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At least 19 recordsLinked to original sources
PubMed2026

The impact of acute sleep fragmentation on muscle blood flow responses to handgrip exercise.

Sleep fragmentation is reported to impair resting vascular function. The aim of this study was to test the hypothesis that acute sleep fragmentation would impair muscle blood flow during exercise. Twenty adults (10 females and 10 males) participated in a randomized crossover study that included one night of habitual sleep and one night of fragmented sleep. Sleep was assessed at home using wrist actigraphy. Arousals from sleep were increased by an audio alarm sounding every 30 min. The morning following each sleep condition, participants performed single handgrip contractions and rhythmic handgrip exercise at 15%, 30%, and 45% MVC. Forearm blood flow (FBF) was measured using Doppler ultrasound. Nightly awakenings and wake after sleep onset significantly increased by 18% and 43%, respectively, after fragmented sleep, leading to lower sleep duration (P < 0.001). Peak FBF and total hyperemic responses following single contractions were similar between sleep conditions (all P > 0.05). During rhythmic handgrip exercise, brachial artery dilation was reduced after fragmented sleep (main effect: 5.5 &#xb1; 4.8 vs. 3.3 &#xb1; 3.7%; P = 0.01), leading to a lower FBF response to rhythmic exercise (main effect: 122 &#xb1; 58 vs. 110 &#xb1; 56 mL/min; P = 0.04). Endothelial sensitivity to shear rate was similar between sleep conditions (habitual vs. fragmented: 0.039 &#xb1; 0.024 vs. 0.042 &#xb1; 0.031%/s-1; P = 0.77). In summary, acute sleep fragmentation decreases skeletal muscle blood flow during exercise. This finding suggests that blunted oxygen delivery may be a contributing factor for exercise performance deficits after disturbed sleep.NEW & NOTEWORTHY We demonstrate that one night of fragmented sleep decreases steady-state blood flow and vascular conductance during low- to moderate-intensity handgrip exercise. This impairment was not due to an impaired rapid vasodilation to single contractions nor altered endothelial sensitivity to shear rate as these variables were unchanged after acute sleep fragmentation. These results reveal a negative impact of disrupted sleep on the steady-state muscle vasodilatory response to rhythmic contractions.

Humans↗
PubMed1991

Chronic use of triazolam in patients with periodic leg movements, fragmented sleep and daytime sleepiness.

Many studies have shown a relationship between fragmented nocturnal sleep and daytime sleepiness. In the current study, 9 patients, aged 55-79, with fragmented nocturnal sleep secondary to periodic leg movements and objective daytime sleepiness, as verified by Multiple Sleep Latency Test (MSLT), had 12 weeks of treatment with 0.125 mg of triazolam following 2 screening nights and 2 placebo baseline nights; 2 final placebo nights were placed 5 nights following the last medication night. The medication increased total sleep time and sleep efficiency throughout the administration period, as compared to average placebo values; total leg movements were not changed. Generally, daytime performance, as measured by a vigilance task, and objective alertness, as measured by MSLT, were improved following the use of triazolam. No adverse reactions or significant side effects were noted. It was concluded that 0.125 mg triazolam, when used for up to 3 months, could improve sleep and daytime function in older patients with periodic leg movements, fragmented sleep, and daytime sleepiness.

Aged↗
PubMed1991

Triazolam diminishes daytime sleepiness and sleep fragmentation in patients with periodic leg movements in sleep.

Fifteen subjects (9 men and 6 women) exhibiting objective evidence of excessive daytime somnolence and periodic leg movements in sleep underwent 4-7 days of treatment with triazolam (0.25 or 0.50 mg) and placebo in a double-blind crossover design. One night of polysomnography followed by daytime multiple sleep latency testing were conducted on the first and last days of each treatment block. By the last day of treatment, the mean multiple sleep latency test score after triazolam (9.0 minutes) was significantly greater than that after placebo (5.7 minutes). Thus, triazolam treatment led to a decrease in daytime somnolence. Triazolam also improved sleep architecture and continuity; it increased total sleep time, decreased the number of awakenings and arousals, and decreased stage 1 and increased stage 2 percentages. Although the frequency of periodic electromyographic bursts remained unchanged, the frequency of associated arousals decreased after treatment. Short-term treatment with triazolam is thus effective in diminishing daytime sleepiness and in improving sleep architecture, continuity and duration in patients with periodic leg movements in sleep. These effects do not seem to be mediated through a decrease in periodic leg movement activity.

