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6 results

  • Chapter 11 - Sleep Disorders and Psychiatry

  • Edited by David Kingdon, University of Southampton, Paul Rowlands, Derbyshire Healthcare NHS foundation Trust, George Stein, Emeritus of the Princess Royal University Hospital
  • Book:
    Seminars in General Adult Psychiatry
    Published online:
    04 April 2024
    Print publication:
    18 April 2024, pp 546-564

  • Summary

    Sleep is one of the great mysteries of human experience. It is a behaviour that is highly preserved throughout the animal kingdom, and it constitutes a third of our existence. It begins before birth and is with us throughout life. For a newborn baby, it is their predominant behaviour and continues to occupy a large proportion of our lives as we age. It has long been suspected that it is essential for good mental and physical health, and in the last century, there has been growing scientific evidence to confirm this suspicion. Yet, we know very little about the functions of sleep and are only just beginning to understand the mechanisms that control it. In the past, it was commonly assumed that sleep had ’a function’, but the more we have come to understand, the clearer it has become that sleep performs multiple functions. Precisely what those functions are is still uncertain, and they may change across the lifespan or possibly even vary across different species. We know that sleep is essential for life and total sleep deprivation for long enough is fatal, and the fact that we spend a third of our lives in this vulnerable state underlines how important sleep must be.

  • Cannabinoid Use and Obstructive Sleep Apnea: A Retrospective Cohort Study

  • Matthew R. Veitch, Sean Jairam, Patrick Gurges, Elliott Cohen, Tetyana Kendzerska, Brian J. Murray, Mark I. Boulos
  • Journal:
    Canadian Journal of Neurological Sciences , First View
    Published online by Cambridge University Press:
    22 February 2024, pp. 1-8
    • Article
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  • Background:

    Obstructive sleep apnea (OSA) is a sleep disorder with no widely accepted pharmacological therapy. Cannabinoids have been suggested to reduce OSA severity in small human studies. The purpose of this retrospective cohort study was to explore the association of self-reported cannabis use on OSA severity and sleep parameters in a large cohort of adults undergoing in-laboratory polysomnography.

    Methods:

    Sleep and medication data were collected for all consecutive adults who completed diagnostic polysomnography at Sunnybrook Health Sciences Centre from 2010 to 2022. Multivariable linear regression models were employed that adjusted for age, sex, and BMI (minimally adjusted model), as well as medication and comorbidity data (maximally adjusted model). An exploratory subgroup analysis was additionally run in patients with moderate to severe OSA.

    Results:

    Of 6,958 individuals (mean age 54.7 ± 16.3, BMI 29.1 ± 6.8, 51.0% female), 71 reported cannabis use. In our minimally adjusted models, cannabis use predicted a reduced respiratory disturbance index (RDI) (β: −4.8 [95% CI: −9.4, −0.2]; p = 0.042); this association became nonsignificant in the fully adjusted models. In an exploratory analysis of patients with moderate to severe OSA (n = 613), cannabis use (n = 7) predicted increased stage N3 sleep (β: 33.5 [95% CI: 15.6, 51.4]; p < 0.001) and decreased REM sleep (β: 16.0 [95% CI: 0.3, 31.7]; p = 0.046).

    Conclusion:

    Self-reported cannabis use was not associated with OSA severity after adjusting for confounders. In an exploratory subgroup analysis of patients with moderate to severe OSA, cannabis use impacted sleep architecture. Future studies should further explore these findings.

  • Effects of subacute ingestion of chlorogenic acids on sleep architecture and energy metabolism through activity of the autonomic nervous system: a randomised, placebo-controlled, double-blinded cross-over trial

  • Insung Park, Ryuji Ochiai, Hitomi Ogata, Momoko Kayaba, Sayaka Hari, Masanobu Hibi, Yoshihisa Katsuragi, Makoto Satoh, Kumpei Tokuyama
  • Journal:
    British Journal of Nutrition / Volume 117 / Issue 7 / 14 April 2017
    Published online by Cambridge University Press:
    17 April 2017, pp. 979-984
    Print publication:
    14 April 2017
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  • Chlorogenic acids (CGA) are the most abundant polyphenols in coffee. Continuous consumption of CGA reduces body fat and body weight. Since energy metabolism and sleep are controlled by common regulatory factors, consumption of CGA might modulate sleep. Lack of sleep has been identified as a risk factor for obesity, hypertension and type 2 diabetes. The aim of this study was to determine the effects of ingesting CGA over 5 d on energy metabolism and sleep quality in humans. A total of nine healthy subjects (four male and five female) completed a placebo-controlled, double-blinded, cross-over intervention study. Subjects consumed a test beverage containing 0 or 600 mg of CGA for 5 d. On the fifth night, subjects stayed in a whole-room metabolic chamber to measure energy metabolism; sleep was evaluated using polysomnographic recording. It was found that CGA shortened sleep latency (9 (sem 2) v. 16 (sem 4) min, P<0·05) compared with the control, whereas no effect on sleep architecture, such as slow-wave sleep, rapid eye movement or waking after sleep onset, was observed. Indirect calorimetry revealed that consumption of CGA increased fat oxidation (510 (sem 84) kJ/8 h (122 (sem 20) kcal/8 h) v. 331 (sem 79) kJ/8 h (81 (sem 19) kcal/8 h), P<0·05) but did not affect energy expenditure during sleep. Consumption of CGA enhanced parasympathetic activity assessed from heart-rate variability during sleep (999 (sem 77) v. 919 (sem 54), P<0·05). A period of 5-d CGA consumption significantly increased fat oxidation during sleep, suggesting that beverages containing CGA may be beneficial to reduce body fat and prevent obesity. Consumption of CGA shortened sleep latency and did not adversely affect sleep quality.

