Experimental Sleep Fragmentation

Roehrs, Timothy; Merlotti, Lori; Petrucelli, Nancie; Stepanski, Edward J.; Roth, Thomas

doi:10.1093/sleep/17.5.438

Cited by 125 publications

(99 citation statements)

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“…Despite the fact that the PD-patients in this study had more fragmented sleep, longer sleep latency onset and worse sleep efficiency, than the comparison groups, they did not report more daytime symptoms related to poor sleep. In healthy subjects daytime symptoms have been reported after only one night with fragmented sleep [37]. Our findings can partly be explained by the fact that symptoms of fatigue are, both by patients and healthcare personnel, considered to be a part of the disease [26,38] and therefore are easily overlooked.…”

Section: Discussionmentioning

confidence: 73%

Fragmented sleep: An unrevealed problem in peritoneal dialysis patients

Yngman-Uhlin

Johansson

Fernström

et al. 2011

Scandinavian Journal of Urology and Nephrology

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Objective: The aim of this study was to describe the sleep-wake cycle, sleep quality, fatigue and HRQoL measured with questionnaires, actigraphy and sleep a diary during a one-week period in patients with peritoneal dialysis treatment at home. Further, to explore differences compared to patients with coronary artery disease (CAD) and individuals from the general population. Material and Methods:In this study one week, actigraphy registration, four questionnaires (Uppsala Sleep Inventory, SF-36, FACIT-fatigue, International Restless Legs Study Groups´ form) and a sleep diary were used. Results:In total data from 68 participants and 470 nights were collected. PD-patients (n=28) had more fragmented sleep (p<0.001) and worse sleep efficiency (SE) (p<0.0001) compared to the CAD (n=22) and the population (n=18) groups. Pruritus (57%), restless legs (46%) and fatigue (89%) were prevalent in PD-patients. Pruritus correlated to fragmented sleep (r=-0.45, p=0.01) and SE (r=-0.49, p =0.01). In HRQoL, the physical component score was decreased in the PD and angina groups (p<0.01) compared to the population group.Conclusions: To our knowledge this study is the first to demonstrate that PD-patients have a deteriorated sleep with serious fragmentation measured with a one-week actigraphy registration. Further, PD-patients exhibit worse sleep quality compared to CAD patients and individuals in the population. More evaluation of sleep in clinical practice is highly recommended since PD-patients are vulnerable individuals with extended self-care responsibilities and at risk for co-morbidity secondary to insufficient. Future research on whether PD-patient´ sleep problems and fatigue can be improved by an individual nonpharmacological intervention programme is required.3

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Section: Discussionmentioning

confidence: 73%

Fragmented sleep: An unrevealed problem in peritoneal dialysis patients

Yngman-Uhlin

Johansson

Fernström

et al. 2011

Scandinavian Journal of Urology and Nephrology

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“…(B) Relation between ORP and Arousability: By its very name, sleep depth reflects the ease with which the brain arouses in response to arousal stimuli (arousability); the lighter sleep is, the easier it is to arouse from a given stimulus (Philip et al 1994;Roehrs et al 1994;Berry et al 1998). Arousal occurs when the intensity of a spontaneous or induced stimulus exceeds the intensity required to cause arousal; the arousal threshold.…”

Section: Assessment Of Sleep Depth and Qualitymentioning

confidence: 99%

“…2) and arousability is lowest (Philip et al 1994;Roehrs et al 1994;Berry et al 1998), it can be assumed that ORP correlates with conventionally measured arousal threshold. However, we wanted to determine if differences in ORP within lighter stages ( Figs.…”

Section: Assessment Of Sleep Depth and Qualitymentioning

confidence: 99%

“…Measurement of arousal threshold is typically performed by applying stimuli (e.g. sound) with different intensities and determining the minimum stimulus intensity that causes EEG arousal (Philip et al 1994;Roehrs et al 1994;Martin et al 1997). Alternatively, if the arousal stimulus is known, it is determined by measuring the intensity of the known stimulus just before arousal (e.g.…”

Section: Assessment Of Sleep Depth and Qualitymentioning

confidence: 99%

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The case for using digital EEG analysis in clinical sleep medicine

Younes

2017

Sleep Science Practice

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Evaluation of sleep in clinical polysomnograms continues to rely almost exclusively on visual scoring that implements rules proposed by Rechtschaffen and Kales nearly 50 years ago. Apart from its cost and timeconsuming nature, visual scoring has limitations including: A) Sleep depth, which is a continuous variable, is treated as if it changes in a stepwise fashion from light (stage 1), to intermediate (stage 2) to deep (stage 3). B) Even with this limited scale, there is considerable inter-scorer variability, particularly in scoring stages 1 and 3 of non-REM sleep, thereby adding uncertainty to %time spent in these stages as a reliable metric for evaluating sleep depth. C) Limitation in scoring some of EEG features, including 1) arousal intensity, 2) extent of Alpha intrusion and 3) frequency, and characteristics of sleep spindles and K complexes. Digital analysis can solve these problems but producing a reliable system has been a challenge. In this review I begin with recent advances in digital scoring of sleep according to the Rechtschaffen and Kales rules and conclude that this technology has progressed enough to make it possible to obtain reliable, reproducible scoring, comparable in accuracy to scoring by highly experienced technologists, with minimal editing. This is followed by description of several new metrics that can be obtained if digital scoring systems were to be used routinely in clinical studies. The scientific evidence supporting the potential of these metrics to positively impact sleep medicine practice and the wide range of such metrics in patients studied in the sleep laboratory are highlighted.

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“…Obtaining continuous stretches of sleep is important because fragmented sleep may produce poorer performance despite an adequate number of hours of sleep (Roehrs, Merlotti, Petrucelli, Stepanski, & Roth, 1994).…”

Section: Discussionmentioning

confidence: 99%