Adult↗
PubMed1991

Factors which contribute to fatigue associated with rheumatoid arthritis.

The purpose of this research was to identify the factors which people with rheumatoid arthritis (RA) believed contributed to their fatigue. A second purpose was to examine the relationships among identified factors and the sensation of fatigue. One hundred people with RA were asked to identify verbally factors which they believed contributed to their fatigue. The three most frequently identified factors included RA disease activity, disturbed sleep and increased physical effort. These factors were operationalized and measured as joint pain using the Modified McGill Pain Inventory, fragmented sleep through overnight electroencephalographic (EEG) sleep studies, and reduced physical ability using walking time and grip strength measures. Fifteen of the original subjects with RA and 12 age and gender matched control subjects completed the second phase of the research. Five of the RA subjects were experiencing a disease flare while the remaining 10 were either in remission or their disease was midly active. Those subjects in flare had significantly (P less than 0.01) more joint pain, significantly (P less than 0.05) more fragmented sleep, and significantly reduced functional capacity as measured through walking time (P less than 0.05) and grip strength (P less than 0.05) when compared to non-flare and control subjects. Fatigue levels of the subjects in flare were positively correlated with joint pain (r = 0.62), fragmented sleep (r = 0.42) and grip strength of the right hand (r = 0.52) and left hand (r = 0.88). Fatigue levels of non-flare and control subjects were negatively correlated with the majority of measured variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1991

Metabolism during normal, fragmented, and recovery sleep.

Average metabolic data (O2 uptake and CO2 output) were obtained for each 3-min period during consecutive nights of normal, experimentally fragmented, and recovery sleep in a group of 12 normal young adult males. Naturally occurring arousals and awakenings resulted in a characteristic increase in metabolism on the baseline night. The placement of brief frequent experimental arousals on the following night resulted in significantly increased metabolism throughout the night and significantly decreased sleep restoration as measured by morning performance, mood, and alertness tests, even though total sleep time was minimally reduced. Metabolic variables were significantly decreased compared with baseline on the nondisturbed recovery night that followed the sleep fragmentation night. The data cannot be used to infer that increased metabolism during sleep causes nonrestorative sleep, but the direction and time course of metabolic change accompanying arousal are consistent with that hypothesis.

Adolescent↗
PubMedDate not supplied

[Sleep apnea syndrome: psychiatric aspects].

The prognosis of sleep apnea syndrome (SAS) is dominated by cardiovascular complications. However, this disease is concerned with psychiatric field through specific clinical patterns. Nocturnal respiratory arrests are responsible for hypoxic and hypercapnic events including sleep fragmentation, reduction of slow wave sleep and rapid eye movement sleep. Alertness disturbances and sleep disorders are the most common functional complaints. Memory and cognitive disorders, personality changes and anxiodepressive syndromes may occur but are often neglected due to the increase of frequency with age together with the frequency of SAS; clinicians should consequently be aware of the fact that such troubles may be related to sleep respiratory disorders. In this case polysomnography should be performed before prescribing hypnotics, tranquilizers or sedative antidepressants.

Blood Gas Monitoring, Transcutaneous↗
PubMed1992

Sleep architecture and sleep apnea in patients with Cushing's disease.

