scholarly journals Healthy and disturbed sleep: from the laboratory to actigraphy

2016 ◽  
Author(s):  
Thomas Penzel ◽  
Ingo Fietze
Keyword(s):  
Sleep Disorders ◽  
Sleep Duration ◽  
Body Position ◽  
Human Life ◽  
Recovery Period ◽  
Sleep Medicine ◽  
Sleep Stages ◽  
Brain Functions ◽  
Mental Problems ◽  
Cardiorespiratory Polysomnography

Sleep presents a third of human life and a healthy and restorative sleep is indispensable for a good performance during daytime. Human functions follow circadian rhythms and follow the need to relax and recover from daytime stressors. According to human senses and abilities this relaxation and recovery period is concentrated on nighttime. Sleep is shutting off senses and follow a dedicated program for recovery with light sleep, deep sleep and rapid eye movement sleep with different functions linked to these sleep phases and with different consequences for the physical and mental functions. Unfortunately in patients with sleep disorders this recovery program is disturbed. In order to identify reasons and in order to explore physical and mental problems related to this, sleep studies had been developed and are conducted in sleep medicine centers. Sleep medicine centers perform a cardiorespiratory polysomnography. During cardiorespiratory polysomnography brain functions and sleep stages are quantifed through assessing electroencephalography (EEG), electrooculography (EOG), electromyography (EMG) on the head and on the legs, electrocardiography (ECG), respiratory airflow, respiratory effort, oxygen concentration (SaO2), body position, and body movements. Because going to bed to find sleep is a behavioral action as well, we record video and sound in addition. This is done under laboratory conditions in a controlled and supervised setting, called sleep medicine center. Sleep disorders can be identified and are classified into six categories: insomnia, hypersomnia of central origin, sleep related breathing disorders, sleep related movement disorders, sleep-wake rhythm disorders, and parasomnias. In addition secondary sleep disorders due to medical or mental problems or due to substances or drugs are known as well. Due to the high prevalence of sleep disorders and sleep complaints there is an urgent need to develop and introduce simplified tools to identify sleep problems. For some sleep disorders protable recorder systems were developed. This is the case for sleep disordered breathing. For insomnia problems and sleep-wake rhythm disorders actigraphy systems are used. Only based on the recording of movement and motion using statistical analysis it is possible to distinguish sleep and wake with a good accuracy and reliability. This method is used to study sleep duration as well as sleep fragmentation to some extent. A study on sleep duration and impaired sleep in ballet dancers over a period of 60 days prior to a major premiere event is presented.

scholarly journals Healthy and disturbed sleep: from the laboratory to actigraphy

2016 ◽  
Author(s):  
Thomas Penzel ◽  
Ingo Fietze
Keyword(s):  
Sleep Disorders ◽  
Sleep Duration ◽  
Body Position ◽  
Human Life ◽  
Recovery Period ◽  
Sleep Medicine ◽  
Sleep Stages ◽  
Brain Functions ◽  
Mental Problems ◽  
Cardiorespiratory Polysomnography

Sleep presents a third of human life and a healthy and restorative sleep is indispensable for a good performance during daytime. Human functions follow circadian rhythms and follow the need to relax and recover from daytime stressors. According to human senses and abilities this relaxation and recovery period is concentrated on nighttime. Sleep is shutting off senses and follow a dedicated program for recovery with light sleep, deep sleep and rapid eye movement sleep with different functions linked to these sleep phases and with different consequences for the physical and mental functions. Unfortunately in patients with sleep disorders this recovery program is disturbed. In order to identify reasons and in order to explore physical and mental problems related to this, sleep studies had been developed and are conducted in sleep medicine centers. Sleep medicine centers perform a cardiorespiratory polysomnography. During cardiorespiratory polysomnography brain functions and sleep stages are quantifed through assessing electroencephalography (EEG), electrooculography (EOG), electromyography (EMG) on the head and on the legs, electrocardiography (ECG), respiratory airflow, respiratory effort, oxygen concentration (SaO2), body position, and body movements. Because going to bed to find sleep is a behavioral action as well, we record video and sound in addition. This is done under laboratory conditions in a controlled and supervised setting, called sleep medicine center. Sleep disorders can be identified and are classified into six categories: insomnia, hypersomnia of central origin, sleep related breathing disorders, sleep related movement disorders, sleep-wake rhythm disorders, and parasomnias. In addition secondary sleep disorders due to medical or mental problems or due to substances or drugs are known as well. Due to the high prevalence of sleep disorders and sleep complaints there is an urgent need to develop and introduce simplified tools to identify sleep problems. For some sleep disorders protable recorder systems were developed. This is the case for sleep disordered breathing. For insomnia problems and sleep-wake rhythm disorders actigraphy systems are used. Only based on the recording of movement and motion using statistical analysis it is possible to distinguish sleep and wake with a good accuracy and reliability. This method is used to study sleep duration as well as sleep fragmentation to some extent. A study on sleep duration and impaired sleep in ballet dancers over a period of 60 days prior to a major premiere event is presented.

