The space-time profiles of sleep spindles and their coordination with slow oscillations on the electrode manifold

Sleep spindles are important for sleep quality and cognitive functions, with their coordination with slow oscillations (SOs) potentially organizing cross-region reactivation of memory traces. Here, we describe the organization of spindles on the electrode manifold and their relation to SOs. We analyzed the sleep night EEG of 34 subjects and detected spindles and SOs separately at each electrode. We compared spindle properties (frequency, duration, and amplitude) in slow wave sleep (SWS) and Stage 2 sleep (S2); and in spindles that coordinate with SOs or are uncoupled. We identified different topographical spindle types using clustering analysis that grouped together spindles co-detected across electrodes within a short delay (±300 ms). We then analyzed the properties of spindles of each type, and coordination to SOs. We found that SWS spindles are shorter than S2 spindles, and spindles at frontal electrodes have higher frequencies in S2 compared to SWS. Furthermore, S2 spindles closely following an SO (about 10% of all spindles) show faster frequency, shorter duration, and larger amplitude than uncoupled ones. Clustering identified Global, Local, Posterior, Frontal-Right and Left spindle types. At centro-parietal locations, Posterior spindles show faster frequencies compared to other types. Furthermore, the infrequent SO-spindle complexes are preferentially recruiting Global SO waves coupled with fast Posterior spindles. Our results suggest a non-uniform participation of spindles to complexes, especially evident in S2. This suggests the possibility that different mechanisms could initiate an SO-spindle complex compared to SOs and spindles separately. This has implications for understanding the role of SOs-spindle complexes in memory reactivation.     

Spindles are highly heritable as identified by different spindle detectors

Study ObjectivesSleep spindles, a defining feature of stage N2 sleep, are maximal at central electrodes and are found in the frequency range of the electroencephalogram (EEG) (sigma 11–16 Hz) that is known to be heritable. However, relatively little is known about the heritability of spindles. Two recent studies investigating the heritability of spindles reported moderate heritability, but with conflicting results depending on scalp location and spindle type. The present study aimed to definitively assess the heritability of sleep spindle characteristics.MethodsWe utilized the polysomnography data of 58 monozygotic and 40 dizygotic same-sex twin pairs to identify heritable characteristics of spindles at C3/C4 in stage N2 sleep including density, duration, peak-to-peak amplitude, and oscillation frequency. We implemented and tested a variety of spindle detection algorithms and used two complementary methods of estimating trait heritability.ResultsWe found robust evidence to support strong heritability of spindles regardless of detector method (h² > 0.8). However not all spindle characteristics were equally heritable, and each spindle detection method produced a different pattern of results.ConclusionsThe sleep spindle in stage N2 sleep is highly heritable, but the heritability differs for individual spindle characteristics and depends on the spindle detector used for analysis.     

Spindle and slow wave rhythms at slow wave sleep transitions are linked to strong shifts in the cortical direct current potential

Electroencephalographic activity at the transition from wakefulness to sleep is characterized by the appearance of spindles (12-15 Hz) and slow wave rhythms including delta activity (1-4 Hz) and slow oscillations (0.2-1 Hz). While these rhythms originate within neocortico-thalamic circuitry, their emergence during the passage into slow wave sleep (SWS) critically depends on the activity of neuromodulatory systems. Here, we examined the temporal relationships between these electroencephalogram rhythms and the direct current (DC) potential recorded from the scalp in healthy men (n=10) using cross-correlation analyses. Analyses focused on transitions from wakefulness to SWS in the beginning of the sleep period, and from SWS to lighter sleep and rapid eye movement (REM) sleep at the end of the first sleep cycle. For spindle, delta and slow oscillatory activity strong negative correlations with the DC potential were found at the transition into SWS with peak correlation coefficients (at zero time lag) averaging r=-0.81, -0.88 and -0.88, respectively (P<0.001). Though slightly lower, distinct negative correlations between these measures were also found at the transition from SWS to REM sleep (-0.78, -0.77 and -0.77, respectively, P<0.001). Fast oscillatory activity in the beta frequency band (15-25 Hz) was correlated positively with the DC potential (r=+0.75, P<0.05, at the passage to SWS). Data indicate close links between increasing spindle, delta and slow oscillatory activity and the occurrence of a steep surface negative cortical DC potential shift during the transition from wake to SWS. Likewise, a DC potential shift toward surface positivity accompanies the disappearance of these oscillatory phenomena at the end of the non-REM sleep period. The DC potential shifts may reflect gradual changes in extracellular ionic (Ca2+) concentration resulting from the generation of spindle and slow wave rhythms, or influences of neuromodulating systems on cortical excitability thereby controlling the emergence of cortical spindle and slow wave rhythms at SWS transitions.     

