Conscious experiences during non-rapid eye movement sleep parasomnias.

Disorders of Arousal (DOA) are non-rapid eye movement (NREM) parasomnias traditionally regarded as unconscious states. However, recent research challenges this assumption. This narrative review aims to explore the presence and qualitative features of conscious experiences in patients with DOA during their episodes.

Cortico-autonomic local arousals and heightened somatosensory arousability during NREMS of mice in neuropathic pain.

Frequent nightly arousals typical for sleep disorders cause daytime fatigue and present health risks. As such arousals are often short, partial, or occur locally within the brain, reliable characterization in rodent models of sleep disorders and in human patients is challenging. We found that the EEG spectral composition of non-rapid eye movement sleep (NREMS) in healthy mice shows an infraslow (~50 s) interval over which microarousals appear preferentially.

A critical review on sleep assessment methodologies in athletic populations: factors to be considered.

A growing body of research focus on athletes' sleep in order to investigate the effects of sleep in sports performance and recovery or the prevalence of sleep disorders in athletes. At the same time, several sleep monitoring tools have been developed and used in athletic populations for fulfilling these purposes. This review aimed to provide critical assessment to the most used by athletes' methodological approaches and compared them with the gold standard approach.

Sleep-related leg movements in obstructive sleep apnea: definitions, determinants, and clinical consequences.

Study Objectives: To investigate (1) the effect of different scoring rules on leg movement (LM) classification in patients with obstructive sleep apnea (OSA); (2) determinants of respiratory event related leg movements (rLM); and (3) to relate LM parameters to clinical outcomes.

Methods: (1) LM classification was compared between the World Association of Sleep Medicine (WASM) 2006 and the WASM 2016 rules in 336 participants with apnea hypopnea index (AHI) ≥ 5; (2) determinants and features of rLM were investigated with logistic mixed regression in 172 participants with AHI ≥ 10 and respiratory disturbance index (RDI) ≥ 15, and (3) LM parameters were compared for patients with and without cardiovascular events and related to continuous positive airway pressure (CPAP) adherence.

Results: WASM-2016 scoring significantly reduced periodic limb movements of sleep (PLMS) frequency in OSA participants even when only considering the new periodicity criteria.

Sleepiness as a Local Phenomenon.

Sleep occupies a third of our life and is a primary need for all animal species studied so far. Nonetheless, chronic sleep restriction is a growing source of morbidity and mortality in both developed and developing countries. Sleep loss is associated with the subjective feeling of sleepiness and with decreased performance, as well as with detrimental effects on general health, cognition, and emotions.

Peculiar lifespan changes of periodic leg movements during sleep in restless legs syndrome.

The objective of this observational cohort study was to analyse the age-related changes of periodic leg movements during sleep using the newest international scoring rules, to expand past analyses, including patients in the paediatric age range, and also to analyse the changes of short-interval and isolated leg movements during sleep throughout the lifespan. One hundred and sixty-five patients (84 women) with restless legs syndrome were recruited in the following age groups: 16 preschoolers (≤5 years of age), 29 school-age children (6-12 years), 19 adolescents (13-17 years), 17 young adults (19-40 years), 47 adults (41-60 years) and 37 seniors (>60 years). Total, periodic, short-interval and isolated leg movements during sleep and periodicity indexes were obtained by polysomnography.

The paradox of paradoxical insomnia: A theoretical review towards a unifying evidence-based definition.

Paradoxical insomnia is one of the most intriguing yet challenging subtypes of insomnia. Despite being recognized for a long time by the international community, it is still unclear whether this entity really exists, which are its features and boundaries. Much of the debate is fuelled by the lack of a consensus on its precise definition.

Sleep Abnormalities in Multiple Sclerosis.

Purpose Of Review: This review summarizes the most well-documented sleep disorders seen in patients with multiple sclerosis (MS), with a special focus on the impact on quality of life.

Recent Findings: Sleep abnormalities in patients with MS are a multifactorial and relatively complex issue affecting approximately 60% of the patients while the pathophysiology of these symptoms is not fully understood. Circadian rhythm disorders and increased levels of pro-inflammatory cytokines have been recognized as potential players in affecting sleep homeostasis in MS patients.

Sleep and Tibialis Anterior Muscle Activity in Mice With Mild Hypoxia and Iron Deficiency: Implications for the Restless Legs Syndrome.

Restless legs syndrome (RLS) is a neurological disorder that entails an urge to move with a circadian pattern during the evening/night. RLS may be accompanied by decreased sleep time and increased occurrence of periodic leg movements during sleep (PLMS), which involve bursts of tibialis anterior (TA) muscle electromyogram (EMG). Mild hypoxia and non-anemic iron deficiency, a highly prevalent nutritional deficiency, are relatively unexplored factors in RLS pathophysiology.

Frequent lucid dreaming associated with increased functional connectivity between frontopolar cortex and temporoparietal association areas.

Humans typically lack awareness that they are dreaming while dreaming. However, at times a remarkable exception occurs and reflective consciousness can be regained while dreaming, referred to as lucid dreaming. While most individuals experience lucid dreams rarely there is substantial variance in lucid dream frequency.

REM sleep without atonia with REM sleep-related motor events: broadening the spectrum of REM sleep behavior disorder.

