showed that, first, increased perceived fatigue was associated with increased time in bed (3.6 ± 1.8 min, p = 0.037) and deep sleep (1.2 ± 0.6 min, p = 0.007). Increased rapid eye movement (REM) sleep was associated with subsequently decreased perceived fatigue (−0.21 ± 0.08 arbitrary units [AU], p = 0.008), and increased respiration rate in non-REM sleep was associated with subsequently increased fatigue (0.27 ± 0.09 AU, p = 0.002). Second, game night was associated with reduced time in bed (−1.0 h ± 8.4 min, p = <0.001), total sleep time (−55.2 ± 6.6 min, p = <0.001), time in sleep stages (light: −27.0 ± 5.4 min, p = <0.001; deep: −3.6 ± 1.2 min, p = 0.001; REM: −21.0 ± 3.0 min, p = <0.001), longer sleep-onset latency (3.0 ± 1.2 min, p = 0.013), and increased respiration rate in non-REM sleep (0.32 ± 0.08 respirations per min, p = <0.001), compared to the night before the game. The present findings show that deep and REM sleep and respiration rate in non-REM sleep are the key indicators of perceived fatigue in female elite soccer players. Moreover, sleep is disrupted during game night, likely due to the high physical and mental loads experienced during soccer games. Sleep normalizes during the first and second night after soccer games, likely preventing further negative performance-related consequences.

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Study of correlation between perceived sleep disturbances in depressed patients with objective changes in sleep architecture using polysomnography before and after antidepressant therapy

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20202894 ◽

2020 ◽

Vol 8 (7) ◽

pp. 2551

Author(s):

Ganesh Ingole ◽

Harpreet S. Dhillon ◽

Bhupendra Yadav

Keyword(s):

Sleep Disturbances ◽

Total Sleep Time ◽

Antidepressant Treatment ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Efficiency ◽

Sleep Architecture ◽

Wake Time ◽

Depressed Patients ◽

Before And After

Background: A prospective cohort study to correlate perceived sleep disturbances in depressed patients with objective changes in sleep architecture using polysomnography (PSG) before and after antidepressant therapy.Methods: Patients were recruited into the study after applying strict inclusion and exclusion criterion to rule out other comorbidities which could influence sleep. A diagnosis of Depressive episode was made based on ICD-10 DCR. Psychometry, in the form of Beck Depressive inventory (BDI) and HAMD (Hamilton depression rating scale) insomnia subscale was applied on Day 1 of admission. Patients were subjected to sleep study on Day 03 of admission with Polysomnography. Patients were started on antidepressant treatment post Polysomnography. An adequate trial of antidepressants for 08 weeks was administered and BDI score ≤09 was taken as remission. Polysomnography was repeated post remission. Statistical analysis was performed using Kruskal Wallis test and Pearson correlation coefficient.Results: The results showed positive (improvement) polysomnographic findings in terms of total sleep time, sleep efficiency, wake after sleep onset, percentage wake time and these findings were statistically significant. HAM-D Insomnia subscale was found to correlate with total sleep time, sleep efficiency, wake after sleep onset, total wake time and N2 Stage percentage.Conclusions: Antidepressant treatment effectively improves sleep architecture in Depressive disorder and HAM-D Insomnia subscale correlates with objective findings of total sleep time, sleep efficiency, wake after sleep onset, total wake time and duration of N2 stage of NREM.

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A study on sleep apnea in patients with abnormal sewda type of depression

Traditional Medicine and Modern Medicine ◽

10.1142/s2575900020500044 ◽

2020 ◽

pp. 1-8

Author(s):

Aman Gul ◽

Nassirhadjy Memtily ◽

Pirdun Mijit ◽

Palidan Wushuer ◽

Ainiwaer Talifu ◽

...

