scholarly journals Automatic analysis of muscular activity in the flexor digitorum superficialis muscles: A fast screening method for rapid eye movement sleep without atonia

SLEEP ◽  
2022 ◽  
Author(s):  
Matteo Cesari ◽  
Anna Heidbreder ◽  
Carles Gaig ◽  
Melanie Bergmann ◽  
Elisabeth Brandauer ◽  
...  
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Muscle Activity ◽  
Screening Method ◽  
Muscular Activity ◽  
Apnea Hypopnea Index ◽  
Flexor Digitorum Superficialis ◽  
Rapid Eye Movement ◽  
Artifact Correction ◽  
Flexor Digitorum

Abstract Study objectives To identify a fast and reliable method for rapid eye movement (REM) sleep without atonia (RWA) quantification. Methods We analyzed 36 video-polysomnographies (v-PSGs) of isolated REM sleep behavior disorder (iRBD) patients and 35 controls’ v-PSGs. Patients diagnosed with RBD had: i) RWA, quantified with a reference method, i.e. automatic and artifact-corrected 3-s Sleep Innsbruck Barcelona (SINBAR) index in REM sleep periods (RSPs, i.e. manually selected portions of REM sleep); and ii) v-PSG-documented RBD behaviors. We quantified RWA with other (semi)-automated methods requiring less human intervention than the reference one: the indices proposed by the SINBAR group (the 3-s and 30-s phasic flexor digitorum superficialis (FDS), phasic/”any”/tonic mentalis), and the REM atonia, short and long muscle activity indices (in mentalis/submentalis/FDS muscles). They were calculated in whole REM sleep (i.e. REM sleep scored following international guidelines), in RSPs, with and without manual artifact correction. Area under curves (AUC) discriminating iRBD from controls were computed. Using published cut-offs, the indices’ sensitivity and specificity for iRBD identification were calculated. Apnea-hypopnea index in REM sleep (AHIREM) was considered in the analyses. Results RWA indices from FDS muscles alone had the highest AUCs and all of them had 100% sensitivity. Without manual RSP selection and artifact correction, the “30-s phasic FDS” and the “FDS long muscle activity” had the highest specificity (85%) with AHIREM<15/h. RWA indices were less reliable when AHIREM≥15/h. Conclusions If AHIREM<15/h, FDS muscular activity in whole REM sleep and without artifact correction is fast and reliable to rule out RWA.

Flexor digitorum superficialis muscular activity is more reliable than mentalis muscular activity for rapid eye movement sleep without atonia quantification

SLEEP ◽  
2021 ◽  
Author(s):  
Matteo Cesari ◽  
Anna Heidbreder ◽  
Melanie Bergmann ◽  
Evi Holzknecht ◽  
Birgit Högl ◽  
...  
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Interrater Reliability ◽  
Muscular Activity ◽  
Emg Activity ◽  
Flexor Digitorum Superficialis ◽  
Rapid Eye Movement ◽  
Independent Expert ◽  
Flexor Digitorum ◽  
Artefact Correction

Abstract Study objectives To evaluate interrater reliability for artefact correction in the context of semi-automated quantification of rapid eye movement (REM) sleep without atonia (RWA) in the mentalis and flexor digitorum superficialis (FDS) muscles. Methods We included video-polysomnographies of 14 subjects with apnea-hypopnea-index in REM sleep (AHIREM)<15/h and 11 subjects with AHIREM≥15/h. Eight subjects had isolated REM sleep behavior disorder. A validated algorithm (www.osg.be) automatically scored phasic and “any” EMG activity in the mentalis muscle, and phasic EMG activity in the FDS muscles. Four independent expert scorers performed artefact correction according to the SINBAR (Sleep Innsbruck Barcelona) recommendations. Interrater reliability for artefact correction was computed with B-statistics. The variability across scorers of four RWA indices (phasic mentalis, “any” mentalis, phasic FDS and SINBAR – i.e. “any” mentalis and/or phasic FDS – EMG activity indices) was computed. With Friedman tests we compared B-statistics obtained for mentalis and FDS muscles, and the variability of the RWA indices. Influence of AHIREM and RBD diagnosis on the RWA indices variability was evaluated with linear regressions. Results Interrater reliability for artefact correction was higher in the FDS than in the mentalis muscle (p<0.001). Phasic FDS activity was minimally affected by artefacts. Accordingly, the phasic FDS EMG activity index had the lowest variability across scorers (p<0.001). Variability across scorers of the RWA indices including the mentalis muscle increased with AHIREM and was independent from RBD diagnosis. Conclusions Due to the consistently found low number of artefacts, phasic FDS activity is a reliable measure of RWA.

Rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia are more frequent in advanced versus early Parkinson’s disease

SLEEP ◽  
2021 ◽  
Author(s):  
Jirada Sringean ◽  
Ambra Stefani ◽  
Kathrin Marini ◽  
Melanie Bergmann ◽  
Mario Werkmann ◽  
...  
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Early Stage ◽  
Behavior Disorder ◽  
Emg Activity ◽  
Advanced Stage ◽  
Flexor Digitorum Superficialis ◽  
Rapid Eye Movement ◽  
Sleep Behavior ◽  
Flexor Digitorum

Abstract Study Objectives To evaluate macro sleep architecture and characterize rapid eye movement (REM) sleep without atonia (RWA) by using the SINBAR excessive electromyographic (EMG) montage including mentalis and upper extremity muscles in early and advanced Parkinson’s disease (PD). Methods We recruited 30 patients with early- and advanced-stage of PD according to Movement Disorder Society (MDS) Clinical Diagnostic Criteria. Participants were classified as early-stage PD if they were treatment-naïve or had no motor complications and had been diagnosed with PD within the previous 6 years. Advanced PD was defined as a disease duration equal to or >6 years with or without motor complications. Results There was significantly shorter REM sleep latency in early as compared to the advanced stage of PD. We found that the sleep Innsbruck Barcelona (SINBAR) EMG index and tonic EMG activity of the mentalis muscle in advanced-stage PD were significantly higher than in early-stage PD with a trend in phasic EMG activity of the flexor digitorum superficialis muscles. The SINBAR EMG index, tonic and any EMG activity of the mentalis muscle, and phasic EMG activity of flexor digitorum superficialis muscles significantly correlated with disease duration. Conclusions This study analyzed RWA using the SINBAR EMG montage in early- and advanced-stage of PD and showed higher RWA in mentalis and flexor digitorum superficialis muscles and SINBAR EMG index in advanced-PD patients compared to patients in the early stage. Also, polysomnography-confirmed REM sleep behavior disorder was more common in advanced versus early-stage patients. Our findings suggest that RWA worsens or is more intense or more frequent with disease progression.

Abstract P417: Relationship Between Blood Pressure Variability and Sleep Architecture

Circulation ◽  
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.

scholarly journals Quantitative electroencephalography measures in rapid eye movement and nonrapid eye movement sleep are associated with apnea–hypopnea index and nocturnal hypoxemia in men

SLEEP ◽  
2019 ◽  
Vol 42 (7) ◽  
Author(s):  
Sarah L Appleton ◽  
Andrew Vakulin ◽  
Angela D’Rozario ◽  
Andrew D Vincent ◽  
Alison Teare ◽  
...  
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Nrem Sleep ◽  
Community Dwelling ◽  
Total Power ◽  
Apnea Hypopnea Index ◽  
Rapid Eye Movement ◽  
Quantitative Electroencephalography ◽  
Nocturnal Hypoxemia ◽  
Eeg Power

AbstractStudy ObjectivesQuantitative electroencephalography (EEG) measures of sleep may identify vulnerability to obstructive sleep apnea (OSA) sequelae, however, small clinical studies of sleep microarchitecture in OSA show inconsistent alterations. We examined relationships between quantitative EEG measures during rapid eye movement (REM) and non-REM (NREM) sleep and OSA severity among a large population-based sample of men while accounting for insomnia.MethodsAll-night EEG (F4-M1) recordings from full in-home polysomnography (Embletta X100) in 664 men with no prior OSA diagnosis (age ≥ 40) were processed following exclusion of artifacts. Power spectral analysis included non-REM and REM sleep computed absolute EEG power for delta, theta, alpha, sigma, and beta frequency ranges, total power (0.5–32 Hz) and EEG slowing ratio.ResultsApnea–hypopnea index (AHI) ≥10/h was present in 51.2% (severe OSA [AHI ≥ 30/h] 11.6%). In mixed effects regressions, AHI was positively associated with EEG slowing ratio and EEG power across all frequency bands in REM sleep (all p < 0.05); and with beta power during NREM sleep (p = 0.06). Similar associations were observed with oxygen desaturation index (3%). Percentage total sleep time with oxygen saturation <90% was only significantly associated with increased delta, theta, and alpha EEG power in REM sleep. No associations with subjective sleepiness were observed.ConclusionsIn a large sample of community-dwelling men, OSA was significantly associated with increased EEG power and EEG slowing predominantly in REM sleep, independent of insomnia. Further study is required to assess if REM EEG slowing related to nocturnal hypoxemia is more sensitive than standard PSG indices or sleepiness in predicting cognitive decline.

