REM sleep episodes during the maintenance of wakefulness test in patients with sleep apnea syndrome and patients with narcolepsy

Twelve patients with sleep apnea, 12 narcoleptic patients, and 10 controls were given 20-min opportunities to remain awake while sitting comfortably. Test sessions were administered at 10:00, 12:00, 14:00, 16:00, and 18:00. Apneic and narcoleptic subjects were less capable of maintaining wakefulness than controls. Patients with sleep apnea had an average of 1.4 daytime rapid eye movement (REM) episodes with the peak incidence at 14:00. Narcoleptics also had sleep onset REM periods (mean of 2.7), whereas none of the controls had REM episodes during the daytime testing. Narcoleptic and control groups differed in the probability of REM occurring at each session. There were time-of-day differences in the probability of REM occurring between patient groups. The amount of stage REM the night preceding testing was unrelated to the occurrence of REM episodes during the day in either patient group. In addition, there were notable differences in the frequency of sleep onset REM periods when patients were sitting as opposed to being supine during nap studies. Sleep latency and frequency of REM episodes on the maintenance of wakefulness test were independent of the subject's age. The maintenance of wakefulness test proved unsatisfactory as a diagnostic procedure, but appeared useful as an adjunct procedure in the evaluation of treatment efficacy of hypersomnia.     

Sleep-related increase in activity of mesopontine neurons in old rats

Relationships between age-related changes in sleep patterns and neuronal activity have received scant attention. In the present study, reticularis pontis oralis (RPO) and ventral tegmental nucleus of Gudden (VTN) neurons were recorded in unanesthetized restrained young (3 months) and old (23 months) Sprague-Dawley rats during wakefulness (W), slow wave sleep (SWS) and rapid eye movement (REM) sleep. All RPO neurons displayed a tonic activity. Firing rates were similar during W in young and old rats. In contrast, firing rates were higher during SWS in old rats (P < 0.001). In both young and old rats, firing rates increased significantly during REM sleep as compared to W and SWS but this increase was markedly greater in old rats. Neurons recorded from VTN displayed bursting activity at theta frequencies during W and REM sleep. The frequency of VTN bursting neurons was higher during REM sleep as compared to W in both groups of age. This difference was significantly more pronounced in old as compared to young rats (P < 0.001). Sleep-related hyperactivity of pontine neurons is discussed in terms of a possible deficit in inhibitory processes in old rats.     

Age-related modifications of NREM sleep EEG: from childhood to middle age

This study investigated the modifications in non-rapid eye movement (NREM) sleep electroencephalogram (EEG) power in 54 subjects, from children to middle-aged adults. Spectral analyses were performed on 5 h of NREM sleep. A marked decrease of absolute slow-wave activity (SWA) was observed with increasing age; children had significantly more SWA than adolescents, young and middle-aged adults. The decline of SWA across the night seems to level off with increasing age, suggesting an age-related attenuation of homeostatic sleep pressure. Absolute theta power was higher for children compared with the other three groups, and adolescents had more theta power than young and middle-aged adults. In comparison to young and middle-aged adults, alpha power was higher for children and adolescents. Children and adolescents had more sigma power than middle-aged adults. Absolute beta power was higher for children than for the other age groups. Therefore, the major alterations of NREM sleep EEG occurring between childhood and middle age are not restricted to SWA, but encompassed the theta, alpha, sigma and beta frequency bands.     

Developmental changes in the sleep electroencephalogram of adolescent boys and girls

