P018 The effects of zopiclone on sleep spindles in obstructive sleep apnea: A randomized placebo-controlled trial

Abstract Purpose This study aimed to determine the effects of a standard dose of zopiclone (7.5mg) on sleep spindle activity and to assess if potential changes in sleep spindles correlate with improvements in next-day measures of sleepiness and simulated driving performance in people with obstructive sleep apnoea (OSA). Methods Thirty-one people with OSA completed polysomnography (PSG) at baseline followed by 1-month nightly treatment with 7.5mg zopiclone or placebo according to a double-blind, parallel design (ANZCTRN12613001106729). Participants completed two further PSGs on the first (night1) and final (night30) night of treatment. A 30-min AusEd driving simulator task and a subjective sleepiness questionnaire (Karolinska sleepiness scale, KSS) on each visit were also performed in the morning. Sleep spindle events and spindle frequency activity (SFA, sigma EEG power) were quantified during N2 sleep from all-night EEG recordings. Results Sleep spindle events were consistently higher in both frontal and central EEG sites on night1 and night30 treatment nights in the zopiclone group compared to placebo (e.g. F4 night30 = 346[SEM±28] vs. 239[SEM±27] total # of sleep spindles respectively, p=0.009). Additionally, greater sleep spindle density in the zopiclone group correlated with better next-day simulated driving performance on night1 and night30. No correlations were observed between sleep spindle activity and the KSS. Conclusions Zopiclone is associated with greater sleep spindle activity in OSA compared to placebo, and sleep spindle increases are associated with better driving simulator performance. Thus, hypnotic-induced increases in sleep spindles may help alleviate certain cognitive performance decrements in people with OSA.

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0672 The Effect Of Armodafinil On Sleep Spindles In Obstructive Sleep Apnea: Secondary Analysis Of A Randomized Placebo-controlled Trial

SLEEP ◽

10.1093/sleep/zsaa056.668 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A256-A257

Author(s):

L Emami ◽

N S Marshall ◽

J L Chapman ◽

G Cho ◽

R R Grunstein ◽

...

Keyword(s):

Driving Simulator ◽

Research Training ◽

Controlled Trial ◽

Nrem Sleep ◽

Driving Performance ◽

Sleep Spindles ◽

Time On Task ◽

Sleep Spindle ◽

Simulated Driving ◽

Obstructive Sleep

Abstract Introduction Armodafinil has been trialed in OSA patients to promote wakefulness and simulated driving performance. We have previously completed a 6-month trial of 150mg of armodafinil vs placebo in moderate-severe OSA patients not using CPAP (ACTRN# 12611000847910) observing that participants on armodafinil learned to perform better across a 90-minute driving simulator task faster than those on placebo. It is possible that this reduction in time-on-task decrement may have been due to increased learning on armodafinil. Sleep spindles have previously been implicated in procedural learning and neurobehavioral performance. We hypothesized that armodafinil increases sleep spindle events during NREM sleep to enhance learning. Methods Sixty-three overweight severe OSA patients (mean BMI: 32.3kg/m2 (26.1-42.5); age 53.1 years (28-71), 52 males) underwent overnight in-lab polysomnography at baseline (0 months) and at a 6-month follow-up. All-night EEG signals were analyzed using a previously validated automated spindle detection algorithm. EEG recordings were visually inspected by an experienced sleep physician (LE), who was blinded to drug allocation. To minimize the likelihood of type 1 error we selected three key spindle variables detected at Cz for analysis of change between 0 and 6 months: 1) total number of spindle events (11-16 Hz) in NREM sleep 2) density of slow spindles (≥11 to ≤ 13Hz) per minute of NREM sleep, and 3) fast spindle density in NREM (>13 to ≤ 16Hz). Results The change in total spindle count in NREM sleep (armodafinil=11.6 vs Placebo =-17.1, p=0.57), fast spindle density (armodafinil=0.06 vs Placebo =-0.02, p=0.63) and slow spindle density (armodafinil=-0.00 vs. Placebo =-0.03, p=0.74) were not increased by armodafinil. Conclusion If armodafinil enhances simulated driving performance in a way that suppresses time-on-task effects it does not appear to be through a sleep spindle enhancing mechanism. Armodafinil is probably not a pharmacological method of enhancing sleep spindles. Support World Sleep Society (International Sleep Research Training Program)CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney

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Effect of 1 month of zopiclone on obstructive sleep apnoea severity and symptoms: a randomised controlled trial

European Respiratory Journal ◽

10.1183/13993003.00149-2018 ◽

2018 ◽

Vol 52 (1) ◽

pp. 1800149 ◽

Cited By ~ 9

Author(s):

Sophie G. Carter ◽

Jayne C. Carberry ◽

Garry Cho ◽

Lauren P. Fisher ◽

Charlotte M. Rollo ◽

...

