Interaction of REM Deprivation and Stage 4 Deprivation With Total Sleep Loss: Experiment 2

To determine whether prior deprivation of stage REM or stage 4 sleep would potentiate the effects of total sleep loss, 7 young adult males were denied REM sleep and 7 were denied stage 4 sleep for 3 nights before 1 night of total sleep loss. Measures of autonomic and EEG activity, mood, anxiety, Rorschach CET and on several performance tasks were obtained during baseline, following stage deprivation, total sleep loss, and during recovery. There were no marked changes in any area following 3 nights of stage REM and stage 4 deprivation. The changes following total sleep loss were similar for both groups. Prior deprivation of stage REM or stage 4 did not potentiate sleep loss effects. Ss who had no stage deprivation prior to 1 night of sleep loss had more impairment following sleep loss than did the Ss of this study.     

Body Movements During Sleep After Sleep Loss

Following 4 baseline nights, 7 Ss were deprived of REM sleep for 3 nights and 7 were deprived of stage 4 sleep. Both groups were then deprived of total sleep for 1 night and then allowed 2 nights of uninterrupted recovery sleep. Compared to baseline nights, on the first recovery night the number of body movements was significantly reduced in all sleep stages and for total sleep. On the second recovery night, the number of movements was back to baseline level. The increased amount of slow-wave sleep (stages 3 and 4) during recovery sleep was not the primary reason for the reduced body motility.     

REM Sleep Interruption: Experimental Shortening of REM Period Duration

This experiment concerns itself with the extent to which psychological factors can influence normal sleep patterns. After 4 baseline nights of uninterrupted sleep, each of 4 Ss was awakened in the course of 2 nights during every REM period about 10 min following each REM onset. Ss, however, were not REM deprived. The interruption nights were followed by a recovery night of uninterrupted sleep. All nights were consecutive. The results show that during recovery nights all Ss continued to have significantly shorter than normal REM periods by going into NREM sleep at about the time they would have been awakened during the interruption nights. These shortened REM periods occurred even during early morning hours, when REM periods normally become longer. Arguments are advanced that this finding may best be explained in terms of a conditioned avoidance response.     

Sleep Stage Deprivation and Total Sleep Loss: Effects On Sleep Behavior

The combined effects of total sleep loss and the deprivation of stage 4 or stage REM were studied in I two separate experiments. Two full nights or sleep loss preceded stage 4 deprivation or stage REM deprivation in Experiment 1 (N=12); 1 full night of sleep loss followed 3 nights or stage 4 deprivation or stage REM deprivation in Experiment 2 (N=I4). Total sleep loss before sleep stage deprivation significantly increased the number of attempts to enter stage 4, but had little influence on stage REM. A significant REM rebound was found in only one of the REM-deprived groups, but there was a significant stage 4 rebound in all groups on the first full recovery night, supporting the hypothesis from other studies that stage 4 has priority over REM in terms of recovery from sleep loss. The results suggested that stages 2, 3, and 4 partially overlap in their recuperative functions.     

The Effects of Continuous, High Intensity, White Noise on the Human Sleep Cycle

Eight male college students slept for 8 consecutive nights under conditions of 93 ± 2 dB white noise (N) and under normal quiet conditions (Q). On N nights the percentage of total sleep time spent in stage REM was decreased (p < .001), the percentages of stages 1 and 2 were increased (p < .05, p < .001, respectively) and REM latency was increased (p < .02) compared to Q nights prior to N nights. On Q nights following N nights the percentages of stage REM increased above baseline levels indicating compensatory recovery effects from REM sleep deprivation on the prior N nights. Stages 3 and 4 remained unchanged throughout the study. The reduction in stage REM on N nights was directly attributed to the effects of noise on the CNS and not a secondary result of an increased number of awakenings on N nights.     

Reliability of Sleep Measures

The reliability of sleep measures was calculated over two nights (and within the nights) for 20 young adult males. Percent time in stages 1, 2, 3, and 4, percent movement time, number of movements, and number of stage changes were significantly correlated between Ss over nights. The percent REM time and REM cycle duration were not significantly correlated over nights. Within Ss, the length of the REM period had a significant negative correlation with the length of the preceding NREM period but not with the following NREM period. These data raise questions as to the use of the standard sleep measures as reliable human traits in young male adults.     

