Cardiovascular changes associated with spontaneous and evoked K-complexes

This study examines the relationship between blood pressure and spontaneous and sound-evoked K-complexes (KCs) during stage 2 NREM sleep, in 8 volunteers studied by intraarterial blood pressure (BP) monitoring and polysomnography. A robust oscillation of blood pressure with a period of 16-30 s (Mayer waves) was seen in all subjects. Spontaneous KCs predominantly occurred during a drop (downward slope) in blood pressure. Randomly administered sound stimuli were more likely to evoke a KC if the stimulus was given during a downward slope of BP. During the last 20 s prior to a sound-evoked KC, the mean drop in systolic BP was 0.3 mmHg, and evoked and spontaneous K-complexes were preceded by a mean drop in BP of 1.9 and 2.7 mmHg, respectively. Finally, K-complexes, either spontaneous or evoked, during the first 6 s, induced a rise in systolic BP. The results indicate that if the BP falls during stage 2 NREM sleep, there is a greater likelihood that an external stimulus will evoke a K-complex and that spontaneous K-complexes may occur more frequently as well. Spontaneous and evoked K-complexes may play a role in the control of BP during NREM sleep.     

睡眠相关性癫痫儿童全夜自然睡眠结构变化的研究

目的：探讨睡眠相关性癫痫儿童发作间期全夜自然睡眠结构的特点以及与正常对照组睡眠结构的差异。方法：对53例癫痫患儿和20例对照组健康儿童进行全夜自然睡眠多项睡眠图（PSG）监测并分析其结果,评价患儿与正常对照组间各睡眠参数的差异。结果：53例睡眠相关性癫痫儿童的全夜睡眠结构与对照组比较,显示NREMⅢ＋Ⅳ期睡眠及REM睡眠时间减少,NREMI及Ⅱ期睡眠时间增加,睡眠效率下降,睡眠潜伏期延长;REM期睡眠时间减少,入睡后觉醒时间增加,觉醒次数增多。结论：睡眠相关性癫痫患儿存在睡眠结构紊乱,并伴有多项睡眠生理参数改变,其睡眠质量下降。     

Evoked potential components unique to non-REM sleep: relationship to evoked K-complexes and vertex sharp waves.

Following the loss of wakeful consciousness, the averaging of responses to stimuli produce evoked potential waveforms with prominent components either unique to or greatly enhanced by non-REM sleep. In the sleep onset periods (stage 1) these are the P2 and N350. Following the establishment of stable sleep (stage 2 and SWS), the N550 and P900 are also prominent. Investigation of the EEG associated with individual responses indicates that a good proportion of stimuli elicit, K-complexes or vertex sharp waves (VSWs) and occasionally will elicit both. Recent work has indicated that the N550 in the averaged response is due to the presence of K-complexes and that the N350 is at least largely due to the presence of VSWs. The large size of these grapho-elements indicates that they are probably produced by a synchronized discharge of multiple neural units. Both are readily observed in the absence of external stimulation and occur as normal components of sleep, indeed the K-complex is used as one of the identifying features of the onset of stable non-REM sleep. The present review details the investigation of these features and their associated evoked potential components, in terms of stimulus features, brain states associated with their production, their scalp topography, and changes as a function of age.     

Slow sleep oscillation, rhythmic K-complexes, and their paroxysmal developments

This paper presents the relations between the slow (< 1 Hz) oscillation (characterizing the activity of corticothalamic networks during quiescent sleep in cats and humans), sleep K-complexes, and some paroxysmal developments of sleep patterns. At the cellular level, the slow oscillation is built up by rhythmic membrane depolarizations and hyperpolarizations of cortical neurons. The EEG expression of this activity is marked by periodic K-complexes which reflect neuronal excitation. The slow oscillation triggers, groups and synchronizes other sleep rhythms, such as thalamically generated spindles as well as thalamically and cortically generated delta oscillations. We discuss the distinctness of the slow (< 1 Hz) and delta (1–4 Hz) oscillations. We also show that the slow cortical oscillation underlies the onset of spike-wave seizures during sleep by transforming the periodic K-complexes into recurrent paroxysmal spike-wave complexes.     

