scholarly journals P142 Head flexion has the greatest impact on OSA severity during REM sleep

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A67-A68
Author(s):  
A Tate ◽  
V Kurup ◽  
B Shenoy ◽  
C Freakley ◽  
P Eastwood ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Interaction Effect ◽  
Head Rotation ◽  
Nrem Sleep ◽  
Outcome Variable ◽  
Sleep State ◽  
Respiratory Event ◽  
Supine Sleep ◽  
Logistic Mixed Effects Model ◽  
Head Flexion

Abstract Introduction Recent work has shown that head flexion has a modest worsening effect and head rotation has a modest protective effect on OSA severity. However, there is substantial variability both within and between individuals. In this analysis we aimed to identify if this variability is explained by sleep-state, BMI, age or sex. Methods 28 participants provided informed consent and were studied using diagnostic polysomnography with the addition of a customised, accelerometry based, head posture measurement device. For each epoch during supine sleep, the sleep state (NREM/REM), average head flexion (degrees) and average head rotation (degrees) were recorded. A logistic mixed effects model was fit across all epochs with the anthropometrics (BMI, sex, age), sleep state, average head flexion and average head rotation as explanatory variables with the absence/presence of one or more respiratory event(s) as the binary outcome variable. Results In total, 2122 of 5369 supine sleep epochs had a respiratory event. Three participants had no supine sleep. There were significant interaction effects for flexion-rotation, BMI-rotation and REM-flexion. The REM-flexion interaction effect was the strongest interaction effect with an odds ratio per 5 degrees of head flexion in REM sleep of 1.47 (95% CI: 1.13 – 1.86). Discussion Head flexion related worsening of OSA severity is greatest during REM sleep. This may be explained by attenuated upper airway neuromuscular activation in REM sleep compared with NREM sleep.

Circadian rhythms of sleep and wakefulness in mice: analysis using long-term automated recording of sleep

1985 ◽  
Vol 248 (3) ◽  
pp. R320-R330 ◽  
Author(s):  
G. S. Richardson ◽  
M. C. Moore-Ede ◽  
C. A. Czeisler ◽  
W. C. Dement
Keyword(s):  
Circadian Rhythms ◽  
Rem Sleep ◽  
Wheel Running ◽  
Nrem Sleep ◽  
Sleep State ◽  
Continuous Darkness ◽  
Running Activity ◽  
Wheel Running Activity ◽  
Significant Difference ◽  
Wake State

Circadian rhythms of wheel-running activity and polygraphically defined wakefulness, rapid-eye-movement (REM) sleep and non-REM (NREM) sleep were continuously observed in ten mice (Mus musculus) under both alternating light-dark (LD 12:12) and continuous darkness (DD) conditions. Sleep-wake state was determined automatically using a computer-based method that allowed continuous recordings of from 60 to 280 days in duration. The sleep-wake state percentages (of the circadian cycle) thus obtained were in substantial agreement with other estimates for this or similar strains and showed no significant difference between LD 12:12 (wake 54.3%, NREM sleep 38.1%, REM sleep 7.6%) and DD (wake 53.1%, NREM sleep 39.9%, REM sleep 7.0%) conditions. All 10 mice exhibited clear circadian rhythms in each of the three states and wheel-running activity under both lighting conditions for the entire duration of observation. Probability functions, computed using stationary sections of data from all 10 mice, showed distinct waveforms for all three states and wheel running. These waveforms were remarkably similar under entrained and free-running conditions. This documentation of sustained circadian rhythmicity in sleep-wake state throughout observations of unprecedented length contradicts the currently common assertion that circadian control of sleep state is weaker than that of activity.

Drug-induced changes in fetal breathing activity and sleep state

1983 ◽  
Vol 61 (4) ◽  
pp. 315-324 ◽  
Author(s):  
Arno H. Jansen ◽  
S. Ioffe ◽  
V. Chernick
Keyword(s):  
Rem Sleep ◽  
Femoral Vein ◽  
Nrem Sleep ◽  
Primary Response ◽  
Sleep State ◽  
Drug Induced ◽  
Fetal Breathing ◽  
Near Term ◽  
Induced Changes ◽  
Stimulation Of

