Sleep Variability Across Consecutive Nights of Home Monitoring in Older Mixed DIMS Patients

Edinger, Jack D.; Marsh, Gail R.; McCall, W. Vaughn; Erwin, C. W.; Lininger, Anne W.

doi:10.1093/sleep/14.1.13

Cited by 61 publications

(48 citation statements)

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“…The need for an adaptation night may vary between different kinds of sleep disorders. Edinger et al [61], for instance, did not find any systemat- ic first-night effects in a group of elderly subjects with difficulties in initiating and maintaining sleep, while in our own sleep studies in patients suffering from generalized anxiety disorder [45], panic disorder [46], depression [62] and dysthymia [63], adaptation nights were deemed absolutely necessary. Akiskal et al [64] reported a first-night effect in a mixed sample of anxious and depressed patients.…”

Section: Discussioncontrasting

confidence: 42%

Sleep Laboratory Studies in Restless Legs Syndrome Patients as Compared with Normals and Acute Effects of Ropinirole

et al. 2000

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Although the restless legs syndrome (RLS) is a disorder with a relatively high prevalence rate (8% in Austria) and leads to insomnia and excessive daytime tiredness, there is a paucity of sleep laboratory data concerning objective and subjective sleep and awakening quality. Thus, the aim of this study was to investigate 12 untreated RLS patients as compared with 12 normal controls and subsequently measure the acute effects of 0.5 mg ropinirole (Requip^®) – a nonergoline dopamine agonist – as compared with placebo. In 3 nights (adaptation, placebo, ropinirole night) sleep induction, maintenance and architecture were measured objectively by polysomnography, subjective sleep and awakening quality were assessed by self-rating scales and visual-analog scales, and objective awakening quality was evaluated by a psychometric test battery. In polysomnography, RLS patients demonstrated, as compared with normal controls, a decreased total sleep time (TST) and sleep efficacy, increased wakefulness during the total sleep period and frequency of nocturnal awakenings, increased sleep stage S1, decreased S2 and increased stage shifts. Subjective sleep quality tended to decrease, and morning well-being, mood, affectivity and wakefulness were deteriorated. In the noopsyche, fine motor activity and reaction time performance were deteriorated. Ropinirole 0.5 mg induced, as compared with placebo, an increase in TST, sleep efficacy, S2 sleep and stage shifts. In the morning, somatic complaints increased slightly, while fine motor activity and reaction time performance improved. Our findings suggest a key-lock principle in the diagnosis/treatment of RLS and a dopaminergic mechanism in its pathogenesis, which is supported by the data on periodic leg movements during sleep and arousals of the subsequent paper.

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Section: Discussioncontrasting

confidence: 42%

Sleep Laboratory Studies in Restless Legs Syndrome Patients as Compared with Normals and Acute Effects of Ropinirole

et al. 2000

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“…The need for adaptation nights may vary from one sleep disorder to another. Edinger et al (1991) found no systematic ®rst-night effects in a group of elderly subjects with dif®culties in initiating and maintaining sleep. However, in our own sleep studies in generalized anxiety disorder , panic disorder (Saletu-Zyhlarz et al, 2000b), depression (Saletu-Zyhlarz et al, in press) and dysthymia (Saletu et al, in press) adaptation nights deemed absolutely necessary.…”

Section: Discussionmentioning

confidence: 76%

Sleep laboratory studies in periodic limb movement disorder (PLMD) patients as compared with normals and acute effects of ropinirole

Saletu

Anderer

Saletu

et al. 2001

Human Psychopharmacology

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Periodic limb movement disorder (PLMD) occurs in a variety of sleep disorders and can cause insomnia as well as hypersomnia with daytime somnolence. The aim of this study was to investigate 12 untreated PLMD patients as compared with 12 normal controls and to measure the acute effects of 0.5 mg ropinirole (Requip((R))) - a non-ergoline dopamine agonist - as compared with placebo. In three nights (adaptation, placebo, ropinirole night) objective and subjective sleep and awakening quality were evaluated. In the target variable 'periodic leg movements per hour of sleep' (PLM/(hTST)) PLMD patients showed an increased value of 42/h (normal 0-5/h) with a greater number of arousals due to periodic leg movements (PLM) in sleep. They further demonstrated an increased number of awakenings, sleep stage S1, S4, stage shifts and decreased S2, but there were no significant differences concerning total sleep time, sleep efficiency (SE), subjective sleep quality and morning measures of mood, drive and drowsiness. However, measures of attention variability, numerical memory, fine motor activity and reaction time performance were impaired. Ropinirole 0.5 mg was shown to significantly improve the index PLM/(hTST) by 64% and arousals due to PLM, increase spontaneous arousals, REM-latency, stage 2 and stage shifts and decrease SREM. In the morning attention variability was attenuated and numerical memory augmented. Thus, ropinirole improved some sleep architecture and early morning measures of performance but specifically all PLM variables, which suggests a dopaminergic pathogenesis in PLMD. Copyright 2001 John Wiley & Sons, Ltd.

