scholarly journals No Difference in Sleep and RBD between Different Types of Patients with Multiple System Atrophy: A Pilot Video-Polysomnographical Study

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Maria-Lucia Muntean ◽  
Friederike Sixel-Döring ◽  
Claudia Trenkwalder
Keyword(s):  
Multiple System Atrophy ◽  
Rem Sleep ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Sleep Efficiency ◽  
Periodic Limb Movements ◽  
Limb Movements ◽  
Different Types ◽  
Cerebellar Type

Background. Patients with multiple system atrophy (MSA), similarly to patients with alpha-synucleinopathies, can present with different sleep problems. We sought to analyze sleep problems in the two subtypes of the disease MSA cerebellar type (MSA-C) and MSA parkinsonian type (MSA-P), paying special attention to REM sleep disturbances and periodic limb movements (PLMs).Methods. In the study we included 11 MSA-C and 27 MSA-P patients who underwent one night polysomnography. For the analysis, there were 37 valid polysomnographic studies.Results. Sleep efficiency was decreased in both groups (MSA-C, 64.27% ± 12.04%; MSA-P, 60.64% ± 6.01%). The PLM indices using standard measures, in sleep (PLMS) and while awake (PLMW), were high in both groups (MSA-C patients: PLMS index 72 ± 65, PLMW index 38 ± 33; MSA-P patients: PLMS index 66 ± 63, PLMW index 48 ± 37). Almost one-third of the MSA patients of both groups presented features of RLS on video-polysomnography. RBD was described in 8/11 (73%) patients with MSA-C and 19/25 (76%) patients with MSA-P (P=0.849).Conclusion. Our results showed very similar polysomnographic results for both MSA-P and MSA-C patients as a probable indicator for the similar pathologic mechanism of the disease and especially of its sleep problems.

803 Sleep Disturbances in Patients with Frontotemporal Dementia

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A312-A314
Author(s):  
Nathan Walker ◽  
Bradley Vaughn
Keyword(s):  
Sleep Apnea ◽  
Frontotemporal Dementia ◽  
Rem Sleep ◽  
Sleep Disturbances ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Retrospective Chart Review ◽  
Sleep Efficiency ◽  
Periodic Limb Movements ◽  
Apnea Hypopnea Index

Abstract Introduction Frontotemporal dementia (FTD) is a degenerative process and,as the name implies, involves the frontal and temporal lobes of the brain. Patients with FTD make up 10–15% of all cases of dementia and 20% diagnosed before age 65, however not much is reported about sleep disturbances in these patients. Given the area of neuronal loss one would expect that sleep may be influenced early and by issues in arousal mechanisms and in breathing pattern. This study examined the polysomnography (PSG) reports of patients with a diagnosis FTD. Methods A retrospective chart review was performed to identify patients with both a diagnosis of FTD and having undergone a PSG. 23 patients were identified as fulfilling both requirements. Data recorded included, diagnosis, age at time of PSG, Epworth sleepiness scale (ESS), total sleep time (TST), wake after sleep onset (WASO), sleep latency (SL), REM sleep latency, sleep efficiency (SE), percentage of stage N1, N2, N3, and REM sleep, apnea-hypopnea index (AHI), presence of Cheyne-Stoke breathing, periodic limb movement index, and presence of REM without atonia. Results Patient age ranged from 57–85 years. Average ESS was 8.8 with only 5 patients reported excessive daytime sleepiness(as assessed by ESS). The average TST was 290 minutes, average SL was 37.9 minutes, average WASO was 147.5 minutes, and average sleep efficiency was 60.3%. Patients spent the majority of time in N2 sleep with an average of 68.3% of the time spent in N2. The average time spent in N3 was 9.6% of sleep. 8.9% of sleep was spent in REM. 83% of patients were diagnosed with sleep apnea (as defined by an AHI > 5), with an average AHI of 20.2 events/hour. Cheyne-Stokes breathing was only noted in 4 of the 23 patients, or 17%. Periodic limb movements of sleep were noted in 48% of the patients (n=11). REM without atonia or RBD was not noted for any patients. Conclusion This study shows that patients with FTD suffer from typical sleep disturbances, however there is a high prevalence of sleep apnea as well as PLMS. In addition, patients with FTD have decreased sleep efficiency with increased WASO. Support (if any):

