ISSN:0962-1105    

DOI:10.1111/j.1365-2869.1993.tb00087.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARY A number of studies, some done by us, are reviewed concerning the function of foetal/neonatal REM sleep. The hypothesis is put forward that REM sleep in early life serves as an indicator for: (1) the degree of brain maturation, and (2) the promotion of further brain development. This hypothesis, although not exclusive, differs from: the original theory of Roffwarget al.(1966) that REM sleep serves as “wakefulness” during the period in which wakefulness is limited; and also from the theory of Crick and Mitchson (1983—the “unlearning” hypothesis of REM sleep). As the functions of sleep in general, and REM sleep in particular, are still unclear, we hope this review will suggest new possibilities for futu

ISSN:0962-1105    

DOI:10.1111/j.1365-2869.1993.tb00088.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARY Similar periodicities of about 90–100 min characterize both hormone pulsatility and NREM‐REM sleep cycles suggesting that both processes could be temporally linked. From the current knowledge of the literature, it appears that, in spite of the diversity of the relationship between hormones and the sleep/wake cycle, systematic relationships exist between hormone pulses and the NREM‐REM sleep cycles. Early studies have demonstrated the temporal association between GH and SWS episodes occurring soon after sleep onset. Renin, a key enzyme of the renin‐angiotensin system, displays nocturnal oscillations that are associated strongly with the NREM‐REM sleep cycles, and represents the first identified biological marker of sleep stage alternation. SWS invariably occurs in the descending phases of TSH and cortisol pulses which suggests that some specific mechanisms of this sleep stage could modulate their levels or, conversely, that increased TSH and cortisol secretion prevents the occurrence of deep sleep. Apart from the period of sleep onset associated with reduced prolactin secretion, no systematic relationship has been found between REM sleep and hormone release. These results highlight the complexity of hormone and sleep interactions and provide a basis for further research into their functional s

ISSN:0962-1105    

DOI:10.1111/j.1365-2869.1993.tb00089.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARY The discovery, 40 years ago, of REM sleep and of its putative association with dreaming in the adult human raised the possibility that neuroscientific investigations of REM‐sleep physiology would someday ‘explain’ the distinctive features of dream experience. I argue here against the possibility, since replicated psychological data demonstrate that REM sleep is neither a necessary nor a sufficient condition for dreaming to occur. Dreaming depends, rather, upon the possession of conscious representational intelligence in conjunction with any psychophysiological state in which ideation is being driven neither volitionally nor by external stim

ISSN:0962-1105    

DOI:10.1111/j.1365-2869.1993.tb00090.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARY Successful psychological and physical adaptation in late life correlates with preservation of sleep quality and physiological integrity of nocturnal EEG sleep measures. Failure to adapt is associated with loss of sleep continuity, alterations in the temporal distribution of delta wave activity, and by either a relative increase in REM sleep (e.g. in mood disorders) or a decrease in REM sleep (e.g. neurodegenerative disorders). Maintenance of sleep (particularly REM sleep) into late life may not be just a correlate, but also possibly a mechanism, of successful aging and thus necessary to the long‐term maintenance of vitality and engagement in l

ISSN:0962-1105    

DOI:10.1111/j.1365-2869.1993.tb00091.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARY Abnormalities of REM sleep, i.e. shortening of REM latency, lengthening of the duration of the first REM period and heightening of REM density, which are frequently observed in patients with a major depressive disorder (MDD), have attracted considerable interest. Initial hopes that these aberrant patterns of sleep constitute specific markers for the primary/endogenous sub‐type of depression have not been fulfilled. The specificity of REM sleep disinhibition for depression in comparison with other psychopathological groups is challenged as well. Demographic variables like age and sex exert strong influences on sleep physiology and must be controlled when searching for specific markers of depressed sleep. It is still an open question whether abnormalities of sleep are state‐ or trait‐markers of depression. Beyond baseline studies, the cholinergic REM induction test (CRIT) indicated a heightened responsitivity of the REM sleep system to cholinergic challenge in depression compared with healthy controls and other psychopathological groups, with the exception of schizophrenia. A special role for REM sleep in depression is supported by the well‐known REM sleep suppressing effect of most antidepressants. The antidepressant effect of selective REM deprivation by awakenings stresses the importance of mechanisms involved in REM sleep regulation for the understanding of the pathophysiology of depressive disorders. The positive effect of total sleep deprivation on depressive mood which can be reversed by daytime naps, furthermore emphasizes relationships between sleep and depression. Experimental evidence as described above instigated several theories like the REM deprivation hypothesis, the 2‐process model and the reciprocal interaction model of nonREM‐REM sleep regulation to explain the deviant sleep pattern of depression. The different models will be discussed with reference to empirical data gathered