Sleep spindles and rapid eye movement sleep as predictors of next morning cognitive performance in healthy middle‐aged and older participants

Spindles and slow waves are hallmarks of non‐rapid eye movement sleep. Both these oscillations are markers of neuronal plasticity, and play a role in memory and cognition. Normal ageing is associated with spindle and slow wave decline and cognitive changes. The present study aimed to assess whether spindle and slow wave characteristics during a baseline night predict cognitive performance in healthy older adults the next morning. Specifically, we examined performance on tasks measuring selective and sustained visual attention, declarative verbal memory, working memory and verbal fluency. Fifty‐eight healthy middle‐aged and older adults (aged 50–91 years) without sleep disorders underwent baseline polysomnographic sleep recording followed by neuropsychological assessment the next morning. Spindles and slow waves were detected automatically on artefact‐free non‐rapid eye movement sleep electroencephalogram. All‐night stage N2 spindle density (no./min) and mean frequency (Hz) and all‐night non‐rapid eye movement sleep slow wave density (no./min) and mean slope (μV/s) were analysed. Pearson's correlations were performed between spindles, slow waves, polysomnography and cognitive performance. Higher spindle density predicted better performance on verbal learning, visual attention and verbal fluency, whereas spindle frequency and slow wave density or slope predicted fewer cognitive performance variables. In addition, rapid eye movement sleep duration was associated with better verbal learning potential. These results suggest that spindle density is a marker of cognitive functioning in older adults and may reflect neuroanatomic integrity. Rapid eye movement sleep may be a marker of age‐related changes in acetylcholine transmission, which plays a role in new information encoding.     

The activity of thalamus and cerebral cortex neurons in rabbits during “slow wave-spindle” EEG complexes

“Slow wave-spindle” complexes were studied during slow wave sleep in rabbits at the thalamic (medial thalamus) and cortical (upper and lower layers of the sensorimotor cortex) levels. Slow wave complexes are biphasic positive-negative complexes or triphasic complexes with a predominantly negative component. Spindles have characteristics close to those of spontaneous sleep spindles. Complexes arise singly, as though inserted into the rhythm of spontaneous sleep spindles, or in series with periods similar to the spindle rhythm. Medial thalamus neurons and some cortical neurons had the same activity during waves as during spindles: if the neuron decreased (increased) its spike frequency in a spindle, then decreases (increases) in frequency were also seen in slow waves; if the neuron produced trains of discharges during spindles, then trains of activity were also seen from the slow-wave part of “slow wave-spindle” complexes. The membrane potential changed in a similar fashion: on a background of hyperpolarization which started at the slow wave, individual depolarization oscillations appeared in the EEG wave rhythm; these oscillations were not always accompanied by spike trains. The slow wave mechanisms, the rhythms of isolated complexes and simultaneous complexes and spontaneous sleep spindles may share a common underlying mechanism: slow, cyclical variations in excitability in thalamocortical neuronal networks, which have previously been demonstrated for spindle-likes activity. The possibility that there are common mechanisms for slow waves in complexes and other EEG slow waves, particularly δ activity, remains hypothetical. Translated from Rossiiskii Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 84, No. 3, pp. 182–190, March, 1998.     

EEG sigma and slow‐wave activity during NREM sleep correlate with overnight declarative and procedural memory consolidation

Previous studies suggest that sleep‐specific brain activity patterns such as sleep spindles and electroencephalographic slow‐wave activity contribute to the consolidation of novel memories. The generation of both sleep spindles and slow‐wave activity relies on synchronized oscillations in a thalamo‐cortical network that might be implicated in synaptic strengthening (spindles) and downscaling (slow‐wave activity) during sleep. This study further examined the association between electroencephalographic power during non‐rapid eye movement sleep in the spindle (sigma, 12–16 Hz) and slow‐wave frequency range (0.1–3.5 Hz) and overnight memory consolidation in 20 healthy subjects (10 men, 27.1 ± 4.6 years). We found that both electroencephalographic sigma power and slow‐wave activity were positively correlated with the pre–post‐sleep consolidation of declarative (word list) and procedural (mirror‐tracing) memories. These results, although only correlative in nature, are consistent with the view that processes of synaptic strengthening (sleep spindles) and synaptic downscaling (slow‐wave activity) might act in concert to promote synaptic plasticity and the consolidation of both declarative and procedural memories during sleep.     