The Effects of a Chronic Limitation of Sleep Length

Fifteen male subjects (Ss) were studied once each week while on a sleep regime of 5 1/2 hrs of sleep a night for 60 days. The electroencephalogram and electro-oculogram were recorded in the laboratory once each week. Performance was measured each week using the Wilkinson Vigilance Task, the Wilkinson Addition Test, and a word memory test, and grip strength was measured using a hand dynomometer. The Zung Depression Scale and the Gough Adjective Check List were used to measure mood. The Ss completed a sleep log on a daily basis. The effect on sleep of the restricted regime was to initially increase the absolute amount of stage 4 sleep. But by the 5th week of the study the stage 4 amount decreased to near baseline levels. The initial effect on REM sleep was to sharply reduce this type of sleep when compared with baseline values. During the course of the experiment there was a REM deprivation of some 25% of baseline values and 30 min in absolute amount. During the course of the experiment the latency to the onset of the first stage 4 and the latency to the first REM period were reduced. Only the Wilkinson Vigilance Task showed a decline in performance associated with continued restricted sleep. The sleep logs revealed that initially the Ss experienced difficulty in arousing from sleep in the morning and felt drowsy during the day, but these effects did not continue throughout the experiment. The mood scales showed no changes associated with continuing to sleep 5 1/5 hrs a night. These findings suggest that a chronic loss of sleep as much as 2 1/2 hours a night is not likely to result in major behavioral consequences.     

The Reliability of Arousal Threshold During Sleep

Thirty-five subjects from two independent studies were awakened at EEG-defined periods during the night with 1000 Hz ascending tone series. Awakenings were made five to eight times per night during stage 2, stage 4, or REM sleep over a series of nights in good and poor sleepers. Reliability was assessed within stage, within night, between stages, and between nights. Good and poor sleepers did not differ in either depth of sleep or reliability of arousal threshold and were thus pooled in the analyses. From night to night, the most consistency was seen in stage 4 (r=.74), although REM reliability (r?₁= .49) and stage 2 reliability (r?₁= .50 and r?₁= .69 in the two respective studies) estimates were also greater than zero. Early sleep onset and morning arousals were more variable. Reliability estimates on arousal thresholds taken within the same night for stage 2 were r= .64 and r?₁= .77 for the two studies and r= .96 for REM. The depth of sleep was not correlated with awake auditory threshold. It was concluded that five or six carefully placed arousals could give a good estimate of an individual's usual arousal threshold.     

Auditory Evoked Potential in Stage 2 and REM Sleep During a 30-Day Exposure to Tone Pulses

Ten subjects were exposed to 3.5K Hz tone pulses of 660 msec duration, presented 24-hr-per-day for 30 days. The interstimulus interval was 22 sec. There were 10 days each at 80, 85, and 90 dB in that order. The average evoked potential (AEP) at C₃ referenced to linked mastoids was obtained from contiguous stage 2 and REM sleep segments on the first, second, and last recorded nights of tone-pulse exposure. The AEP was consistently larger in stage 2 than in REM sleep. In both stage 2 and REM sleep, AEP amplitude on the second recorded night bore no consistent relationship to first or last recorded night AEPs. Only the N2–P3 amplitude yielded consistent decreases, with 9 of 10 subjects in both stage 2 and REM sleep having smaller N2–P3 amplitudes on the last than on the first recorded night. There were no changes in latency of any component. During sleep there is little, if any, habituation of the auditory AEP during long-duration exposures to nonmeaningful stimuli, and certainly no extinction of the AEP under these conditions.     

Neurobehavioral Dynamics Following Chronic Sleep Restriction: Dose-Response Effects of One Night for Recovery

Objective:

Establish the dose-response relationship between increasing sleep durations in a single night and recovery of neurobehavioral functions following chronic sleep restriction.

Design:

Intent-to-treat design in which subjects were randomized to 1 of 6 recovery sleep doses (0, 2, 4, 6, 8, or 10 h TIB) for 1 night following 5 nights of sleep restriction to 4 h TIB.

