Paradoxes of the first-night effect: a quantitative analysis of antero-posterior EEG topography

Curcio, Giuseppe; Ferrara, Michele; Piergianni, Assunta; Fratello, Fabiana; Gennaro, Luigi De

doi:10.1016/j.clinph.2003.12.018

Cited by 89 publications

(75 citation statements)

References 36 publications

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“…In line with previous research (e.g., Curcio et al, 2004), our study found decreased sleep duration, lower sleep efficiency, longer WASO and decreased REM duration at the first night compared to the second, which is in accordance with the well-known phenomenon of the firstnight effect (Agnew et al, 1966). We also found previously unreported differences in the ratio of S2 and SWS between the first and the second night.…”

Section: Discussionsupporting

confidence: 82%

“…Specifically, compared to the recordings of the second night, first-night sleep is characterized by decreased total sleep time and reduced REM sleep, lower sleep efficiency, more intermittent wake time, longer REM latency, and an increased amount of Stage-1 (S1) sleep (Curcio, Ferrara, Piergianni, Fratello, & De Gennaro, 2004). The origins of this effect can be attributed to multiple reasons: unfamiliar environment, discomfort, limitations of movements because of the electrodes and cables, and the psychological consequences of "being under investigation" (Bon et al, 2003;Tamaki, Nittono, Hayashi, & Hori, 2005).…”

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confidence: 99%

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Objective and Subjective Components of the First-Night Effect in Young Nightmare Sufferers and Healthy Participants

Kis

Szakadát

Simor³

et al. 2013

Behavioral Sleep Medicine

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Section: Discussionsupporting

confidence: 82%

mentioning

confidence: 99%

Objective and Subjective Components of the First-Night Effect in Young Nightmare Sufferers and Healthy Participants

Kis

Szakadát

Simor³

et al. 2013

Behavioral Sleep Medicine

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“…44 With gaboxadol treatment, low-frequency EEG activity was increased and spindle activity was attenuated in a dose-related manner. This is consistent with the increase in visually scored SWS in the same study.…”

Section: Referencesmentioning

confidence: 99%

EEG Power Spectra Response to a 4-h Phase Advance and Gaboxadol Treatment in 822 Men and Women

Dijk²,

Svetnik³

et al. 2011

Journal of Clinical Sleep Medicine

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study objective: To explore the effect of gaboxadol on NREM EEG in transient insomnia using power spectral analysis and evaluate the response between men and women. methods: This was a randomized, double-blind, 3-way, parallel-group transient insomnia study in 22 sleep laboratories. After a baseline night (N1), subjects underwent a 4-h phase-advance of their habitual sleep time the following night (N2). Healthy subjects aged 18-64 y were given singleblind placebo on N1 followed by double-blind treatment on N2 (gaboxadol 10 mg [n = 271], 15 mg [n = 274], or placebo [n = 277]) Results: At baseline, women showed signifi cantly greater values in low frequency activity (< 10 Hz) and in high spindle/ low beta frequency activity (14-18 Hz) compared to men. During the phase advance (placebo N2-baseline N1), there was a signifi cant increase in power within the high spindle/low beta frequency range (15-17 Hz) and a signifi cant reduction in beta activity (20-32 Hz), which was greater in women than men. Gaboxadol induced a signifi cant (dose-related) increase in low frequencies (< 8 Hz) and a signifi cant (dose-related) decrease within the alpha/spindle range (11-12 Hz). The effect was dependent upon sex, with a greater magnitude of effect observed in women than men. Conclusion: Gaboxadol shows a characteristic NREM EEG spectral profi le in a model of transient insomnia. Men and women show clear differences in NREM EEG activity at baseline, to gaboxadol treatment and to phase-shifts in habitual sleep/wake times. The exact mechanisms underlying the sex differences remain unclear, but sex is an important variable in studies evaluating sleep and gaboxadol. s C I e N t I F I C I N V e s t I G A t I o N sT he functional signifi cance of individual differences in SWS and the pharmacological enhancement of SWS is under intense investigation. [1][2][3][4] The clinical interest in a SWS-enhancing agent, one that augments delta activity, is that such agents may be able to do so in a subject group with diminished SWS/SWA (e.g., aging and males) and thereby provide some form of benefi t to the individual in terms of sleep, daytime performance, and ultimately quality of life. Sex (gender) is beginning to emerge as one of the key predictors of individual differences of SWS under normal sleep conditions, but it is not known whether sex can contribute to the individual differences observed in sleep disruption or in specifi c pharmacological manipulations of SWS. Even though gaboxadol is no longer in clinical development for insomnia, it can be used as a pharmacological research tool with a unique mechanism of action, and specifi cally one that enhances SWS. Ultimately such investigations may lead to a better understanding of both the functional signifi cance of SWS as well as the profound sex differences in the prevalence of insomnia.Gaboxadol is a novel selective extrasynaptic GABA A agonist with the α 4 δ containing receptors currently seeming the most relevant target for mediating its hypnotic activity.5 This receptor subtype occurs ...