The sleep electroencephalogram (EEG) changes across adolescence; however, there are conflicting data as to whether EEG changes are regionally specific, are evident in non‐rapid eye movement (NREM) and rapid eye movement (REM) sleep, and whether there are sex differences. The present study seeks to resolve some of these issues in a combined cross‐sectional and longitudinal analysis of sleep EEG in adolescents. Thirty‐three healthy adolescents (18 boys, 15 girls; 11–14 years) were studied on two occasions 6–8 months apart. Cross‐sectional analysis of data from the initial visit revealed significantly less slow‐wave sleep, delta (0.3 to <4 Hz) and theta (4 to <8 Hz) power in both NREM and REM sleep with advancing age. The age–delta power relationship was significant at the occipital site, with age accounting for 26% of the variance. Longitudinal analysis revealed that NREM delta power declined significantly from the initial to follow‐up visit, in association with declining delta amplitude and incidence (P < 0.01), with the effect being greatest at the occipital site. REM delta power also declined over time in association with reduced amplitude (P < 0.01). There were longitudinal reductions in theta, alpha and sigma power in NREM and REM sleep evident at the occipital site at follow‐up (P < 0.01). No sex differences were apparent in the pattern of change with age for NREM or REM sleep. Declines in sleep EEG spectral power occur across adolescence in both boys and girls, particularly in the occipital derivation, and are not state‐specific, occurring in both NREM and REM sleep.     

EEG spectral power analysis of phasic and tonic REM sleep in young and older male subjects

EEG spectral power was studied during periods of rapid eye movements (REMs) and tonic intervals in REM sleep of 7 young and 7 older male subjects. Significant symmetrical decreases in alpha and beta1 power at central and occipital sites, concurrent with an increase in frontal theta power, were observed during the production of REMs. The former findings are discussed as sleep analogues to changes in alpha and beta1 during waking, showing increased information processing and behavioural activation, and that of theta is tentatively presented as reflecting an increase in afferent thresholds. Independent of the phasic-tonic REM distinction, total EEG power markedly decreased as a function of time of night and did not interact with age. Significant age differences in the overall spectral composition of the EEG were obtained, namely, a lower level of delta power and a relative shift towards more power in frequencies above 12 Hz for the older group. Further, older subjects also demonstrated a more uniform topographical distribution of alpha and sigma power.     

The effect of donepezil on sleep and REM sleep EEG in patients with Alzheimer disease: a double-blind placebo-controlled study

STUDY OBJECTIVE: Examine the effects of donepezil on sleep and rapid eye movement (REM) sleep electroencephalogram (EEG) in patients with Alzheimer disease, using polysomnography, and the correlation between REM sleep EEG parameters and cognitive scores. DESIGN: Randomized, double-blind, placebo-controlled design. SETTINGS: Two sleep research centers, University Hospital. PARTICIPANTS: Thirty-five patients with mild to moderate Alzheimer disease, allocated to 2 groups: donepezil treated (n=17) and placebo treated (n=18). INTERVENTION: Patients were administered donepezil or placebo. OUTCOME MEASURES: Polysomnography with REM sleep EEG spectral analysis and cognitive evaluation using the Alzheimer Disease Assessment Scale, cognitive subscale, were performed at baseline and after 3 and 6 months. Slowing ratio was the ratio between slow and fast EEG frequency bands. Cognitive and sleep data were analyzed using analysis of variance. Correlations between cognitive improvement and REM sleep EEG were also calculated. RESULTS: REM sleep increased significantly after 3 and 6 months of donepezil treatment compared with baseline and placebo (p < .01). Overall theta (p = .04), frontal theta (p < .01) and frontal delta (p = .03) absolute power during REM sleep decreased after 6 months of donepezil treatment. The occipital slowing ratio decreased during treatment (p = .04). REM sleep overall and frontal and centroparietal alpha absolute power significantly correlated with the cognitive improvement rate on the Alzheimer Disease Assessment Scale, cognitive subscale (r = 0.75, r = 0.71, r = 0.78); p < .01). CONCLUSIONS: Donepezil treatment enhanced REM sleep and reduced slow frequencies of REM sleep EEG, suggesting a possible action upon REM sleep-related cholinergic neurons in patients with Alzheimer disease. Furthermore, REM sleep alpha power may predict the cognitive response to donepezil.     