Drugs reported to stimulate fetal breathing (FB) were injected into a femoral vein of near-term fetal iambs during rapid eye movement (REM) and non-REM (NREM) sleep. The primary response to NaCN, 0.25–0.5 mg, a dose which did not flatten the electrocorticogram, was a brief burst of gasping in any sleep state. When injected during REM sleep, NaCN caused the cessation of spontaneous FB and the onset of gasping. Stimulation of FB was observed infrequently. Caffeine (10 mg) and doxapram (3 mg) frequently caused an immediate change in sleep state or arousal. The incidence of FB increased concomitantly with a change to REM sleep or wakefulness (W), but FB still ceased with the onset of NREM sleep. When administered during an episode of spontaneous FB during REM sleep, both caffeine and doxapram caused stimulation of the frequency and depth of breathing. Pilocarpine (4 mg) caused arousal and gasping followed by prolonged vigorous breathing that was dependent on intact carotid sinus nerves, Indomethacin (120 mg over several hours) did not affect sleep states but induced FB in both NREM and REM sleep. In summary, in the fetus the primary effect of NaCN is to suppress spontaneous FB and induce gasping and the effects of pilocarpine, caffeine, and doxapram are intimately related to sleep states or arousal. Indomethacin causes the conversion from episodic fetal to continuous postnatal-type breathing. These data indicate the importance of assessing fetal state of consciousness in interpreting the respiratory response to drugs.

Covert REM sleep effects on REM mentation: Further methodological considerations and supporting evidence

2000 ◽  
Vol 23 (6) ◽  
pp. 1040-1057 ◽  
Author(s):  
Tore A. Nielsen
Keyword(s):  
Eye Movements ◽  
Future Development ◽  
Rem Sleep ◽  
Nrem Sleep ◽  
Explanatory Models ◽  
Supporting Evidence ◽  
Sleep State ◽  
Detailed Understanding ◽  
Methodological Considerations

Whereas many researchers see a heuristic potential in the covert REM sleep model for explaining NREM sleep mentation and associated phenomena, many others are unconvinced of its value. At present, there is much circumstantial support for the model, but validation is lacking on many points. Supportive findings from several additional studies are summarized with results from two new studies showing (1) NREM mentation is correlated with duration of prior REM sleep, and (2) REM sleep signs (eye movements, phasic EMG) occur frequently in NREM sleep. The covert REM sleep model represents one class of explanatory models that combines the two assumptions of mind-body isomorphism and a 1-gen mentation generator; its future development will depend largely upon a more detailed understanding of sleep state interactions and their contribution to mind-body isomorphisms.

Changes in ventilation and chest wall mechanics during sleep in normal adolescents

1981 ◽  
Vol 51 (3) ◽  
pp. 557-564 ◽  
Author(s):  
E. Tabachnik ◽  
N. L. Muller ◽  
A. C. Bryan ◽  
H. Levison
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Muscle Activity ◽  
Minute Ventilation ◽  
Nrem Sleep ◽  
Work Load ◽  
Sleep State ◽  
Rib Cage ◽  
Diaphragmatic Muscle ◽  
Normal Adolescents

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).

scholarly journals A role for spindles in the onset of rapid eye movement sleep

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Mojtaba Bandarabadi ◽  
Carolina Gutierrez Herrera ◽  
Thomas C. Gent ◽  
Claudio Bassetti ◽  
Kaspar Schindler ◽  
...  
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Nrem Sleep ◽  
State Regulation ◽  
Thalamic Reticular Nucleus ◽  
Reticular Nucleus ◽  
Rapid Eye Movement ◽  
Thalamic Nuclei ◽  
Sleep State ◽  
Field Coupling

Abstract Sleep spindle generation classically relies on an interplay between the thalamic reticular nucleus (TRN), thalamo-cortical (TC) relay cells and cortico-thalamic (CT) feedback during non-rapid eye movement (NREM) sleep. Spindles are hypothesized to stabilize sleep, gate sensory processing and consolidate memory. However, the contribution of non-sensory thalamic nuclei in spindle generation and the role of spindles in sleep-state regulation remain unclear. Using multisite thalamic and cortical LFP/unit recordings in freely behaving mice, we show that spike-field coupling within centromedial and anterodorsal (AD) thalamic nuclei is as strong as for TRN during detected spindles. We found that spindle rate significantly increases before the onset of rapid eye movement (REM) sleep, but not wakefulness. The latter observation is consistent with our finding that enhancing spontaneous activity of TRN cells or TRN-AD projections using optogenetics increase spindle rate and transitions to REM sleep. Together, our results extend the classical TRN-TC-CT spindle pathway to include non-sensory thalamic nuclei and implicate spindles in the onset of REM sleep.