Setting:

Twelve consecutive days in a controlled laboratory environment.

Participants:

N = 159 healthy adults (aged 22-45 y), median = 29 y).

Interventions:

Following a week of home monitoring with actigraphy and 2 baseline nights of 10 h TIB, subjects were randomized to either sleep restriction to 4 h TIB per night for 5 nights followed by randomization to 1 of 6 nocturnal acute recovery sleep conditions (N = 142), or to a control condition involving 10 h TIB on all nights (N = 17).

Measurements and Results:

Primary neurobehavioral outcomes included lapses on the Psychomotor Vigilance Test (PVT), subjective sleepiness from the Karolinska Sleepiness Scale (KSS), and physiological sleepiness from a modified Maintenance of Wakefulness Test (MWT). Secondary outcomes included psychomotor and cognitive speed as measured by PVT fastest RTs and number correct on the Digit Symbol Substitution Task (DSST), respectively, and subjective fatigue from the Profile of Mood States (POMS). The dynamics of neurobehavioral outcomes following acute recovery sleep were statistically modeled across the 0 h-10 h recovery sleep doses. While TST, stage 2, REM sleep and NREM slow wave energy (SWE) increased linearly across recovery sleep doses, best-fitting neurobehavioral recovery functions were exponential across recovery sleep doses for PVT and KSS outcomes, and linear for the MWT. Analyses based on return to baseline and on estimated intersection with control condition means revealed recovery was incomplete at the 10 h TIB (8.96 h TST) for PVT performance, KSS sleepiness, and POMS fatigue. Both TST and SWE were elevated above baseline at the maximum recovery dose of 10 h TIB.

Conclusions:

Neurobehavioral deficits induced by 5 nights of sleep restricted to 4 h improved monotonically as acute recovery sleep dose increased, but some deficits remained after 10 h TIB for recovery. Complete recovery from such sleep restriction may require a longer sleep period during 1 night, and/or multiple nights of recovery sleep. It appears that acute recovery from chronic sleep restriction occurs as a result of elevated sleep pressure evident in both increased SWE and TST.

Citation:

Banks S; Van Dongen HPA; Maislin G; Dinges DF. Neurobehavioral dynamics following chronic sleep restriction: dose-response effects of one night for recovery. SLEEP 2010;33(8):1013–1026.     

Enhancing Slow Wave Sleep with Sodium Oxybate Reduces the Behavioral and Physiological Impact of Sleep Loss

Study Objectives:

To investigate whether enhancement of slow wave sleep (SWS) with sodium oxybate reduces the impact of sleep deprivation.

Design:

Double-blind, parallel group, placebo-controlled design

Setting:

Sleep research laboratory

Participants:

Fifty-eight healthy adults (28 placebo, 30 sodium oxybate), ages 18-50 years.

Interventions:

A 5-day protocol included 2 screening/baseline nights and days, 2 sleep deprivation nights, each followed by a 3-h daytime (08:00-11:00) sleep opportunity and a recovery night. Sodium oxybate or placebo was administered prior to each daytime sleep period. Multiple sleep latency test (MSLT), psychomotor vigilance test (PVT), Karolinska Sleepiness Scale (KSS), and Profile of Mood States were administered during waking hours.

Measurements and Results:

During daytime sleep, the sodium oxybate group had more SWS, more EEG spectral power in the 1-9 Hz range, and less REM. Mean MSLT latency was longer for the sodium oxybate group on the night following the first daytime sleep period and on the day following the second day sleep period. Median PVT reaction time was faster in the sodium oxybate group following the second day sleep period. The change from baseline in SWS was positively correlated with the change in MSLT and KSS. During recovery sleep the sodium oxybate group had less TST, SWS, REM, and slow wave activity (SWA) than the placebo group.

Conclusions:

Pharmacological enhancement of SWS with sodium oxybate resulted in a reduced response to sleep loss on measures of alertness and attention. In addition, SWS enhancement during sleep restriction appears to result in a reduced homeostatic response to sleep loss.