Patients with Cushing's syndrome (CS) frequently have sleep complaints. We evaluated sleep polysomnographically in 22 patients, including 17 with pituitary-ACTH-dependent Cushing's disease (CD) and five with CS from an adrenal tumor. Data were compared to healthy controls of comparable age. Seven patients (32%) demonstrated at least mild sleep apnea (> or = 9.4 events/hour), and four of 22 (18%) had > or = 17.5 events/hour. The apneic CD and CS patients had a trend for a greater complaint of excessive daytime sleepiness. Both apneic and nonapneic groups had considerable snoring and obesity. The electroencephalographic (EEG) sleep of nonapneic patients was compared to that of normal subjects. Nonapneic CD patients differed strikingly from healthy volunteers in sleep continuity and architecture, demonstrating lighter, fragmented sleep. Rapid eye movement (REM) sleep in CD patients bore many similarities to the sleep of patients with major depression, with REM latency being significantly shortened and REM density significantly increased. Continued examination of EEG sleep in CD patients may shed light on similarities in pathophysiology between CD and major depression, disorders which are characterized by both a dysfunction of the hypothalamic-pituitary-adrenal axis and alterations in mood.

ACTH Syndrome, Ectopic↗
PubMed1992

Cassette EEG sleep recordings in Gilles de la Tourette syndrome.

Tourette syndrome (TS) patients often complain of sleep problems, and questionnaire studies indicate that sleep disturbance is frequent. Decreased slow wave sleep and increased awakenings have been reported in laboratory polysomnography in TS patients, and a serotoninergic disorder of arousal has been postulated. We recorded outpatient sleep in 20 patients newly diagnosed with TS utilizing a 4-channel cassette EEG system. The newly-diagnosed patients were predominantly male, and ranged in age from 10 to 36 years. Some had taken psychotropic medications in the past, but none had been treated systematically for TS. Seven patients had chronic tics only, 8 had tics and attention deficit-hyperactivity, and 5 had tics plus obsessions and compulsions. None had other medical, neurologic, or psychiatric disorders. All were nocturnal sleepers, and were recorded in their usual sleeping environments and routines. TS patients had reduced sleep, decreased sleep efficiency, increased awakenings, and decreased slow wave sleep. Tic patients had increased nocturnal awakenings and movements, particularly those who had tics during sleep. Sleep fragmentation and loss of slow wave sleep was most marked in TS patients with attention deficit-hyperactivity. Sleep latency was increased, REM sleep reduced, and REM sleep latency decreased in TS patients with obsessions and compulsions. These findings accord with previous reports of sleep disturbance in TS, and suggest that these disturbances may vary with TS symptoms. Chronic tics may persist in sleep and cause awakenings, TS with attention deficit may be associated with a disorder of arousal and alertness, and obsessions and compulsions may be manifestations of a biochemical disturbance involving paradoxical sleep.

Adolescent↗
PubMedDate not supplied

[Diagnosis of obstructive sleep apnea syndrome].

Symptoms and signs in 12 patients with severe obstructive sleep apnea (OSA) syndrome have been presented. The most common symptoms were snoring , increased motor activity during sleep and excessive daytime somnolence. The factors predisposing to OSA syndrome were obesity and anatomic abnormalities of the upper airway structure. In some cases the signs of OSA syndrome included hypertension, right heart failure, chronic alveolar hypoventilation and polycythemia. Polysomnography showed sleep fragmentation and the prevalence of light sleep stages. Obstructive sleep apneas repeated 73 +/- 23 times per hour of sleep. The mean apnea duration was 19 +/- 8 s. The mean arterial oxygen saturation during apnea was 72 +/- 14%.

Adult↗
PubMed1992

Plasma renin activity and sleep-wake structure of narcoleptic patients and control subjects under continuous bedrest.