Effect of REM sleep on retroglossal cross-sectional area and compliance in normal subjects

2001 ◽  
Vol 91 (1) ◽  
pp. 239-248 ◽  
Author(s):  
James A. Rowley ◽  
Carrie S. Sanders ◽  
Brian R. Zahn ◽  
M. Safwan Badr
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Sleep Stage ◽  
Nrem Sleep ◽  
Normal Subjects ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Sleep State ◽  
Cross Sectional ◽  
Pharyngeal Pressure

It has been proposed that the upper airway compliance should be highest during rapid eye movement (REM) sleep. Evidence suggests that the increased compliance is secondary to an increased retroglossal compliance. To test this hypothesis, we examined the effect of sleep stage on the relationship of retroglossal cross-sectional area (CSA; visualized with a fiber-optic scope) to pharyngeal pressure measured at the level of the oropharynx during eupneic breathing in subjects without significant sleep-disordered breathing. Breaths during REM sleep were divided into phasic (associated with eye movement, PREM) and tonic (not associated with eye movements, TREM). Retroglossal CSA decreased with non-REM (NREM) sleep and decreased further in PREM [wake 156.8 ± 48.6 mm2, NREM 104.6 ± 65.0 mm2( P < 0.05 wake vs. NREM), TREM 83.1 ± 46.4 mm2 ( P = not significant NREM vs. TREM), PREM 73.9 + 39.2 mm2 ( P < 0.05 TREM vs. PREM)]. Retroglossal compliance, defined as the slope of the regression CSA vs. pharyngeal pressure, was the same between all four conditions (wake −0.7 + 2.1 mm2/cmH2O, NREM 0.6 ± 3.0 mm2/cmH2O, TREM −0.2 ± 3.3 mm2/cmH2O, PREM −0.6 ± 5.1 mm2/cmH2O, P = not significant). We conclude that the intrinsic properties of the airway wall determine retroglossal compliance independent of changes in the neuromuscular activity associated with changes in sleep state.

scholarly journals 1259 Periodic Neck Myoclonus During Sleep (PNMS) is Associated with Upper Airway Resistant Syndrome, but Resolves with CPAP

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A479-A479
Author(s):  
Majed A Alfi ◽  
Alon Y Avidan
Keyword(s):  
Rem Sleep ◽  
Sleep Disordered Breathing ◽  
Incidental Finding ◽  
Upper Airway ◽  
Nrem Sleep ◽  
Clinical History ◽  
Temporal Association ◽  
Sleep State ◽  
Upper Airway Resistance Syndrome ◽  
Disordered Breathing

Abstract Introduction Periodic neck myoclonus during Sleep (PNMS) is a movement disorder of sleep characterized by sudden myoclonic flexion or version of the head that manifest during REM and NREM sleep. While its finding has been attributed to a normal physiologic phenomenon, to the best of our knowledge, our case represents the first report of with PNMS attributed to sleep disordered breathing with resolution using CPAP Report of Case A 22 y/o male with no significant clinical history was referred for evaluation of snoring and excessive sleepiness. Nocturnal polysomnogram coupled with expanded EMG montage demonstrates evidence of upper airway resistance syndrome (UARS), characterized by frequents respiratory effort-related arousals (RERAS), primarily during REM sleep associated with arousals. The majority of these events resulted in sudden myoclonic movements of the neck and head that were associated with arousals and sleep fragmentation. PNMS manifested in the PSG as a flexion myoclonic motor artifact lasting 200-800 ms during REM sleep with an associated EEG arousal. The overall Respiratory Disturbance Index (RDI) was12/hr. The subsequent application of CPAP at a setting of 5-6 cm resolved these movements supporting this origin as a phenomenon of sleep-state instability. Conclusion While previous investigators have explained PNMS as an incidental finding or one common in patients with RBD, our case highlights a potential new mechanism for their appearance. This case helps shed more light on the origin of PNMS as a secondary phenomenon related to sleep state instability due to sleep disordered breathing given the temporal association with RERAS and dramatic resolution with CPAP therapy.