Citation:

Walsh JK; Hall-Porter JM; Griffin KS; Dodson ER; Forst EH; Curry DT; Eisenstein RD; Schweitzer PK. Enhancing slow wave sleep with sodium oxybate reduces the behavioral and physiological impact of sleep loss. SLEEP 2010;33(9):1217-1225.     

Variability of Sleep Measures in Normal Subjects

Variability of sleep measures during 4 nights was examined in 10 normal young adults. The variables analyzed included: Sleep Stage Percentages; Sleep Time; Latency, Duration, and Cycle Time of REM; No. of REM Periods; and No. of Eye Movements (EM). No indication of First Night Effect was found, except that EM showed significant increases across nights. Although group means corresponded to conventional norms, considerable inter- and intraindividual variability was apparent, with Stage 2 and REM yielding lowest Variability Coefficients. Between nights, consistent positive correlations were found for Awake, REM, REM Latency, and particularly for Stage 4 and EM. Consistency of the relationship between nights for the sleep stages was not generally improved by equating sleep time either within or between Ss. Few intercorrelations between variables were significant. Within nights the first REM Duration was the shortest and the first Non-REM Duration the longest, while neither REM nor Non-REM Cycle Time changed significantly. In 25% of the records, Stage 3 terminated before Stage 4. Variability was discussed in terms of procedural aspects, trait characteristics, and situational factors.     

Performance and Sleepiness as a Function of Frequency and Placement of Sleep Disruption

Eight normal young adult sleepers spent 4 nonconsecutive weeks in the laboratory. Each week consisted of a baseline night followed by 2 consecutive nights of disrupted sleep, followed by 2 recovery nights. Disruption conditions included: a) brief awakening after each minute of accumulated sleep, b) brief awakening after each 10 min of accumulated sleep, c) 2.5 hrs of normal sleep followed by a brief awakening at each sleep onset, and d) total sleep deprivation. Morning testing revealed that all disruption conditions decreased sleep latency in a morning nap test. Performance after 1-min disruptions approximated that seen after total sleep loss. Performance decrements were less in the 10-min condition and least in the 2.5-hr sleep condition. Performance under baseline and total sleep loss conditions was used to predict performance during the sleep deprivation condition using four sleep stage rules. Total time asleep and total time asleep minus stage 1 predicted performance poorly. Total SWS plus REM predicted performance best but could not differentiate the 10-min and 2.5-hr conditions. Therefore, it was concluded that the data were most parsimoniously explained by the Sleep Continuity Theory—i.e., that periods of uninterrupted sleep in excess of 10 min are required for sleep to be restorative.     

The Effect of Presleep Focal Attention Load on Subsequent Sleep Patterns

The hypothesis that a load on focal attention prior to sleep results in subsequent changes in sleep patterns was investigated. Eight females and 2 males slept in the laboratory for 4 nights: 2 adaptation nights, 1 experimental night preceded by a focal attention load, and 1 control night preceded by relaxed activity. On the experimental night, time in bed, total sleep time, and stage REM sleep were significantly longer than on the control night. The results support the hypothesis and suggest that attention during REM sleep has a unique character.     

Sleep, dreaming, and adaptation to a stressful intellectual activity

Sixteen male subjects slept in the laboratory for 4 consecutive nights. Night 1 was an adaptation night and night 2 was a baseline night of uninterrupted sleep. On nights 3 and 4 subjects were asked to complete "intelligence" tests prior to sleep. One half of the subjects attempted to complete difficult versions of "intelligence" tests without knowing that they could not be completed in te time allotted. The other subjects were given easier versions of the same tests that they were able to complete in the time allotted. Night 3 was a night of uninterrupted sleep and night 4 involved REM period awakenings for the purpose of dream collection. Stressful manipulation consisted of telling the subjects before the administration of either set of tests that an average university student should complete most of the items within the allotted time. On night 3 both groups showed a significant increase in sleep latency and a significant decrease in REM density compared to the baseline night. On night 4 subjects in the difficult condition experienced significantly more anxiety in their dreams and somewhat higher levels of incorporation of the presleep material than subjects in the easy condition. Our findings suggest that following a stressful experience uninterrupted sleep has more short term adaptive value than a procedure which enhances dream recall and that subjects who incorporate elements from a presleep stressful event into their remembered dreams show less adaptation on awakening than subjects who do not.     