EEG spectral analysis of the sleep-onset period in narcoleptics and normal sleepers

The sleep-onset period of 10 drug-free patients with narcolepsy-cataplexy and 10 normals matched for age and gender was investigated using the multiple sleep latency test to elicit episodes of intentional sleep onset. Spectral analyses were calculated for delta, theta, alpha, sigma, and beta frequencies using 5-second epochs beginning at lights-out and continuing until the first 2 minutes of stage 2 or REM sleep were reached, or until 20 minutes had elapsed. The sleep-onset period was divided into quartiles, and mean root mean square (RMS) amplitude within each quartile was calculated. Mean delta amplitude was significantly higher across the sleep-onset period of narcoleptic REM naps and narcoleptic stage 2 naps compared to the sleep-onset period of normal stage 2 naps or normal stage 1 naps. Mean theta amplitude was significantly higher for narcoleptic REM naps compared to normal stage 1 naps, and tended to be higher for narcoleptic stage 2 naps compared to normal stage 1 naps. Mean alpha amplitude was significantly lower for narcoleptic REM naps and narcoleptic stage 2 naps compared to normal naps containing just stage 1. Mean sigma amplitude was significantly lower for narcoleptic REM naps compared to normal stage 1 naps, and tended to be lower for narcoleptic REM naps compared to normal stage 2 naps. Mean beta amplitude did not differ between the narcoleptic and normal sleep-onset process. These findings support the existence of electrophysiologic differences within the microstructure of the process of sleep entry in narcoleptics and normals.     

Effects of systemic atropine sulfate administration on the frequency content of the cat sensorimotor EEG during sleep and waking

Sensorimotor electroencephalogram (EEG) frequencies in cats were evaluated with power spectral analysis before and after 3 doses of atropine sulfate. All doses of atropine tested caused enhanced EEG slow waves (0-7 Hz) and spindles (8-15 Hz) during waking immobility, and postdrug frequency profiles during slow-wave sleep and waking immobility were identical. With 0.75 mg/kg atropine, movement (head movement, locomotion) resulted in EEG desynchronization and reduced power in all frequencies less than 24 Hz. After 1.5 or 3.0 mg/kg atropine, power in low frequencies remained elevated during movement, but power in spindle frequencies was significantly reduced compared with other states. During active REM sleep after 1.5 mg/kg atropine, power in spindle frequencies was significantly lower than that during quiet REM sleep. These results indicate that the sensorimotor cortical EEG in cats is under the control of multiple systems. At least 1 of these systems is active during movement, and its actions are resistant to muscarinic receptor blockade.     

Quantitative electroencephalography during rapid eye movement (REM) and non‐REM sleep in combat‐exposed veterans with and without post‐traumatic stress disorder

Sleep disturbances are a hallmark feature of post‐traumatic stress disorder (PTSD), and associated with poor clinical outcomes. Few studies have examined sleep quantitative electroencephalography (qEEG), a technique able to detect subtle differences that polysomnography does not capture. We hypothesized that greater high‐frequency qEEG would reflect ‘hyperarousal’ in combat veterans with PTSD (n = 16) compared to veterans without PTSD (n = 13). EEG power in traditional EEG frequency bands was computed for artifact‐free sleep epochs across an entire night. Correlations were performed between qEEG and ratings of PTSD symptoms and combat exposure. The groups did not differ significantly in whole‐night qEEG measures for either rapid eye movement (REM) or non‐REM (NREM) sleep. Non‐significant medium effect sizes suggest less REM beta (opposite to our hypothesis), less REM and NREM sigma and more NREM gamma in combat veterans with PTSD. Positive correlations were found between combat exposure and NREM beta (PTSD group only), and REM and NREM sigma (non‐PTSD group only). Results did not support global hyperarousal in PTSD as indexed by increased beta qEEG activity. The correlation of sigma activity with combat exposure in those without PTSD and the non‐significant trend towards less sigma activity during both REM and NREM sleep in combat veterans with PTSD suggests that differential information processing during sleep may characterize combat‐exposed military veterans with and without PTSD.     

