The Comparative Effects of Premarin (Conjugated Estrogen), Evista (Raloxifine) and Placebo on Sleep Architecture, Sleep Quality and Hot Flush Frequency in Postmenopausal Patients

Abstract Introduction Children with achondroplasia and Trisomy 21 (T21) have increased incidence of sleep disturbances including sleep disordered breathing. Abnormal sleep architecture has been documented in children with T21. It is important to continue to analyze sleep parameters in both groups since poor sleep quality is associated with neurocognitive impairment. Methods Following IRB approval, we performed a retrospective chart review of patients at Nemours/A.I. duPont Hospital for Children in Wilmington, DE with achondroplasia and T21 who underwent an initial polysomnogram (PSG) between 2015 and 2020. We compared sleep architecture parameters between the groups including sleep efficiency, total sleep time (TST), sleep latency, arousal index and concentration of N3 and REM sleep. Results In patients with achondroplasia (n=49, mean age 5.8 months and 63.3% male), 12% reported restless sleep. PSG data revealed TST of 392 minutes, mean sleep efficiency of 82%, mean sleep latency of 9.4 min, mean arousal index of 40, 22% REM sleep and 32% N3 sleep. In the patients with T21 (n=32, mean age 17.8 months and 50% male), 59% reported restless sleep. PSG data revealed TST of 393 minutes, mean sleep efficiency of 82%, mean sleep latency of 14 minutes, arousal index of 35, 15% REM sleep and 40% N3 sleep. The differences in REM and N3 sleep between the two groups were statistically significant (p-values of 0.001 and 0.04, respectively), but the differences in arousal index, TST and sleep efficiency were not. Conclusion Our study showed that children with T21 subjectively noted more restless sleep compared to patients with achondroplasia although TST and sleep efficiency were similar. Patients with achondroplasia had a higher arousal index that was not statistically significant. Children with achondroplasia had a shorter sleep latency and more robust REM concentration, likely due to their younger age. There was a higher concentration of N3 sleep in patients with T21. This is likely due to the decrease in REM concentration. In conclusion, it is important to establish expected sleep parameters in patients with achondroplasia and T21 to maximize sleep quality and mitigate negative neurocognitive effects of poor sleep. Support (if any):

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Depression and anxiety disorders

10.1093/med/9780199682003.003.0047 ◽

2017 ◽

Author(s):

Susan Mackie ◽

John W. Winkelman

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Anxiety Disorders ◽

Sleep Quality ◽

Sleep Disorders ◽

Sleep Architecture ◽

Major Depressive ◽

Compulsive Disorder ◽

Mood And Anxiety Disorders ◽

Obstructive Sleep

This chapter discusses the frequent comorbidity of major depressive disorder and anxiety disorders with specific sleep disorders as well as associated changes in sleep architecture and sleep quality. It includes a review of several of the most common mood and anxiety disorders that are known to be associated with abnormalities in sleep: major depressive disorder, post-traumatic stress disorder, obsessive–compulsive disorder, and panic disorder. Changes in objective and subjective sleep parameters, including sleep architecture, sleep quality, and sleep quantity, are addressed in association with each psychiatric condition. The effects on sleep of medications used in the treatment of mood and anxiety disorders are also outlined. Finally, the chapter discusses the over-representation in these psychiatric conditions of many common sleep disorders, including insomnia, obstructive sleep apnea, and delayed sleep phase disorder.

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Nightmares affect the experience of sleep quality but not sleep architecture: an ambulatory polysomnographic study

Borderline Personality Disorder and Emotion Dysregulation ◽

10.1186/s40479-014-0023-4 ◽

2015 ◽

Vol 2 (1) ◽

Cited By ~ 9

Author(s):

Franc Paul ◽

Michael Schredl ◽

Georg W Alpers

Keyword(s):

Sleep Quality ◽

Sleep Architecture

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Disturbed dreaming and sleep quality: altered sleep architecture in subjects with frequent nightmares

European Archives of Psychiatry and Clinical Neuroscience ◽

10.1007/s00406-012-0318-7 ◽

2012 ◽

Vol 262 (8) ◽

pp. 687-696 ◽

Cited By ~ 45

Author(s):

Péter Simor ◽

Klára Horváth ◽

Ferenc Gombos ◽

Krisztina P. Takács ◽

Róbert Bódizs

Keyword(s):

Sleep Quality ◽

Sleep Architecture

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Effects of subacute ingestion of chlorogenic acids on sleep architecture and energy metabolism through activity of the autonomic nervous system: a randomised, placebo-controlled, double-blinded cross-over trial

British Journal Of Nutrition ◽

10.1017/s0007114517000587 ◽

2017 ◽

Vol 117 (7) ◽

pp. 979-984 ◽

Cited By ~ 16

Author(s):

Insung Park ◽

Ryuji Ochiai ◽

Hitomi Ogata ◽

Momoko Kayaba ◽

Sayaka Hari ◽

...