Increased spontaneous eye blink rate following prolonged wakefulness

Sleep deprivation (SD) is a technique of sleep-wake manipulation which has been used to treat depression. Changes in neurotransmitter systems, that are also involved in the effects of the antidepressant drugs, have been suggested as the possible mechanisms of action of SD. However, the therapeutic effect of SD is acute and transient, while antidepressant effects of drug treatments are gradual and stable. SD might work throughout mechanisms that are different from those mediating drug's effects. In the present study we analyzed the role of dopamine activity in SD. Spontaneous eye blink rate provides a non invasive measure of central dopamine activity. We assessed eye blink rate across prolonged wakefulness (from 10:00 a.m. to 07:00 a.m.) in 25 young normal subjects. Eye blink rate increased at the end of the wakefulness period. Blink rates and sleepiness as assessed by Karolinska Sleepiness Scale correlated positively with time spent awake. We propose that increased blink rate might reflect a dopamine activation that counteracts sleep drive. Antidepressant effects of sleep deprivation might be related to activation of the physiological mechanisms which regulate wake maintenance.     

The night before night shift: Chronotype impacts total sleep and rapid eye movement sleep during a strategically delayed sleep

Transition to night shift may be improved by strategically delaying the main sleep preceding a first night shift. However, the effects of delayed timing on sleep may differ between chronotypes. Therefore, the study aim was to compare the impacts of chronotype on sleep quality and architecture during a normally timed sleep opportunity and a delayed sleep opportunity. Seventy-two (36 female, 36 male) healthy adults participated in a laboratory study. Participants were provided with a normally timed sleep opportunity (23:00–08:00) and a delayed sleep opportunity (03:00–12:00) over two consecutive nights in a sleep laboratory. Sleep was monitored by polysomnography (PSG), and chronotype was determined from dim light melatonin onset (DLMO). A tertile split of DLMO defined early (20:24 ± 0:42 h), intermediate (21:31 ± 0:12 h), and late chronotype (22:56 ± 0:54 h) categories. Although there was no main effect of chronotype on any sleep measure, early chronotypes obtained less total sleep with delayed sleep than with normally timed sleep (p = 0.044). Intermediate and late chronotypes obtained more rapid eye movement (REM) sleep with delayed sleep than with normally timed sleep (p = 0.013, p = 0.012 respectively). Wake was more elevated for all chronotypes in the later hours of the delayed sleep opportunity than at the start of the sleep opportunity. Strategically delaying the main sleep preceding a first night shift appears to benefit intermediate and late chronotypes (i.e., more REM sleep), but not early chronotypes (i.e., less total sleep). Circadian processes appear to elevate wakefulness for all chronotypes in the later stages of a delayed sleep opportunity.     

Increased cerebral response during a divided attention task following sleep deprivation

We recently reported that the brain showed greater responsiveness to some cognitive demands following total sleep deprivation (TSD). Specifically, verbal learning led to increased cerebral activation following TSD while arithmetic resulted in decreased activation. Here we report data from a divided attention task that combined verbal learning and arithmetic. Thirteen normal control subjects performed the task while undergoing functional magnetic resonance imaging (FMRI) scans after a normal night of sleep and following 35 h TSD. Behaviourally, subjects showed only modest impairments following TSD. With respect to cerebral activation, the results showed (a) increased activation in the prefrontal cortex and parietal lobes, particularly in the right hemisphere, following TSD, (b) activation in left inferior frontal gyrus correlated with increased subjective sleepiness after TSD, and (c) activation in bilateral parietal lobes correlated with the extent of intact memory performance after TSD. Many of the brain regions showing a greater response after TSD compared with normal sleep are thought to be involved in control of attention. These data imply that the divided attention task required more attentional resources (specifically, performance monitoring and sustained attention) following TSD than after normal sleep. Other neuroimaging results may relate to the verbal learning and/or arithmetic demands of the task. This is the first study to examine divided attention performance after TSD with neuroimaging and supports our previous suggestion that the brain may be more plastic during cognitive performance following TSD than previously thought.     