Susceptibility to auditory closed-loop stimulation of sleep slow oscillations changes with age

Study ObjectivesCortical slow oscillations (SOs) and thalamocortical sleep spindles hallmark slow wave sleep and facilitate memory consolidation, both of which are reduced with age. Experiments utilizing auditory closed-loop stimulation to enhance these oscillations showed great potential in young and older subjects. However, the magnitude of responses has yet to be compared between these age groups. We examined the possibility of enhancing SOs and performance on different memory tasks in a healthy middle-aged population using this stimulation and contrast effects to younger adults.MethodsIn a within-subject design, 17 subjects (55.7 ± 1.0 years) received auditory stimulation in synchrony with SO up-states, which was compared to a no-stimulation sham condition. Overnight memory consolidation was assessed for declarative word-pairs and procedural finger-tapping skill. Post-sleep encoding capabilities were tested with a picture recognition task. Electrophysiological effects of stimulation were compared to a previous younger cohort (n = 11, 24.2 ± 0.9 years).ResultsOvernight retention and post-sleep encoding performance of the older cohort revealed no beneficial effect of stimulation, which contrasts with the enhancing effect the same stimulation protocol had in our younger cohort. Auditory stimulation prolonged endogenous SO trains and induced sleep spindles phase-locked to SO up-states in the older population. However, responses were markedly reduced compared to younger subjects. Additionally, the temporal dynamics of stimulation effects on SOs and spindles differed between age groups.ConclusionsOur findings suggest that the susceptibility to auditory stimulation during sleep drastically changes with age and reveal the difficulties of translating a functional protocol from younger to older populations.     

The effect of zolpidem on memory consolidation over a night of sleep

Study Objectives: Nonrapid eye movement sleep boosts hippocampus-dependent, long-term memory formation more so than wake. Studies have pointed to several electrophysiological events that likely play a role in this process, including thalamocortical sleep spindles (12–15 Hz). However, interventional studies that directly probe the causal role of spindles in consolidation are scarce. Previous studies have used zolpidem, a GABA-A agonist, to increase sleep spindles during a daytime nap and promote hippocampal-dependent episodic memory. The current study investigated the effect of zolpidem on nighttime sleep and overnight improvement of episodic memories. Methods: We used a double-blind, placebo-controlled within-subject design to test the a priori hypothesis that zolpidem would lead to increased memory performance on a word-paired associates task by boosting spindle activity. We also explored the impact of zolpidem across a range of other spectral sleep features, including slow oscillations (0–1 Hz), delta (1–4 Hz), theta (4–8 Hz), sigma (12–15 Hz), as well as spindle–SO coupling. Results: We showed greater memory improvement after a night of sleep with zolpidem, compared to placebo, replicating a prior nap study. Additionally, zolpidem increased sigma power, decreased theta and delta power, and altered the phase angle of spindle–SO coupling, compared to placebo. Spindle density, theta power, and spindle–SO coupling were associated with next-day memory performance. Conclusions: These results are consistent with the hypothesis that sleep, specifically the timing and amount of sleep spindles, plays a causal role in the long-term formation of episodic memories. Furthermore, our results emphasize the role of nonrapid eye movement theta activity in human memory consolidation.     

Sleep spindle characteristics and sleep architecture are associated with learning of executive functions in school‐age children

The macro‐ and microstructural characteristics of sleep electroencephalography have been associated with several aspects of executive functioning. However, only a few studies have addressed the association of sleep characteristics with the learning involved in the acquisition of executive functions, and no study has investigated this for planning and problem‐solving skills in the developing brain of children. The present study examined whether children's sleep stages and microstructural sleep characteristics are associated with performance improvement over repeated assessments of the Tower of Hanoi task, which requires integrated planning and problem‐solving skills. Thirty children (11 boys, mean age 10.7 years, SD = 0.8) performed computerized parallel versions of the Tower of Hanoi three times across 2 days, including a night with polysomnographically assessed sleep. Pearson correlations were used to evaluate the associations of Tower of Hanoi solution time improvements across repeated assessments with sleep stages (% of total sleep time), slow‐wave activity, and fast and slow spindle features. The results indicated a stronger performance improvement across wake in children with more Stage N2 sleep and less slow‐wave sleep. Stronger improvements across sleep were present in children in whom slow spindles were more dense, and in children in whom fast spindles were less dense, of shorter duration and had less power. The findings indicate that specific sleep electroencephalography signatures reflect the ability of the developing brain to acquire and improve on integrated planning and problem‐solving skills.     