Response of genioglossus muscle activity to nasal airway occlusion in normal sleeping adults

1988 ◽  
Vol 64 (1) ◽  
pp. 347-353 ◽  
Author(s):  
S. T. Kuna ◽  
J. Smickley
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Muscle Activity ◽  
Upper Airway ◽  
Nrem Sleep ◽  
Mouth Breathing ◽  
Nasal Airway ◽  
Rapid Eye Movement ◽  
Genioglossus Muscle ◽  
Airway Occlusion

To determine the combined effect of increased subatmospheric upper airway pressure and withdrawal of phasic volume feedback from the lung on genioglossus muscle activity, the response of this muscle to intermittent nasal airway occlusion was studied in 12 normal adult males during sleep. Nasal occlusion at end expiration was achieved by inflating balloon-tipped catheters located within the portals of a nose mask. No seal was placed over the mouth. During nose breathing in non-rapid-eye-movement (NREM) sleep, nasal airway occlusion resulted in multiple respiratory efforts before arousal. Mouth breathing was not initiated until arousal. Phasic inspiratory genioglossus activity was present in eight subjects during NREM sleep. In these subjects, comparison of peak genioglossus inspiratory activity on the first three occluded efforts to the value just before occlusion showed an increase of 4.7, 16.1, and 28.0%, respectively. The relative increases in peak genioglossus activity were very similar to respective increases in peak diaphragm activity. Arousal was associated with a large burst in genioglossus activity. During airway occlusion in rapid-eye-movement (REM) sleep, mouth breathing could occur without a change in sleep state. In general, genioglossus responses to airway occlusion in REM sleep were similar in pattern to those in NREM sleep. A relatively small reflex activation of upper airway muscles associated with a sudden increase in subatmospheric pressure in the potentially collapsible segment of the upper airway may help compromise upper airway patency during sleep.

scholarly journals Neural ensemble reactivation in rapid eye movement and slow-wave sleep coordinate with muscle activity to promote rapid motor skill learning

2020 ◽  
Vol 375 (1799) ◽  
pp. 20190655 ◽  
Author(s):  
M. J. Eckert ◽  
B. L. McNaughton ◽  
M. Tatsuno
Keyword(s):  
Eye Movement ◽  
Slow Wave ◽  
Rem Sleep ◽  
Motor Skill ◽  
Muscle Activity ◽  
Slow Wave Sleep ◽  
Skill Learning ◽  
Memory Storage ◽  
Motor Skill Learning ◽  
Rapid Eye Movement

Neural activity patterns of recent experiences are reactivated during sleep in structures critical for memory storage, including hippocampus and neocortex. This reactivation process is thought to aid memory consolidation. Although synaptic rearrangement dynamics following learning involve an interplay between slow-wave sleep (SWS) and rapid eye movement (REM) sleep, most physiological evidence implicates SWS directly following experience as a preferred window for reactivation. Here, we show that reactivation occurs in both REM and SWS and that coordination of REM and SWS activation on the same day is associated with rapid learning of a motor skill. We performed 6 h recordings from cells in rats' motor cortex as they were trained daily on a skilled reaching task. In addition to SWS following training, reactivation occurred in REM, primarily during the pre-task rest period, and REM and SWS reactivation occurred on the same day in rats that acquired the skill rapidly. Both pre-task REM and post-task SWS activation were coordinated with muscle activity during sleep, suggesting a functional role for reactivation in skill learning. Our results provide the first demonstration that reactivation in REM sleep occurs during motor skill learning and that coordinated reactivation in both sleep states on the same day, although at different times, is beneficial for skill learning. This article is part of the Theo Murphy meeting issue ‘Memory reactivation: replaying events past, present and future’.