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“…[4][5][6] It has been suggested that factors such as the location of monitoring or pleasantness of the laboratory environment may attenuate this effect, or that individual variability may cancel out differences for entire samples. 5,[7][8][9][10] Many studies observing a FNE have also noted a "paradoxical" or "reverse" fi rst night effect (RFNE) in some of their subjects. [11][12][13][14] The RFNE is characterized by the observation of decreased sleep onset latency, decreased REM latency, a higher percentage of REM, and greater sleep effi ciency in the fi rst night at the laboratory relative to successive nights, as measured by PSG.…”

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confidence: 99%

Objective vs. Subjective Measurements of Sleep in Depressed Insomniacs: First Night Effect or Reverse First Night Effect?

McCall

2012

Journal of Clinical Sleep Medicine

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Study Objectives: This study examined changes in sleep parameters between the laboratory and the home setting before and after laboratory monitoring in depressed insomniacs undergoing treatment. Methods: This study was a post hoc analysis of a double-blind, randomized, placebo-controlled clinical trial performed with 60 depressed, insomniac outpatients. Patients underwent actigraphic monitoring along with sleep diaries over a continuous 2-week period. After one week of baseline monitoring, subjects spent one night in the laboratory with concurrent actigraphic and PSG monitoring with sleep diaries. Actigraphic monitoring and sleep diaries were continued for another week at home, along with initiation of open-label fl uoxetine (FLX). Results: Actigraphically recorded laboratory sleep during the night in the laboratory was found to be improved relative to actigraphically recorded sleep at home, with less wake time and greater sleep time and sleep effi ciency occurring in the laboratory. In contrast, sleep diaries indicated a slight worsening of sleep in the laboratory compared to home, with signifi cantly more awakenings in the laboratory compared to the week at home before and after the laboratory night. Conclusions S C I E N T I F I C I N V E S T I G A T I O N SM any individuals experience worse sleep during their fi rst night in a sleep laboratory than on successive nights. This "fi rst night effect" (FNE) is typically characterized by increased sleep onset latency, increased REM latency, a lower percentage of REM stage sleep, and lower sleep effi ciency as measured by polysomnography (PSG). While many studies have observed the FNE phenomenon in normal subjects and in those with depression or insomnia, 1-3 others have observed a reduced or absent FNE. [4][5][6] It has been suggested that factors such as the location of monitoring or pleasantness of the laboratory environment may attenuate this effect, or that individual variability may cancel out differences for entire samples. 5,7-10Many studies observing a FNE have also noted a "paradoxical" or "reverse" fi rst night effect (RFNE) in some of their subjects.11-14 The RFNE is characterized by the observation of decreased sleep onset latency, decreased REM latency, a higher percentage of REM, and greater sleep effi ciency in the fi rst night at the laboratory relative to successive nights, as measured by PSG.13 For insomniacs who demonstrate this phenomenon, several explanations have been proposed. Hauri et al. suggested that maladaptive reinforcements are formed between the insomniac's sleeping problems and their normal sleep environment. 13,15 This conditioned arousal reaction to their normal sleep environment does not generalize to the novel sleep environment of the laboratory, where they fall asleep more easily. Alternatively, de la Pena proposed that some insomniacs require a higher level of waking sensory stimulation to induce sleep, and the greater sensory stimulation of the novel laboratory environment improves their sleep. 16Studies investigating sleep ...

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Sleep Variability Across Consecutive Nights of Home Monitoring in Older Mixed DIMS Patients

Cited by 61 publications

References 0 publications

Sleep Laboratory Studies in Restless Legs Syndrome Patients as Compared with Normals and Acute Effects of Ropinirole

Sleep Laboratory Studies in Restless Legs Syndrome Patients as Compared with Normals and Acute Effects of Ropinirole

Sleep laboratory studies in periodic limb movement disorder (PLMD) patients as compared with normals and acute effects of ropinirole

Objective vs. Subjective Measurements of Sleep in Depressed Insomniacs: First Night Effect or Reverse First Night Effect?

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