Eveningness is associated with poor sleep quality and negative affect in obsessive-compulsive disorder.

Background Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive behaviors that severely encumber daily functioning. OCD patients seem to exhibit sleep disturbances, especially delayed bedtimes that reflect disrupted circadian rhythmicity. Morningness-eveningness is a fundamental factor reflecting individual variations in diurnal preferences related to sleep and waking activities. Eveningness reflecting a delayed sleep-wake timing has repeatedly been associated with sleep problems and negative affect (NA). Therefore, the aim of this study was to examine the associations between morningness-eveningness, sleep complaints, and symptom severity in OCD patients and compared with a mixed psychiatric control group. Materials and methods The data of 49 OCD and 49 mixed psychiatric inpatients (with unipolar depression and anxiety disorders) were analyzed. Patients completed questionnaires regarding morningness-eveningness, sleep quality, nightmare frequency, depression, anxiety, and affective states. Obsessive and compulsive symptom severity was also assessed within the OCD group by clinician-rated scales. Results Eveningness preference was associated with impaired sleep quality and higher NA in OCD patients. In addition, impaired sleep quality showed a moderate correlation with anxiety and strong correlations with depressive symptoms and NA. Interestingly, in the mixed psychiatric group, eveningness was not linked to NA, and sleep quality also showed weaker associations with depressive symptoms and NA. Within the OCD group, eveningness preference was predictive of poorer sleep quality regardless the influence of depressive symptoms. Conclusion Our findings suggest that eveningness and sleep complaints are predictive of affective dysfunctions, and should be carefully considered in the evaluation and treatment of OCD patients.

[Diabetes, dementia, depression, distress]. / Diabetes, dementia, depresszió, distressz.

The number of people living with diabetes continues to rise. Therefore neurologists or other health care practitioners may be increasingly faced with comorbid neuropsychiatric disorders commonly presented by diabetic patients. More recently there has been an increasing research interest not only in the interactions between diabetes and the nervous system, the fine structure and functional changes of the brain, but also in the cognitive aspects of antidiabetic treatments. Patients with both types of diabetes mellitus may show signs of cognitive decline, and depression. Comorbid insomnia, anxiety, and distress may also occur. The bidirectional relationships between all these phenomena as well as their connection with diabetes can lead to further health and quality of life deterioration. Therefore it is important that all practitioners involved in the care of diabetic patients recognize the presence of comorbid neuropsychiatric disturbances early on during the healthcare process. Identifying higher risk patients and early screening could improve the prognosis of diabetes and may prevent complications.

Reduced fronto-cortical brain connectivity during NREM sleep in Asperger syndrome: an EEG spectral and phase coherence study.

OBJECTIVE: To investigate whether sleep macrostructure and EEG power spectral density and coherence during NREM sleep are different in Asperger syndrome (AS) compared to typically developing children and adolescents. METHODS: Standard all night EEG sleep parameters were obtained from 18 un-medicated subjects with AS and 14 controls (age range: 7.5-21.5years) after one adaptation night. Spectral, and phase coherence measures were computed for multiple frequency bands during NREM sleep. RESULTS: Sleep latency and wake after sleep onset were increased in AS. Absolute power spectrum density (PSD) was significantly reduced in AS in the alpha, sigma, beta and gamma bands and in all 10 EEG derivations. Relative PSD showed a significant increase in delta and a decrease in the sigma band for frontal, and in beta for centro-temporal derivations. Intrahemispheric coherence measures were markedly lower in AS in the frontal areas, and the right hemisphere over all EEG channels. The most prominent reduction in intrahemispheric coherence was observed over the fronto-central areas in delta, theta, alpha and sigma EEG frequency bands. CONCLUSION: EEG power spectra and coherence during NREM sleep, in particular in fronto-cortical derivations are different in AS compared to typically developing children and adolescents. SIGNIFICANCE: Quantitative analysis of the EEG during NREM sleep supports the hypothesis of frontal dysfunction in AS.

Sleep apnea is associated with cardiovascular risk factors among kidney transplant patients.

BACKGROUND AND OBJECTIVES: We assessed the prevalence of obstructive sleep apnea (OSA) and its clinical correlates in a large sample of patients who received a kidney transplant (Tx). We also compared the prevalence of the disorder between dialysis patients who were on the waiting list for a Tx (WL) and Tx patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a cross-sectional study of 100 Tx and 50 WL patients who underwent one-night polysomnography (SLeep disorders Evaluation in Patients after kidney Transplantation [SLEPT] Study). Sociodemographic information and data about medication, comorbidity, and laboratory parameters were collected. RESULTS: The prevalence of mild (apnea-hypopnea index [AHI] > or =5/h and <15/h), moderate (AHI > or =15/h and <30/h), and severe OSA (AHI > or =30/h) was 18, 11, and 14% in the Tx group and 28, 16, and 10% in the WL group, respectively. The AHI was significantly correlated with age (rho = 0.34), body mass index (rho = 0.45), neck circumference (rho = 0.4), abdominal circumference (rho = 0.51), and hemoglobin (rho = 0.24) in the Tx group. The proportion of Tx patients who were treated with three or more antihypertensive drugs was significantly higher in the OSA group (56 versus 31%; P = 0.022). Despite taking significantly more antihypertensive drugs, the average systolic BP was still higher in patients with versus without OSA (147 +/- 21 versus 139 +/- 18 mmHg; P = 0.059). CONCLUSIONS: The prevalence of OSA is similar in Tx and WL patients and it may contribute to presence of hypertension in patients who receive a Tx.

