Influence of frequent nightmares on REM sleep-dependent emotional memory processing

La littérature suggère que le sommeil paradoxal joue un rôle dans l'intégration associative de la mémoire émotionnelle. De plus, les rêves en sommeil paradoxal, en particulier leur nature bizarre et émotionnelle, semblent refléter cette fonction associative et émotionnelle du sommeil paradoxal. La conséquence des cauchemars fréquents sur ce processus est inconnue, bien que le réveil provoqué par un cauchemar semble interférer avec les fonctions du sommeil paradoxal. Le premier objectif de cette thèse était de reproduire conceptuellement des recherches antérieures démontrant que le sommeil paradoxal permet un accès hyper-associatif à la mémoire. L'utilisation d'une sieste diurne nous a permis d'évaluer les effets du sommeil paradoxal, comparativement au sommeil lent et à l’éveil, sur la performance des participants à une tâche sémantique mesurant « associational breadth » (AB). Les résultats ont montré que seuls les sujets réveillés en sommeil paradoxal ont répondu avec des associations atypiques, ce qui suggère que le sommeil paradoxal est spécifique dans sa capacité à intégrer les traces de la mémoire émotionnelle (article 1). En outre, les rapports de rêve en sommeil paradoxal étaient plus bizarres que ceux en sommeil lent, et plus intenses émotionnellement ; ces attributs semblent refléter la nature associative et émotionnelle du sommeil paradoxal (article 2). Le deuxième objectif de la thèse était de préciser si et comment le traitement de la mémoire émotionnelle en sommeil paradoxal est altéré dans le Trouble de cauchemars fréquents (NM). En utilisant le même protocole, nos résultats ont montré que les participants NM avaient des résultats plus élevés avant une sieste, ce qui correspond aux observations antérieures voulant que les personnes souffrant de cauchemars soient plus créatives. Après le sommeil paradoxal, les deux groupes, NM et CTL, ont montré des changements similaires dans leur accès associatif, avec des résultats AB-négatif plus bas et AB-positif plus grands. Une semaine plus tard, seul les participants NM a maintenu ce changement dans leur réseau sémantique (article 3). Ces résultats suggèrent qu’au fil du temps, les cauchemars peuvent interférer avec l'intégration de la mémoire émotionnelle pendant le sommeil paradoxal. En ce qui concerne l'imagerie, les participants NM avaient plus de bizarrerie et plus d’émotion positive, mais pas négative, dans leurs rêveries (article 4). Ces attributs intensifiés suggèrent à nouveau que les participants NM sont plus imaginatifs et créatifs à l’éveil. Dans l'ensemble, les résultats confirment le rôle du sommeil paradoxal dans l'intégration associative de la mémoire émotionnelle. Cependant, nos résultats concernant le Trouble de cauchemars ne sont pas entièrement en accord avec les théories suggérant que les cauchemars sont dysfonctionnels. Le groupe NM a montré plus d’associativité émotionnelle, de même que plus d'imagerie positive et bizarre à l’éveil. Nous proposons donc une nouvelle théorie de sensibilité environnementale associée au Trouble de cauchemar, suggérant qu'une sensibilité accrue à une gamme de contextes environnementaux sous-tendrait les symptômes uniques et la richesse imaginative observés chez les personnes souffrant de cauchemars fréquents. Bien que davantage de recherches doivent être faites, il est possible que ces personnes puissent bénéficier e milieux favorables, et qu’elles puissent avoir un avantage adaptatif à l'égard de l'expression créative, ce qui est particulièrement pertinent lorsque l'on considère leur pronostic et les différents types de traitements.