Topographic distribution of sleep spindles in young healthy subjects

The application of an automatic sleep spindle detection procedure allowed the documentation of the topographic distribution of spindle characteristics, such as number, amplitude, frequency and duration, as a function of sleep depth and of recording time. Multichannel all-night EEG recordings were performed in 10 normal healthy subjects aged 20–35 years. Although the interindividual variability in the number of sleep spindles was very high (2.7±2.1 spindles per minute stage 2 sleep), all but two subjects showed maximal spindle activity in centro-parietal midline leads. Moreover, this topography was seen in all sleep stages and changed only slightly – to a more central distribution – towards the end of the night. On the other hand, slow (11.5–14 Hz) and fast (14–16 Hz) spindles showed a completely different topography, with slow spindles distributed anteriorly and fast spindles centro-parietally. The number of sleep spindles per min was significant depending on sleep stages, with the expected highest occurrence in stage 2, and on recording time, with a decrease in spindle density from the beginning towards the end of the night. However, spindle amplitude, frequency and individual duration was not influenced by sleep depth or time of the night.     

Spontaneous slow oscillation—slow spindle features predict induced overnight memory retention

Study ObjectivesSynchronization of neural activity within local networks and between brain regions is a major contributor to rhythmic field potentials such as the EEG. On the other hand, dynamic changes in microstructure and activity are reflected in the EEG, for instance slow oscillation (SO) slope can reflect synaptic strength. SO-spindle coupling is a measure for neural communication. It was previously associated with memory consolidation, but also shown to reveal strong interindividual differences. In studies, weak electric current stimulation has modulated brain rhythms and memory retention. Here, we investigate whether SO-spindle coupling and SO slope during baseline sleep are associated with (predictive of) stimulation efficacy on retention performance.MethodsTwenty-five healthy subjects participated in three experimental sessions. Sleep-associated memory consolidation was measured in two sessions, in one anodal transcranial direct current stimulation oscillating at subjects individual SO frequency (so-tDCS) was applied during nocturnal sleep. The third session was without a learning task (baseline sleep). The dependence on SO-spindle coupling and SO-slope during baseline sleep of so-tDCS efficacy on retention performance were investigated.ResultsStimulation efficacy on overnight retention of declarative memories was associated with nesting of slow spindles to SO trough in deep nonrapid eye movement baseline sleep. Steepness and direction of SO slope in baseline sleep were features indicative for stimulation efficacy.ConclusionsFindings underscore a functional relevance of activity during the SO up-to-down state transition for memory consolidation and provide support for distinct consolidation mechanisms for types of declarative memories.     

Variations in slow wave activity during sleep in the rat

Scoring of human electroencephalogram (EEG) recordings usually includes subdivisions of non-rapid eye movement (NREM) sleep based on amount of slow wave activity. This procedure has revealed relationships between slow wave activity and many other variables. In animals, however, few experimenters have described variations in slow wave activity within NREM sleep. The present study quantifies, by filtering and integration techniques, variations in amount of slow wave activity during NREM sleep in the rat. Slow wave activity was found to be greatest at the start of the light period; the diurnal variation of slow wave activity within NREM sleep was correlated with variations in amount of NREM sleep. An amplitude criterion was used to define NREM sleep, but overall EEG amplitude during NREM sleep did not show the same diurnal variation as slow wave activity. The results indicate the value of measuring variations in slow wave amplitude during NREM sleep in animals in addition to overall EEG amplitude.     

Investigation of sleep spindle activity and morphology as predictors of neurocognitive functioning in medicated patients with schizophrenia

Neurocognitive impairment is a trait marker of schizophrenia, but no effective treatment has yet been identified. Sleep spindle deficits have been associated with diminished sleep‐dependent memory learning. We examined whether this link could be extended into various cognitive domains by investigating the association of a neurocognitive test battery (the Brief Assessment of Cognition in Schizophrenia) with sleep spindle activity and morphology. We examined 37 outpatients diagnosed with schizophrenia and medicated with both antipsychotics and benzodiazepines. Participants underwent 1 night polysomnography and test of neurocognitive functioning. We identified and analysed sleep spindles in all non‐rapid eye movement sleep and in non‐rapid eye movement sleep stage 2 in a central electroencephalography channel using an automatic sleep spindle detector previously validated. Slow sleep spindle density was computed from a frontal electroencephalography channel as well. We found no association between cognitive functioning and sleep spindle density or sleep spindle morphology for spindles in non‐rapid eye movement sleep when controlling for gender, age, symptom severity, and daily dose of antipsychotics and benzodiazepines. For spindles in non‐rapid eye movement sleep stage 2, we found that motor speed was associated with frontal slow sleep spindle density. We conclude that frontal slow spindle density might predict motor speed in medicated patients with schizophrenia, but that no other sleep spindle activity or sleep spindle morphology measures were predictors of neurocognitive functioning.     

