Abstracts

Abstract

and excessive daytime sleepiness (EDS) are frequent sleep complaints, whose prevalence increases with age. Some studies reported that insomnia and EDS may predict depression in adults. However, none of them have examined these associations specifically in community-dwelling elderly and none took into account together the phenotype of insomnia symptom (IS) in terms of its component symptoms i.e. sleep quality (SQ), difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS) and early morning awakening (EMA), EDS, and sleep medication. The aim of our present study was to examine the relationships between sleep disturbances and the incidence of depressive symptoms (DEPs) over 4-year in community-dwelling elderly (3824 subjects aged 65 years) free of depressive symptoms at baseline, and taking into account sleep disturbance characteristics, sleep medication and multiple independent and interacting causes of depressive symptoms. Sleep disturbances were assessed at baseline by a face-to-face clinical interview followed by the completion of a sleep questionnaire. DEPs were assessed using the Center for Epidemiologic StudiesDepression scale at baseline, at 2-and 4-year follow-up. Logistic regression models controlling for potential confounders were generated to determine whether sleep disturbances were associated with depressive symptoms and to determine the effect of individual IS. Insomnia and EDS increased independently the risk of incident DEPs (Odds Ratio (OR) = 1.69, 95% Confidence Interval (CI) = 1.26-2.26 and OR = 3.06, 95% CI = 1. 99-4.73, respectively). Poor sleep quality, difficulty in initiating and in maintaining sleep but not early morning awakening were identified as risk factors of DEPs, with risk increasing with the severity and the frequency of IS. Sleep medication was also a risk factor for DEPs independently of sleep disturbances (OR = 1.87, 95% CI = 1.46-2.38 for insomnia, OR = 2.03, 95% CI = 1.59-2.58 for EDS). To conclude, insomnia, EDS and the use of medication increase independently the risk of subsequent depression in elderly. Physicians should carefully consider sleep disorders or durable prescription of sleep medications to prevent late depression. S32Sleep and circadian rhythms in Parkinson's disease: from bench to bedside C. GRONFIER University of Lyon, Lyon, FR Although Parkinson disease (PD) is mainly known for its classical motor features of resting tremor, rigidity, slowness, freezing, bradykinesia, and postural instability, nonmotor symptoms are increasingly recognized as key components of this neurodegenerative disorder. Nonmotor impairments are even often more detrimental on the quality of life than motor symptoms in PD. Sleep disorders are among the most frequent nonmotor features in PD, and are believed to affect almost all patients, with different expressions (insomnia, REM sleep behavior disorder (RBD), excessive daytime sleepiness). Their precise origins are unknown, but they are thought to be multifactorial, and to involve degeneration of several neuronal struct...

The nature of delayed dream incorporation (‘dream‐lag effect’): Personally significant events persist, but not major daily activities or concerns

“…As argued by Wamsley and Stickgold (2011), dreaming may be the experience of memory consolidation (during sleep see also Blagrove, Ruby, & Eichenlaub, 2013;Eichenlaub, Cash, & Blagrove, 2017; for critical discussions). Whereas it is arguable that day-residues reflect waking life experiences with no functional purpose (De Koninck, Wong, & H ebert, 2012), it seems difficult to devise a non-functional process that can result in these delayed incorporations, and Nielsen and Stenstrom (2005) proposed a physiological reason for the 5-7-day delayed incorporation, involving the gradual transfer of new memories from the hippocampus to the neocortex over a period of about one week.…”

Comparing personal insight gains due to consideration of a recent dream and consideration of a recent event using the Ullman and Schredl dream group methods

“…To distinguish functional from non-functional accounts of dreaming would require investigations of the cognitive or other effects, if any, of unrecalled dreams, in addition to recalled dreams as in the current study: due to the difficulties involved such studies have as yet not been performed. Furthermore, Blagrove (2011) cautions that studies that do not experimentally alter dream content are insufficient to demonstrate that characteristics or effects of dream content are functional, as opposed to being solely reflective of pre-sleep emotions, cognitions and experiences (the latter view is argued by De Koninck et al, 2012), although possible higher level socio-cognitive characteristics of dream content, and possibly REM sleep processes (Blagrove et al, 2013) do need to be considered. In addition, we acknowledge also that there is the view, discussed in van Rijn et al (2015), that declarative memory consolidation is primarily a function of Slow Wave Sleep rather than REM sleep (Diekelmann and Born, 2010; Lewis and Durrant, 2011).…”

STOP-Bang questionnaire should be used in all adults with Down Syndrome to screen for moderate to severe obstructive sleep apnea

“…These questionnaires were answered by the patients' proxies, in agreement with other studies in individuals with DS. [4,5,20] Moreover, all research subjects underwent type III polysomnography according to international guidelines. [21] This type III polysomnography has been previously used in OSA studies in individuals with DS [22] and in other populations [23,24].…”