Sexual behavior in sleep, sleepwalking and possible REM behavior disorder: a case report.

Seven cases of sexual behavior during sleep (SBS) have been recently reported. The subjects had histories of behavioral parasomnias as well as positive family histories of parasomnia. A 27 year-old man with a history of sexual behavior during sleep was reported. His sleep history disclosed sleepwalking (SW) since 9 years of age. He also developed episodes of highly disruptive and violent nocturnal behavior with dream enactment at age 20 years, which often resulted in physical injuries either to himself or his wife and infant. His wife also reported episodes of amnestic sexual behavior that began 4 years before referral. During the episodes, the patient typically procured his wife, achieving complete sexual intercourse with total amnesia. Physical and neurological diagnostic workups were unremarkable. Family history disclosed sleepwalking in his brother. He was put on 2mg/day of bedtime clonazepam with a remarkable clinical improvement. This case involves either the combination of violent and non-violent sleepwalking with SBS, or the superimposition of presumed REM sleep behavior disorder (RBD) on top of preexisting SW in a man who also developed SBS in adulthood. Thus, this is a case report of probable parasomnia overlap syndrome.

Correlation between blood adenosine metabolism and sleep in humans.

Blood adenosine metabolism, including metabolites and metabolizing enzymes, was studied during the sleep period in human volunteers. Searching for significant correlations among biochemical parameters found: adenosine with state 1 of slow-wave sleep (SWS); activity of 5'-nucleotidase with state 2 of SWS; inosine and AMP with state 3-4 of SWS; and activity of 5'-nucleotidase and lactate with REM sleep. The correlations were detected in all of the subjects that presented normal hypnograms, but not in those who had fragmented sleep the night of the experiment. The data demonstrate that it is possible to obtain information of complex brain operations such as sleep by measuring biochemical parameters in blood. The results strengthen the notion of a role played by adenosine, its metabolites and metabolizing enzymes, during each of the stages that constitute the sleep process in humans.

Temporal variations of adenosine metabolism in human blood.

Eight diurnally active (06:00-23:00 h) subjects were adapted for 2 days to the room conditions where the experiments were performed. Blood sampling for adenosine metabolites and metabolizing enzymes was done hourly during the activity span and every 30 min during sleep. The results showed that adenosine and its catabolites (inosine, hypoxanthine, and uric acid), adenosine synthesizing (S-adenosylhomocysteine hydrolase and 5'-nucleotidase), degrading (adenosine deaminase) and nucleotide-forming (adenosine kinase) enzymes as well as adenine nucleotides (AMP, ADP, and ATP) undergo statistically significant fluctuations (ANOVA) during the 24 h. However, energy charge was invariable. Glucose and lactate chronograms were determined as metabolic indicators. The same data analyzed by the chi-square periodogram and Fourier series indicated ultradian oscillatory periods for all the metabolites and enzymatic activities determined, and 24-h oscillatory components for inosine, hypoxanthine, adenine nucleotides, glucose, and the activities of SAH-hydrolase, 5'-nucleotidase, and adenosine kinase. The single cosinor method showed significant oscillatory components exclusively for lactate. As a whole, these results suggest that adenosine metabolism may play a role as a biological oscillator coordinating and/or modulating the energy homeostasis and physiological status of erythrocytes in vivo and could be an important factor in the distribution of purine rings for the rest of the organism.

Fetal suprachiasmatic nucleus transplants: diurnal rhythm recovery of lesioned rats.

The diurnal rhythm organization of drinking behavior was determined prior to and after suprachiasmatic nucleus (SCN) lesions. Five weeks after SCN lesions which produced total loss of the diurnal rhythm, the anterior hypothalamus including the SCN of fetal rats was transplanted into the floor of the 3rd ventricle of the lesioned rats. Eight weeks after the graft, rats recovered their rhythm. The results show that grafts allow animals to recover lost functional properties due to lesions, and further support the notion that the SCN is a pacemaker for certain behaviors.

Is vasoactive intestinal polypeptide (VIP) a sleep factor?

Vasoactive intestinal peptide (VIP) was tested in order to determine its hypnogenic properties in cats. VIP was administered intraventricularly in doses of 10 and 100 ng and compared to Ringer controls. In addition the dose of 100 ng was tested in cats pretreated with 150 mg/kg of chloramphenicol (CAP). The results showed that the 100 ng dose of VIP had small but significant REM enhancing properties, but that it did not protect the animals from the specific REM inhibiting properties of CAP. The results suggest that VIP may participate in the regulation of REM sleep.

Increasing PGO spike density by auditory stimulation increases the duration and decreases the latency of rapid eye movement (REM) sleep.

The purpose of this study was to determine whether ponto-geniculo-occipital (PGO) spikes play a role in triggering or maintaining sleep. During the recording of the sleep cycle of cats, the appearance of the first PGO spike automatically triggered an auditory stimulus through a speaker placed in the cat's recording cage. The effect of this procedure was compared to similar period when no such stimulus was given. The results showed that the auditory stimulus increased PGO spike density during REM sleep. It also produced a spectacular increase in the duration of REM, while decreasing the latency of its appearance from the first PGO spike. It is suggested that the auditory stimulus reinforces the 'PGO system', which in turn may function as a pace-setter for priming and maintaining REM sleep.