Sleepiness/alertness on a simulated night shift following sleep at home with triazolam

Physiological sleep tendency during a simulated night shift schedule was examined in 15 middle-aged subjects following daytime sleep after administration of triazolam or placebo. A double-blind, counterbalanced, crossover design involving two tours of five laboratory nights and four daytime home sleep periods was used. Triazolam lengthened daytime sleep as measured by wrist actigraph and improved nighttime alertness as measured by the MSLT. Sleepiness was most profound during the early morning hours (0430 to 0630) but improved significantly across nights for both conditions. Repeated test of sustained wakefulness latencies and simulated assembly line task performance decreased slightly across the night, but there were no significant condition effects. Subjective data tended to support objective measures, although Stanford Sleepiness Scale ratings indicated that subjects did not perceive improved alertness at night after triazolam-aided daytime sleep.     

Nasal and sleep cycle--possible synchronization during night sleep

Regular cyclic changes in nostril airflow due to a nasal congestion and decongestion are known in literature as nasal cycle. Registration of breathing from each nostril separately gives possibility to registrate moments of alternative change of airflow of nostrils and periods of nasal cycle. This registration during night sleep shows that the length of these periods are about 1.5h, 3.0 h and 4.5h. The length of these periods are multiple of mean length of sleep cycle--about 1.5h. The alternative change of airflow through nostrils occurs through some of REM stages of the sleep. This shows, that during the night sleep becomes synchronization of nasal and sleep cycles in some of the REM phases of sleep. As a result--length of periods of the nasal cycle are one or more length of sleep cycle.     

Increased IL-10 production during spontaneous apoptosis of monocytes

Monocytes/macrophages undergo apoptosis and are in contact with apoptotic cells both in vitro and in vivo. The data show that monocytes undergoing spontaneous apoptosis in vitro change their cytokine production profile. We demonstrate that the lipopolysaccharide (LPS)-induced production of interleukin-10 (IL-10) is up-regulated, while production of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) is either not affected or reduced. These differences seen both at the protein and mRNA level directly correlate with the appearance of apoptotic cells in the culture. Flow cytometry analysis using double staining, surface with annexin V and intracellular with anti-IL-10, suggested that annexin V-negative monocytes are the predominant source of IL-10. Analysis of sorted populations of monocytes indicated that the increase in IL-10 synthesis appears to result from direct interactions between non-apoptotic and apoptotic cells at the time of stimulation. Also non-apoptotic, freshly isolated monocytes produced more IL-10 upon stimulation with LPS, Staphylococcus aureus or zymosan when apoptotic neutrophils were added to the culture. In contrast, monocyte-derived macrophages did not produce more IL-10 in the presence of apoptotic neutrophils. Finally, we found that the presence of apoptotic monocytes in the culture may influence specific immune responses. The data show that in the presence of annexin V-positive monocytes CD4-positive memory T cells produce less IFN-gamma upon stimulation with purified protein derivative of tuberculin, which could be partially reversed by anti-IL-10 neutralizing antibodies. We conclude that these findings might illustrate the mechanisms operating within an inflammatory site and play an important immunoregulatory role during the resolution of inflammation and specific immune responses.     