Slow Wave Sleep and REM Sleep Awakenings Do Not Affect Sleep Dependent Memory Consolidation

Study Objectives:

The effects of REM sleep and slow wave sleep (SWS) deprivation on sleep-dependent motor and declarative memory consolidation.

Design:

Randomized, within-subject, cross-over study

Setting:

Weekly (women: monthly) sleep laboratory visits, with retest 60 hours later

Participants:

Twelve healthy subjects (6 men) aged between 20 and 30 years

Interventions:

REM sleep deprivation, SWS deprivation, or undisturbed sleep

Measurements and Results:

We deprived subjects once each of REM sleep and SWS, and once let them sleep undisturbed through the night. After each night, we tested declarative and procedural memory consolidation. We tested memory performance by a verbal paired associate task and a sequential finger-tapping task at 21:00 on the study night and again 60 hours later. Although REM sleep and SWS awakenings led to a significant reduction of the respective sleep stages, memory consolidation remained unaffected. We also found a significant correlation between the declarative task and sleep spindles in the undisturbed condition, especially the sleep spindles in the first third of the night.

Conclusion:

We suggest that word-pair learning relies on stage 2 sleep spindles and requires little SWS. Their sleep dependent consolidation is not affected by SWS deprivation. Simple motor tasks may either be consolidated in stage 2 sleep or depend on only small amounts of REM sleep. Their sleep dependent consolidation is not influenced by REM sleep deprivation.

Citation:

Genzel L; Dresler M; Wehrle R; Grözinger M; Steiger A. Slow wave sleep and REM sleep awakenings do not affect sleep dependent memory consolidation. SLEEP 2009;32(3):302–310.     

Sleep deprivation and phasic activity of REM sleep: independence of middle-ear muscle activity from rapid eye movements

In the recovery nights after total and partial sleep deprivation there is a reduction of rapid eye movements during REM sleep as compared to baseline nights; recent evidence provided by a selective SWS deprivation study also shows that the highest percentage of variance of this reduction is explained by SWS rebound. The present study assesses whether the reduction of rapid eye movements (REMs) during the recovery night after total sleep deprivation is paralleled by a decrease of middle-ear muscle activity (MEMA), another phasic muscle activity of REM sleep. Standard polysomnography, MEMA and REMs of nine subjects were recorded for three nights (one adaptation, one baseline, one recovery); baseline and recovery night were separated by a period of 40 hours of continuous wake. Results show that, in the recovery night, sleep deprivation was effective in determining an increase of SWS amount and of the sleep efficiency index, and a decrease of stage 1, stage 2, intra-sleep wake, and NREM latencies, without affecting REM duration and latency. However, MEMA frequency during REM sleep did not diminish during these nights as compared to baseline ones, while there was a clear effect of REM frequency reduction. Results indicate an independence of phasic events of REM sleep, suggesting that the inverse relation between recovery sleep after sleep deprivation and REM frequency is not paralleled by a concomitant variation in MEMA frequency.     

Effects of sleep fragmentation on the arousability to resistive loading in NREM and REM sleep in normal men

STUDY OBJECTIVE: In healthy subjects, arousability to inspiratory resistive loading is greater during rapid eye movement (REM) sleep compared with non-REM (NREM) sleep but is poorest in REM sleep in patients with sleep apnea. We therefore examined the hypothesis that sleep fragmentation impairs arousability, especially from REM sleep. DESIGN: Two blocks of 3 polysomnographies (separated by at least 1 week) were performed randomly. An inspiratory-loaded night followed either 2 undisturbed control nights (LN(C)) or 2 acoustically fragmented nights (LN(F)) SETTING: Sleep laboratory. PARTICIPANTS: Sixteen healthy men aged 20 to 29 years. INTERVENTIONS: In both loaded nights, an inspiratory resistive load was added via a valved facemask every 2 minutes during sleep and turned off either when arousal occurred or after 2 minutes. MEASUREMENTS AND RESULTS: During LN(F), arousability remained significantly greater in REM sleep (71% aroused within 2 minutes) compared with stage 2 (29%) or stage 3/4 (16%) sleep. After sleep fragmentation, arousability was decreased in stage 2 sleep (LN(F): 29%; LN(C): 38%; p < .05) and low in early REM sleep, increasing across the night (p < .01). In stage 3/4 sleep, neither an attenuation nor a change across the night was seen after sleep fragmentation. CONCLUSIONS: Mild sleep fragmentation is already sufficient to attenuate arousability in stage 2 sleep and to decrease arousability in early, compared with late, REM sleep. This means that sleep fragmentation affects the arousal response to increasing resistance and that the effects are different in stage 2 and REM sleep. The biologic reason for this increase in the arousal response in REM sleep across the night is not clear.     