523 Characteristics of Patients with REM Sleep without Atonia/Periodic Limb Movements of Sleep without Dream Enactment Behaviors

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A206-A206
Author(s):  
Lina Barker ◽  
Maja Tippmann-Peikert
Keyword(s):  
Rem Sleep ◽  
Psychiatric Diagnosis ◽  
Neurological Disorders ◽  
Rem Sleep Behavior Disorder ◽  
Control Group ◽  
Periodic Limb Movements ◽  
Limb Movements ◽  
Sleep Behavior ◽  
Rem Sleep Without Atonia ◽  
Antidepressant Use

Abstract Introduction While REM sleep without atonia (RSWA) in REM sleep behavior disorder (RBD) is associated with male sex, age greater than or equal to 50 years, alpha-synucleinopathies, and narcolepsy, the characteristics of patients with RSWA/persistent periodic limb movements of sleep in REM sleep (RSWA/PLMS-REM) without dream enactment behaviors are unexplored. The aim of this study was to compare the demographics, comorbidities, and concomitant medication use between RSWA/PLMS-REM patients and non-RSWA/non-PLMS-REM controls. Based on anecdotal clinical observations, we hypothesized that these patients are more commonly young, women, have psychiatric or neurological diseases, and use antidepressants. Methods We conducted a retrospective review of the Mayo Clinic electronic medical record to identify all patients with RSWA/PLMS-REM between November 2018 and November 2020. After excluding all patients with RBD, restless legs syndrome, narcolepsy, and RSWA/non-PLMS-REM, we identified 27 patients. All in-lab polysomnograms (PSGs) were reviewed to calculate the periodic limb movement index per hour of REM sleep (REM-PLMI). We also identified a control group of 15 individuals without RSWA, reviewed their PSGs, and calculated the REM-PLMI. Results The mean REM-PLMI of patients with RSWA was 64 +/- 8.3 (standard error of mean (SEM)) per hour versus 1 +/- 0.6 (SEM) per hour in non-RSWA controls (p < 0.001). Patients with RSWA/PLMS-REM and non-RSWA controls had similar age and gender, 62 +/- 3 (SEM) versus 58 +/- 3 (SEM) years and 81% versus 87% men, respectively. However, psychiatric diagnosis, neurological disorders, and antidepressants use were more common among RSWA/PLMS-REM patients compared to non-RSWA controls with p = 0.0002, p = 0.0035 and p = 0.0074 respectively (Fisher’s Exact Test). Conclusion Psychiatric diagnosis, neurological disorders, and antidepressant use are more common among RSWA/PLMS-REM patients compared to non-RSWA/non-PLMS-REM controls. Further research to determine the implications of a diagnosis of RSWA/PLMS-REM for the future development of alpha-synucleinopathies are needed and currently ongoing. Support (if any):

102 Single-Prolonged Stress as a Model of PTSD in Mice: Effects on Sleep and Anxiety

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A42-A42
Author(s):  
Katelyn Gutowsky ◽  
Carolyn Jones ◽  
Miranda Lim
Keyword(s):  
Rem Sleep ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Power Spectra ◽  
Post Traumatic Stress ◽  
Sleep State ◽  
Single Prolonged Stress ◽  
Post Traumatic ◽  
And Control ◽  
Prolonged Stress