Keyword(s):

Energy Metabolism ◽

Sleep Quality ◽

Body Fat ◽

Slow Wave Sleep ◽

Sleep Latency ◽

Sleep Onset ◽

Fat Oxidation ◽

Sleep Architecture ◽

Chlorogenic Acids ◽

Double Blinded

AbstractChlorogenic acids (CGA) are the most abundant polyphenols in coffee. Continuous consumption of CGA reduces body fat and body weight. Since energy metabolism and sleep are controlled by common regulatory factors, consumption of CGA might modulate sleep. Lack of sleep has been identified as a risk factor for obesity, hypertension and type 2 diabetes. The aim of this study was to determine the effects of ingesting CGA over 5 d on energy metabolism and sleep quality in humans. A total of nine healthy subjects (four male and five female) completed a placebo-controlled, double-blinded, cross-over intervention study. Subjects consumed a test beverage containing 0 or 600 mg of CGA for 5 d. On the fifth night, subjects stayed in a whole-room metabolic chamber to measure energy metabolism; sleep was evaluated using polysomnographic recording. It was found that CGA shortened sleep latency (9 (sem 2) v. 16 (sem 4) min, P<0·05) compared with the control, whereas no effect on sleep architecture, such as slow-wave sleep, rapid eye movement or waking after sleep onset, was observed. Indirect calorimetry revealed that consumption of CGA increased fat oxidation (510 (sem 84) kJ/8 h (122 (sem 20) kcal/8 h) v. 331 (sem 79) kJ/8 h (81 (sem 19) kcal/8 h), P<0·05) but did not affect energy expenditure during sleep. Consumption of CGA enhanced parasympathetic activity assessed from heart-rate variability during sleep (999 (sem 77) v. 919 (sem 54), P<0·05). A period of 5-d CGA consumption significantly increased fat oxidation during sleep, suggesting that beverages containing CGA may be beneficial to reduce body fat and prevent obesity. Consumption of CGA shortened sleep latency and did not adversely affect sleep quality.

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Documenting orang-utan sleep architecture: sleeping platform complexity increases sleep quality in captive Pongo

Behaviour ◽

10.1163/1568539x-00003082 ◽

2013 ◽

Vol 150 (8) ◽

pp. 845-861 ◽

Cited By ~ 20

Author(s):

David R. Samson ◽

Robert W. Shumaker

Keyword(s):

Sleep Quality ◽

Pan Paniscus ◽

Body Movement ◽

Sleep Architecture ◽

Human Species ◽

Muscle Atonia ◽

Quality Sleep ◽

Improve Sleep Quality ◽

Time Awake ◽

Orang Utan

Of the extant primates, only 20 non-human species have been studied by sleep scientists. Notable sampling gaps exist, including large-bodied hominoids such as gorillas (Gorilla gorilla), orang-utans (Pongo spp.) and bonobos (Pan paniscus), for which data have been characterized as high priority. Here, we report the sleep architecture of three female and two male orang-utans housed at the Indianapolis Zoo. Sleep states were identified by scoring correlated behavioural signatures (e.g., respiration, gross body movement, muscle atonia, random eye movement, etc.). The captive orang-utans were focal subjects for a total of 70 nights (1013 h) recorded. We found that orang-utans slept an average of 9.11 h (range 5.85–11.2 h) nightly and were characterized by an average NREM of 8.03 h (range 5.47–10.2 h) and REM of 1.11 (range: 0.38–2.2 h) per night. In addition, using a sleeping platform complexity index (SPCI) we found that individuals that manufactured and slept in more complex beds were characterized by higher quality sleep. Sleep fragmentation (the number of brief awakenings greater than 2 min per hour), arousability (number of motor activity bouts per hour), and total time awake per night were reduced by greater quality sleep environments. Therefore, comfortable sleeping environments reduced arousability and improve sleep quality in captive orang-utans. These results support Fruth & Hohmann’s (1996) hypothesis, which purported that the tree-limb-to-sleeping platform transition in Miocene apes improved sleep quality.

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