Modafinil, d-amphetamine and placebo during 64 hours of sustained mental work. II. Effects on two nights of recovery sleep

Polysomnograms were obtained from 37 volunteers, before (baseline) and after (two consecutive recovery nights) a 64-h sleep deprivation, with (d-amphetamine or modafinil) or without (placebo) alerting substances. The drugs were administered at 23.00 hours during the first sleep deprivation night (after 17.5 h of wakefulness), to determine whether decrements in cognitive performance would be prevented; at 05.30 hours during the second night of sleep deprivation (after 47.5 h of wakefulness), to see whether performance would be restored; and at 15.30 hours during the third day of continuous work, to study effects on recovery sleep. The second recovery night served to verify whether drug-induced sleep disturbances on the first recovery night would carry over to a second night of sleep. Recovery sleep for the placebo group was as expected: the debt in slow-wave sleep (SWS) and REM sleep was paid back during the first recovery night, the rebound in SWS occurring mainly during the first half of the night, and that of REM sleep being distributed evenly across REM sleep episodes. Recovery sleep for the amphetamine group was also consistent with previously published work: increased sleep latency and intrasleep wakefulness, decreased total sleep time and sleep efficiency, alterations in stage shifts, Stage 1, Stage 2 and SWS, and decreased REM sleep with a longer REM sleep latency. For this group, REM sleep rebound was observed only during the second recovery night. Results for the modafinil group exhibited decreased time in bed and sleep period time, suggesting a reduced requirement for recovery sleep than for the other two groups. This group showed fewer disturbances during the first recovery night than the amphetamine group. In particular, there was no REM sleep deficit, with longer REM sleep episodes and a shorter REM latency, and the REM sleep rebound was limited to the first REM sleep episode. The difference with the amphetamine group was also marked by less NREM sleep and Stage 2 and more SWS episodes. No REM sleep rebound occurred during the second recovery night, which barely differed from placebo. Hence, modafinil allowed for sleep to occur, displayed sleep patterns close to that of the placebo group, and decreased the need for a long recovery sleep usually taken to compensate for the lost sleep due to total sleep deprivation.     

Sleep Stage Physiology, Mood, and Vigilance Responses to Total Sleep Deprivation in Healthy 80-Year-Olds and 20-Year-Olds

Little is known about sleep and the effects of total sleep loss in the 'old old' (i.e., 80-year-olds). We investigated sleep, mood, and performance responses to acute sleep deprivation in healthy 80-year-olds (n = 10) and 20-year-olds (n = 14). The protocol consisted of three nights of baseline sleep, one night of total sleep deprivation, and two nights of recovery sleep. Mood and vigilance were tested using visual analog scales and a Mackworth clock procedure in the morning and evening of each study day. Daytime sleepiness was measured by five naps on the days following the third and sixth nights. Old subjects had lower sleep efficiency and less delta sleep than young subjects. However, sleep continuity and delta sleep were enhanced in both groups on the first recovery night, indicating that sleep changes in old subjects are at least partially reversible by this procedure. Surprisingly, young subjects had shorter daytime sleep latencies than the old, suggesting a greater unmet sleep need in the former group. Mood and performance were disturbed by sleep loss in both groups, but to a greater extent among the young. This suggests that acute total sleep loss is a more disruptive procedure for the young than for the old.