Bart Haex

The role of presleep negative emotion in sleep physiology

Although daytime emotional stressful events are often presumed to cause sleep disturbances, the few studies of stressful life events on sleep physiology have resulted in various and contradictory findings. As research has focused in particular on stress in itself, the present study is the first to investigate the effect using polysomnography (PSG). Results indicate a significant increase in sleep fragmentation, as expressed by decreased sleep efficiency, total sleep time, percentage of rapid eye movement (REM) sleep, and an increased wake after sleep onset latency, total time awake, latency to SWS, number of awakenings and number of awakenings from REM sleep. The results demonstrate that negative emotion correlates with enhanced sleep fragmentation helping us to understand why sleep patterns change and how sleep disturbances may develop.

An Evaluation of Cardiorespiratory and Movement Features With Respect to Sleep-Stage Classification

Polysomnography (PSG) is considered the gold standard to assess sleep accurately, but it can be expensive, time-consuming, and uncomfortable, specifically in long-term sleep studies. Actigraphy, on the other hand, is both cheap and user-friendly, but depending on the application lacks detail and accuracy. Our aim was to evaluate cardiorespiratory and movement signals in discriminating between wake, rapid-eye-movement (REM), light (N1N2), and deep (N3) sleep. The dataset comprised 85 nights of PSG from a healthy population. Starting from a total of 750 characteristic variables (features), problem-specific subsets of 40 features were forwardly selected using the combination of a wrapper method (Cohens kappa statistic on radial basis function (RBF)-kernel support vector machine (SVM) classifier) and filter method (minimum redundancy maximum relevance criterion on mutual information). Final classification was performed using an RBF-kernel SVM. Non-subject-specific wake versus sleep classification resulted in a Cohens kappa value of 0.695, while REM versus NREM resulted in 0.558 and N3 versus N1N2 in 0.553. The broad pool of initial features gave insight in which features discriminated best between the different classes. The classification results demonstrate the possibility of making long-term sleep monitoring more widely available.

Sleep misperception, EEG characteristics and Autonomic Nervous System activity in primary insomnia: A retrospective study on polysomnographic data

Misperception of Sleep Onset Latency, often found in Primary Insomnia, has been cited to be influenced by hyperarousal, reflected in EEG- and ECG-related indices. The aim of this retrospective study was to examine the association between Central Nervous System (i.e. EEG) and Autonomic Nervous System activity in the Sleep Onset Period and the first NREM sleep cycle in Primary Insomnia (n=17) and healthy controls (n=11). Furthermore, the study examined the influence of elevated EEG and Autonomic Nervous System activity on Stage2 sleep-protective mechanisms (K-complexes and sleep spindles). Confirming previous findings, the Primary Insomnia-group overestimated Sleep Onset Latency and this overestimation was correlated with elevated EEG activity. A higher amount of beta EEG activity during the Sleep Onset Period was correlated with the appearance of K-complexes immediately followed by a sleep spindle in the Primary Insomnia-group. This can be interpreted as an extra attempt to protect sleep continuity or as a failure of the sleep-protective role of the K-complex by fast EEG frequencies following within one second. The strong association found between K-alpha (K-complex within one second followed by 8-12 Hz EEG activity) in Stage2 sleep and a lower parasympathetic Autonomic Nervous System dominance (less high frequency HR) in Slow-wave sleep, further assumes a state of hyperarousal continuing through sleep in Primary Insomnia.

Effects of Pre-Sleep Media Use on Sleep/Wake Patterns and Daytime Functioning Among Adolescents: The Moderating Role of Parental Control

The aim of this cross-sectional study was to investigate the influence of media use in the hour before bedtime on sleep/wake patterns and daytime functioning among adolescents and to examine the moderating role of parental control. A total of 1,926 Belgian students, 55% girls and 45% boys, with a mean age of 16.9 ± 1.5 years, completed a modified version of the School Sleep Habits Survey. Correlational analyses showed that media use, except television viewing, was associated with later bedtimes and longer sleep latencies. Cell phone and computer usage was negatively associated with daytime functioning. On schooldays, parental control had a moderating effect on the relationship between bedtime and computer use (β = .05; p < .05) and between bedtime and mp3 player use (β = .08; p < .01). During the weekend, parental control played a moderating role between bedtime and television viewing (β = .06; p = .01). As media use can influence the sleep of adolescents considerably, parental control is necessary to regulate the exposure of adolescents to media and to moderate the detrimental effect of media use on sleep.