Sleep quality and stress levels among higher education students

A good night sleep enables to achieve physical and mental wellbeing (Paiva, 2015). The preservation of sleep quality is paramount as who sleeps well has a high adaptation capacity to adverse circumstances such as stress and anxiety, amongst others. There is an impacting relationship between reduced sleeping hours and high levels of anxiety, depression and stress (Pinto et al., 2012). Measure the sleep quality and stress levels amongst higher education students.Quantitative study with a descriptive-correlational and transversal design. A socio-demographic record, the Pittsburgh Sleep Quality Index (PSQI) from Ramalho (2008) and the Anxiety, Depression and Stress Scale (EADS-21) from Ribeiro, Honrado and Leal (2004) were applied. The sample included 358 students. 54% of the students present a bad sleep quality, go to bed on average at 1am, take about 19 minutes to fall asleep and sleep on average 7 hours effectively. Female students have a 48% higher probability of having bad sleep quality. Stress, anxiety and depression levels were considered disperse with stress presenting the higher average. The majority of the students that refer having a bad sleep quality present an average score of 6.57 on the stress scale being approximately double of the students that refer having a good sleep quality (3.35). Stress, anxiety and depression are positively and with statistic signiicance correlated to the sleep quality index where a higher score means worse sleep quality.

A perfect day for zebrafish : neuromodulation of sleep in a diurnal vertebrate

Every day, we shift among various states of sleep and arousal to meet the many demands of our bodies and environment. A central puzzle in neurobiology is how the brain controls these behavioral states, which are essential to an animal's well-being and survival. Mammalian models have predominated sleep and arousal research, although in the past decade, invertebrate models have made significant contributions to our understanding of the genetic underpinnings of behavioral states. More recently, the zebrafish (Danio rerio), a diurnal vertebrate, has emerged as a promising model system for sleep and arousal research.

In this thesis, I describe two studies on sleep/arousal pathways that I conducted using zebrafish, and I discuss how the findings can be combined in future projects to advance our understanding of vertebrate sleep/arousal pathways. In the first study, I discovered a neuropeptide that regulates zebrafish sleep and arousal as a result of a large-scale effort to identify molecules that regulate behavioral states. Taking advantage of facile zebrafish genetics, I constructed mutants for the three known receptors of this peptide and identified the one receptor that exclusively mediates the observed behavioral effects. I further show that the peptide exerts its behavioral effects independently of signaling at a key module of a neuroendocrine signaling pathway. This finding contradicts the hypothesis put forth in mammalian systems that the peptide acts through the classical neuroendocrine pathway; our data further generate new testable hypotheses for determining the central nervous system or alternative neuroendocrine pathways involved.

Second, I will present the development of a chemigenetic method to non-invasively manipulate neurons in the behaving zebrafish. I validated this technique by expressing and inducing the chemigenetic tool in a restricted population of sleep-regulating neurons in the zebrafish. As predicted by established models of this vertebrate sleep regulator, chemigenetic activation of these neurons induced hyperactivity, whereas chemigenetic ablation of these neurons induced increased sleep behavior. Given that light is a potent modulator of behavior in zebrafish, our proof-of-principle data provide a springboard for future studies of sleep/arousal and other light-dependent behaviors to interrogate genetically-defined populations of neurons independently of optogenetic tools.

Sleep Deprivation and Pain Intensity

Little or poor quality sleep is often reported in patients suffering from acute or chronic pain. Conversely, sleep loss has been known to elevate pain perception; thus a potential bi-direction relationship exists between sleep deprivation and pain. The effect of sleep deprivation on the thermal pain intensity has yet to be determined, furthermore, sex differences in pain have not been examined following sleep deprivation. There is also a higher prevalence of insomnia in women, and reports indicate that sleep quality is diminished and pain sensitivity may be greater during high hormone phases of the menstrual cycle. In Study 1 we examined the effects of 24-hour total sleep deprivation (TSD) on pain intensity during a 2-minute cold pressor test (CPT). We hypothesized that TSD would augment thermal pain intensity during CPT and women would demonstrate an elevated response compare to men. In Study 2 we investigated the effects of menstrual phase on pain intensity during CPT following TSD. We hypothesized that pain intensity would be augmented during the mid-luteal (ML) phase of the menstrual cycle. In Study 1, pain intensity was recorded during CPT in 14 men and 13 women after normal sleep (NS) and TSD. Pain intensity responses during CPT were elevated in both conditions; however, pain intensity was augmented (~ 1.2 a.u.) following TSD. When analyzed for sex differences, pain intensity was not different between men and women in either condition. In Study 2, pain intensity was recorded during CPT in 10 female subjects during the early follicular (EF) and ML phases of the menstrual cycle after TSD. Estradiol and progesterone levels were elevated during the ML phase, however, pain intensity was not different between the two phases. We conclude that TSD significantly augments pain intensity during CPT, but this response is not sex dependent. We further demonstrate that the collective effect of TSD and elevated gonadal hormone concentrations do not result in a differential pain response during the EF and ML phases of the menstrual cycle. Collectively, sleep loss augments pain intensity ratings in men and women and may contribute to sleep loss in painful conditions.