Study Objectives: To assess the presence of increased REM-related motor activity during sleep, by questionnaires for REM sleep behavior disorder (RBD), in participants with "isolated" REM sleep without atonia (RWA).

Participants And Methods: Two hundred forty-nine patients were consecutively enrolled, with age ≥18 years, sharing bedroom with a roommate, and without a severe health, neurological, or cognitive problem. Motor activity during sleep was assessed by means of the RBD Screening Questionnaire (RBDSQ) and the RBD questionnaire-Hong Kong (RBDQ-HK).

Human Rapid Eye Movement Sleep Shows Local Increases in Low-Frequency Oscillations and Global Decreases in High-Frequency Oscillations Compared to Resting Wakefulness.

It is often assumed that during rapid eye movement (REM) sleep the cerebral cortex homogenously shows electroencephalogram (EEG) activity highly similar to wakefulness. However, to date no studies have compared neural oscillatory activity in human REM sleep to resting wakefulness with high spatial sampling. In the current study, we evaluated high-resolution topographical changes in neural oscillatory power between both early and late naturalistic REM sleep and resting wakefulness in adult humans.

Rapid eye movements sleep as a predictor of functional outcome after stroke: a translational study.

Study Objectives: Sleep disturbances are common in acute stroke patients and are linked with a negative stroke outcome. However, it is also unclear which and how such changes may be related to stroke outcome. To explore this link, we performed a sleep electroencephalogram (EEG) study in animals and humans after ischemic stroke.

Long-term clinical effect of group cognitive behavioral therapy for insomnia: a case series study.

Objective: Cognitive-behavioral therapy for insomnia (CBT-I) is recognized as the first-choice intervention for insomnia. One of the best-known advantages of CBT-I in comparison with pharmacotherapy is its long-term effect. However, only few studies have assessed its benefits with follow-up periods of longer than three years.

Restless legs syndrome in Multiple Sclerosis patients: a contributing factor for fatigue, impaired functional capacity, and diminished health-related quality of life.

Objectives Restless legs syndrome (RLS) symptoms are common in Multiple Sclerosis (MS) patients. The aim of the current study was to examine for the first time whether RLS could affect the functional capacity and various contributing parameters related to quality of life and fatigue in MS patients. Methods According to their RLS status, 50 relapsing-remitting MS patients were divided into the RLS (n = 10) and non-RLS groups (n = 40).

Effects of controlled dehydration on sleep quality and quantity: A polysomnographic study in healthy young adults.

Dehydration is associated with several alternations in body homeostasis involving both physiological and mental aspects. In addition some studies have reported a negative effect of dehydration on subjectively assessed sleep-related parameters. The aim of the current study was to examine for the first time the effect of controlled dehydration on sleep quality and quantity using the gold-standard method of polysomnography.

Leg movement activity during sleep in school-age children and adolescents: a detailed study in normal controls and participants with restless legs syndrome and narcolepsy type 1.

Study Objectives: To evaluate leg movement activity during sleep (LMS) in normal school-age children and adolescents, to eventually establish age-specific periodic LMS (PLMS) index thresholds that support the diagnosis of restless legs syndrome (RLS), and to evaluate the utility of other LMS indices.

Methods: Polysomnographic recordings from 61 controls, 46 children with RLS, and 44 children with narcolepsy type 1 (NT1) were analyzed for total leg movements (LMS), PLMS, and isolated leg movements (ISOLMS) duration and indices, separately for school-age children and adolescents. Moreover, intermovement interval (IMI) graphs and time-of-night distribution of LMS were analyzed, and cut-off thresholds for PLMS index and total LMS index were assessed for the separation of RLS from controls.

Data-driven approaches to define the upper limit of the intermovement interval of periodic leg movements during sleep.

Study Objectives: To define statistically the upper limit of the intermovement interval (IMI, the time interval between the onset of consecutive movements) of periodic leg movements during sleep (PLMS).

Methods: We computed the IMI distribution of a large sample (n = 141) of patients with restless legs syndrome (RLS) and analyzed it with two independent approaches, based on fitting either empirical functions or normal and exponential functions to the data.

Results: The two fitting approaches consistently pointed to an upper limit of the PLMS IMI in the range between 50 and 60 s.

REM Sleep EEG Instability in REM Sleep Behavior Disorder and Clonazepam Effects.

Study Objectives: We aimed to analyze quantitatively rapid eye movement (REM) sleep electroencephalogram (EEG) in controls, drug-naïve idiopathic REM sleep behavior disorder patients (iRBD), and iRBD patients treated with clonazepam.

Methods: Twenty-nine drug-naïve iRBD patients (mean age 68.2 years), 14 iRBD patients under chronic clonazepam therapy (mean age 66.

Short-interval leg movements during sleep entail greater cardiac activation than periodic leg movements during sleep in restless legs syndrome patients.

Periodic leg movements during sleep (PLMS) are sequences of ≥4 motor events with intermovement intervals (IMI) of 10-90 s. PLMS are a supportive diagnostic criterion for restless legs syndrome (RLS) and entail cardiac activation, particularly when associated with arousal. RLS patients also over-express short-interval leg movements during sleep (SILMS), which have IMI <10 s and are organized mainly in sequences of two movements (doublets).