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“…15 This is important as home PM may be most relevant to patient's "true disease burden" and where "noise" such as variability due to first-night effect is minimized. [16][17][18] We hypothesized that night-to-night variability assessed in patients' usual sleep environment (by home PM) would be higher in mild OSA and in patients without signs and symptoms of sleepiness (due to lower chronic exposure to intermittent hypoxia and sleep fragmentation). We prospectively examined night-to-night variability in AHI with home PM (AHI PM ) over 2 to 8 nights in a sample of middle-aged newly diagnosed OSA patients.…”

Section: Brief Summarymentioning

confidence: 99%

Short-Term Variability in Apnea-Hypopnea Index during Extended Home Portable Monitoring

Prasad

Usmani

Steffen

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Apnea-hypopnea index (AHI) is the primary measure used to confirm a diagnosis of obstructive sleep apnea (OSA). However, there may be significant night-to-night variability (NNV) in AHI, limiting the value of AHI in clinical decision-making related to OSA management. We examined shortterm NNV in AHI and its predictors during home portable monitoring (PM). Methods: Single center prospective observational study of patients (n = 84) with newly diagnosed OSA by polysomnography (PSG) AHI ≥ 5/h. All participants underwent 2 to 8 consecutive nights of PM. Results: Participants (n = 84) were middle-aged (47 ± 8.3 y, mean ± standard deviation; SD), including 28 women, with mean AHI on baseline PSG (AHI PSG ) of 30.1 ± 31.8. Mean AHI on PM (AHI PM ) was 27.4 ± 23.7. Intraclass correlation coefficient (ICC) for AHI PM in the entire sample was 0.73 (95% CI 0.66-0.8), indicating that 27% of the variability in AHI PM was due to intra-individual factors. Mild severity of OSA, defined by AHI PSG 5-15/h, was associated with higher NNV (likelihood ratio, −0.4 ± 0.14; p = 0.006) and absence of comorbidity showed a trend towards higher NNV (−0.54 ± 0.27, p = 0.05) on AHI PM . Conclusions:The intraindividual short-term NNV in AHI PM is higher in mild versus moderately severe OSA, even in the home setting, where first-night effect is not expected. Larger studies of NNV focused on patients with mild OSA are needed to identify characteristics that predict need and timing for repeated diagnostic testing and treatment. Commentary: A commentary on this article appears in this issue on page 787.

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Paradoxes of the first-night effect: a quantitative analysis of antero-posterior EEG topography

Cited by 89 publications

References 36 publications

Objective and Subjective Components of the First-Night Effect in Young Nightmare Sufferers and Healthy Participants

Objective and Subjective Components of the First-Night Effect in Young Nightmare Sufferers and Healthy Participants

EEG Power Spectra Response to a 4-h Phase Advance and Gaboxadol Treatment in 822 Men and Women

Short-Term Variability in Apnea-Hypopnea Index during Extended Home Portable Monitoring

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