Recovery sleep at different times of the night following loss of the last four hours of sleep

The sleep of 8 women was restricted to the first half of the night for 1 night on two separate occasions. On each occasion, heavy loss of REM (64%) and stage 2 (60%) with only a relatively light loss (20%) of slow wave sleep resulted. The purpose of the present study was to investigate whether or not the circadian timing of recovery sleep, particularly the second 4 h, would affect the response of the sleep system to the differential loss of the sleep stages. Recovery sleep commenced at 2000 h (i.e., after a normal daily span of 16 h of wakefulness) and was either continuous or interrupted after 4 h with 4 h of enforced wakefulness. Thus, the second 4 h of recovery sleep occurred between either 0000-0400 h or 0400-0800 h, two periods of the night normally associated with low and high levels of REM, respectively. The composition of recovery sleep, particularly the level of REM sleep, was found to be relatively unaffected by circadian factors. Instead, the response of the sleep system was mainly determined by stage 4 debt. It was suggested that obtaining a daily stage 4 quota acts as the primary drive mechanism of the sleep system.     

Source estimation of spontaneous MEG activity and auditory evoked responses in normal subjects during sleep

Summary This study focuses on source estimation of spontaneous MEG activity and auditory evoked responses during sleep. Sources of K-complexes and auditory evoked responses were investigated by magnetoencephalograph (MEG) and electroencephalograph (EEG) measurements, simultaneously. Sources of K-complexes during stage 2 sleep were investigated. The MEG results suggested that the sources of K-complexes can be modeled by two current dipoles. Dipoles for the K-complexes were estimated to be located 5 mm away from the sources of the N100 components of auditory evoked responses during wakefulness. Sources of auditory evoked responses during each sleep stage were also investigated to clarify the origins of the K-complex, the vertex sharp transient, and delta waves. Estimated dipoles for the N100 component for each sleep stage were estimated to be at slightly different locations in the auditory area. Based upon results of the MEG measurements and the EEG topographies, sources of the N330 component can be modeled by multiple current dipoles, which are seen to be distributed diffusely throughout the cerebral cortex.This work was supported in part by the grant 03505002, from the Ministry of Education Science and Culture, Japan.     

Functional brain imaging of a complex navigation task following one night of total sleep deprivation: a preliminary study

Several neuroimaging studies have demonstrated compensatory cerebral responses consequent to sleep deprivation (SD), but all have focused on simple tasks with limited behavioral response options. We assessed the cerebral effects associated with SD during the performance of a complex, open-ended, dual-joystick, 3D navigation task (simulated orbital docking) in a cross-over protocol, with counterbalanced orders of normal sleep (NS) and a single night of total SD (approximately 27 h). Behavioral performance on multiple measures was comparable in the two sleep conditions. Functional magnetic resonance imaging revealed multiple compensatory SD > NS cerebral responses, including the posterior superior temporal sulcus [Brodmann area (BA) 39/22/37], prefrontal cortex (BA 9), lateral temporal cortex (BA 22/21), and right substantia nigra. Right posterior cingulate cortex (BA 31) exhibited NS > SD activity. Our findings extend the compensatory cerebral response hypothesis to complex, open-ended tasks.     

Increased antibody production following depression of hepatic phagocytosis.

The influence of Kupffer cell blockade on the humoral immune response to suboptimal doses of intravenous sheep red blood cells has been measured in mice. Hepatic phagocytosis was suppressed using dextran sulphate. Direct (IgM) and indirect (IgG) plaque-forming cells were measured in spleens from treated and untreated mice at varying times after the antigen. The results show that after Kupffer cell blockade both IgM and IgG responses correspond to the responses seen after a 10-fold greater dose of cells in control animals. The implications of this are discussed.     