Theta oscillation in the human anterior cingulate cortex during all-night sleep: an electrocorticographic study

Ten epileptic patients each with subdural electrodes surgically attached to the anterior cingulate cortex (ACC; two cases), the orbitofrontal cortex (OFC; seven cases), or both (one case) were included in this study. We recorded each patient's ACC or OFC electrocorticogram (ECoG) during the time period that the patient was awake and naturally asleep. We performed a Fast Fourier Transformation (FFT) power spectral analysis on each ECoG to examine its frequency component. We found that the ACC showed regular and continuous theta oscillation (5-7Hz) during wakefulness and rapid eye movement (REM) sleep, but not during slow wave sleep. Theta waves observed in REM sleep were not as distinct as those found in wakefulness. We also discovered that the orbitofrontal signals represented spectral peaks in the theta band only during wakefulness. This suggests the coexistence of theta oscillation in the ACC. Considering our previous observations of gamma and beta oscillations in the human hippocampus, we hypothesize that the human limbic system manifests two oscillatory activities. The results obtained in this study suggest that electrophysiological activity in the ACC could be related to particular psychological functions in wakefulness and in REM sleep. These results are useful in elucidating the human brain mechanism.     

Circadian and homeostatic modulation of sleep in older adults during a 90-minute day study

STUDY OBJECTIVES: To identify age-associated changes in circadian and homeostatic characteristics of sleep in healthy elderly and young adults using electroencephalogram (EEG) power spectral analysis during a 90-minute sleep-wake schedule. DESIGN: Controlled clinical experiment. SETTING: University sleep laboratory. PARTICIPANTS: 16 older (77 +/- 5 years) and 19 younger adults (23 +/- 3 years). INTERVENTIONS: Subjects followed a 90-minute sleep-wake schedule (30 minutes in bed, 60 minutes awake) for 60 hours. Sleep was recorded for each bed-rest episode, and core body temperature was continuously recorded. The EEG power density was determined for non-rapid eye movement sleep in each bed-rest episode. Power density data were analyzed with mixed-effects models to assess rhythmic and linear components. RESULTS: Younger subjects had greater power in delta, theta, and sigma power bands across the study interval. Significant circadian rhythms were observed in delta, sigma, and beta power bands. Age-related differences in circadian modulation of EEG activity, indicated by significant interaction terms, were present in alpha and beta bands. A significant linear component was present in delta and theta power bands, with no significant age-interaction effect. CONCLUSIONS: Despite overall differences in the level of EEG power, older and younger adults exhibited similar rhythmic and linear patterns in most frequency bands. Age appears to affect circadian rhythmicity in higher EEG frequencies and homeostatic drive in lower EEG frequencies.     

Sleep and EEG spectra in the rabbit under baseline conditions and following sleep deprivation

The 24-hr sleep-wake distribution and power spectra of the electroencephalogram were determined in rabbits that had been implanted with cortical and hippocampal electrodes. A diurnal preference for sleep was observed. The spectral power density in nonrapid eye movement sleep (NREM sleep) of the cortex showed a decreasing trend in most frequencies within the 12-hr light period. In the 12-hr dim period no clear trend was present. Most hippocampal EEG frequencies decreased in NREM sleep in the first two hours of the light period, and thereafter stayed on a constant level. Sleep deprivation elicited the following changes: a prolonged increase of NREM sleep and a short increase of REM sleep; in the cortex, an increase of slow-wave activity (SWA; power density in the 0.25-2.0 Hz frequency band) in NREM sleep, which declined in the course of recovery; an enhancement of slow-wave (1.25-3 Hz) and theta (6.25-7 Hz) activity in REM sleep. The hippocampus showed an increase in NREM sleep power density in almost all frequencies. In REM sleep the hippocampus exhibited an increase in power density in the 6.25-7 Hz and 12.25-13 Hz bands, whereas in the 7.25-8 Hz band the values were below baseline. The results show that SWA in NREM sleep and theta activity in REM sleep are enhanced by sleep deprivation, as has been observed in other mammalian species. The EEG changes in the hippocampus resembled those in the cortex.     

Behavioural and electrophysiological studies of entorhinal cortex lesions in the rat.