Abstract Introduction Sleep problems are common in humans with post-traumatic stress disorder (PTSD). Rapid eye movement (REM) sleep is involved in processing emotional memories; it is often disrupted in those with PTSD, and may be related to increased anxiety. Single prolonged stress (SPS) is a protocol used to model PTSD in rats, however little is known about how this model impacts sleep in mice. Prior research suggests SPS produces short term disturbances in REM sleep and increases in anxiety-like behavior, but further validation of this model is needed to understand how SPS impacts sleep and anxiety-like behaviors in mice specifically, as they have greater potential for transgenic manipulation Methods C57BL6/J mice underwent a SPS protocol in which they were tube-restrained for 2 hours, followed by a 15 minute forced swim in a group, ether exposure until loss of consciousness, and 10 days of social isolation. Following SPS, mice were tested for anxiety-like behavior in a light-dark box and sleep was measured from surgically implanted EEG and EMG leads. Time spent in wake, REM sleep, and non-REM sleep was quantified for 24 continuous hours in SPS and Control mice. Results There were no significant effects of SPS on the amount of time spent in any vigilance state, or in sleep-wake transitions. However, SPS-exposed mice showed significantly more anxiety-like behavior. EEG power spectra were analyzed in relevant frequency bands during each sleep state, and exploratory analyses were conducted Conclusion Minimal effects on sleep macroarchitecture were seen in mice 10 days after SPS. It is possible that sleep disturbances seen immediately after trauma exposure (such as in prior studies in rats) may have diminished over time. Further studies will need to include additional timepoints and analysis of sleep microarchitecture following SPS, and in other mouse models of PTSD, in order to more comprehensively examine changes in sleep. Support (if any) VA CDA #IK2 BX002712, Portland VA Research Foundation, Medical Research Foundation

217 Sleep in heavy marijuana users after smoking differing THC doses compared to controls

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A87-A87
Author(s):  
Mohammad Sibai ◽  
Timothy Roehrs ◽  
Gail Koshor ◽  
Jelena Verkler ◽  
Leslie Lundahl
Keyword(s):  
Drug Use ◽  
Rem Sleep ◽  
Sleep Disturbances ◽  
Fixed Time ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Medical Illness ◽  
Time In Bed ◽  
Henry Ford ◽  
History Of

Abstract Introduction Sleep disturbances are commonly reported by chronic marijuana (MJ) users and often identified as reasons for MJ relapse and/or other drug use. In the current study we compared the sleep architecture of 12 heavy MJ users to 11 normal controls. Methods Participants in the marijuana group met DSM-V criteria for cannabis use disorder but were otherwise healthy individuals. On the first study day, individuals smoked (1330-1400 hr) 11 puffs from a cannabis cigarette (7% THC). During the next four days, under varying experimental contingencies participants smoked an average of 4.58 (±3.48) day 1, 4.92 (±3.62) day 2, 4.75 (±3.52) day 3, and 4.17 (±3.56) day 4 puffs from cannabis cigarettes (7% THC). Their sleep was recorded the first four study nights using standard polysomnography procedures at Henry Ford Sleep and Research Center Hospital, under an 8-hr fixed time in bed (2300-0700 hr). Controls (n=11) had no history of illicit drug use or medical illness and were not shift workers. Neither group reported a history of sleep-related disorders. PSG recordings were scored using Rechtschaffen and Kales standard criteria. Sleep measures included sleep efficiency (total sleep time/time in bed * 100), latency to persistent sleep, and percent of time spent in Stage 1, 2, 3/4, and rapid eye movement (REM). Results PSGs taken across all four nights of inpatient stay showed that MJ users spent significantly more time in REM sleep compared to controls (means 24.91, 24.64, 24.42, 24.13 vs 18.81, p<.001) and less time in stage 3/4 sleep (means 4.33, 4.79, 4.53, 6.91 vs 15.68, p<.001). MJ users showed reduced sleep efficiency compared to controls on night 4 (means 82.03 vs 90.32, p=0.039), and increased latency to persistent sleep on night 1 (means 6.04 vs 17.77, p=0.026). Conclusion These data show reduced sleep efficiency, lightened sleep (reduced stage 3/4), as well as an increased duration during REM sleep in heavy MJ users during decreased use, findings that are predictive of relapse in other drug abuse populations. Support (if any) NIH/NIDA R21 DA040770 (LHL)

601 Comparison of Sleep Parameters in Children with Achondroplasia and Trisomy 21

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A236-A237
Author(s):  
Jodi Gustave ◽  
Kaelyn Gaza ◽  
Jennifer Marriner ◽  
Seema Rani ◽  
Abigail Strang ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Rem Sleep ◽  
Trisomy 21 ◽  
Sleep Disturbances ◽  
Sleep Latency ◽  
Sleep Efficiency ◽  
Sleep Architecture ◽  
Poor Sleep ◽  
Arousal Index ◽  
Sleep Parameters