  • 20 - Right hemisphere syndromes

  • from Section 1 - Clinical manifestations
  • Edited by Louis R. Caplan, Jan van Gijn
  • Book:
    Stroke Syndromes, 3ed
    Published online:
    05 August 2012
    Print publication:
    12 July 2012, pp 229-244

  • Summary

    Sleep-wake disturbances (SWD) are frequently (20%-50%) encountered in stroke patients. Clinical symptoms include hypersomnia, excessive daytime sleepiness, fatigue, and insomnia. The most dramatic forms of poststroke hypersomnia are observed in patients with bithalamic paramedian stroke. The presence of SWD after stroke is associated with cognitive and psychiatric (depression, anxiety) disturbances. The recognition and diagnosis of poststroke SWD occur primarily on clinical grounds. Validated questionnaires such as the Epworth Sleepiness Scale and the Fatigue Severity Scale may help in the recognition of poststroke sleepiness and fatigue. In patients with paramedian thalamic stroke, treatment with 20-40 mg of bromocriptine may improve apathy and presleep behavior. Changes in sleep architecture depend upon: patient and health characteristics present before the stroke, topography and extent of the lesion, associated complications of stroke (e.g. SDB, fever, infections, cardiovascular disturbances, depression, anxiety), drug treatment, and time after stroke onset.

  • 15 - Sleep and fibromyalgia in the elderly

  • from Part 3 - Sleepdisorders in the elderly
  • Edited by S. R. Pandi-Perumal, Jaime M. Monti, Universidad de la República, Uruguay, Andrew A. Monjan, National Institute on Aging, Bethesda, Maryland
  • Book:
    Principles and Practice of Geriatric Sleep Medicine
    Published online:
    04 August 2010
    Print publication:
    26 November 2009, pp 160-166

  • Summary

    The central research topic of this chapter is embedded within three major fields of research, that is, sleep, memory, and cognitive aging research. Sleep is further characterized by changes in cerebral activity across the sleep-wake cycle. At a global level, brain activity decreases from waking to non-REM (NREM) sleep and returns back to waking levels during rapid eye movement (REM) sleep. Like sleep, memory is not a unitary system. In fact, there are several different classification schemes for human memory. In the context of sleep-dependent memory consolidation, an important distinction is usually drawn between declarative and non-declarative memory systems. Age-related cognitive decline is characterized by healthy and pathological processes in adult brain development. In this context, an important distinction is drawn between normal aging, mild cognitive impairment (MCI), and Alzheimer's disease (AD). Several psychiatric disorders such as Alzheimer's disease and depression are associated with disturbances of both sleep and memory.

  • 37 - Self-help treatments for older adults with primary and co-morbid insomnia

  • from Part 4 - Treatment of sleep disorders in the elderly
  • Edited by S. R. Pandi-Perumal, Jaime M. Monti, Universidad de la República, Uruguay, Andrew A. Monjan, National Institute on Aging, Bethesda, Maryland
  • Book:
    Principles and Practice of Geriatric Sleep Medicine
    Published online:
    04 August 2010
    Print publication:
    26 November 2009, pp 394-402

  • Summary

    This chapter addresses the age-related changes in sleep and the nature, assessment, diagnosis, and epidemiology of older adults with insomnia (OAWI) from a behavioral sleep medicine perspective. Complaints of insomnia are categorized into difficulty falling asleep, difficulty maintaining sleep, unwanted early morning awakenings, and non-restorative sleep often with daytime consequences such as excessive daytime sleepiness and fatigue. Factors that interfere with the opportunity to obtain sufficient sleep include other sleep disorders, substance use, shift work, or the presence of another psychiatric disorder. As one moves from middle age to the later years of life, the aging process creates changes in sleep architecture and continuity that increase the vulnerability to developing chronic insomnia. Research indicates that some crucial interventions that buffer against chronic insomnia may help the older adult to adopt a regular daily schedule, a healthier lifestyle and sleep behaviors, and increase the quality of social interactions and physical activity.