Bilateral ibotenic acid injections aimed at the entorhinal cortex (EC) lesioned the EC and subiculum in 30% of animals (group EC/S) and caused additional hippocampal damage in 50% (group RH). Both lesions increased acetylcholinesterase (AChE) staining in the intermediate molecular layer of the dentate gyrus. EC/S lesions increased diurnal deep sleep and the incidence of spindles but decreased REM sleep. RH lesions increased nocturnal deep sleep and decreased nocturnal quiet sleep. Both lesions reduced power over the theta frequency range from 6-10 Hz for epochs of REM sleep and quiet waking but not deep sleep. Peak frequency was unaffected. The RH group and a subset of the EC/S group were nocturnally, but not diurnally, hyperactive. Six weeks after the lesion there was no evidence for hyperactivity in a novel open field. The EC/S lesion impaired exploration as indicated by reduced motility and rearing in an open field and by the failure of EC/S-lesioned rats to increase contact time in response to a novel olfactory cue. Place navigation learning in a Morris maze was not affected by EC/S or RH lesions. However, when the spatial location of the hidden platform was shifted EC/S-lesioned rats were impaired. The sprouting response, reduced theta power and exploration deficits resemble those reported following electrolytic lesions, but the lack of effect on place navigation learning contrasts with reports of impaired spatial learning following electrolytic lesions. The data prompt a reexamination of the role which the EC projection to the hippocampus plays in spatial learning.     

Surges of arterial pressure during REM sleep in spontaneously hypertensive rats

STUDY OBJECTIVES: Rapid-eye-movement sleep (REM sleep) physiologically entails arterial pressure surges. Pressure surges may lead to acute cardiovascular events in risk conditions such as arterial hypertension. We investigated whether arterial hypertension alters the rate of occurrence and the characteristics of the pressure surges during REM sleep. DESIGN: Spontaneously hypertensive rats (SHR) were compared with Wistar-Kyoto normotensive controls (WKY) and a group of SHR, in which hypertension was prevented by long-term enalapril treatment (ena-SHR). SETTING: N/A. SUBJECTS: Seven male rats per group. INTERVENTIONS: Instrumentation with electrodes for polygraphic recordings, a nasal thermistor for measuring ventilatory period, and an arterial catheter for measuring arterial pressure and heart period. MEASUREMENTS AND RESULTS: SHR showed a significant increase in the rate of occurrence but a similar magnitude of the pressure surges during REM sleep, with respect to WKY and ena-SHR. The pressure surges were associated with a decrease of heart period and an increase of electroencephalographic theta frequency, which were significantly less pronounced in SHR than in either WKY or ena-SHR. The ventilatory period showed only a modest increase before the surges without significant differences among the groups. CONCLUSIONS: Pressure surges independent of sleep apnea occur during REM sleep at a rate increased in SHR with respect to their controls, supporting a potential role of REM sleep in triggering acute cardiovascular events in arterial hypertension. The characteristics of the pressure surges suggest that, in SHR, the underlying central autonomic commands are increased in frequency, but not in magnitude, by arterial hypertension.     

EEG sleep of young adults with major depression: a controlled study

The EEG sleep of 75 subjects aged 16-25 years was studied. Thirty-eight were in an episode of RDC major depression, and 37 were normal controls. Only one sleep continuity measure differed between the two groups: sleep latency was significantly longer in the depressive group. REM period latencies and other sleep variables did not differ between the groups. Subgroup analyses, within the depressed group with respect to inpatient status, revealed significantly higher REM density (P less than 0.03) and a marginally shortened REM period latency (P less than 0.07) among the inpatient depressives. Subgroup analysis across suicidal ratings revealed a significantly higher REM density (P less than 0.04) among suicidal depressives. Severity estimates of depression did not correlate with sleep findings. These results parallel another recent report on adolescent depressed subjects, suggesting that inpatient and/or suicidal status is an important variable in the expression of EEG sleep abnormalities in the adolescent/young adult age group.     