Geniohyoid muscle activity in normal men during wakefulness and sleep

1990 ◽  
Vol 69 (4) ◽  
pp. 1262-1269 ◽  
Author(s):  
D. A. Wiegand ◽  
B. Latz ◽  
C. W. Zwillich ◽  
L. Wiegand
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Muscle Activity ◽  
Sleep Stage ◽  
Upper Airway ◽  
Rapid Eye Movement ◽  
Nasal Breathing ◽  
Sleep Study ◽  
Pharyngeal Airway ◽  
Normal Men

Reduction in the activity of upper airway "dilator" muscles during sleep may allow the pharyngeal airway to collapse in some individuals. However, quantitative studies concerning the effect of sleep on specific upper airway muscles that may influence pharyngeal patency are sparse and inconclusive. We studied seven normal men (mean age 27, range 22-37 yr) during a single nocturnal sleep study and recorded sleep staging parameters, ventilation, and geniohyoid muscle electromyogram (EMGgh) during nasal breathing throughout the night. Anatomic landmarks for placement of intramuscular geniohyoid recording electrodes were determined from a cadaver study. These landmarks were used in percutaneous placement of wire electrodes, and raw and moving-time-averaged EMGgh activities were recorded. Sleep stage was determined using standard criteria. Stable periods of wakefulness and non-rapid-eye-movement (NREM) and rapid-eye-movement (REM) sleep were selected for analysis. The EMGgh exhibited phasic inspiratory activity during wakefulness and sleep in all subjects. In six of seven subjects, mean and peak inspiratory EMGgh activities were significant (P less than 0.05) reduced during stages 2 and 3/4 NREM sleep and REM sleep compared with wakefulness. This reduction of EMGgh activity was shown to result from a sleep-related decline in the level of tonic muscle activity. Phasic inspiratory EMGgh activity during all stages of sleep was not significantly different from that during wakefulness. Of interest, tonic, phasic, and peak EMGgh activities were not significantly reduced during REM sleep compared with any other sleep stage in any subject. In addition, the slope of onset of phasic EMGgh activity was not different during stage 2 NREM and REM sleep compared with wakefulness in these subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Rapid Eye Movement (REM) Sleep Behavior Disorder and REM Sleep with Atonia in the Young

2019 ◽  
Vol 47 (1) ◽  
pp. 100-108 ◽  
Author(s):  
Garima Shukla ◽  
Anupama Gupta ◽  
Kamalesh Chakravarty ◽  
Angela Ann Joseph ◽  
Aathira Ravindranath ◽  
...  
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Muscle Activity ◽  
Young Patients ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Normal Subjects ◽  
Rapid Eye Movement ◽  
Sleep Behavior ◽  
Patients With Epilepsy

ABSTRACT:Background:Rapid eye movement (REM) sleep behavior disorder (RBD) and REM sleep without atonia (RWA) have assumed much clinical importance with long-term data showing progression into neurodegenerative conditions among older adults. However, much less is known about RBD and RWA in younger populations. This study aims at comparing clinical and polysomnographic (PSG) characteristics of young patients presenting with RBD, young patients with other neurological conditions, and normal age-matched subjects.Methods:A retrospective chart review was carried out for consecutive young patients (<25 years) presenting with clinical features of RBD; and data were compared to data from patients with epilepsy, attention deficit hyperactivity disorder (ADHD), and autism, as well as normal subjects who underwent PSG during a 2-year-period.Results:Twelve patients fulfilling RBD diagnostic criteria, 22 autism patients, 10 with ADHD, 30 with epilepsy, and 14 normal subjects were included. Eight patients with autism (30%), three with ADHD (30%), one with epilepsy (3.3%), and six patients who had presented with RBD like symptoms (50%) had abnormal movements and behaviors during REM sleep. Excessive transient muscle activity and/or sustained muscle activity during REM epochs was found in all patients who had presented with RBD, in 16/22 (72%) autistic patients, 6/10 (60%) ADHD patients compared to only 6/30 (20%) patients with epilepsy and in none of the normal subjects.Conclusion:We observed that a large percentage of young patients with autism and ADHD and some with epilepsy demonstrate loss of REM-associated atonia and some RBD-like behaviors on polysomnography similar to young patients presenting with RBD.

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