ISSN:0962-1105    

DOI:10.1111/j.1365-2869.1993.tb00092.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARY REM sleep behaviour disorder (RBD) is an injurious clinical disorder of attempted dream‐enactment (‘oneirism’) in humans which has a corresponding experimental animal model involving dorsolateral pontine tegmental lesions in cats. To date, our sleep disorders centre has collected data on 96 chronic RBD cases which can be compared with pooled data on 70 chronic RBD cases from other centres contained in 26 reports published in the world literature since 1985, when our initial cases were first reported. The data from our centre and from other centres demonstrate a male predominance in RBD (87.5% vs 63.5%); indicate a similar mean age of RBD onset (52.4 yvs55.9y); contain substantial numbers of diverse central nervous system disorders causally associated with RBD (47.9%vs60.0%); and identify clonazepam treatment as being very effective in controlling both the (violent) dream and sleep behavioural disturbances of RBD. Our centre's data additionally reveal an 80% prevalence of elevated stage 3/4 (slow‐wave) sleep% for age in RBD, and reveal a frequent presence of periodic and aperiodic limb movements during NREM sleep. Thus, RBD in humans is a complex syndrome in which there is generalized REM and NREM sleep motor dyscontrol, as was originally observed in the animal RBD model by Jouvet and Delorm

ISSN:0962-1105    

DOI:10.1111/j.1365-2869.1993.tb00093.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARY The experiments reported here sought to investigate whether the K‐complex evoked during sleep is comprised of activity from two separate physiological systems with different response properties. To that end, the parameters of stimulation in a two tone auditory ‘odd‐ball’ task were varied systematically as stimuli were presented to subjects during NREM sleep. During experiment 1, the frequency (pitch) of the odd‐ball stimulus varied systematically while intensity (loudness) was matched between tones. During experiment 2, pitch was matched between tones while the loudness of the odd‐ball stimulus was varied. The long‐latency event‐related potentials (ERPs) N2 and P3 could be dissociated from the K‐complex (N3 and P4) in response to these parametric manipulations. Information processing occurs during sleep, and is reflected in ERPs with a morphology largely analogous to those observed under similar conditions while subjects are awake. The second (K‐complex) system is sleep specific. A model was constructed to explain the activity of these two hypothesized systems. As predicted by the model, K‐complex latency was longer in Stage 2 when N2 and P3 were also active, than in Stage 4 where N2‐P3 activity was lessened. These results support the two‐system hypothesis; electrical brain activity evoked during sleep should not be considered a unitary sleep‐specific response. Furthermore, the data indicate that the K‐complex is sensitive to the physical characteristics of stimuli, that the sleeping brain processes information to a high degree, and that the ‘endogenous’ components of the ERP observed in awake humans reflect more automatic

ISSN:0962-1105    

DOI:10.1111/j.1365-2869.1993.tb00094.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARY The generation of phasic muscle activity during REM sleep is regulated by the brainstem. We proposed two sleep indices for phasic muscle activity during REM sleep, and examine their usefulness in assessing normal brainstem maturation and functional brainstem impairment during infancy. One ‐ the dissociation index (DI) ‐ seems to reflect maturation of thetonicinhibitory system functioning during REM sleep, and the other ‐ % body movements in REMs bursts (%BMs‐R) ‐ to reflect that of thephasicone. In normal infants, DI showed a gradual, linear and significant increase with age, whereas %BMs‐R showed a gradual and significant decrease with age. In infants with sudden infant death syndrome (SIDS) and one who had experienced apparent life‐threatening events (ALTE), the DI values were lower than those in controls, although %BMs‐R values were identical in the controls. In contrast, DI was variable in infants with West syndrome (WS), while %BMs‐R exceeded normal values. Thetonicinhibitory system seemed to be specifically involved in SIDS and ALTE, but thephasicinhibitory one in WS. Anatomical differences between these inhibitory systems

ISSN:0962-1105    

DOI:10.1111/j.1365-2869.1993.tb00095.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARY Eighteen narcoleptic patients were treated in a single‐blind study with brofaromine, a new selective and reversible MAO‐A‐inhibitor. After a drug‐free period of seven days, brofaromine was administered for two weeks. Patients were treated with 75 mg brofaromine for the first week and with 150 mg brofaromine for the second week of the study. After an adaptation night nocturnal sleep EEGs were recorded under placebo before brofaromine was given, one week later under 75 mg, and another week later under 150 mg brofaromine. Excessive daytime sleepiness (EDS) was evaluated under placebo at the beginning of the study, under 75 mg at the end of the first week, and under 150 mg brofaromine at the end of the second week by means of the Multiple Sleep Latency Test (MSLT) and the Maintenance of Wakefulness Test (MWT). The number of cataplexies was protocolled by the patients. Compared to placebo the administration of 150 mg brofaromine led to a significant increase of sleep latency in the MLST as well as in the MWT. REM sleep was significantly suppressed in the nocturnal sleep EEG, in the MSLT and in the MWT. The number of cataplexies protocolled by the patient was significantly decreased under 150 mg of brofaromine compared to placebo. Improvement of vigilance and cataplexy occurred in dose‐dependent manner. No serious side effects were observed. The results of the present single‐blind study indicate that brofaromine seems to be a well‐tolerated and effective drug for the treatment of excessive daytime sleepiness and cataplexy in narco

ISSN:0962-1105    

DOI:10.1111/j.1365-2869.1993.tb00096.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY