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Night-to-night arousal variability and interscorer reliability of arousal measurements.

STUDY OBJECTIVES: Measurement of arousals from sleep is clinically important, however, their definition is not well standardized, and little data exist on reliability. The purpose of this study is to determine factors that affect arousal scoring reliability and night-to-night arousal variability. DESIGN: The night-to-night arousal variability and interscorer reliability was assessed in 20 subjects with and without obstructive sleep apnea undergoing attended polysomnography during two consecutive nights. Five definitions of arousal were studied, assessing duration of electroencephalographic (EEG) frequency changes, increases in electromyographic (EMG) activity and leg movement, association with respiratory events, as well as the American Sleep Disorders Association (ASDA) definition of arousals. SETTING: NA. PATIENTS: NA. INTERVENTIONS: NA. RESULTS: Interscorer reliability varied with the definition of arousal and ranged from an Intraclass correlation (ICC) of 0.19 to 0.92. Arousals that included increases in EMG activity or leg movement had the greatest reliability, especially when associated with respiratory events (ICC 0.76 to 0.92). The ASDA arousal definition had high interscorer reliability (ICC 0.84). Reliability was lowest for arousals consisting of EEG changes lasting <3 seconds (ICC 0.19 to 0.37). The within subjects night-to-night arousal variability was low for all arousal definitions CONCLUSION: In a heterogeneous population, interscorer arousal reliability is enhanced by increases in EMG activity, leg movements, and respiratory events and decreased by short duration EEG arousals. The arousal index night-to-night variability was low for all definitions.

Arousal↗

Effect of cognitive arousal on sleep latency, somatic and cortical arousal following partial sleep deprivation.

Emerging research has shown that sleepiness, defined as the tendency to fall asleep, is not only determined by sleep pressure and time of day, but also by physiological and cognitive arousal. In this study we evaluated (i) the impact of experimentally induced cognitive arousal on electroencephalogram (EEG) defined sleep latency, and subjective, somatic and cortical arousal, and (ii) whether experimentally induced cognitive arousal enhances performance on a driving simulator test. Twelve healthy sleepers each spent three nights and the following day in the sleep laboratory: an adaptation, a cognitive arousal and a neutral testing day. In the cognitive arousal condition, a visit of a television camera crew took place and subjects were asked to be interviewed. On each testing day, a 5-min heart rate recording, subjective sleepiness and arousal scales, Multiple Sleep Latency Test and a 25-min driving simulator task were scheduled three times at 2-h intervals. Experimentally induced cognitive arousal resulted in significant increases in objective sleep latency. Significantly elevated levels of subjective and somatic arousal--as indexed by a subjective arousal scale and heart rate--were also evidenced following cognitive arousal induction. A marginally significant trend for increased cortical arousal, measured by EEG beta activity, was also found. No effects were found on driving simulator performance. These findings support the concept of cognitive arousal as a significant component in determining sleep latency. In addition, it was illustrated that cognitively induced arousal can provoke increases in somatic and possibly even cortical arousal in normal sleepers. However, this was not accompanied by an enhanced ability to perform adequately on a driving simulator test.

Adaptation, Physiological↗

Effects of cognitive arousal and physiological arousal on sleep perception.

STUDY OBJECTIVES: Two experiments were conducted to investigate the effect of presleep arousal on sleep perception. Experiment 1 examined the link between presleep cognitive arousal and distorted perception of sleep and compared the relative effect of anxious and neutral cognitive arousal on sleep perception. Experiment 2 compared the relative effect of anxious cognitive arousal and physiological arousal on sleep perception. DESIGN: Participants completed a nap session. Just prior to the nap, the participants were randomly assigned to 1 of 3 groups to receive different arousal manipulations. They were then allowed to go to sleep and were asked to report their sleep perception upon waking. SETTING: Sleep laboratory. PARTICIPANTS: Fifty-four healthy good sleepers in each experiment. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Self-reported sleep, actigraphy-defined sleep, and the discrepancy between them were indexed. In Experiment 1, participants who were experimentally manipulated to experience anxious cognitive arousal during the presleep period reported longer sleep-onset latency. Both the Anxious Cognitive Arousal Group and the Neutral Cognitive Arousal Group exhibited a greater discrepancy between self-reported and actigraphy-defined sleep, relative to participants who received no manipulation. In Experiment 2, participants who were experimentally manipulated to experience anxious cognitive arousal or physiological arousal during the presleep period reported longer sleep-onset latency and shorter total sleep time, and both groups exhibited a greater discrepancy between the self-reported and actigraphy-defined sleep, relative to participants who received no manipulation. CONCLUSIONS: Results suggest that both presleep cognitive arousal and presleep physiological arousal contribute to distorted perception of sleep.

Adolescent↗

Cardiac activation during arousal in humans: further evidence for hierarchy in the arousal response.

OBJECTIVES: One major subject of discussion in sleep studies is whether bursts of K-complexes (K-bursts) and delta waves (D-bursts), expressions of a subcortical arousal, truly reflect an arousal response during sleep. To address this question we studied the changes in heart rate (HR) during spontaneous arousals in healthy subjects. METHODS: Twenty-seven healthy adults were examined. Arousals were graded in 4 levels, including the standard definition of a microarousal (MA), phases of transitory activation (PAT), D-bursts and K-bursts. HR was analyzed for 10 beats before and 20 beats during arousal. EEG spectral analysis was performed for all types of arousals, including in the analysis the 20 s period preceding the actual event. RESULTS: Each type of arousal was associated with HR changes consisting of a tachycardia followed by a bradycardia. Changes were more pronounced during MA and PAT. Detailed analysis of the HR response showed that HR always increased before MA and PAT onset, associated with a rise in delta, theta and fast EEG activities, and suggesting a cerebral activation. CONCLUSIONS: Our data suggest that such subcortical arousals represent a real arousal response inducing cardiac activation similar to that found during MA and PAT. During MA and PAT, a rise in HR appears before the onset of the actual arousal associated with an increase in EEG slow and fast activity. The link between EEG and HR variation during MA and PAT and the fluctuations in HR during subcortical arousal suggest a continuous spectrum in the arousal mechanisms, starting at the brainstem level and progressing to cortical areas.

Adult↗

Prediction of physiological arousability: a validation of the Arousal Predisposition Scale.

The Arousal Predisposition Scale (APS) is a brief (12-item) scale, that purportedly measures arousability, and has already been shown to predict task related arousal changes measured via self-report indexes. To determine if APS scores could predict individual differences in physiological measures of arousal, it was administered to 239 subjects. From this group, 9 highly arousable subjects and 9 low arousable subjects (based on APS scores) were selected. Each subject was repeatedly exposed to an arousing stimulus consisting of a 105 dB white noise. Electrodermal activity and the electromyographic response were used as indexes of change in autonomic and affective arousal. Subjects who scored highly arousable on the APS showed a greater change in electrodermal and electromyographic response than subjects judged low on arousability. This appears to validate the usefulness of the APS as a measure of individual differences in predisposition toward arousability.

Adolescent↗

The Sexual Arousal and Desire Inventory (SADI): a multidimensional scale to assess subjective sexual arousal and desire.