Keyword(s):

Obstructive Sleep Apnoea ◽

Driving Simulator ◽

Controlled Trial ◽

Safety Data ◽

Clinical Trial Data ◽

Sleep Apnoea ◽

Double Blind ◽

Obstructive Sleep ◽

Single Night ◽

Randomised Controlled

Hypnotic use in obstructive sleep apnoea (OSA) is contraindicated due to safety concerns. Recent studies indicate that single-night hypnotic use worsens hypoxaemia in some and reduces OSA severity in others depending on differences in pathophysiology. However, longer clinical trial data are lacking. This study aimed to determine the effects of 1 month of zopiclone on OSA severity, sleepiness and alertness in patients with low–moderate respiratory arousal thresholds without major overnight hypoxaemia.69 participants completed a physiology screening night with an epiglottic catheter to quantify arousal threshold. 30 eligible patients (apnoea–hypopnoea index (AHI) 22±11 events·h−1) then completed standard in-laboratory polysomnography (baseline) and returned for two additional overnight sleep studies (nights 1 and 30) after receiving either nightly zopiclone (7.5 mg) or placebo during a 1-month, double-blind, randomised, parallel trial (ANZCTRidentifier ANZCTRN12613001106729).The change in AHI from baseline to night 30 was not different between zopicloneversusplacebo groups (−5.9±10.2versus−2.4±5.5 events·h−1; p=0.24). Similarly, hypoxaemia, next-day sleepiness and driving simulator performance were not different.1 month of zopiclone does not worsen OSA severity, sleepiness or alertness in selected patients without major overnight hypoxaemia. As the first study to assess the effect of a hypnotic on OSA severity and sleepiness beyond single-night studies, these findings provide important safety data and insight into OSA pathophysiology.

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Sleep spindle activity correlates with implicit statistical learning consolidation in untreated obstructive sleep apnea patients

Sleep Medicine ◽

10.1016/j.sleep.2021.01.035 ◽

2021 ◽

Author(s):

David Stevens ◽

Celeste WY. Leong ◽

Helena Cheung ◽

Joanne Arciuli ◽

Andrew Vakulin ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Statistical Learning ◽

Sleep Spindle ◽

Spindle Activity ◽

Obstructive Sleep

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Effects of Individual Differences, Attention, and Memory Deficits on Driver Distraction

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181320641285 ◽

2020 ◽

Vol 64 (1) ◽

pp. 1196-1201

Author(s):

Alejandro A. Arca ◽

Kaitlin M. Stanford ◽

Mustapha Mouloua

Keyword(s):

Individual Differences ◽

Driving Simulator ◽

Memory Deficits ◽

Driving Performance ◽

Driver Distraction ◽

Phone Call ◽

Traffic Density ◽

Attention And Memory ◽

Adhd Diagnosis ◽

Simulated Driving

The current study was designed to empirically examine the effects of individual differences in attention and memory deficits on driver distraction. Forty-eight participants consisting of 37 non-ADHD and 11 ADHD drivers were tested in a medium fidelity GE-ISIM driving simulator. All participants took part in a series of simulated driving scenarios involving both high and low traffic conditions in conjunction with completing a 20-Questions task either by text- message or phone-call. Measures of UFOV, simulated driving, heart rate variability, and subjective (NASA TLX) workload performance were recorded for each of the experimental tasks. It was hypothesized that ADHD diagnosis, type of cellular distraction, and traffic density would affect driving performance as measured by driving performance, workload assessment, and physiological measures. Preliminary results indicated that ADHD diagnosis, type of cellular distraction, and traffic density affected the performance of the secondary task. These results provide further evidence for the deleterious effects of cellphone use on driver distraction, especially for drivers who are diagnosed with attention-deficit and memory capacity deficits. Theoretical and practical implications are discussed, and directions for future research are also presented.

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Low-Dose (0.05 Unit/kg/hour) vs Standard-Dose (0.1 Unit/kg/hour) Insulin in the Management of Pediatric Diabetic Ketoacidosis: A Randomized Double-Blind Controlled Trial

Indian Pediatrics ◽

10.1007/s13312-021-2255-x ◽

2021 ◽

Vol 58 (7) ◽

pp. 617-623

Author(s):

Ramachandran Rameshkumar ◽

Ponnarmeni Satheesh ◽

Puneet Jain ◽

Jagadeesh Anbazhagan ◽

Shilpa Abraham ◽

...

Keyword(s):

Diabetic Ketoacidosis ◽

Low Dose ◽

Standard Dose ◽

Controlled Trial ◽

Double Blind

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Impact of Age-Related Vision Changes on Driving

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17207416 ◽

2020 ◽

Vol 17 (20) ◽

pp. 7416

Author(s):

Sonia Ortiz-Peregrina ◽

Carolina Ortiz ◽

Miriam Casares-López ◽

José J. Castro-Torres ◽

Luis Jiménez del Barco ◽

...

Keyword(s):

Linear Regression ◽

Visual Function ◽

Driving Simulator ◽

Multiple Linear Regression Model ◽

Driving Performance ◽

Older Drivers ◽

Linear Regression Models ◽

Simulated Driving ◽

Age Related ◽

Intraocular Straylight

Aging leads to impaired visual function, which can affect driving—a very visually demanding task—and has a direct impact on an individual’s quality of life if their license is withdrawn. This study examined the associations between age-related vision changes and simulated driving performance. To this end, we attempted to determine the most significant visual parameters in terms of evaluating elderly drivers’ eyesight. Twenty-one younger drivers (aged 25–40) were compared to 21 older drivers (aged 56–71). Study participants were assessed for visual acuity, contrast sensitivity, halos, and intraocular straylight, which causes veiling luminance on the retina and degrades vision. Driving performance was evaluated using a driving simulator. The relationships between simulated driving performance and the visual parameters tested were examined with correlation analyses and linear regression models. Older drivers presented impairment in most visual parameters (p < 0.05), with straylight being the most significantly affected (we also measured the associated effect size). Older drivers performed significantly worse (p < 0.05) in the simulator test, with a markedly lower performance in lane stability. The results of the multiple linear regression model evidenced that intraocular straylight is the best visual parameter for predicting simulated driving performance (R2 = 0.513). Older drivers have shown significantly poorer results in several aspects of visual function, as well as difficulties in driving simulator performance. Our results suggest that the non-standardized straylight evaluation could be significant in driver assessments, especially at the onset of age-related vision changes.

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