Sleep spindles and arousal: the effects of age and sensory stimulation.

This study assessed a proposed sleep-preserving role for sleep spindles by evaluating variations in this activity as a function of factors, both naturally occurring and experimentally induced, known to affect and effect arousal from sleep. These factors included age, auditory stimulation, and experimentally induced arousal from sleep. Analyses were based on data from 84 males (5-49 yrs. old) from normal and clinical (hyperactive, enuretic, and chronic pain) populations who had participated in sleep auditory arousal threshold studies involving adaptation and 1-2 experimental nights. Spindles on experimental nights were visually analyzed and incidence determined for the two minutes preceding and throughout all Stage 2 arousal attempts. Prestimulation spindle occurrence in 39 preadolescent subjects with two experimental nights did not vary significantly from night-to-night, and prestimulation period comparisons between clinical groups and their respective controls were also non-significant. Anticipated relationships between spindle activity and indices of arousal-either inverse with respect to known variations in arousal threshold, i.e., decreases with age and across the night, or direct with respect to stimulus intensity particularly on trials when arousal did not occur-were not observed. Instead, all age groups showed significant decreases in spindle density as an increasing negative function of stimulus intensity. These findings suggest that to the extent to which sleep spindles can be considered to play a role in sleep preservation by inhibiting or attenuating potentially arousing stimuli, these effects appear to be restricted to endogenously generated stimuli and are passive rather than reactive in nature.

Elevated sleep arousal thresholds in enuretic boys: clinical implications.

Enuretic children are described as difficult to arouse from sleep. We studied auditory sleep arousal thresholds in enuretic boys and report on the clinical implications of these findings. Fifteen enuretic and 18 control subjects (7-12-year-old males) were studied in a sleep laboratory for four consecutive nights using standard polysomnographic recording techniques. Sleep was undisturbed for the initial two nights and waking thresholds were measured on the following two nights. Enuretic children wet most frequently in the first two-thirds of the night. Arousal attempts were successful 39.7% of the time in controls and only 9.3% of the time in enuretics. In conclusion, enuretic males were more difficult to arouse than age-matched controls. The elevated arousal thresholds may be due to delayed maturation. Treatment programmes that rely on awakening should be aware of these features.

Heart rate variations during sleep in preadolescents.

Heart rate variations during sleep have been documented for infant and adult populations, but not for children and adolescents. To provide normative data for the preadolescent age group, this investigation used a combination of time-domain measures and nonlinear procedures (Poincare plots) to describe heart rate variations during two consecutive nights of undisturbed baseline sleep in 14 normal 8- to 10-year-old males. Heart rate variables, based on all-night analyses of computer-determined beat-to-beat (RR) intervals, were related to sleep stage and sleep cycle measures within and across nights. Time-domain summary statistics revealed a tendency for higher mean heart rates in rapid eye movement (REM) compared to slow-wave (SW) and stage 2 sleep, but the differences were not significant. Heart rate variability, as measured by average RR interval standard deviation, was greatest in stage 2 and least in SW sleep, but it did not vary significantly across sleep stages. Analyses of heart rate variables across the initial four sleep cycles showed a significant heart rate decrease (quadratic trend) and a significant increase (linear trend) for heart rate variability. All effects replicated across nights. Poincare plots revealed wide-ranging individual differences, generally characterized by greater dispersion at longer RR intervals and a remarkable night-to-night consistency in whole-night as well as stage-specific patterns. The sleep-stage plots uniformly indicated reduced overall range and variability in SW relative to REM and stage 2 and a general equivalence of stage 2 and REM patterns. The results indicate several features of sleep-related heart rate variations in preadolescents that differ from those in adults. The differences can be attributed to developmental variations in autonomic cardiac control and are consistent with increased parasympathetic influences reported to occur at this time.

Ontogenetic variations in auditory arousal threshold during sleep.

Developmental variations in auditory arousal thresholds during sleep were investigated in four groups of normal male subjects--children, preadolescents, adolescents, and young adults. Arousal thresholds were determined during NREM and REM sleep for tones presented via earphone insert on a single night following two adaptation nights of undisturbed sleep. Age-related relationships were observed for both awakening frequency and stimulus intensity required to effect awakening, with awakenings occurring more frequently in response to lower stimulus intensities with increasing age. Although stimulus intensities required for awakening were high and statistically equivalent across sleep stages in nonadults, higher intensity stimuli were required in Stage 4 relative to Stage 2 and REM sleep in adults. These results confirm previous observations of marked resistance to awakening during sleep in preadolescent children and suggest that processes underlying awakening from sleep undergo systematic modification during ontogenetic development.

Waking ultradian rhythms of performance and motility in hyperkinetic and normal children.

Waking ultradian rhythms in a visual performance task (detections and false positives) and in motility (global body movements and segmental limb movements during the task, and segmental limb movements during off-task periods) were examined in groups of nonmedicated hyperkinetic (HK) children (N = 11) and matched normal controls (N = 11). Testing was conducted for 5 minutes every 15 minutes (with 10-minute "rest periods") over a 6-hour period on 2 consecutive days. Increased limb movement (p less than .01) during off-task periods on both days. Increased limb movement in HK subjects during the task was marginally significant (p less than .06) on one day. False positives and global body movements failed to differentiate the groups. With regard to ultradian rhythmicity, some subjects in both groups showed evident ultradian peaks, which were present across a wide range of frequencies in one or more variables. There were no significant differences in the incidence of the period of evident ultradian peaks between the two groups.