Caffeine Intake and its Association with Disease Progression, Sleep Quality and Anxiety Symptoms and Nutritional Alterations in People Living with HIV in the Miami Adult Studies on HIV Cohort

Miami-Dade County has approximately 27,000 people living with HIV (PLWH), and the highest HIV incidence in the nation. PLWH have reported several types of sleep disturbances. Caffeine is an anorexic and lipolytic stimulant that may adversely affect sleep patterns, dietary intakes and body composition. High caffeine consumption (>250 mg. per day or the equivalent of >4 cups of brewed coffee) may also affect general functionality, adherence to antiretroviral treatment (ART) and HIV care. This study assess the relationship of high caffeine intake with markers of disease progression, sleep quality, insomnia, anxiety, nutritional intakes and body composition. A convenience sample of 130 PLWH on stable ART were recruited from the Miami Adult Studies on HIV (MASH) cohort, and followed for three months. After consenting, questionnaires on Modified Caffeine Consumption (MCCQ), Pittsburg Insomnia Rating Scale (PIRS), Pittsburg Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), socio-demographics, drug and medication use were completed. CD4 count, HIV viral load, anthropometries, and body composition measures were obtained. Mean age was 47.89±6.37 years, 60.8% were male and 75.4% were African-Americans. Mean caffeine intake at baseline was 337.63 ± 304.97 mg/day (Range: 0-1498 mg/day) and did not change significantly at 3 months. In linear regression, high caffeine consumption was associated with higher CD4 cell count (β=1.532, P=0.049), lower HIV viral load (β=-1.067, P=0.048), higher global PIRS (β=1.776, P=0.046), global PSQI (β=2.587, P=0.038), and GAD-7 scores (β=1.674, P=0.027), and with lower fat mass (β=-0.994, P=0.042), energy intakes (β=-1.643, P=0.042) and fat consumption (β=-1.902, P=0.044), adjusting for relevant socioeconomic and disease progression variables. Over three months, these associations remained significant. The association of high caffeine with lower BMI weakened when excluding users of other anorexic and stimulant drugs such as cocaine and methamphetamine, suggesting that caffeine in combination, but not alone, may worsen their action. In summary, high caffeine consumption was associated with better measures of disease progression; but was also detrimental on sleep quality, nutritional intakes, BMI and body composition and associated with insomnia and anxiety. Large scale studies for longer time are needed to elucidate the contribution of caffeine to the well-being of PLWH.

Poorer subjective sleep quality is related to higher fantasy-induced sexual arousal in women of reproductive age

Lack of sleep enhances erections and lubrication the next day. This raises the possibility that poorer subjective sleep quality is related to sexual arousal. To test this hypothesis, sexual arousal was elicited in 70 Portuguese women of reproductive age by means of fantasy. The level of salivary testosterone before and shortly after fantasy was determined by luminescence immunoassays. Participants completed the Pittsburgh Sleep Quality Index (PSQI), reported their sexual arousal before and during fantasy, and how anxious they were after the fantasy. The hypothesis was confirmed. Anxiety did not explain the association, but testosterone response (poststimulus minus baseline) had a slight explanatory effect.

Sleep and academic performance of Portuguese teenagers

Abstract: Sleep has numerous important functions in the body, such as consolidation of memory, concentration and learning. Changes in sleep cycles in adolescents lead to sleep deprivation with consequences to academic performance. Our research question was What are the sleep habits that influence school performance (study environment, study planning, study method, reading skills, motivation to study, overall school performance) in adolescents? We aimed to identify sleep habits predictors of the quality of school performance in adolescents. Research Methods: Crosssectional analytical study. Data were collected through a self-administered questionnaire with socio-demographic questions, sleep habits and school performance scale. The sample consisted of 380 students between 7th and 9th grade, with an average age of 13.56 ± 1.23 years in the school year 2011/2012, from a 2nd and 3rd Cycle Basic School of the municipality of Viseu, Portugal. Findings: School performance in adolescents was associated with better subjective quality of sleep (p=0.000), with longer sleep duration (p=0.000), with watching tv/video before sleep (p=0.000), with the habit of studying before bedtime (p=0.012), with no computer use (p=0.013) and with reading habits before bed (p=0.000). School performance was also associated with adolescents who reported not feeling sleepy during class. The teenagers who sleep more and better, and who watch tv/video, study, do not use computers, and who read before going to bed, have a better school performance.