Sleep spindle activity changes in patients with affective disorders

Various polysomnographic sleep patterns are associated with affective disorders, but very little is known about sleep spindle characteristics in adult depression. In primary endogenous depressive male patients (unipolar, UP, and bipolar, BP) with comparable depression scores and in normal control subjects recorded during 3 consecutive nights, no night effect was observed on the sleep variables investigated except for REM latencies of stages 1 and 2. Stage 2 duration and variables related to sleep spindle characteristics (the number and the density of spindles of 1/2 s; the number and the density of full spindles of stage 2 over the 3 nights) were significantly lower in depressed patients than in control subjects, the mean number of spindles being lower in UP than in BP patients. Sleep spindle measures were clearly negatively correlated with age in the overall group (i.e., depressed plus control subjects). They were also negatively correlated with the REM latencies of stages 1 and 2 in BP depressed patients, whereas this relation was not observed in UP patients.     

低频光诱发脑电在浅睡期的样本熵复杂度分析

睡眠障碍患者通常表现为从浅睡期进入深睡期存在困难,分析浅睡期脑电波的变化对研究睡眠效率和睡眠质量至关重要。通过分析低频光刺激下睡眠过程中脑电波的复杂度值变化,研究人在浅睡期脑电波对光刺激的响应,进而探讨外部光刺激对睡眠过程中脑电波的影响。使用美国neuroscan型脑电图仪,采集10例志愿者的光刺激睡眠和正常睡眠的脑电数据。首先,利用时频分析,对睡眠过程中的脑电信号进行分期,获得浅睡期脑电信号;然后,使用小波包分解,获得该期脑电波的各频段分量（δ波、θ波、α波和纺锤波）;接着,采用样本熵算法,分别计算浅睡期脑电信号的复杂度以及各频段脑电波的复杂度;最后,对志愿者在光刺激（5 Hz）和正常睡眠下浅睡期脑电复杂度进行比较,研究光刺激对脑电复杂度的响应情况。结果显示：在低频光刺激下,浅睡期脑电波复杂度的均值为0514 15,明显低于正常睡眠复杂度的均值0589 23,在中央区和顶区有显著性差异（P<005）。研究表明,5 Hz光刺激可诱发浅睡期θ波的同步响应,增强脑电波的节律性,有助于更好地进入深度睡眠。     

Theta wave amplitude and frequency are differentially correlated with pontine waves and rapid eye movements during REM sleep in rats

The present study examined the correlations between the dynamics of hippocampal theta waves and pontine waves (P waves) and rapid eye movements (REMs) densities during REM sleep. Theta wave peak frequency and theta amplitude were estimated as the parameters of theta wave dynamics in each 3s segment. The peak frequency and theta amplitude were positively correlated with P wave and REMs densities, however their detailed correlation properties were distinct from each other. Dependency of peak frequency on P wave/REMs density did not change significantly from that on REMs/P wave density. On the other hand, dependency of the theta amplitude on P wave/REMs density significantly increased with an increased REMs/P wave density. Because hippocampal theta waves and P waves are involved in learning and memory functions during REM sleep, the correlation between theta parameters and P wave density might help to clarify these functions.     

Chronobiology of aging: Temperature, sleep-wake rhythms and entrainment

—Studies were carried out on a group of six young (ages 23–30) and six older (ages 53–70) normal men who lived under conditions of temporal, but not social isolation, from three to eight weeks. During entrained and non-entrained (free-running) conditions, comparative measurements were made of sleep-wake cycles, sleep stages and rectal temperature rhythms for these two age groups. Results demonstrated a reduction in the period and amplitude of the body temperature rhythms during free-running in the older group. Sleep efficiency, total sleep time, REM sleep latency, REM episode length, percent REM in the last 2 hours of sleep, the length and frequency of arousals during sleep, and the terminal wake latency were all age related and dependent on entrainment. The period of the sleep-wake cycle, terminal awakenings from REM and percent REM in the first 3 hours of sleep were not age related but were dependent on entrainment. Sleep stages as percents of total sleep time were found to be age related but independent of entrainment, while sleep latency, mid-REM to mid-REM cycle length and the ratio of sleep to total time were neither age related nor dependent on entrainment. In addition, individual chronobiological differences were prominent in the older group. Changes of period and of the phase relationship of sleep-wake and temperature rhythms occurred in several subjects during the non-entrained condition.