Keyword(s):

Rem Sleep ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Efficiency ◽

Control Group ◽

Poor Sleep ◽

Sleep Structure ◽

Maintenance Rate ◽

Sleep Maintenance ◽

Insomnia Symptoms

Objective: To preliminarily investigate the clinical features and PSG in abnormal sewda-type depressive insomnia. Methods: A total of 127 abnormal sewda-type depressive insomnia patients were evaluated with overnight PSG, and 32 normal participants were compared. Results: Patients with abnormal sewda-type depressive insomnia were compared with the control group; the sleep symptoms showed a long incubation period of sleep, low sleep maintenance rate, low sleep efficiency and poor sleep quality as well as daytime dysfunction. At process and continuity of sleep: Total sleep time, sleep efficiency, sleep maintenance rate in abnormal sewda-type depressive insomnia group were shorter than the control group. Wake after sleep onset, and sleep latency were longer than the control group. At sleep structure: N1 ratio and N2 ratio in depressive insomnia group were longer than the control group, N3 ratio and REM sleep ratio shorter than the control group. At REM index: REM latency, REM cycles, and REM sleep time were shorter than the control group. Conclusion: Insomnia symptoms in abnormal sewda-type depression comorbid insomnia patients were similar to the ordinary insomnia patients. The PSG characteristics had significant changes in sleep process, sleep structure and REM indicators. The severity of the abnormal sewda-type depression was closely related to REM indicators. Change of REM sleep characteristics may be the specificity, and these could be taken as reference in diagnosis and identification of abnormal sewda-type depressive insomnia.

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1129 Sex Dependent Effects on Sleep Architecture After Traumatic Brain Injury: Impact on Outcome

SLEEP ◽

10.1093/sleep/zsaa056.1123 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A430-A430

Author(s):

G S Griesbach ◽

S E Robinson ◽

S Howell

Keyword(s):

Quality Of Life ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Rem Sleep ◽

Sleep Disturbances ◽

Emotional Health ◽

Verbal Learning ◽

Sleep Architecture ◽

Sleep Stages

Abstract Introduction Traumatic Brain Injury (TBI) is frequently associated with problems with sleep and diurnal somnolence. After determining if subjective somnolence was associated with sleep disturbances, we investigated if alterations in sleep architecture were associated with cognitive, social and emotional health in a sex dependent manner. For patients receiving positive airway pressure (PAP) treatment, we determined if lack of compliance contributed to cognitive and quality of life issues. Methods Adult TBI subjects (n=57) were assessed via overnight polysomnography. Mean age was 41 years and mean TBI chronicity was 2.5 years. Overall level of disability was determined by the Mayo Portland Inventory II. Sleep measures included slow wave sleep (SWS), REM latency, percent time in all sleep stages, apnea/hypopnea index, wake after sleep onset (WASO), and arousal index. Outcome measures were the California Verbal Learning Test (CVLT), Montreal Cognitive Assessment (MoCA), Trails A and B, Beck Depression Inventory, and Neuro-QoL. Results No sex effects for reporting somnolence were found. Besides being associated with increased subjective anxiety and stigma, somnolence was associated with increased arousals, decreases in SWS and higher incidence of REM AHI. WASO and number of arousals had a negative impact on the amount of SWS and sleep efficiency. Men spent significantly more time in REM sleep, which was correlated with higher scores on the MoCA and CVLT. Women showed more disability. Longer latencies to SWS were associated with increased CVLT performance. AHI was associated with increases in emotional/behavioral dyscontrol, fatigue and self-reported sleep disturbance. All effects were statistically significant. Conclusion Female TBI patients show significant impairments in REM sleep, which may impact learning and memory. Sleep disturbances were associated with poorer cognitive performance and may ultimately affect outcome, as indicated by lower scores on quality of life measures. Support Centre for Neuro Skills

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Effect of sleep deprivation on responses to airway obstruction in the sleeping dog

Journal of Applied Physiology ◽

10.1152/jappl.1994.77.4.1811 ◽

1994 ◽

Vol 77 (4) ◽

pp. 1811-1818 ◽

Cited By ~ 23

Author(s):