Sleep disorders in Multiple System Atrophy: a longitudinal study

Introduction: A higher frequency of sleep and breathing disorders in Multiple System Atrophy (MSA) populations is documented in literature. The analysis of disease progression and prognosis in patients with sleep and breathing disorders could shed light on specific neuropathology and pathophysiology of MSA. Objective: To characterize sleep disorders and their longitudinal modifications during disease course in MSA patients, and to determine their prognostic value. Methods: This is a retrospective and prospective cohort study including 182 MSA patients (58.8% males). Type of onset was defined by the first reported motor or autonomic symptom/sign related to MSA. The occurrence of symptoms/signs and milestones of disease progression and their latency were collected. REM sleep behaviour disorder (RBD) and stridor were video-polysomnography (VPSG)-confirmed. VPSG recordings were analysed in a standardized fashion during the disease course. Survival data were based on time to death from the first symptom of disease. Results: Isolated RBD represented the first MSA symptom in 30% of patients, preceding disease onset according to international criteria with a median of 3(1–5) years. Patients developing early stridor or presenting with RBD at disease onset showed a more rapid and severe disease progression. These features had independent negative prognostic value for survival. Sleep architecture was characterized by peculiar features which could represent negative markers in MSA prognosis. Patients with stridor treated with tracheostomy showed a reduced risk of death. Conclusions: This is one of the first studies focusing on longitudinal progression of sleep in MSA. Sleep disorders are key features of disease, playing a role in presentation, prognosis and progression. In our MSA cohort, RBD represented the most frequent mode of disease presentation. Moreover, some specific clinical and instrumental sleep features could represent a hallmark of MSA and could be involved in prognosis and, in particular, in sudden death and death during sleep.

Sinus rhythm restoration with electrical cardioversion: acute effect of shock configuration and subsequent modifications in peripheral flow and sleep.

Atrial fibrillation (AF) is a widespread arrhythmia, associated with higher risk of stroke, sleep disorders and dementia. In some conditions, electrical cardioversion (ECV) represents the best choice for rhythm control. Nowadays, there is a growing interest in developing new devices for screening and monitoring of AF patients. We aimed to improve acute efficacy of ECV procedure and to explore the feasibility of the use of new wearable devices for monitoring in candidates to AF ECV. We compared antero-apical pads vs antero-posterior patches approach for AF ECV, and we elaborated a decision algorithm to improve acute efficacy. After, we evaluated the feasibility of the use of new wearable devices for monitoring of candidates to AF ECV. In particular, we analysed the effect of AF ECV on heart rate variability and vascular age parameters derived from PPG signals registered with Empatica (CE 1876/MDD 93/42/EEC), and on EEG pattern registered with Neurosteer (Israel). From December 2005 to September 2019, 492 patients were enrolled. We evaluated acute efficacy of the two approaches for AF ECV and we elaborated a decision algorithm based on body surface area, weight, and height. The decision algorithm improved first shock efficacy (93.2% vs. 87.2%, p=0.025). From 1st November 2021 to 1st April 2022, 24 patients were enrolled in PPEEG-AF pilot study. Considering vascular age parameters, a significant reduction in TPR and a wave was observed (p<0.001). Considering sleep patterns, a tendency to higher coherence was observed in registrations acquired during AF, or considering signals registered for each patient independently from AF. The new decision algorithm improved acute efficacy and reduced costs associated with adhesive patches. Significant modifications were observed on vascular age parameters measured before and after ECV, and a possible AF effect on sleep pattern was noticed. More data are necessary to confirm these preliminary results.