The individual adjustment method of sleep spindle analysis: methodological improvements and roots in the fingerprint paradigm.

Evidence supports the robustness and stability of individual differences in non-rapid eye movement (NREM) sleep electroencephalogram (EEG) spectra with a special emphasis on the 9-16 Hz range corresponding to sleep spindle activity. These differences cast doubt on the universal validity of sleep spindle analysis methods based on strict amplitude and frequency criteria or a set of templates of natural spindles. We aim to improve sleep spindle analysis by the individual adjustments of frequency and amplitude criteria, the use of a minimum set of a priori knowledge, and by clear dissections of slow- and fast sleep spindles as well as to transcend the concept of visual inspection as being the ultimate test of the method's validity. We defined spindles as those segments of the NREM sleep EEG which contribute to the two peak regions within the 9-16 Hz EEG spectra. These segments behaved as slow- and fast sleep spindles in terms of topography and sleep cycle effects, while age correlated negatively with the occurrence of fast type events only. Automatic detections covered 92.9% of visual spindle detections (A&VD). More than half of the automatic detections (58.41%) were exclusively automatic detections (EADs). The spectra of EAD correlated significantly and positively with the spectra of A&VD as well as with the average (AVG) spectra. However, both EAD and A&VD had higher individual-specific spindle spectra than AVG had. Results suggest that the individual adjustment method (IAM) detects EEG segments possessing the individual-specific spindle spectra with higher sensitivity than visual scoring does.

[The structure and patterns of sleep in autism spectrum disorders]. / Az alvás szerkezete és mintázatai autizmus spektrumzavarban.

Human sleep, as an ancient demeanor emerging at the meeting-point of psychogenetic and ontogenetic brain development as well as of specific environmental factors, frames the basis of adaptation to complex information processing conditions. Therefore sleep befalls in the focus of modern sleep research as the sensitive indicator of psychological and biological integrity. Autism spectrum disorders (ASD) are characterized by peculiarly altered behaviours occurring in various life situations, which can be traced in the structure and patterns of sleep as well. There is convincing evidence suggesting that ASD are associated with various sleep disorders at times of extreme severity. The frequency of these sleep disorders is different from those seen in typically developing children of the same age and mental abilities, but often overlapping with other neuropsychiatric disorders. The present article while reviewing core methodological milestones of sleep research provides an extensive overview of the nature of sleep disorders emerging in ASD as well as of the composite relationships between psychological and physiological features. Emerging knowledge regarding the etiological background and treatment options will be also addressed.

Prediction of general mental ability based on neural oscillation measures of sleep.

The usual assessment of general mental ability (or intelligence) is based on performance attained in reasoning and problem-solving tasks. Differences in general mental ability have been associated with event-related neural activity patterns of the wakeful working brain or physical, chemical and electrical brain features measured during wakeful resting conditions. Recent evidences suggest that specific sleep electroencephalogram oscillations are related to wakeful cognitive performances. Our aim is to reveal the relationship between non-rapid eye movement sleep-specific oscillations (the slow oscillation, delta activity, slow and fast sleep spindle density, the grouping of slow and fast sleep spindles) and general mental ability assessed by the Raven Progressive Matrices Test (RPMT). The grouping of fast sleep spindles by the cortical slow oscillation in the left frontopolar derivation (Fp1) as well as the density of fast sleep spindles over the right frontal area (Fp2, F4), correlated positively with general mental ability. Data from those selected electrodes that showed the high correlations with general mental ability explained almost 70% of interindividual variance in RPMT scores. Results suggest that individual differences in general mental ability are reflected in fast sleep spindle-related oscillatory activity measured over the frontal cortex.

Human parahippocampal activity: non-REM and REM elements in wake-sleep transition.

The covert-rapid-eye-movement (REM) sleep hypothesis of dreaming suggests that elements of REM sleep emerge during sleep onset, leading to vivid hypnagogic imagery. Based on parahippocampal electrocorticography of epileptic patients we found an increase in REM-like 1.5-3.0 Hz parahippocampal activity during wake-sleep transition, which peaks after on average 30s of sleep onset, and reaches 82% of REM sleep value. The increase in 1.5-3.0 Hz parahippocampal activity followed alpha dropout, but did not relate to short-term fluctuations in alpha waves or sleep spindles. Non-REM sleep-specific slow (<1.25 Hz) activity showed a continuous increase during wake-sleep transition in both temporal scalp and parahippocampal recordings. It is suggested that REM-like parahippocampal rhythmic slow activity is an after-effect of hypothalamic wake-promoting centers' switch-off at sleep onset, leading to an inhibited hippocampal functioning and hypnagogic hallucinations.