In order to determine if renin release would be affected by a dysfunction of the circadian and ultradian organization of sleep, 24-hour profiles of plasma renin activity (PRA) concomitant with sleep stages were established in 10 normal subjects and nine narcoleptic patients, with 10-minute blood sampling intervals. Mean PRA levels were similar in control subjects and narcoleptic patients. Individual 24-hour profiles revealed that the previously described association between renin oscillations and sleep stage alternations was preserved. Increased PRA release was observed during the transition from rapid eye movement (REM) sleep or waking periods to nonrapid eye movement (NREM) sleep, and REM sleep occurred as PRA levels were decreasing. Thus, PRA curves exactly reflected the irregularities and disturbances in the sleep structure of the narcoleptic patients. The 24-hour PRA profiles of the patients did not show the general upward trend during nighttime sleep, which is probably induced in the control subjects by the repetitive recurrence of longer episodes of undisturbed NREM sleep. Because of marked sleep fragmentation in the patients, the duration of NREM sleep was often insufficient to allow for the occurrence of a significant PRA increase. Because sleep onset REM (SOREM) episodes, characteristic of narcolepsy, are not preceded by NREM sleep and its associated increase in PRA, no relative PRA decline occurred during this type of REM sleep. In conclusion, the 24-hour PRA profiles of the narcoleptic patients reflected exactly their sleep stage distribution, confirming previous findings that PRA oscillations appear to be inseparable from the NREM-REM sleep cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Daytime sleepiness after long-term continuous positive airway pressure (CPAP) treatment in obstructive sleep apnea syndrome.

A modified maintenance of wakefulness test was performed in 58 patients with obstructive sleep apnea (OSA) syndrome before treatment and after long-term (554 +/- 28 days) home therapy with nasal continuous positive airway pressure (CPAP). Before treatment the patients had a shorter mean sleep latency than controls (16 +/- 1 vs. 27 +/- 1 min, mean +/- SEM, P less than 0.001). After treatment, the mean sleep latency increased to 20 +/- 1 min (P less than 0.002 as compared to baseline), but was still shorter than in controls (P less than 0.001). The incomplete normalization of the mean latency contrasted with the patients' claim that they no longer felt sleepy. The improvement in daytime alertness was significantly correlated with the reduction in sleep fragmentation after CPAP treatment and with the baseline mean sleep latency. These results support the hypothesis that sleep disruption related to respiratory events plays a role in the pathogenesis of daytime sleepiness.

Electrocardiography↗
PubMed1992

T-sleep: an improved method for scoring breathing-disordered sleep.

We developed a new method to score sleep fragmented by respiratory events that we call the T-sleep (transitional sleep scoring) method. Five control polysomnograms from subjects without sleep-related breathing abnormalities were scored by the Rechtschaffen and Kales (R&K) method, and 10 polysomnograms from patients with severe obstructive sleep apnea were scored by both the R&K and the T-sleep method. Comparative analyses were performed on sleep variables of the control and apnea polysomnograms, and interscorer correlations were assessed for sleep and apnea variables. The interscorer correlations were high for both R&K control scoring and for apnea recordings scored by the T-sleep method. The number of sleep stage events documented for the 10 apnea recordings was significantly less for the T-sleep method than the R&K method (36, SD 17.0 vs. 332, SD 144.0; p = 0.0002). The T-sleep method was shown to be an effective, accurate and quick method for scoring sleep in patients with sleep-related breathing disorders.

Adult↗
PubMed1991

Neuroendocrine evaluation in Kleine-Levin syndrome: evidence of reduced dopaminergic tone during periods of hypersomnolence.

A patient with Kleine-Levin syndrome had polysomnography and neuroendocrinological assays performed during asymptomatic (ASMP) and symptomatic (SMP) 24-hr periods. During the SMP, sleep data revealed poor nocturnal sleep efficiency, increased sleep fragmentation and reduced stages 3, 4 and rapid eye movement (REM). No sleep onset REM episodes were seen. Sleep staging in the ASMP was normal. Blood samples were obtained every 20 min and assayed for thyroid-stimulating hormone (TSH), cortisol (CORT), prolactin (PRL) and growth hormone (GH). Patterns of secretion, 24-hr mean and total integrated concentrations, and mean sleep period time values during the ASMP and SMP were compared. The mean 24-hr level of TSH was increased and GH decreased in the SMP. Comparing sleep period time in the SMP to the ASMP, values for TSH and PRL were increased and GH and CORT were reduced in the SMP. These hormone changes support the hypothesis that reduced hypothalamic dopaminergic tone is present in the SMP compared to the ASMP in Kleine-Levin patients.

Adult↗
PubMed1979

[Anamnesis of sleep in the internal medicine hospital (author's transl)].

An anamnestic sleep questionnaire was developed with which 41 unselected but seriously ill hospitalised patients in the age of 23 to 71 years (43,7 y.) were investigated. 1. The data analysis suggests that disturbed sleep is an universal problem but it shows significantly in the clinic. The frequently fragmented sleep occurs to be the most important form of disturbed sleep patterns. 2. Answers to often used stereotyped questions on the conditions of sleep are neither correlated to the subjective status nor to objective behavioral datas of sleep. 3. Physical-technical stimulus patterns occur to be of minor importance related to internal conditions in disturbing the sleep. Highly range fear of medical investigation (71%) and expectation of an uncertain future. This underlines the necessity of a psychosocial guidance of hospitalised patients. 4. Accordingly the medication rate of hypnotices and tranquilizers is high-rated; the percentage of patients who are engaged in exercising consciously presomnic behavioral patterns is low. Patients who demonstrate a negative attitude towards soporifics perceive side effects on a significantly larger scale than positively motivated patients. A negative attitude towards these drugs has no behavioral consequences.

Adult↗
PubMed1991

[Sleep in normal aging].

Sleep in the elderly is characterized by a decrease in the ability to stay asleep resulting in a more fragmented sleep. Spindles are less frequent and less ample, shorter, without an increase during the night contrary young subjects. Delta activity in slow wave sleep is decreased in the 0.5-2 Hz frequency band only. REM sleep occurs earlier the first REM period duration increases. The REM sleep appearance is almost uniform during the night. REMs density does not increase toward the end of the sleeping period. The sleep-wake circadian rhythm is advanced (bedtime and morning awakening occur earlier). The temperature rhythm is also advanced. The rise in temperature after the nadir begins earlier for females and the initial ascent is more rapid. This explains why women wake up earlier and sleep for shorter durations than men. The nocturnal and diurnal mean plasmatic norepinephrine values increase. The rhythm of cortisol secretion is advanced. The GH and melatonin peaks of secretion are decreased. The acrophase of melatonin rhythm is occurring later in the elderly. These results suggest a weakening of circadian structure in the course of aging and an altered relationship between the pacemakers driving melatonin and cortisol circadian rhythms.

Aging↗
PubMed1991

Prevalent sleep problems in the aged.

Quality of sleep influences the level of daytime functioning, including stress levels, psychosomatic complaints, general health, and overall well-being. As people age, they complain more about disturbed sleep, insomnia, increased time in bed, and sleep fragmentation. These complaints can be related to circadian rhythm desynchronization, hypnotic or other medication use, chronic bedrest, napping, dementia, or to sleep apnea, a disorder of respiratory cessation which is quite prevalent in the elderly. We review here the results of 12 years of research on sleep in the elderly. In studies of three populations of elderly, it was found that between 24% and 42% had five or more apneas per hour of sleep and 4%-14% had 20 or more apneas per hour of sleep. Since apnea is related to dementia and even to mortality, this high prevalence of apnea is of extreme importance.

Aged↗
PubMed1978

Twenty-four-hour recording in REM-narcoleptics with special reference to nocturnal sleep disruption.

Twenty narcoleptic patients and ten age-matched normals were polygraphically monitored for 58 consecutive hours. All subjects were on regimented sleep (hours between 2230 and 0700). Group A (11 patients and 10 normals) had enforced wakefulness during the day whereas Group B (9 patients) were permitted to sleep (mean = 2 1/2 hr.). On day 2, all subjects were permitted to sleep for 15-min periods every 2 hr. In narcoloptics, sleep recordings demonstrated a reduction of sleep latency, an increase of stage 1, and a decrease in stages 3 and 4 compared to normals, but total REM time and percentage of REM sleep were similar. Groups A and B showed no difference in the incidence of nocturnal awakenings. REM cyclic periodicity was larger in narcoleptics who also demonstrated a REM-sleep fragmentation. This fragmentation became more pronounced as time passed, with several shifts from REM to wakefulness and stage 1. Narcoleptics present REM onset sleep period but also show an inability to remain in REM sleep.

Adult↗