Forensic Sleep Medicine

2020 ◽  
pp. 497-510
Author(s):  
Kenneth J. Weiss ◽  
Clarence Watson ◽  
Mark R. Pressman
Keyword(s):  
Sleep Disorders ◽  
Expert Testimony ◽  
Violent Behavior ◽  
Behavior Disorder ◽  
Sleep Medicine ◽  
Sleep Stages ◽  
Rem Behavior Disorder ◽  
Criminal Charges ◽  
Violent Acts ◽  
Criminal Culpability

Patients with sleep disorders can exhibit behavior that includes violent acts. The behavior may occur during various sleep stages, ranges in complexity, and requires an analysis of consciousness. When the behavior harms another person and criminal charges follow, expert testimony will be required to explain the physiology of the disorder and impairments in consciousness that determine criminal culpability, that is, whether there was conscious intent behind the behavior. In this chapter, sleep-related conditions associated with violent behavior are discussed, along with guidelines for presenting scientific testimony in court. These disorders include rapid eye movement (REM) behavior disorder, somnambulism and other non-REM partial awakenings, and hypersomnolence. Feigned symptoms and malingering must be ruled out, and the clinical parameters for them are discussed. While the physiology of sleep disorders has widely been known, admissibility in court is not automatic. Standards for acceptable expert testimony are discussed.

scholarly journals POLYSOMNOGRAPHY

JMS SKIMS ◽  
2015 ◽  
Vol 18 (2) ◽  
pp. 165-166
Author(s):  
Juhi Jamwal ◽  
Suhail Malik
Keyword(s):  
Sleep Disorders ◽  
Eye Movement ◽  
Rem Sleep ◽  
Ph Monitoring ◽  
Body Position ◽  
Nrem Sleep ◽  
Response To Treatment ◽  
Sleep Stages ◽  
Normal Person ◽  
Rapid Eye Movement

Polysomnography (PSG) is the gold standard diagnostic test for several sleep disorders. It records , analyzes, & interprets multiple simultaneous physiologic characteristics during sleep. These parameters include brain waves, the oxygen level in the blood, heart rate and breathing, body position, as well as eye and leg movements, along with synchronized audiovisual monitoring. Moreover, in certain conditions, additional parameters may be included such as esophageal pH monitoring, esophageal manometry , and overnight blood pressure monitoring. The test is usually performed at a sleep disorders unit within a hospital or at a sleep disorders centre. Sleep architecture is largely divided into non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. NREM is further divided into three stages: N1, N2, and N3 : N3 being the deepest stage of sleep. REM sleep alternates with NREM sleep and a normal person usually has 4–6 cycles of REM and NREM sleep . Monitoring of the different sleep stages, sleep interruptions, movements, and the other respiratory and cardiac signals are clinically helpful for identifying the nature of patient’s sleep problems and assessing response to treatment. JMS 2015;18(2):165-166

scholarly journals 214 Longitudinal Changes in Sleep Duration, Timing, Variability, and Stages during the COVID-19 Pandemic: Large-Scale Fitbit Data

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A86-A86
Author(s):  
Michael Grandner ◽  
Naghmeh Rezaei
Keyword(s):  
New York ◽  
Los Angeles ◽  
San Francisco ◽  
Sleep Duration ◽  
Large Scale ◽  
Age Groups ◽  
Population Level ◽  
Sleep Stages ◽  
Longitudinal Changes ◽  
Timing Variability

