Polysomnography Sleep Latency Research Articles

Correlation between Serum Levels of Sympathetic Nerve Activity Markers and Sleep Quality and Cognitive Function in Patients with Chronic Insomnia Disorder

Objectives: To explore the changes of the serum levels of copeptin and α-amylase and the correlations with sleep quality and cognition function in the patients with chronic insomnia disorder (CID). Methods: Fifty-seven CID patients and thirty healthy controls were enrolled continuously. Pittsburgh Sleep Quality Index (PSQI), polysomnography (PSG) and Pre-Sleep Arousal Scale (PSAS) were used to assess the insomnia severity and cognitive and somatic manifestations of arousal experienced at bedtime. Montreal Cognitive Assessment scale (MoCA) and Nine-Box Maze were used to respectively assess general cognition and memories. The serum levels of copeptin and α-amylase were detected using Enzyme-Linked ImmunoSorbent Assay. Results: Compared to the controls, the CID patients had increased PSQI and PSAS scores (Z=‒7.678 and ‒7.350; Ps<0.001), decreased MoCA score (t=‒4.625, P<0.001), increased numbers of errors in the object working, spatial working and object recognition (Z=‒2.099, ‒3.935 and ‒2.266; Ps<0.05) memories, and elevated serum levels of copeptin and α-amylase (t=5.414 and 5.597, P <0.001). In the CID patients，the level of copeptin positively correlated with PSQI and PSAS scores (r=0.338 and 0.316; Ps<0.05), and PSG sleep latency, wake time and N1% (r=0.324, 0.325 and 0.278, Ps<0.05), and negatively correlated with PSG N 2% (r=‒0.279, Ps<0.05). Alpha-amylase was positively correlated with waking numbers in PSG (r=0.293, P< 0.05). Multiple linear regression analysis showed that copeptin level affected PSQI score and PSG sleep latency (P<0.05). Conclusions: The serum levels of copeptin and α-amylase elevated in the CID patients, and the serum levels of copeptin may be associated with the poor sleep quality, especially in the individuals of initial sleep difficulties.

Objective sleep disturbance is associated with poor response to cognitive and behavioral treatments for insomnia in postmenopausal women

Study objectivesTo determine whether insomnia patients with objective sleep disturbance are less responsive to cognitive and behavioral treatments than those without objective sleep disturbance, characterize effects of insomnia therapy on objective sleep, and determine whether reductions in nocturnal cognitive arousal correspond to changes in objective sleep. MethodsSecondary analysis of a single-site, randomized controlled trial. 113 postmenopausal women (56.40 ± 5.34 years) with menopause-related insomnia disorder were randomized to three treatment conditions: cognitive-behavioral therapy for insomnia (CBTI), sleep restriction therapy (SRT), or sleep education control. Primary outcomes were the Insomnia Severity Index (ISI) and polysomnography (PSG) sleep parameters and were collected at pretreatment, posttreatment, and six-month follow-up. ResultsPatients with lower pretreatment PSG sleep efficiency had lower rates of insomnia remission after active treatment relative to those with higher sleep efficiency (37.8% vs 61.8%). Neither CBTI and SRT produced clinically meaningful effects on PSG sleep. Exploratory analyses revealed that reductions in nocturnal cognitive arousal were associated with decreases in PSG sleep latency, but not wake after sleep onset. ConclusionsOur findings support an emerging literature suggesting that insomnia patients with objective sleep disturbance may have blunted response to insomnia therapy. Research is needed to enhance treatments to better improve insomnia in patients with objective sleep disturbance. A lack of observed CBTI and SRT effects on PSG sleep suggests that these therapies may be presently ill-designed to improve objective sleep. Nocturnal cognitive arousal may represent an entry point to improve objective sleep latency in insomnia. NameBehavioral Treatment of Menopausal Insomnia: Sleep and Daytime Outcomes. URL: clinicaltrials.gov. Registration: NCT01933295.

Effectiveness of non-benzodiazepine hypnotics in treatment of adult insomnia: meta-analysis of data submitted to the Food and Drug Administration

Objectives To investigate the effectiveness of non-benzodiazepine hypnotics (Z drugs) and associated placebo responses in adults and to evaluate potential moderators of effectiveness in a dataset used to approve these...

Ramelteon in the treatment of chronic insomnia: systematic review and meta-analysis

As a melatonin receptor agonist, ramelteon has been approved in the United States as a treatment for insomnia. As a potential alternation, ramelteon should be further evaluated in different doses and populations. This systematic review with meta-analysis aims to determine the efficacy and safety of ramelteon in the treatment of chronic insomnia. We systematically searched and identified in Medline, Embase, PsycINFO and Cochrane Library until September 2011. We only included randomised controlled trials focused on ramelteon, vs. placebo, or any other treatment for patients with chronic insomnia. Data were extracted and evaluated by two independent investigators. If neither clinical nor statistical heterogeneity was found, we pooled results using a fixed-effect model. Eight studies were selected to include from 175 identified references. There were significant improvements in all the outcomes (subjective and polysomnographic sleep latency, total sleep time and latency to REM), except for the percentage of REM. By subgroup analysis, subjective sleep latency was reduced only in the patients of 18-64 years old, without in the patients over 65 years old. For the safety, ramelteon was not associated with higher risk ratio of any frequent adverse events comparing with control. The efficacy and safety of ramelteon are promising for the chronic insomnia patients. More researches are required for robust conclusions, particularly well-designed; double-blind randomised controlled trials with higher doses of ramelteon (32 or 64 mg) for the older population comparing with other sedative hypnotics.

Does Subjective Sleepiness Predict Objective Sleep Propensity?

Research has shown variability in the correlations observed between subjective sleepiness and objective polysomnographic sleep latency. The present study evaluated whether eliciting subjective judgments of sleepiness after a 1-minute period of quiet with eyes closed would strengthen the relationship between subjective and objective measures. Subjective judgments of sleepiness were collected following three 1-minute conditions (eyes-closed, eyes-open fixed gaze, and visual reaction time task) using the Stanford Sleepiness Scale and a visual analogue scale, prior to a measure of polysomnographic sleep latency. For each participant, subjective and objective measures were obtained a total of 12 times half-hourly from 20:00 to 01:30. Sleep laboratory of the Flinders University. Participants were 12 young adult good sleepers. Within-subjects correlations between subjective and objective sleepiness across an evening period of increasing sleepiness were generally high (means approximately -0.63) and significant (P < 0.05). Contrary to expectation, there were no differences in correlations among the 3 conditions. Unexpectedly, when the correlations were calculated across subjects, correlations were noticeably weaker (means around -0.42), whereas the correlation means calculated across subjects, controlling for clock time, were close to 0. In controlled laboratory conditions, high correlations between subjective and objective measures of sleepiness within subjects were found across a large range of sleepiness (20:00 to 01:30) for all conditions. Calculating correlations within subjects and across a range of the circadian variation in sleepiness contributed substantially to the strength of the relationship found. These results suggest that the variability of prior research findings may be due, at least partly, to the way in which correlations were derived.