Abstract Introduction Children with achondroplasia and Trisomy 21 (T21) have increased incidence of sleep disturbances including sleep disordered breathing. Abnormal sleep architecture has been documented in children with T21. It is important to continue to analyze sleep parameters in both groups since poor sleep quality is associated with neurocognitive impairment. Methods Following IRB approval, we performed a retrospective chart review of patients at Nemours/A.I. duPont Hospital for Children in Wilmington, DE with achondroplasia and T21 who underwent an initial polysomnogram (PSG) between 2015 and 2020. We compared sleep architecture parameters between the groups including sleep efficiency, total sleep time (TST), sleep latency, arousal index and concentration of N3 and REM sleep. Results In patients with achondroplasia (n=49, mean age 5.8 months and 63.3% male), 12% reported restless sleep. PSG data revealed TST of 392 minutes, mean sleep efficiency of 82%, mean sleep latency of 9.4 min, mean arousal index of 40, 22% REM sleep and 32% N3 sleep. In the patients with T21 (n=32, mean age 17.8 months and 50% male), 59% reported restless sleep. PSG data revealed TST of 393 minutes, mean sleep efficiency of 82%, mean sleep latency of 14 minutes, arousal index of 35, 15% REM sleep and 40% N3 sleep. The differences in REM and N3 sleep between the two groups were statistically significant (p-values of 0.001 and 0.04, respectively), but the differences in arousal index, TST and sleep efficiency were not. Conclusion Our study showed that children with T21 subjectively noted more restless sleep compared to patients with achondroplasia although TST and sleep efficiency were similar. Patients with achondroplasia had a higher arousal index that was not statistically significant. Children with achondroplasia had a shorter sleep latency and more robust REM concentration, likely due to their younger age. There was a higher concentration of N3 sleep in patients with T21. This is likely due to the decrease in REM concentration. In conclusion, it is important to establish expected sleep parameters in patients with achondroplasia and T21 to maximize sleep quality and mitigate negative neurocognitive effects of poor sleep. Support (if any):

Periodic limb movements both in non-REM and REM sleep: Relationships between cerebral and autonomic activities

2009 ◽  
Vol 120 (7) ◽  
pp. 1282-1290 ◽  
Author(s):  
M. Allena ◽  
C. Campus ◽  
E. Morrone ◽  
F. De Carli ◽  
S. Garbarino ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Periodic Limb Movements ◽  
Limb Movements

scholarly journals Periodic limb movements during REM sleep in multiple sclerosis: a previously undescribed entity

2015 ◽  
pp. 2323 ◽  
Author(s):  
Christian Veauthier ◽  
Gunnar Gaede ◽  
Helena Radbruch ◽  
Joern-Peter Sieb ◽  
Klaus-Dieter Wernecke ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Rem Sleep ◽  
Periodic Limb Movements ◽  
Limb Movements

scholarly journals Sleep-Wake Cycle and Daytime Sleepiness in the Myotonic Dystrophies

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
A. Romigi ◽  
M. Albanese ◽  
C. Liguori ◽  
F. Placidi ◽  
M. G. Marciani ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Myotonic Dystrophy ◽  
Rem Sleep ◽  
Sleep Disturbances ◽  
Periodic Limb Movements ◽  
Myotonic Dystrophy Type ◽  
Myotonic Dystrophy Type 2 ◽  
Rem Sleep Without Atonia ◽  
Central Apnoea

Myotonic dystrophy is the most common type of muscular dystrophy in adults and is characterized by progressive myopathy, myotonia, and multiorgan involvement. Two genetically distinct entities have been identified, myotonic dystrophy type 1 (DM1 or Steinert’s Disease) and myotonic dystrophy type 2 (DM2). Myotonic dystrophies are strongly associated with sleep dysfunction. Sleep disturbances in DM1 are common and include sleep-disordered breathing (SDB), periodic limb movements (PLMS), central hypersomnia, and REM sleep dysregulation (high REM density and narcoleptic-like phenotype). Interestingly, drowsiness in DM1 seems to be due to a central dysfunction of sleep-wake regulation more than SDB. To date, little is known regarding the occurrence of sleep disorders in DM2. SDB (obstructive and central apnoea), REM sleep without atonia, and restless legs syndrome have been described. Further polysomnographic, controlled studies are strongly needed, particularly in DM2, in order to clarify the role of sleep disorders in the myotonic dystrophies.

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