[New opportunities for non-drug treatment of insomnia using sleep normalization medical device SONYA]. / Novye vozmozhnosti nelekarstvennoi korrektsii insomnii s pomoshch'yu apparata dlya normalizatsii sna SONYa.

OBJECTIVE: To study the effectiveness and safety of the sleep normalization medical device SONYA in the treatment of insomnia. MATERIAL AND METHODS: The effectiveness and safety of the SONYA device was studied in 32 subjects randomized into two groups - those who received stimulation using this device and those who received false stimulation (placebo). The indicators of subjective sleep characteristics, polysomnography, and emotional state were evaluated. RESULTS: The SONYA device exerts the positive effect on the main characteristics of night sleep and the emotional state of patients. The overall sleep efficiency, the total duration of delta sleep in its 1st and 2nd cycles, the delta sleep index significantly increased, while the time of falling asleep and the time of onset of delta sleep as well as the number and duration of night awakenings decreased. The severity of emotional and motivational disorders significantly decreased in the form of a decrease in the level of state anxiety, an increase in the background mood, the level of cheerfulness and well-being. No adverse events and side-effects from the use of the SONYA device have been recorded. CONCLUSION: According to the results of clinical studies, the SONYA device was registered as a medical device of the 2nd safety class for the treatment of insomnia of inorganic nature (F51.0) and sleep-wake disorders of inorganic nature (F51.2).

Improvement of the night sleep quality by electrocutaneous subthreshold stimulation synchronized with the slow wave sleep.

Changes in sleep characteristics were studied under the non-wake-up stimulation with current pulses of less than 1 µA on average, applied to the palmar surface skin receptors during Δ-sleep. A significant increase in duration of the first and second cycles of deep sleep has been found, as well as a shorter latent period before the Δ-sleep onset and a longer time of the rapid sleep (REM phase). The sleep structure improvement was accompanied by the reduced reactive anxiety and depression and an increase in subjective physical efficiency.

A new application of rTMS: the sleeping brain and depression.

A new method of modifying brain function is rTMS (rapid transcranial magnetic stimulation) which has a positive effect on depression. Rapid transcranial magnetic stimulation during sleeping should be tested for a possible effect on sleep normalization.

The relationship between subjective sleep estimation and objective sleep variables in depressed patients.

INTRODUCTION: To our knowledge there is no evidence in the literature about the relationship between subjective sleep estimation and objective sleep variables in depression. It is not known whether the subjective estimation of sleep quality and sleep duration is directly related to any objective sleep variable in depressed patients. METHODS: Thirty patients with major depression and 10 healthy subjects have been investigated in our sleep laboratory during 1 or 2 consecutive nights after 1 night for adaptation. Every subject, after final awakening in the laboratory, answered questions concerning the subjective feelings about sleep duration, number of awakenings and sleep depth. We compared the sleep estimation in both groups and calculated the correlation between objective and subjective sleep variables in depressed patients. RESULTS: The degree of a wrong sleep estimation in depressed patients is larger than in healthy subjects. Slow wave sleep (SWS) in depressed patients correlates positively with the subjective estimation of sleep duration. Eye movement density in REM sleep correlates with the subjective estimation of the number of awakenings. CONCLUSION: SWS in depression has a positive influence on the subjective feeling of sleep duration while phasic REM sleep activity has a negative influence.

Change of mood during sleep and REM sleep variables.

Polysomnography was performed during two consecutive nights in 23 patients with major depression. After every final awakening patients estimated the change of their mood from evening to morning: 1. Mood worse in the morning than in the evening; 2. Mood does not change; 3. Mood better in the morning. When mood was estimated as being better in the morning (20% of all nights), eye movement density in REM sleep increased from the first to the fourth cycle. In all other nights eye movement density was slightly higher in the first than in subsequent cycles. Mood improvement correlated positively with eye movement density in the fourth cycle and negatively with REM sleep duration in the first cycle. Eye movement density in the first cycle correlated positively with the subjective estimation of sleep latency. A possible functional difference between initial and final REM sleep periods is proposed.

REM sleep in depressed patients: different attempts to achieve adaptation.

Twenty-seven depressed patients and 10 healthy subjects were investigated in the sleep laboratory during two to three consecutive nights. Eleven of the 27 patients demonstrated the "first night effect" (group I) and 11 other patients demonstrated a clear absence of the "first night effect" (group II). Five of the 27 depressed patients were omitted from the study because they did not fit criteria for first night effect. The 10 healthy controls demonstrated a first night effect. In group I, the duration of the first rapid eye movement (REM) sleep episode was increased on the first night and on the second night the REM sleep latency was decreased, whereas REM sleep duration and eye movement (EM) density was increased. The number of the short sleep cycles (less than 40 minutes) was greater in group I versus group II and the percentage of slow-wave sleep (SWS) was also higher in group I. In depressed patients with the "first night effect" the enhanced REM sleep requirement is satisfied not only by an increased REM sleep duration but also by the improved REM sleep quality that is crucial for adaptation. The adaptive role of the increased first REM period and the increased EM density in this period is very limited.

The new method of special brain points stimulation.

The integrative function of the subcortical brain structures in higher animals, realized partially via points of reinforcement and avoidance present in hypothalamic nuclei or via the hypothalamo-hypophysial system, suggest the special role these points play in the general and specific schemes of regulation of the nerve system. Stimulation of these points probably affects the brain structures by causing certain ascending effects, thus affects the animal's behavior during self-stimulation. The experimental approach described below is based on the brain itself as the stimulation source, thus allowing the investigation of an oriented effect on the hypothalamus on a similar source.