Abstract Introduction The COVID-19 pandemic has resulted in societal-level changes to sleep and other behavioral patterns. Objective, longitudinal data would allow for a greater understanding of sleep-related changes at the population level. Methods N= 163,524 deidentified active Fitbit users from 6 major US cities contributed data, representing areas particularly hard-hit by the pandemic (Chicago, Houston, Los Angeles, New York, San Francisco, and Miami). Sleep variables extracted include nightly and weekly mean sleep duration and bedtime, variability (standard deviation) of sleep duration and bedtime, and estimated arousals and sleep stages. Deviation from similar timeframes in 2019 were examined. All analyses were performed in Python. Results These data detail how sleep duration and timing changed longitudinally, stratified by age group and gender, relative to previous years’ data. Overall, 2020 represented a significant departure for all age groups and both men and women (P<0.00001). Mean sleep duration increased in nearly all groups (P<0.00001) by 5-11 minutes, compared to a mean decrease of 5-8 minutes seen over the same period in 2019. Categorically, sleep duration increased for some and decreased for others, but more extended than restricted. Sleep phase shifted later for nearly all groups (p<0.00001). Categorically, bedtime was delayed for some and advanced for others, though more delayed than advanced. Duration and bedtime variability decreased, owing largely to decreased weekday-weekend differences. WASO increased, REM% increased, and Deep% decreased. Additional analyses show stratified, longitudinal changes to sleep duration and timing mean and variability distributions by month, as well as effect sizes and correlations to other outcomes. Conclusion The pandemic was associated with increased sleep duration on average, in contrast to 2019 when sleep decreased. The increase was most profound among younger adults, especially women. The youngest adults also experienced the greatest bedtime delay, in line with extensive school-start-times and chronotype data. When given the opportunity, the difference between weekdays and weekends became smaller, with occupational implications. Sleep staging data showed that slightly extending sleep minimally impacted deep sleep but resulted in a proportional increase in REM. Wakefulness during the night also increased, suggesting increased arousal despite greater sleep duration. Support (if any) This research was supported by Fitbit, Inc.

Sleep habits and their association with daytime sleepiness among medical students of Tanta University, Egypt

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Salwa A. Atlam ◽  
Hala M. Elsabagh
Keyword(s):  
Medical Students ◽  
Sleep Disorders ◽  
Sleep Duration ◽  
Daytime Sleepiness ◽  
Sleep Habits ◽  
Restless Legs ◽  
Sleeping Pills ◽  
Life Pattern ◽  
Waking Up ◽  
Malaysian Students

AbstractObjectivesThis study aimed to assess the sleep quality (habits and disorders) and the daytime sleepiness among medical students.MethodsA cross-sectional questionnaire-based study was conducted during September 2018, through November 2018 at the Faculty of Medicine, Tanta University, Egypt. The study recruited undergraduate Egyptian and Malaysian students and applied a modified form of two questionnaires, namely the Sleep Habits and Life Style and the Epworth Sleepiness Scale (ESS)”. Statistical analysis was done using SPSS. The results were expressed as frequency, percentage, and mean ± standard deviation (SD). Chi-square test was used to explore associations between categorical variables. An independent sample t-test was used to detect the mean differences between groups. Ordinal regression analyses were done on the ESS findings in relation to demographics and sleep habits. p-values<0.05 were accepted as statistically significant.ResultsThe study included 899 medical students. Most of the participants were Egyptians (67%), rural residents (57.4%), and in the preclinical stage (79.5%). Males represented 66.0% of the study participants and participants average age (SD) was 21.98 (1.13) years. The average durations (SD) of night sleep were 7.3 (1.6) hours in work days and 8.7 (2.1) hours during the weekends. Both were significantly longer among young (<21 years-old) and preclinical students (p<0.05). Students had on average (SD) 1.33 (0.29) hours duration of napping, but 60% of the participants never or rarely scheduled for napping. Larger proportion of male and Malaysian students sometimes scheduled for napping more significantly than their peers (p<0.05). Only 16.24% of students reported that the cause of daytime napping was no enough sleep at night. The students reported sleep disorders of insomnia in the form of waking up too early, trouble falling asleep, or waking up at night with failure to re-sleep (31, 30, and 26%, respectively). Snoring (22.2%) and restless legs (22.0%) were also reported by the students. High chances of dozing off was reported by 22.02% of the participants, of which 10% used sleeping pills, 41.4% suffered psychological affection, and 34.8% reported life pattern affection. We found an increased chance of daytime sleepiness among males (0.430 times) and Egyptian (2.018 times) students. There was a decreased chance of daytime sleepiness in students from rural areas and those below 21-years-old (0.262 and 0.343 times, respectively). Absence of chronic diseases suffering was significantly associated with 5.573 more chance of daytime sleepiness or dozing off. In addition, enough and average sleep at night significantly decreased the chance of daytime sleepiness by 6.292 and 6.578, respectively, whereas daytime consumption of caffeinated beverages significantly decreased the chance of daytime sleepiness by 0.341.ConclusionThere was unbalanced sleep duration in work days and weekends as well as lack of scheduling for napping among the students. Sleep disorders as insomnia, snoring, and restless legs were associated with excessive daytime sleepiness. Some students who suffered daytime sleepiness also underwent psychological and life pattern affection including taking sleeping pills. Enough and average sleep duration at night as well as daytime consumption of caffeinated beverages decreased the chance of daytime sleepiness.