INTRODUCTION: Sexual arousal and desire are integral parts of the human sexual response that reflect physiological, emotional, and cognitive processes. Although subjective and physiological aspects of arousal and desire tend to be experienced concurrently, their differences become apparent in certain experimental and clinical populations in which one or more of these aspects are impaired. There are few subjective scales that assess sexual arousal and desire specifically in both men and women. AIMS: (i) To develop a multidimensional, descriptor-based Sexual Arousal and Desire Inventory (SADI) to assess subjective sexual arousal and desire in men and women; (ii) to evaluate convergent and divergent validity of the SADI; and (iii) to assess whether scores on the SADI would be altered when erotic fantasy or exposure to an erotic film was used to increase subjective arousal. METHODS: Adult men (N = 195) and women (N = 195) rated 54 descriptors as they applied to their normative experience of arousal and desire on a 5-point Likert scale. Another sample of men (N = 40) and women (N = 40) completed the SADI and other measures after viewing a 3-minute female-centered erotic film or engaging in a 3-minute period of erotic fantasy. MAIN OUTCOME MEASURES: Principal components analyses derived factors that the scale descriptors loaded onto. These factors were categorized as subscales of the SADI, and gender differences in ratings and internal validity were analyzed statistically. Factors were considered subscales of the SADI, and mean ratings for each subscale were generated and related to the other scales used to assess convergent and divergent validity. These scales included the Feeling Scale, the Multiple Indicators of Subjective Sexual Arousal, the Sexual Desire Inventory, and the Attitudes Toward Erotica Questionnaire, the Beck Depression Inventory (BDI)-II, and the Beck Anxiety Inventory. RESULTS: Descriptors loaded onto four factors that accounted for 41.3% of the variance. Analysis of descriptor loadings > or = 0.30 revealed an Evaluative factor, a Physiological factor, a Motivational factor, and a Negative/Aversive factor based on the meaning of the descriptors. Men's and women's subjective experiences of sexual desire and arousal on the Physiological and Motivational factors were not significantly different, although on the Evaluative and Negative factors, statistically significant differences were found between the genders. Mean scores on the Evaluative factor were higher for men than for women, whereas mean scores on the Negative factor were higher for women than for men. Internal consistency estimates of the SADI and its subscales confirmed strong reliability. Mean scores on the Evaluative, Motivational, and Physiological subscales of the SADI were significantly higher in the fantasy condition than in the erotic clip condition. Women had significantly higher mean scores than men on the Physiological subscale in the fantasy condition. Cronbach's alpha coefficients demonstrated excellent reliability of the SADI subscales. Evidence of convergent validity between the SADI subscales and other scales that measured the same constructs was strong. Divergent validity was also confirmed between the SADI subscales and the other scales that did not measure levels of sexual arousal, desire, or affect, such as the BDI-II. CONCLUSION: The SADI is a valid and reliable research tool to evaluate both state and trait aspects of subjective sexual arousal and desire in men and women.

Adult↗

Self-report and cardiovascular measures of arousal: fractionation during residual arousal.

Residual arousal has been conceptualized as a state of physiological activation that is amenable to misattribution-like processes because individuals are unaware of their aroused physiological state (Zillmann, 1978). Although there is considerable evidence showing that people in the state labeled "residual arousal" rate excitatory stimuli in a more polarized fashion (see review by Zillmann, 1983), the available evidence for the notion that residual arousal is imperceptible can alternatively be interpreted as evidence of an inability to discriminate the cause of the residual arousal. To determine the nature of the cognitive representation of residual arousal (and, hence, whether excitation transfer is likely to be a nonconscious rather than conscious misattributional process), cardiac activity and reported arousal were tracked before, during, and following exercise. Results replicated previous research showing that exercise-induced cardiac activity remained significantly elevated when subjects ceased to report feeling aroused due to the exercise. These findings were extended through the joint use of magnitude estimation and psychophysiological procedures to index what level of exercise-induced bodily activation was reportable. Results indicated that residual arousal is unperceived rather than perceived and mistaken as to its cause. Implications of the present research range from theories of arousal and of misattribution to the effects of stress-related variations in cardiac performance on cardiac detection.

Adolescent↗

Sexual arousal and arousability in a sexual offender population.

Assessed penile erections in response to descriptions of consenting sex, rape, and nonsexual assault among 78 inpatient male sexual offenders. All forms of sexual arousal were positively correlated, and sexual arousal to consenting stimuli exceeded arousal to coercive stimuli. Subjects who were able to completely inhibit their arousal exhibited less arousal to sexual assault stimuli than did subjects who were unable to completely inhibit arousal when both groups were not instructed to inhibit arousal. Inhibitory ability covaried with victim maturity, and with months spent in a treatment program. The maturity of the victims in the subjects' sexual offenses was not significantly related to sexual arousal. Thus, sexual offenders' sexual arousal as assessed by physiological measures may be more a function of arousability variables than of actual offending behaviors.