C. P. O'Donnell ◽

E. D. King ◽

A. R. Schwartz ◽

P. L. Smith ◽

J. L. Robotham

Keyword(s):

Sleep Deprivation ◽

Airway Obstruction ◽

Eye Movement ◽

Rem Sleep ◽

Recovery Period ◽

Sleep Time ◽

Inspiratory Effort ◽

Sleep Architecture ◽

Rapid Eye Movement ◽

Obstructive Sleep

The effect of sleep deprivation on sleep architecture and respiratory responses to repetitive airway obstruction during sleep was investigated in four chronically instrumented tracheostomized dogs during 12-h nocturnal experiments. A 24-h period of prior sleep deprivation increased (P < 0.05) the rate at which airway obstruction could be induced from 20 +/- 3 (SE) to 37 +/- 10 times/h compared with non-sleep-deprived dogs. During non-rapid-eye-movement sleep the duration of obstruction, minimum arterial hemoglobin saturation, and peak negative inspiratory effort at arousal were 20.5 +/- 1.0 s, 91.7 +/- 0.5%, and 28.4 +/- 1.8 mmHg, respectively, in non-sleep-deprived dogs. Sleep deprivation increased (P < 0.01) the duration of obstruction to 28.0 +/- 0.9 s, worsened (P < 0.05) the minimal arterial hemoglobin desaturation to 85.4 + 3.1%, and increased (P < 0.025) the peak negative inspiratory effort at arousal to 36.1 +/- 1.6 mmHg. Sleep deprivation also caused increases (P < 0.025) in total sleep time, rapid-eye-movement (REM) sleep time, and percentage of time in REM sleep in a 2-h recovery period without airway obstruction at the end of the study. We conclude that airway obstruction in the sleeping dog can reproduce the disturbances in sleep architecture and respiration that occur in obstructive sleep apnea and that prior sleep deprivation will increase apnea severity, degree of somnolence, and REM sleep rebound independent of change in upper airway collapsibility.

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Sleep and hibernation in ground squirrels (Citellus spp): electrophysiological observations

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.1977.233.5.r213 ◽

1977 ◽

Vol 233 (5) ◽

pp. R213-R221 ◽

Cited By ~ 19

Author(s):

J. M. Walker ◽

S. F. Glotzbach ◽

R. J. Berger ◽

H. C. Heller

Keyword(s):

Rem Sleep ◽

Slow Wave Sleep ◽

Dark Period ◽

Total Sleep Time ◽

Brain Temperature ◽

Sleep Time ◽

Light Period ◽

Ground Squirrels ◽

Sleep Stages ◽

Electroencephalogram Eeg

Electroencephalogram (EEG), electrooculogram, electromyogram, and electrocardiogram were recorded from ground squirrels (Citellus beldingi and C. lateralis) during the summer and also during the hibernation season. Summer recordings revealed that the animals spent an average of 66% of the 24-h period asleep (49% of the 12-h light period and 84% of the 12-h dark period); 19% of the total sleep time (TST) consisted of rapid-eye-movement (REM) sleep, and 81% of TST consisted of slow-wave sleep (SWS). Recordings obtained during the hibernation season showed that hibernation was entered through sleep, but the distribution of sleep states was different than in euthermic sleep. During the early entrance when brain temperature (Tbr) was between 35 and 25 degrees C, the animals were asleep 88% of the time, but only 10% of the TST was spent in REM sleep. The EEG amplitude declined with decreased Tbr so that classical sleep stages could not be identified below a Tbr of 25 degrees C. The frequency of the EEG increased as Tbr decreased; but activity in the 0–4 cycles/s band occupied the majority of the record even at a Tbr of 10 degrees C. Below a Tbr of 10 degrees C the EEG was isoelectric except for intermittent bursts of spindles. It was concluded from these and other results that the entrance into hibernation represents an extension of the thermoregulatory adjustments that occur during SWS.

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P084 Is Cognitive Behaviour Therapy for insomnia (CBTi) responsiveness a function of objective sleep efficiency rather than objective sleep duration?