Integrative Sleep Medicine

2021 ◽  
Keyword(s):  
Circadian Rhythm ◽  
Sleep Disorders ◽  
Health Care Providers ◽  
Sleep Disturbances ◽  
Well Being ◽  
Sleep Medicine ◽  
Whole Body ◽  
Care Providers ◽  
Obstructive Sleep ◽  
The Many

Sleep is one of the key underpinnings of human health, yet sleep disturbances and impaired sleep are rampant in modern life. Healthy sleep is a whole-body process impacted by circadian rhythm, daily activities, and emotional well-being, among others. When properly aligned, these work in concert to produce restorative and refreshing sleep. When not in balance, however, sleep disorders result. Yet too often, the approach to treatment of sleep disorders is compartmentalized, failing to recognize all of the complex interactions that are involved. This text offers a comprehensive approach to sleep and sleep disorders by delineating the many factors that interplay into healthy sleep. Health care providers can learn how to better manage their patients with sleep disorders by integrating complementary and conventional approaches. Using an evidence-based approach throughout, this book describes the basics of normal sleep then delves into the foundations of integrative sleep medicine, including the circadian rhythm, mind/body-sleep connection, light, dreaming, the gastrointestinal system, and botanicals/supplements. Specific sleep issues and disorders are then addressed from an integrative perspective, including insomnia, obstructive sleep apnea, sleep related movement disorders, and parasomnias.

scholarly journals 0836 BORN IN THE USA OR BORN IN MEXICO? IMPLICATIONS FOR SLEEP DURATION, SLEEP QUALITY, SLEEP DISORDERS SYMPTOMS AT THE US-MEXICO BORDER

SLEEP ◽  
2017 ◽  
Vol 40 (suppl_1) ◽  
pp. A309-A310
Author(s):  
A Okuagu ◽  
K Granados ◽  
P Alfonso-Miller ◽  
O Buxton ◽  
S Patel ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Disorders ◽  
Sleep Duration ◽  
The Us ◽  
Quality Sleep ◽  
The Usa ◽  
Mexico Border ◽  
Us Mexico Border

scholarly journals Upright versus supine MRI: effects of body position on craniocervical CSF flow

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Marco Muccio ◽  
David Chu ◽  
Lawrence Minkoff ◽  
Neeraj Kulkarni ◽  
Brianna Damadian ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Supine Position ◽  
Cardiac Cycle ◽  
Body Position ◽  
Csf Flow ◽  
Position Change ◽  
Phase Duration ◽  
Brain Functions ◽  
Systolic Phase ◽  
The Brain

Abstract Background Cerebrospinal fluid (CSF) circulation between the brain and spinal canal, as part of the glymphatic system, provides homeostatic support to brain functions and waste clearance. Recently, it has been observed that CSF flow is strongly driven by cardiovascular brain pulsation, and affected by body orientation. The advancement of MRI has allowed for non-invasive examination of the CSF hydrodynamic properties. However, very few studies have addressed their relationship with body position (e.g., upright versus supine). It is important to understand how CSF hydrodynamics are altered by body position change in a single cardiac phase and how cumulative long hours staying in either upright or supine position can affect craniocervical CSF flow. Methods In this study, we investigate the changes in CSF flow at the craniocervical region with flow-sensitive MRI when subjects are moved from upright to supine position. 30 healthy volunteers were imaged in upright and supine positions using an upright MRI. The cranio-caudal and caudo-cranial CSF flow, velocity and stroke volume were measured at the C2 spinal level over one cardiac cycle using phase contrast MRI. Statistical analysis was performed to identify differences in CSF flow properties between the two positions. Results CSF stroke volume per cardiac cycle, representing CSF volume oscillating in and out of the cranium, was ~ 57.6% greater in supine (p < 0.0001), due to a ~ 83.8% increase in caudo-cranial CSF peak velocity during diastole (p < 0.0001) and extended systolic phase duration when moving from upright (0.25 ± 0.05 s) to supine (0.34 ± 0.08 s; p < 0.0001). Extrapolation to a 24 h timeframe showed significantly larger total CSF volume exchanged at C2 with 10 h spent supine versus only 5 h (p < 0.0001). Conclusions In summary, body position has significant effects on CSF flow in and out of the cranium, with more CSF oscillating in supine compared to upright position. Such difference was driven by an increased caudo-cranial diastolic CSF velocity and an increased systolic phase duration when moving from upright to supine position. Extrapolation to a 24 h timeframe suggests that more time spent in supine position increases total amount of CSF exchange, which may play a beneficial role in waste clearance in the brain.