Adult↗

Arousal and differential Fos expression in histaminergic neurons of the ascending arousal system during a feeding-related motivated behaviour.

Arousal depends on the concerted activity of the ascending arousal system (AAS) but specific stimuli may primarily activate some nuclei of this system. Motivated behaviours are characterized by behavioural arousal, although it is not known which AAS nuclei are active during a motivated behaviour. To address this issue, rats were rendered motivated for food by fasting them for 1 day and then were enticed with food that they could not obtain for varying periods of time. We studied the level of arousal by polysomnography or radiotelemetry, and Fos-ir in the AAS, during food enticing. We found a strong arousal and an early increase in Fos-ir in the histaminergic neurons from the tuberomammillary nucleus, after 30 min of enticing, followed by increased Fos-ir in the whole AAS if food enticing was prolonged to 1 or 2 hours. In contrast, food presentation to non-motivated rats did not increase arousal or Fos-ir in the tuberomammillary nucleus. As opposed to the active arousal of the motivated rats, passive arousal induced by sensory stimulation was associated with increased Fos-ir in the locus coeruleus and the orexin neurons, but not with increased Fos-ir in the tuberomammillary nucleus or in the other nuclei of the AAS. We conclude that the arousal during feeding-related motivated behaviour is associated primarily with the activation of the tuberomammillary nucleus, while the other arousal-related nuclei become active later on.

Afferent Pathways↗

Influence of sympathetic autonomic arousal on cortical arousal: implications for a therapeutic behavioural intervention in epilepsy.

Negative amplitude shifts of cortical potential are related to seizure activity in epilepsy. Regulation of the cortical potential with biofeedback has been successfully used to reduce the frequency of some patients' seizures. Although such behavioural treatments are increasingly popular as an alternative to pharmacotherapy, there has been no investigation of the mechanisms that might bridge the behavioural index of peripheral autonomic activity and the central regulation of arousal. Galvanic Skin Response (GSR) is a sensitive measurement of autonomic arousal and physiological state which reflects one's behaviour. Thus we investigated the effect of peripheral autonomic modulation on cortical arousal with the future intention of using GSR biofeedback as a therapeutic treatment for epilepsy. The cortical negative potential was induced using the paradigm called Contingent Negative Variation (CNV) and measured in different physiological states. A high skin resistance state (reflecting a state of relaxation) and a low skin resistance state (reflecting a state of arousal), were engendered by two opposing procedures of GSR biofeedback. The CNV negative potential, acting as an index of cortical excitation, was significantly greater in amplitude at high levels of skin resistance (relaxed state) than at low levels of skin resistance (aroused state). Our results suggest an inverse relationship between a peripheral measure of autonomic arousal and an index of cortical arousal, the CNV. Moreover, we demonstrate modulation of this arousal-related potential by a behavioural intervention, indicating a potential therapeutic use of arousal biofeedback using GSR in the management of treatment-resistant epilepsy.

Adrenergic Fibers↗

Physiological arousal, dissonance, and attitude change: evidence for a dissonance-arousal link and a "don't remind me" effect.

Two experiments replicated and extended research by Croyle and Cooper (1983) indicating that cognitive dissonance involves physiological arousal. In Experiment 1, subjects wrote counterattitudinal essays under conditions of high or low choice, and, to assess arousal effects owing to effort, with or without a list of arguments provided by the experimenter. In high-choice conditions only, and regardless of effort, subjects showed both arousal (heightened galvanic skin response) and attitude change. Arousal, however, did not decline following attitude change. The more effortful task (no arguments provided) produced increased arousal but not greater attitude change. In Experiment 2, the opportunity to change one's attitude following a freely chosen counterattitudinal essay was manipulated. As in Experiment 1, arousal increased following the essay but did not decline following a postessay attitude change opportunity. When subjects were not given an attitude change opportunity, however, arousal did decline. Thus, dissonance seems to create arousal, but attitude change sustains rather than reduces the arousal. It is suggested that if dissonance is a drive state, drive reduction typically may be accomplished through gradual cognitive change or forgetting.