Development of functional MRI protocols in the study of neurodegenerative diseases: MRI study in patients with REM sleep behavior disorder, idiopathic Parkinson's disease and multisystem atrophy

In the central nervous system, iron in several proteins is involved in many important processes: oxygen transportation, oxidative phosphorylation, mitochondrial respiration, myelin production, the synthesis and metabolism of neurotransmitters. Abnormal iron homoeostasis can induce cellular damage through hydroxyl radical production, which can cause the oxidation, modification of lipids, proteins, carbohydrates, and DNA, lead to neurotoxicity. Moreover increased levels of iron are harmful and iron accumulations are typical hallmarks of brain ageing and several neurodegenerative disorders particularly PD. Numerous studies on post mortem tissue report on an increased amount of total iron in the substantia nigra in patients with PD also supported by large body of in vivo findings from Magnetic Resonance Imaging (MRI) studies. The importance and approaches for in vivo brain iron assessment using multiparametric MRI is increased over last years. Quantitative MRI may provide useful biomarkers for brain integrity assessment in iron-related neurodegeneration. Particularly, a prominent change in iron- sensitive T2* MRI contrast within the sub areas of the SN overlapping with nigrosome 1 were shown to be a hallmark of Parkinson's Disease with high diagnostic accuracy. Moreover, differential diagnosis between Parkinson's Disease (PD) and atypical parkinsonian syndromes (APS) remains challenging, mainly in the early phases of the disease. Advanced brain MR imaging enables to detect the pathological changes of nigral and extranigral structures at the onset of clinical manifestations and during the course of the disease. The Nigrosome-1 (N1) is a substructure of the healthy Substantia Nigra pars compacta enriched by dopaminergic neurons; their loss in Parkinson’s disease and atypical parkinsonian syndromes is related to the iron accumulation. N1 changes are supportive MR biomarkers for diagnosis of these neurodegenerative disorders, but its detection is hard with conventional sequences, also using high field (3T) scanner. Quantitative susceptibility mapping (QSM), an iron-sensitive technique, enables the direct detection of Neurodegeneration

Disorders of arousal: a physiopathological window to explore the mechanisms regulating sleep arousal

Disorders of Arousal (DoA) belong to NREM parasomnias and are characterized by motor and emotional episodes arising from incomplete awakenings from NREM sleep. DoA episodes embody at the same time the double nature of the arousal process, that is preserving sleep as well as respond to sleep perturbations, thus being an ideal model to study sleep arousal. In the first part of this work, we performed a spectral whole scalp EEG analysis exploring the neurophysiologic correlates of the pre-motor onset of the episodes in a large sample of patients with DoA, disclosing the co-existence of both slow and fast EEG frequencies over overlapping areas before DoA episodes, suggesting an alteration of local sleep mechanisms. Episodes of different complexity were preceded by a similar EEG activation, implying that they possibly share a similar pathophysiology. In the second part of this work, we performed a spectral whole scalp EEG analysis comparing the pre-motor onset of the episodes and normal arousals from healthy sleepers, disclosing the persistence of slow frequencies as well as sigma band (expression of sleep spindles) in DoA episodes. Overall, these results might subtend a higher tendence to preserve sleep and a more defective mechanism toward developing a complete arousal in patients with DoA. In the last part of our work, we evaluated 15 patients with DoA with 15 controls in a functional MRI study during wakefulness in addition to a proton magnetic resonance spectroscopy (1H-MRS) focused on cingulate cortex. We disclosed subtle alterations on posterior cingulate cortex as well as an increased connectivity in sensory-motor network, possibly representing a trait-functional feature responsible for the dysfunctional arousal process in DoA patients

Relationship Between Orofacial Function, Dentofacial Morphology, And Bite Force In Young Subjects.