scholarly journals Sleep disorders in psychiatry

2018 ◽  
Vol 24 (4) ◽  
pp. 273-283 ◽  
Author(s):  
Hugh Selsick ◽  
David O'Regan
Keyword(s):  
Mental Health ◽  
Sleep Disorders ◽  
Sleep Medicine ◽  
Sleep Apnoea ◽  
Learning Objectives ◽  
List Type ◽  
Obstructive Sleep ◽  
Psychiatric Conditions ◽  
Respiratory Conditions ◽  
Broad Understanding

SUMMARYSleep medicine is a truly multidisciplinary field that covers psychiatric, neurological and respiratory conditions. As the field has developed it has become increasingly clear that there is a great deal of overlap between sleep and psychiatric disorders and it is therefore essential for psychiatrists to have some knowledge of sleep medicine. Even those disorders, such as obstructive sleep apnoea, that may seem to be outside the remit of psychiatry can have complex and important interactions with psychiatric conditions. In this article we give a brief overview of the range of sleep disorders a psychiatrist might encounter, how they are recognised, investigated and treated, and how they relate to psychiatric conditions.LEARNING OBJECTIVES•Be aware of the range of sleep disorders that might be encountered in psychiatric practice•Understand how these sleep disorders affect mental health•Have a broad understanding of how these disorders are investigated and treatedDECLARATION OF INTERESTH.S. has accepted speaker fees from Janssen Pharmaceuticals.

Abstract MP38: Longitudinal Population-Level Changes In Resting Heart Rate During The COVID-19 Pandemic: Impact Of Changes In Sleep, Circadian, And Physical Activity Variables

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Naghmeh Rezaei ◽  
Michael A Grandner
Keyword(s):  
New York ◽  
Heart Rate ◽  
Los Angeles ◽  
Health Behaviors ◽  
San Francisco ◽  
Sleep Duration ◽  
Age Groups ◽  
Population Level ◽  
Sleep Stages ◽  
Resting Heart Rate

Introduction: Population-level objective estimates of changes in health metrics over the course of the COVID-19 pandemic are sparse. This study evaluated change in resting heart rate (RHR) determined by optical plethysmography and relationships to changes in other lifestyle health behaviors (sleep and activity). Methods: Data were obtained from N=197,988 Fitbit users who wore their heart-rate enabled Fitbit device to sleep and had detected sleep stages at least 10 days in the month of January, the baseline period; and synced their devices at least once in the last 10 days of April. In addition, potential participants needed to reside in one of 6 target cities: Chicago, Illinois; Houston, Texas; Los Angeles, California; San Francisco, California; New York City, New York; and Miami, Florida. Users who met these criteria were randomly selected. Daily RHR, sleep duration (minutes), sleep duration variability (standard deviation), bedtime, step count, and active minutes were estimated by the device. Differences between January (before the pandemic) and April (peak of stay-at-home orders) was computed. Correlations between change in RHR and change in other variables were evaluated, stratified by age and sex. Results: For all age groups, in both men and women, mean RHR declined from January to April by about 1bpm, with the highest reductions in the youngest adults (all p<1x10 -100 ). In general, across both genders and all age groups, reductions in RHR were correlated with greater sleep duration, delaying bedtime, reduced sleep variability, and more active minutes. Steps were also associated in younger (but not older) adults. Results for ages 18-29 and >=65 are displayed in the Table. Discussion: During the COVID-19 pandemic, RHR decreased robustly but very slightly. Reductions in RHR were correlated with improvements in other health behaviors (sleep and activity). Causal relationships could not be evaluated, but future studies may explore whether even small changes in health behaviors can measurably impact population RHR.

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