Arousal↗

Determinants of subjective experience of sexual arousal in women: feedback from genital arousal and erotic stimulus content.

Sixty-two women participated in a study designed to explore the association between genital and subjective sexual arousal. Four stimulus conditions were created, designed to evoke differential patterns of genital arousal over time. Subjects were instructed to report sensations in their genitalia while being exposed to the same erotic stimulus on repeated trials or to a series of varying erotic stimuli. Detection of genital arousal was facilitated by the occurrence of changes in genital arousal over trials. That is, genital and subjective sexual arousal were linearly related in conditions that resulted in large differences in genital arousal over trials, whereas such a relation was absent in conditions in which genital arousal levels remained relatively constant. In women, peripheral feedback from consciously detected genital arousal seems to be a relatively unimportant determinant of subjective sexual arousal.

Adolescent↗

Experiencing activation: energetic arousal and tense arousal are not mixtures of valence and activation.

R. E. Thayer (1989) proposed 2 types of activation: energetic arousal (awake-tired) and tense arousal (tense-calm). This view has been challenged by claims that energetic arousal and tense arousal are mixtures of valence and a single activation dimension. The authors present a direct test of this hypothesis by computing the correlation between the residuals of energetic arousal and tense arousal after removing the shared variance with valence. Whereas the valence activation hypothesis predicts a strong positive correlation between the 2 residuals, the authors found that it was not significantly different from 0. This finding reaffirms the view of energetic arousal and tense arousal as 2 distinct types of activation.

Adult↗

Sleep disorders: disorders of arousal? Enuresis, somnambulism, and nightmares occur in confusional states of arousal, not in "dreaming sleep".

In summary, the classical sleep disorders of nocturnal enuresis, somnambulism, the nightmare, and the sleep terror occur preferentially during arousal from slow-wave sleep and are virtually never associated with the rapid-eye-movement dreaming state. Original data are reported here which indicate that physiological differences from normal subjects, of a type predisposing the individual to a particular attack pattern, are present throughout the night. The episode, at least in the case of enuresis, appears to be simply a reinforcement of these differences to a clinically overt level. A number of features are common to all four sleep disorders. These had been shown previously to be attributable to the arousal itself. New data obtained by means of evoked potential techniques suggest that these common symptoms of the confusional period that follows non-REM sleep are related to alterations of cerebral reactivity, at least of the visual system. The symptoms which distinguish the individual attack types (that is, micturition, prolonged confusional fugues, overt terror) appear to be based upon physiological changes present throughout sleep which are markedly accentuated during arousal from slow-wave sleep. These changes may in some way be related to diurnal psychic conflicts. But, to date, it has proved impossible to demonstrate potentially causal psychological activity, dreaming or other forms of mental activity, or even a psychological void in sleep just preceding the attacks. The presence of all-night or even daytime predisposing physiological changes and the difficulty in obtaining any solid evidence of a preceding psychological cause explain, no doubt, why the results of efforts to cure the disorders at the moment of their occurrence (for example, by conditioning procedures in nocturnal enuresis) have been far from satisfactory. I stress the points that the attacks are best considered disorders of arousal and that the slow-wave sleep arousal episode which sets the stage for these attacks is a normal cyclic event. Indeed it is the most intense recurrent arousal that an individual regularly experiences. The most fruitful possibilities for future research would appear to be more detailed studies of those physiological changes that predispose individuals to certain types of attacks when they undergo intense arousal or stress; the reversal of these changes by psychological or pharmacological means; and more refined investigations of the physiological and psychological characteristics of the process of cyclic arousal from non-REM sleep.

Adolescent↗

The effects of prenatal drug exposure, term status, and caregiving on arousal and arousal modulation in 8-week-old infants.