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.128 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A48-A48

Author(s):

N Lovato ◽

G Micic ◽

L Lack

Keyword(s):

Sleep Duration ◽

Cognitive Behaviour Therapy ◽

Sleep Onset ◽

Past Research ◽

Severity Index ◽

Sleep Time ◽

Sleep Efficiency ◽

Behaviour Therapy ◽

Cognitive Behaviour ◽

Pre Treatment

Abstract Introduction Past research and our own has not shown a differential response to Cognitive Behaviour Therapy for insomnia (CBTi) based on objective sleep duration. It is valuable to investigate CBTi responsiveness is a function of objective sleep efficiency (SE) instead of objective sleep duration. This study is a secondary exploratory analysis of our earlier clinical trial to assess the differential therapeutic response to CBTi for older insomniacs based on SE prior to treatment. Method Seventy-nine adults (male=34, mean age=63.38, SD=6.25) with sleep maintenance insomnia were selected. Participants were grouped into 3 ordinal groups; the top 50% of participants (above the median percent sleep time-normal SE), the 25% of participants in the third quartile (moderately low SE), and the bottom 25% of participants (severely low SE) based on 1-night of home-based polysomnography. Participants were randomly allocated to CBTi or wait-list control. One-week sleep diaries, actigraphy and a battery of questionnaires evaluated the efficacy of CBTi for each SE group. Outcome measures were taken at pre-treatment, post-treatment, and 3-month follow-up. Results CBTi produced robust improvements in sleep quality including reduced wake after sleep onset, and improved sleep efficiency. Participants reported a reduction of scores on the Insomnia Severity Index, Flinders Fatigue Scale, Epworth Sleepiness Scale, Daytime Feeling and Functioning Scale, Sleep Anticipatory Anxiety Questionnaire, Dysfunctional Beliefs and Attitudes Scale, and increased Sleep Self-Efficacy Scale. All improvements were significant relative to waitlist and comparable regardless of objective SE at pre-treatment. Discussion CBTi responsiveness did not differ as a function of objective SE.

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Effects of different sleep restriction protocols on sleep architecture and daytime vigilance in healthy men

Physiological Research ◽

10.33549/physiolres.931895 ◽

2010 ◽

pp. 821-829 ◽

Cited By ~ 2

Author(s):

H Wu ◽

WS Stone ◽

X Hsi ◽

J Zhuang ◽

L Huang ◽

...

Keyword(s):

Rem Sleep ◽

Reaction Times ◽

Vigilance Task ◽

Sleep Time ◽

Sleep Architecture ◽

Lower Percentage ◽

Sleep Restriction ◽

Night Sleep ◽

Adult Men ◽

Psychomotor Vigilance

Sleep is regulated by complex biological systems and environmental influences, neither of which is fully clarified. This study demonstrates differential effects of partial sleep deprivation (SD) on sleep architecture and psychomotor vigilance task (PVT) performance using two different protocols (sequentially) that each restricted daily sleep to 3 hours in healthy adult men. The protocols differed only in the period of sleep restriction; in one, sleep was restricted to a 3-hour block from 12:00 AM to 3:00 AM, and in the other, sleep was restricted to a block from 3:00 AM to 6:00 AM. Subjects in the earlier sleep restriction period showed a significantly lower percentage of rapid-eye-movement (REM) sleep after 4 days (17.0 vs. 25.7 %) and a longer latency to the onset of REM sleep (L-REM) after 1 day (78.8 vs. 45.5 min) than they did in the later sleep restriction period. Reaction times on PVT performance were also better (i.e. shorter) in the earlier SR period on day 4 (249.8 vs. 272 ms). These data support the view that earlier-night sleep may be more beneficial for daytime vigilance than later-night sleep. The study also showed that cumulative declines in daytime vigilance resulted from loss of total sleep time, rather than from specific stages, and underscored the reversibility of SR effects with greater amounts of sleep.

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