Cortical thinning and sleep slow wave activity reductions mediate age-related improvements in cognition during mid-late adolescence

Study ObjectivesGains in cognitive test performance that occur during adolescence are associated with brain maturation. Cortical thinning and reduced sleep slow wave activity (SWA) are markers of such developmental changes. Here we investigate whether they mediate age-related improvements in cognition.Methods109 adolescents aged 15–19 years (49 males) underwent magnetic resonance imaging, polysomnography (PSG), and a battery of cognitive tasks within a 2-month time window. Cognitive tasks assessed nonverbal intelligence, sustained attention, speed of processing and working memory and executive function. To minimize the effect of sleep history on SWA and cognitive performance, PSG and test batteries were administered only after at least 8 nights of 9-h time-in-bed (TIB) sleep opportunity.ResultsAge-related improvements in speed of processing (r = 0.33, p = 0.001) and nonverbal intelligence (r = 0.24, p = 0.01) domains were observed. These cognitive changes were associated with reduced cortical thickness, particularly in bilateral temporoparietal regions (rs = −0.21 to −0.45, ps < 0.05), as well as SWA (r = −0.35, p < 0.001). Serial mediation models found that ROIs in the middle/superior temporal cortices, together with SWA mediated the age-related improvement observed on cognition.ConclusionsDuring adolescence, age-related improvements in cognition are mediated by reductions in cortical thickness and sleep SWA.     

Shorter duration of non‐rapid eye movement sleep slow waves in EphA4 knockout mice

Slow waves occurring during non‐rapid eye movement sleep have been associated with neurobehavioural performance and memory. In addition, the duration of previous wakefulness and sleep impacts characteristics of these slow waves. However, molecular mechanisms regulating the dynamics of slow‐wave characteristics remain poorly understood. The EphA4 receptor regulates glutamatergic transmission and synaptic plasticity, which have both been linked to sleep slow waves. To investigate if EphA4 regulates slow‐wave characteristics during non‐rapid eye movement sleep, we compared individual parameters of slow waves between EphA4 knockout mice and wild‐type littermates under baseline conditions and after a 6‐h sleep deprivation. We observed that, compared with wild‐type mice, knockout mice display a shorter duration of positive and negative phases of slow waves under baseline conditions and after sleep deprivation. However, the mutation did not change slow‐wave density, amplitude and slope, and did not affect the sleep deprivation‐dependent changes in slow‐wave characteristics, suggesting that EphA4 is not involved in the response to elevated sleep pressure. Our present findings suggest a role for EphA4 in shaping cortical oscillations during sleep that is independent from sleep need.     

NREM sleep EEG slow waves in autistic and typically developing children: Morphological characteristics and scalp distribution

Autism is a developmental disorder with a neurobiological aetiology. Studies of the autistic brain identified atypical developmental trajectories that may lead to an impaired capacity to modulate electroencephalogram activity during sleep. We assessed the topography and characteristics of non‐rapid eye movement sleep electroencephalogram slow waves in 26 boys aged between 6 and 13 years old: 13 with an autism spectrum disorder and 13 typically developing. None of the participants was medicated, intellectually disabled, reported poor sleep, or suffered from medical co‐morbidities. Results are derived from a second consecutive night of polysomnography in a sleep laboratory. Slow waves (0.3–4.0 Hz; >75 µV) were automatically detected on artefact‐free sections of non‐rapid eye movement sleep along the anteroposterior axis in frontal, central, parietal and occipital derivations. Slow wave density (number per minute), amplitude (µV), slope (µV s^?1) and duration (s) were computed for the first four non‐rapid eye movement periods. Slow wave characteristics comparisons between groups, derivations and non‐rapid eye movement periods were assessed with three‐way mixed ANOVAs. Slow wave density, amplitude, slope and duration were higher in anterior compared with most posterior derivations in both groups. Children with autism spectrum disorder showed lower differences in slow waves between recording sites along the anteroposterior axis than typically developing children. These group differences in the topography of slow wave characteristics were stable across the night. We propose that slow waves during non‐rapid eye movement sleep could be an electrophysiological marker of the deviant cortical maturation in autism linked to an atypical functioning of thalamo‐cortical networks.     