Lipoatrophia semicircularis and the relation with office work

The relation between lipoatrophia semicircularis (LS--band-like circular depressions and isolated atrophy of the subcutaneous fatty tissue on the anterior thighs and sitting posture or pressure on the seat surface of office chairs was investigated in an office environment. A questionnaire was presented to 21 subjects and electromyographic measurements, video analysis and pressure measurements were performed. Remarkable posture differences between the LS group and the group without LS were found: less use of the lumbar support of the chair, static sitting postures and a too high seat surface of the office chair were characteristics of the subjects with LS. These observations were confirmed by higher pressure measurements for the subjects with LS. In addition, highly significant pressure differences were found between different chairs.

Ergonomics in bed design: the effect of spinal alignment on sleep parameters

This study combines concepts of bed design and sleep registrations to investigate how quality of spine support affects the manifestation of sleep in healthy subjects. Altogether, 17 normal sleepers (nine males, eight females; age 24.3±7.1 years) participated in an anthropometric screening, prior to the actual sleep experiments, during which personalised sleep system settings were determined according to individual body measures. Sleep systems (i.e. mattress and supporting structure) with an adjustable stiffness distribution were used. Subjects spent three nights of 8 h in bed in the sleep laboratory in a counterbalanced order (adaptation, personalised support and sagging support). During these nights, polysomnography was performed. Subjective sleep data were gathered by means of questionnaires. Results show that individual posture preferences are a determinant factor in the extent that subjects experience a negative effect while sleeping on a sagging sleep system. Statement of Relevance: This study investigated how spine support affects sleep in healthy subjects, finding that the relationship between bedding and sleep quality is affected by individual anthropometry and sleep posture. In particular, results indicate that a sagging sleep system negatively affects sleep quality for people sleeping in a prone or lateral posture.

Reliability and validity of 4D rasterstereography under dynamic conditions

Purpose of this study was to evaluate the reliability and validity of 4D rasterstereography under dynamic conditions. Therefore simulated anatomical fixed points on a wooden plate were measured during different movements. Seven different motion patterns in all three angles of space were evaluated. The simulated parameter trunk length was measured with an accuracy of 3.58 mm (SD±3.29 mm) and the dimple distance was detected with an accuracy of 0.88 mm (SD±1.04 mm). With this rasterstereographic prototype it is possible to examine dynamically the spinal posture with adequate accuracy.

Effects of pre-sleep simulated on-call instructions on subsequent sleep

Nightly interventions, prevalent to on-call situations, can have negative consequences for those involved. We investigated if intervention-free-on-call-nights would also mean disturbance-free-sleep for people on-call. 16 healthy sleepers spent three nights in the laboratory: after a habituation night, reference and on-call night were counterbalanced. Subjects were instructed to react to a sound, presented at unpredictable moments during the night. Participants were unaware of the fact that the sound would never be presented. These vigilance instructions resulted in more subjective wake after sleep onset (WASO), lower subjective sleep efficiency and significantly lower experienced sleep quality. Objectively, a longer sleep onset, an increased amount of WASO and significantly lower sleep efficiency were observed. During deep sleep, significantly more beta activity was recorded. Apart from real nightly interventions increased vigilance during the night causes sleep to be less efficient and less qualitative as shown by an increase in wake-activity and a distorted sleep perception.

Unobtrusive Assessment of Motor Patterns During Sleep Based on Mattress Indentation Measurements

This study investigates how integrated bed measurements can be used to assess motor patterns (movements and postures) during sleep. An algorithm has been developed that detects movements based on the time derivate of mattress surface indentation. After each movement, the algorithm recognizes the adopted sleep posture based on an image feature vector and an optimal separating hyperplane constructed with the theory of support vector machines. The developed algorithm has been tested on a dataset of 30 fully recorded nights in a sleep laboratory. Movement detection has been compared to actigraphy, whereas posture recognition has been validated with a manual posture scoring based on video frames and chest orientation. Results show a high sensitivity for movement detection (91.2%) and posture recognition (between 83.6% and 95.9%), indicating that mattress indentation provides an accurate and unobtrusive measure to assess motor patterns during sleep.

Elevated variance in heart rate during slow-wave sleep after late-night physical activity.

This study investigates the effect of mild physical activity before bedtime on the sleep pattern and heart rate during the night. Nine healthy subjects underwent a habituation night, a reference night, and a physical induction night. The physical induction night did not alter the sleep pattern. Physical activity before bedtime resulted in higher heart rate variance during slow-wave sleep. The low-frequency/high-frequency component (LF/HF) ratio during slow-wave sleep in the physical induction night was significantly higher than during the reference night. Increased mean heart rate and higher LF/HF ratio are related to decreased parasympathetic dominance. Exercise up to 1 h before bedtime thus seems to modify the quality of sleep. (Author correspondence: Daniel.Berckmans@biw.kuleuven.be)