Geneviève Forest

Sleep architecture and its clinical correlates in first episode and neuroleptic-naive patients with schizophrenia

The goal of the present study was to characterize sleep organization in first episode and neuroleptic-naive patients with schizophrenia and to evaluate relationships between those sleep parameters and clinical symptoms. Eleven patients with acute schizophrenia never treated with neuroleptics were compared to 11 healthy controls. Sleep stages and phasic events (sleep spindles and rapid-eye-movements during REM sleep (REMs) were visually identified. Clinical symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS). Compared to controls, patients with schizophrenia had difficulty initiating sleep, decreased stage 4 duration, reduced rapid eye movement (REM) sleep latency, and normal sleep spindles and REMs densities. Positive symptoms correlated negatively with REM sleep latency. The BPRS total score correlated negatively with REM sleep duration and REMs density. The present results indicate that first episode and neuroleptic-naive patients with schizophrenia have difficulties initiating, but not maintaining, sleep. These results also confirm that the duration of stage 4 and REM sleep latency are reduced in first episode and neuroleptic-naive patients with schizophrenia. The fact that measures of REM sleep correlate with clinical scales of schizophrenia suggests that REM sleep physiology shares common substrates with symptoms of this disease.

Evening and morning EEG differences between young men and women adults

Evening and morning waking EEG (eyes closed) was recorded in 16 women and 13 men aged 18-26 years old. Participants were fitted with a 13-electrode montage (Fp1, Fp2, FZ, F7, F8, C3, C4, T3, T4, P3, P4, O1, and O2) referred to linked ears. For each recording electrode, EEG total spectral amplitude power (microV/Hz, 0.75-19.75 Hz) was compared using 2 (Gender) x 2 (Moments) analyses of variance for repeated measures and LSD post-hoc tests. We found significant simple Gender effects, with women displaying higher EEG values for Central, Frontal, Parietal, and left Temporal leads. Simple Moment effects were also found, with lower morning values in Temporal and left Frontal recording sites. A Gender x Moment interaction was found at the right Frontal recording site. No significant effects were found for Prefrontal and Occipital recording sites, whatsoever. These results bring new understandings of gender and time of day effects in waking EEG and point to different sensitivity in different cortical areas. The present results could explain some of the observations related to gender differences in cognitive performance.

The effects of sleep restriction and altered sleep timing on energy intake and energy expenditure

Experimental evidence suggests that sleep restriction increases energy intake (EI) and may alter energy expenditure (EE). However, it is unknown whether the timing of a sleep restriction period impacts EI and EE the following day. Hence, we examined the effects of sleep restriction with an advanced wake-time or delayed bedtime on next day EI and EE. Twelve men and 6 women (age: 23±4years, body fat: 18.8±10.1%) participated in 3 randomized crossover sessions: control (habitual bed- and wake-times), 50% sleep restriction with an advanced wake-time and 50% sleep restriction with a delayed bedtime. Outcome variables included sleep architecture (polysomnography), EI (food menu), total EE and activity times (accelerometry). Carbohydrate intake was greater on day 2 in the delayed bedtime vs. control session (1386±513 vs. 1579±571kcal; P=0.03). Relative moderate-intensity physical activity (PA) time was greater in the delayed bedtime session vs. control and advanced wake-time sessions on day 1 (26.6±19.9 vs. 16.1±10.6 and 17.5±11.8%; P=0.01), whereas vigorous-intensity PA time was greater following advanced wake-time vs. delayed bedtime on day 1 (2.7±3.0 vs. 1.3±2.4%; P=0.004). Greater stage 1 sleep (β=110kcal, 95% CI for β=42 to 177kcal; P=0.004), and a trend for lower REM sleep (β=-20kcal, 95% CI for β=-41 to 2kcal; P=0.07), durations were associated with greater EI between sleep restriction sessions. These findings suggest that the timing of a sleep restriction period impacts energy balance parameters. Additional studies are needed to corroborate these findings, given the increasing prevalence of shift workers and incidences of sleep disorders and voluntary sleep restriction.

Validation of sleep-2-Peak: A smartphone application that can detect fatigue-related changes in reaction times during sleep deprivation

Despite its high sensitivity and validity in the context of sleep loss, the Psychomotor Vigilance Test (PVT) could be improved. The aim of the present study was to validate a new smartphone PVT-type application called sleep-2-Peak (s2P) by determining its ability to assess fatigue-related changes in alertness in a context of extended wakefulness. Short 3-min versions of s2P and of the classic PVT were administered at every even hour during a 35-h total sleep deprivation protocol. In addition, subjective measures of sleepiness were collected. The outcomes on these tests were then compared using Pearson product-moment correlations, t tests, and repeated measures within-groups analyses of variance. The results showed that both tests significantly correlated on all outcome variables, that both significantly distinguished between the alert and sleepy states in the same individual, and that both varied similarly through the sleep deprivation protocol as sleep loss accumulated. All outcome variables on both tests also correlated significantly with the subjective measures of sleepiness. These results suggest that a 3-min version of s2P is a valid tool for differentiating alert from sleepy states and is as sensitive as the PVT for tracking fatigue-related changes during extended wakefulness and sleep loss. Unlike the PVT, s2P does not provide feedback to subjects on each trial. We discuss how this feature of s2P raises the possibility that the performance results measured by s2P could be less impacted by motivational confounds, giving this tool added value in particular clinical and/or research settings.

Temperature biofeedback and sleep: limited findings and methodological challenges

Given the close link between body temperature and sleep, the perspective of manipu- lating core and peripheral temperature by self-regulation techniques is very appealing. We report here on a series of attempts conducted independently in two laboratories to use self-regulation (biofeedback) of oral (central) and hand (peripheral) temperature, and measured the impact on sleep-onset latency, sleep architecture, and circadian phase. We found that hand temperature was more successful than oral temperature biofeedback. Moreover, an increase in hand tem- perature was associated with reduced sleep-onset latency. However, most participants found the procedure difficult to implement. The temperature response to biofeedback was reduced in the aged and weakest at the time of sleep onset, and there was not a systematic relationship between the change in temperature and change in sleep latency. Methodological limitations and individual differences may account for these results. Recommendations for future research are presented.