Increased natural killer cell cytotoxicity and IL-2 production in recurrent spontaneous abortion

PROBLEM: To determine whether natural killer (NK) cells cytotoxicity in peripheral blood is altered in patients with a history of recurrent spontaneous abortion (RSA); also, if there is any correlation between cytokine production and NK cytotoxicity. METHOD OF STUDY: In this case-control study, 21 patients with RSA within 24 hr of the last abortion (group I), and 32 pregnants with no history of abortion (group II) were surveyed. NK cell cytotoxicity was evaluated by flow cytometry, and IL-2, IL-10, transforming growth factor beta1 were measured in cell culture supernatant by ELISA method. RESULTS: Group I showed higher NK cytotoxicity than group II at all of effector to target (E:T) ratios (P < or = 0.045).The correlation between production of IL-2 and NK cytotoxicity was positively significant (R = 0.350, P = 0.001). Group I had significantly higher levels of IL-2 than group II (P = 0.001). In group II, the production of IL-10 by peripheral blood mononuclear cells was higher than group I (P = 0.002). CONCLUSION: Increased NK cell cytotoxicity and high level of IL-2 may be considered as a risk factor for RSA.     

Oxygen consumption during sleep: influence of sleep stage and time of night

We measured oxygen consumption (VO2) in eight normal male volunteers during sleep, using the ventilated-hood method. Data were collected over 28 subject-nights. There was an overnight trend of gradually decreasing VO2 in the first 4 h, followed by a rise toward the morning. The minimum VO2 was 7.9% lower than that in the first hour. To examine the influence of sleep stages on the VO2, we compared the VO2 of a sleep stage (an overnight average of all epochs in that stage) with that of other stages. The results show that VO2 values in stages awake and 1 are significantly higher than all other stages. Stage rapid eye movement (REM) is significantly lower than stage 2, but stages 3 and 4 are not different from each other or from stages REM and 2. We also compared VO2 of sleep stages that occurred close to each other (within the same hour). VO2 in awake stage is again significantly higher than in all other stages, and stage 2 is higher than stages 3 and 4. However, no difference is found between stage 1 and stages 2, 3 and REM, nor is there any difference between REM and stages 2 and 3. The discrepancy between close-stage comparison and overnight-average comparison can be accounted for by the variation in VO2 of an individual stage with the time of night. Although there is a variation in time distribution of the stages overnight, this factor influences the overnight trend of VO2 in a minor fashion only.     

Daytime noise and subsequent night sleep in man

Summary The effects of daytime noise on recovery processes during subsequent undisturbed night sleep were studied in six healthy men (21–27 years), exposed to 80 dB (A) pink noise 8 h per day for 2 days. Sleep EEG, ECG, and respiration were recorded in the laboratory for five consecutive nights: two baseline nights, two nights following noise stimulation, and again one baseline night. Additionally questionnaire data were collected, reflecting a subjective impairment of the recovery function of sleep after noise exposure. EEG sleep data of the first post-noise night showed an increase in slow wave sleep with a simultaneous decrease in stage 2 sleep. During the second post-noise night these changes were less prominent. Three subjects additionally showed an instability in the sleep course coinciding with elevated heart and respiration rates. However, altogether the autonomic parameters were not clearly affected by the noise exposure. The findings support the assumption that strong daytime noise may interfere with subsequent sleep processes.Part of this work was presented at the Sixth European Congress of Sleep Research, Zürich, Switzerland 1982     

Photically evoked potentials in the visual cortex following paradoxical sleep deprivation in rats

Immediately following 72 hr of paradoxical sleep (PS) deprivation, the P3-N3 amplitude of the photically evoked response in the visual cortex was measured in waking rats. PS deprivation was achieved instrumentally by one of three different techniques: the classical platform, the multiple platform, or the pendulum technique. For each of the techniques a control condition was run additionally. The PS deprivation effect consisted of a decrement in the P3-N3 amplitude, which was interpreted as indicating an increase in tonic arousal having a depressing influence on cortical excitability. Concomitantly, a relatively large technique effect occurred, in which the difference between the two platform techniques on the one hand, and the pendulum technique on the other, was most apparent. The same factors did not influence behavioural activity taking place during the presentation of photic stimulation, but did during the preceding 5 min adaptation period. Although the present findings are in contrast with previous reports in animals, they may not be inconsistent with the basic idea of the neural excitability hypothesis of PS.