Wakefulness

This report describes the variability in the mechanism of upper airway collapse seen in children with obstructive apnea secondary to craniofacial anomalies. Emphasis is on the nasopharyngoscopic observation of the upper airway and the accurate assessment of the site and mechanism of obstruction in order to prescribe the appropriate treatment.

BackgroundToday many merchant ships sail with only two nautical officers, working a shift schedule of 6 hr on and 6 hr off. There are concerns that such a shift schedule is related to fatigue. However, little data exist from onboard studies of seafarers.Today many merchant ships sail with only two nautical officers, working a shift schedule of 6 hr on and 6 hr off. There are concerns that such a shift schedule is related to fatigue. However, little data exist from onboard studies of seafarers.MethodsData were collected on board 13 ships. Fifteen participants worked on a 6-on, 6-off watch system and another 15 on a 4-on, 8-off watch system. Electrooculography, actigraphy, diaries, and reaction time tests were used to measure the effects of shift system on fatigue and sleep.Data were collected on board 13 ships. Fifteen participants worked on a 6-on, 6-off watch system and another 15 on a 4-on, 8-off watch system. Electrooculography, actigraphy, diaries, and reaction time tests were used to measure the effects of shift system on fatigue and sleep.Results and ConclusionsSleepiness was higher during the night shift in the 6-on, 6-off system. Moreover, sleepiness increased more during the watch in the 6-on, 6-off system compared to the 4-on, 8-off system. There was a trend toward shorter sleep episodes in the 6-on, 6-off system and sleep was more often split into two episodes. Am. J. Ind. Med. 53:733–740, 2010. © 2010 Wiley-Liss, Inc.Sleepiness was higher during the night shift in the 6-on, 6-off system. Moreover, sleepiness increased more during the watch in the 6-on, 6-off system compared to the 4-on, 8-off system. There was a trend toward shorter sleep episodes in the 6-on, 6-off system and sleep was more often split into two episodes. Am. J. Ind. Med. 53:733–740, 2010. © 2010 Wiley-Liss, Inc.

Serotonin, acting in the peripheral nervous system, can exacerbate sleep-related apnea, and systemically administered serotonin antagonists reduce sleep-disordered respiration in rats and bulldogs. Because cannabinoid receptor agonists are known to inhibit the excitatory effects of serotonin on nodose ganglion cells, we examined the effects of endogenous (oleamide) and exogenous (delta9-tetrahydrocannabinol; delta9THC) cannabimimetic agents on sleep-related apnea. Sleep architecture, respiratory pattern, and apnea expression in rats were assessed by polysomnography. A repeated measures, within-subjects, fully nested crossover design was used in which each animal was recorded on exactly 12 occasions. Eleven adult male Sprague-Dawley rats were instrumented for chronic polysomnography. Animals were recorded following intraperitoneal injection of various doses of delta9THC, oleamide, and serotonin, alone and in combination. Our data show that delta9THC and oleamide each stabilized respi...

To (1) clarify the epidemiology of bad dreams in children and investigate risk and protective factors related to (2) the child's sleep, (3) parental sleep-enabling practices, and (4) the child's temperament. Longitudinal with 6 time points from 5 months to 6 years. Subjects' homes. Representative sample of 987 children in the Province of Quebec. None. Longitudinal logistic regression analysis models with primary endpoints of presence or absence of parent-rated bad dreams at 29 months, 41 months, 50 months, 5 years, and 6 years and predictor variables of demographic characteristics, parent ratings of child's sleep characteristics, parental sleep-enabling practices (e.g., cosleeping), and child's psychological characteristics at 5 and 17 months (anxiousness, temperament). Mothers' ratings indicated lower than expected prevalence of frequent bad dreams (1.3% to 3.9%). Demographic correlates of bad dreams were high family income, absence of siblings at 29 months,...

The sensory information that the central nervous system receives represents an enormous amount of data coming from the outer world and from the body itself. This constitutes a set of influences that affects the general brain developing as well as on the sleep-waking organization. We have proposed changes in the auditory information processing throughout the sleep-wakefulness cycle may be at least partially evidenced by single neurons extracellular recordings. We introduce the concept that the neural network organization during sleep vs that of wakefulness is different and can be modulated by sensory signals, and vice versa, the sensory input may be influenced by the central nervous system asleep or awake. During sleep the evoked firing of auditory units increases, decreases or remains similar to that observed during quiet wakefulness. There has been no auditory unit yet that stopped firing as the guinea pig enters sleep. Approximately half of the cortical neurons studied did not cha...

Deficits in daytime performance due to sleep loss are experienced universally and associated with a significant social, financial, and human cost. Microsleeps, sleep attacks, and lapses in cognition increase with sleep loss as a function of state instability. Sleep deprivation studies repeatedly show a variable (negative) impact on mood, cognitive performance, and motor function due to an increasing sleep propensity and destabilization of the wake state. Specific neurocognitive domains including executive attention, working memory, and divergent higher cognitive functions are particularly vulnerable to sleep loss. In humans, functional metabolic and neurophysiological studies demonstrate that neural systems involved in executive function (i.e., prefrontal cortex) are more susceptible to sleep deprivation in some individuals than others. Recent chronic partial sleep deprivation experiments, which more closely replicate sleep loss in society, demonstrate that profound neurocognitive d...