Prenatal exposure to cocaine, as well as other drugs, has been linked with "dysregulation," usually defined as problems in arousal and/or behavioral regulation. This study was designed to describe the physiological basis of dysregulation as a function of prenatal cocaine/polydrug exposure and term status. Eight-week-old infants were selected because they are just developing the ability to modulate arousal. One hundred-eighteen infants (23 preterm control, 27 preterm drug-exposed, 29 full-term control, and 39 full-term drug-exposed) completed a protocol during which heart rate (HR) and respiratory rate (RR) were measured. Drug group differences were found in baseline, arousal (response to stress), and arousal modulation (recovery from stress). A hierarchical multiple regression analysis was conducted to determine the portion of variance attributable to postnatal caregiving environment, term status, and specific drug exposure. Term status accounted for significant variance in arousal (both RR and HR), and in arousal modulation (only RR). Prenatal exposure to cocaine contributed a significant amount of unique variance in HR arousal whereas tobacco contributed significantly to HR arousal modulation. Prenatal drug exposure and preterm status contributed differently to dysregulation as measured by physiological responses.

Adaptation, Psychological↗

Graded arousal responses in infants: advantages and disadvantages of a low threshold for arousal.

OBJECTIVE: To review studies of upper airway protective reflexes and other aspects of arousal from sleep. METHODS: Discussion of pertinent physiological studies. CONCLUSIONS: Infant arousal from sleep incorporates two systems. The first comprises a group of periodically occurring reflexes serving cardiorespiratory homeostatic functions as well as providing for several aspects of normal growth and development. The second system is organized to respond to acute threats to survival during sleep. Both systems are integrated in a single arousal network originating in the brainstem. Full arousal occurs as a progression of events occurring sequentially and manifested by various innate motor and cardiovascular responses. During an arousal, rostral progression from brainstem to cortex is retarded by increasing inhibition which serves to decrease cortical arousals thereby preserving the integrity of rapid eye movement and non-rapid eye movement sleep states. Activation of brainstem arousal reflexes alone can cause recovery from obstruction sleep apnea episodes without the need for cortical arousal, a phenomenon more characteristic of infants than adults.

Journal Article↗

Penile erection: a reflection of sexual arousal and arousability in male chimpanzees.

A study was conducted to determine if sexual motivation in male chimpanzees, defined by the two components, sexual arousal and arousability, could be quantified by measuring penile erection during laboratory pair-tests of sexual behavior. Sexual arousal, the momentary level of sexual excitation, was quantified by single measurements on a scale of penile erection. Sexual arousability, the propensity for arousal, was quantified by the rate of approach to full erection and by mean erection scores. Sexual arousability, as defined, was related to the frequency of male courtship displays, copulations, and ejaculations, which were highest at midcycle and positively correlated with a quantitative measure of female anogenital swelling. Sexual arousal was negatively correlated with continued exposure to the female and least variable during midcycle. These operational definitions of sexual motivation in the male chimpanzee facilitate comparative research in which analogous indexes of sexual motivation are required such as when extrapolating from animal to human.

Animals↗

Combined modulating effects of the general arousal and the specific hunger arousal on the olfactory bulb responses in the rat.

The combined modulating effects of the general level of arousal and specific hunger arousal on the olfactory bulb responses were investigated in the rat. Vigilance state parameters and multi-unit mitral cell activity were recorded in freely moving animals stimulated by control odours and by their usual food odour, either in the hungry or the satiated state. The nutritionally modulated bulb responses towards food odour were observed only for high arousal level (wakefulness). In rapid eye movement sleep (REMS), no olfactory response occurred. In slow wave sleep (SWS), one observed either a high bulb responsiveness to stimuli with neocortical arousal, or a general inexcitability. Each odorous stimulus in SWS elicited a higher neocortical arousal rate in the hungry than in the satiated state, as did food odour compared with control odours in both nutritional states. In SWS, a progressive alteration of the nutritionally modulated responses occurred at first at the bulb level and later for inner structures. Rats fed 2 h a day displayed a reversed circadian sleep-waking cycle and a lower SWS proportion compared with rats fed ad libitum. The hunger arousal could quantitatively and qualitatively modulate the activity of structures regulating the sleep-waking pattern.

Animals↗