The aim was to evaluate the relationship between orofacial function, dentofacial morphology, and bite force in young subjects. Three hundred and sixteen subjects were divided according to dentition stage (early, intermediate, and late mixed and permanent dentition). Orofacial function was screened using the Nordic Orofacial Test-Screening (NOT-S). Orthodontic treatment need, bite force, lateral and frontal craniofacial dimensions and presence of sleep bruxism were also assessed. The results were submitted to descriptive statistics, normality and correlation tests, analysis of variance, and multiple linear regression to test the relationship between NOT-S scores and the studied independent variables. The variance of NOT-S scores between groups was not significant. The evaluation of the variables that significantly contributed to NOT-S scores variation showed that age and presence of bruxism related to higher NOT-S total scores, while the increase in overbite measurement and presence of closed lip posture related to lower scores. Bite force did not show a significant relationship with scores of orofacial dysfunction. No significant correlations between craniofacial dimensions and NOT-S scores were observed. Age and sleep bruxism were related to higher NOT-S scores, while the increase in overbite measurement and closed lip posture contributed to lower scores of orofacial dysfunction.

[insomnia Symptoms, Daytime Naps And Physical Leisure Activities In The Elderly: Fibra Study Campinas].

The practice of physical activities contributes to reducing the risk of chronic diseases and improves sleep patterns in the elderly. This research aimed to investigate the association between insomnia symptoms and daytime nap and the participation in physical leisure activities in elderly community residents. Data from the Studies Network of the Fragility in Brazilian Elderly (Campinas site), were used. Information from 689 elderly was analyzed, regarding sociodemographic characterization, physical leisure activity, occurrence of daytime napping and its duration, symptoms of insomnia and use of sleep medication. A significant association was found between the practice of walking and the daytime nap of short duration. Studies indicate that a short nap can benefit the quality of sleep and health of the elderly. Therefore, promoting the practice of walking can be a nursing intervention that favors the sleep patterns of the elderly.

Respiratory Viruses Are Continuously Detected In Children With Chronic Tonsillitis Throughout The Year.

To evaluate the oscillations on the viral detection in adenotonsillar tissues from patients with chronic adenotonsillar diseases as an indicia of the presence of persistent viral infections or acute subclinical infections. Cross-sectional prospective study. Tertiary hospital. The fluctuations of respiratory virus detection were compared to the major climatic variables during a two-year period using adenoids and palatine tonsils from 172 children with adenotonsillar hypertrophy and clinical evidence of obstructive sleep apnoea syndrome or recurrent adenotonsillitis, without symptoms of acute respiratory infection (ARI), by TaqMan real-time PCR. The rate of detection of at least one respiratory virus in adenotonsillar tissue was 87%. The most frequently detected viruses were human adenovirus in 52.8%, human enterovirus in 47.2%, human rhinovirus in 33.8%, human bocavirus in 31.1%, human metapneumovirus in 18.3% and human respiratory syncytial virus in 17.2%. Although increased detection of human enterovirus occurred in summer/autumn months, and there were summer nadirs of human respiratory syncytial virus in both years of the study, there was no obvious viral seasonality in contrast to reports with ARI patients in many regions of the world. Respiratory viruses are continuously highly detected during whole year, and without any clinical symptomatology, indicating that viral genome of some virus can persist in lymphoepithelial tissues of the upper respiratory tract.

Changes In Motor Behavior During Pregnancy In Rats: The Basis For A Possible Animal Model Of Restless Legs Syndrome.

Pregnant women have a 2-3 fold higher probability of developing restless legs syndrome (RLS - sleep-related movement disorders) than general population. This study aims to evaluate the behavior and locomotion of rats during pregnancy in order to verify if part of these animals exhibit some RLS-like features. We used 14 female 80-day-old Wistar rats that weighed between 200 and 250 g. The rats were distributed into control (CTRL) and pregnant (PN) groups. After a baseline evaluation of their behavior and locomotor activity in an open-field environment, the PN group was inducted into pregnancy, and their behavior and locomotor activity were evaluated on days 3, 10 and 19 of pregnancy and in the post-lactation period in parallel with the CTRL group. The serum iron and transferrin levels in the CTRL and PN groups were analyzed in blood collected after euthanasia by decapitation. There were no significant differences in the total ambulation, grooming events, fecal boli or urine pools between the CTRL and PN groups. However, the PN group exhibited fewer rearing events, increased grooming time and reduced immobilization time than the CTRL group (ANOVA, p<0.05). These results suggest that pregnant rats show behavioral and locomotor alterations similar to those observed in animal models of RLS, demonstrating to be a possible animal model of this sleep disorder.