Naps reliably estimate nocturnal sleep spindle density in health and schizophrenia

Sleep spindles, defining oscillations of non‐rapid eye movement stage 2 sleep (N2), mediate memory consolidation. Spindle density (spindles/minute) is a stable, heritable feature of the sleep electroencephalogram. In schizophrenia, reduced spindle density correlates with impaired sleep‐dependent memory consolidation and is a promising treatment target. Measuring sleep spindles is also important for basic studies of memory. However, overnight sleep studies are expensive, time consuming and require considerable infrastructure. Here we investigated whether afternoon naps can reliably and accurately estimate nocturnal spindle density in health and schizophrenia. Fourteen schizophrenia patients and eight healthy controls had polysomnography during two overnights and three afternoon naps. Although spindle density was lower during naps than nights, the two measures were highly correlated. For both groups, naps and nights provided highly reliable estimates of spindle density. We conclude that naps provide an accurate, reliable and more scalable alternative to measuring spindle density overnight.     

Modulation of gamma and spindle-range power by slow oscillations in scalp sleep EEG of children

Deep sleep is characterized by slow waves of electrical activity in the cerebral cortex. They represent alternating down states and up states of, respectively, hyperpolarization with accompanying neuronal silence and depolarization during which neuronal firing resumes. The up states give rise to faster oscillations, notably spindles and gamma activity which appear to be of major importance to the role of sleep in brain function and cognition. Unfortunately, while spindles are easily detectable, gamma oscillations are of very small amplitude. No previous sleep study has succeeded in demonstrating modulations of gamma power along the time course of slow waves in human scalp EEG. As a consequence, progress in our understanding of the functional role of gamma modulation during sleep has been limited to animal studies and exceptional human studies, notably those of intracranial recordings in epileptic patients.     

The impact of slow wave sleep proximity on evoked K-complex generation

During human stage 2 non-rapid eye movement (NREM) sleep, spontaneous K-complexes are more likely to occur prior to transitions to stage 3 or stage 4 sleep (referred to as slow wave sleep or SWS) compared to transitions to REM sleep, suggesting that the K-complex may be the 'forerunner' of SWS. The present study investigated the impact of SWS or REM sleep proximity on the probability of evoking a K-complex (pKC) during stage 2 and on components of the NREM sleep averaged evoked potential. Ten subjects spent three nights in the laboratory. On either the second or third night tones were presented continuously during sleep. Evoked K-complexes and sleep-evoked potentials were assessed for the 10 min of stage 2 prior to SWS (SWS-10) or REM (REM-10) sleep episodes as well as for all of SWS. pKC did not differ between SWS-10 (0.88) and SWS (0.91) but was significantly larger in SWS-10 than REM-10 (0.63). Amplitude effects were seen for the P2, N350, P900 NREM sleep-evoked potential components but not for the K-complex related N550. In each case where amplitude effects were found, SWS-10 was larger than REM-10. No latency differences were seen between conditions for the earlier components (P2, N350) however, both N550 and P900 were significantly shorter during SWS-10 compared to REM-10. These results are consistent with previous spontaneous K-complex studies and are supportive of a relationship between the K-complex and delta activity. They also indicate that stage 2 may consist of a continuum of microstates between SWS and REM sleep that are indicative of different brain stem, diecephalic and cortical patterns of activation.     

Chronic primary insomnia: possible physiopathological involvement of slow wave sleep deficiency.

This study was designed to compare the sleep of a carefully selected group of patients with chronic primary insomnia toage- and sex-matched controls, in order to investigate the possible physiopathological role of slow wave sleep deficiency in this disturbance. In addition, the effect of age on normal sleep was studied in a group of 40 normal subjects. Sleep was recorded in the laboratory and automatically scored with an electronic system already described. The general trends of sleep stages were computed. Aging in normal subjects was characterized by a sharp decrease of stage 4, but a good stability of stage 3. Insomniacs' sleep showed a sleep-waking imbalance and a marked deficiency in stages 3 and 4. This deficiency seems to be similar to the age effect in normals, but more accentuated; it cannot be attributed merely to increased pressure of wakefulness. We suggest that slow wave sleep is involved in sleep induction and maintenance, and that its deficiency is linked to the fragility of sleep in chronic primary insomnia.