Sleep-Induced Changes in Associative Memory

1999 ◽  
Vol 11 (2) ◽  
pp. 182-193 ◽  
Author(s):  
Robert Stickgold ◽  
Laurie Scott ◽  
Cynthia Rittenhouse ◽  
J. Allan Hobson
Keyword(s):  
Semantic Priming ◽  
Associative Memory ◽  
Rem Sleep ◽  
Nrem Sleep ◽  
Memory Systems ◽  
Cognitive Testing ◽  
Sleep Cycle ◽  
Sleep State ◽  
Before And After ◽  
Carry Over

The notion that dreaming might alter the strength of associative links in memory was first proposed almost 200 years ago. But no strong evidence of such altered associative links has been obtained. Semantic priming can be used to quantify the strength of associative links between pairs of words; it is thought to measure the automatic spread of activation from a “node” representing one word to nodes representing semantically related words. Semantic priming could thus be used to test for global alterations in the strengths of associative links across the wake-sleep cycle. Awakenings from REM and nonREM (NREM) sleep produce a period of state carry-over during which performance is altered as a result of the brain's slow transition to full wakefulness, and cognitive testing in this period can provide information about the functioning of the brain during the prior sleep period. When subjects were tested across the night—before and after a night's sleep as well as immediately following forced awakenings from REM and NREM sleep—weak priming (e.g., thief-wrong) was found to be state dependent (p = 0.016), whereas strong priming (e.g., hot-cold) was not (p = 0.89). Weak primes were most effective in the presleep and REM sleep conditions and least effective in NREM and postsleep conditions. Most striking are analyses comparing weak and strong priming within each wake-sleep state. Contrary to the normal pattern of priming, subjects awakened from REM sleep showed greater priming by weak primes than by strong primes (p = 0.01). This result was seen in each of three protocols. In contrast, strong priming exceeded weak priming in NREM sleep. The shift in weak priming seen after REM sleep awakenings suggests that cognition during REM sleep is qualitatively different from that of waking and NREM sleep and may reflect a shift in associative memory systems, a shift that we hypothesize underlies the bizarre and hyperassociative character of REM-sleep dreaming. Known changes in brainstem activity that control the transition into and maintenance of REM sleep provide a possible explanation of this shift.

Regulation of respiration in sleeping dogs

1976 ◽  
Vol 40 (5) ◽  
pp. 688-693 ◽  
Author(s):  
E. A. Phillipson ◽  
E. Murphy ◽  
L. F. Kozar
Keyword(s):  
Rem Sleep ◽  
Sleep Stage ◽  
Respiratory Control ◽  
Nrem Sleep ◽  
Variable Coefficients ◽  
Minute Volume ◽  
Regulation Of Respiration ◽  
Vagus Nerves ◽  
Sleep State ◽  
Coefficients Of Variation

We have examined the respiratory changes that occur during physiological sleep in three dogs with exteriorized cervical vagal loops. Sleep stage was determined by behavioral and EEG criteria. During non-REM (NREM) sleep breathing was slower (mean change, 23%),deeper (mean change, 18%), and less variable (coefficients of variation, 0.05–0.10) than during wakefulness (W); minute volume of ventilation (Ve) decreased (mean change, 14%) and alveolar CO2 pressure (PAco2) increased slightly (mean change, 1.3 mmHg). In addition, the rate of O2 consumption and ventilatory response to hypercapnia were decreased. In contrast, REM sleep was characterized by rapid, shallow, and considerably more irregular (coefficients of variation, 0.18–0.30) breathing; Ve increased markedly and PAco2 decreased (mean change, 5.2 mmHg). Blockade of both cervical vagus nerves produced comparable changes in each stage of sleep (W, NREM, REM): breathing became slower and deeper, but the differences between stages and the marked irregularity in REM sleep persisted. In contrast, the Hering-Breuer inflation reflex (HBIR) was strong in W and NREM sleep, but weak in REM sleep. The results indicate that changes in respiratory control and stability during sleep are not due to fluctuations in vagal influence despite the fact that one vagal reflex (HBIR) was sleep-state dependent.

Development of CO2 sensitivity: effects of gestational age, postnatal age, and sleep state

1981 ◽  
Vol 50 (5) ◽  
pp. 956-961 ◽  
Author(s):  
R. D. Guthrie ◽  
T. A. Standaert ◽  
W. A. Hodson ◽  
D. E. Woodrum
Keyword(s):  
Eye Movement ◽  
Gestational Age ◽  
Rem Sleep ◽  
Nrem Sleep ◽  
Minute Volume ◽  
Full Term ◽  
Macaca Nemestrina ◽  
Sleep State ◽  
Co2 Sensitivity ◽  
Independent Effects

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 ml.min-1.kg-1.Torr-1; P less than 0.05, 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.

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