Sleep
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Comparative Study Clinical Trial
Differential effects of sodium oxybate and baclofen on EEG, sleep, neurobehavioral performance, and memory.
Sodium oxybate (SO) is a GABAβ agonist used to treat the sleep disorder narcolepsy. SO was shown to increase slow wave sleep (SWS) and EEG delta power (0.75-4.5 Hz), both indexes of NREM sleep (NREMS) intensity and depth, suggesting that SO enhances recuperative function of NREM. We investigated whether SO induces physiological deep sleep. ⋯ The SO-induced EEG slow waves seem not to be functionally similar to physiological slow waves. Our findings also suggest a role for GABAβ receptors in REMS generation.
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Observational Study
Temporal disorganization of circadian rhythmicity and sleep-wake regulation in mechanically ventilated patients receiving continuous intravenous sedation.
Sleep is regulated by circadian and homeostatic processes and is highly organized temporally. Our study was designed to determine whether this organization is preserved in patients receiving mechanical ventilation (MV) and intravenous sedation. ⋯ The circadian rhythms and PSG of patients receiving mechanical ventilation and intravenous sedation exhibit pronounced temporal disorganization. The finding that most subjects exhibited preserved, but phase delayed, excretion of aMT6s suggests that the circadian pacemaker of such patients may be free-running.
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To determine the extent to which individual differences in vulnerability to total sleep deprivation also reflect individual differences in vulnerability to multiple nights of sleep restriction. ⋯ Resilience to sleep loss is a trait-like characteristic that reflects an individual's ability to maintain performance during both types of sleep loss (SR and TSD). Whether the findings extend to sleep schedules other than those investigated here (63 h of TSD and 7 nights of 3 h nightly TIB) will be the focus of future studies.
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Although acute sleep loss during 24- to 30-h extended duration work shifts (EDWS) has been shown to impair the performance of resident physicians, little is known about the effects of cumulative sleep deficiency on performance during residency training. Chronic sleep restriction induces a gradual degradation of neurobehavioral performance and exacerbates the effects of acute sleep loss in the laboratory, yet the extent to which this occurs under real-world conditions is unknown. In this study, the authors quantify the time course of neurobehavioral deterioration due to repeated exposure to EDWS during a 3-week residency rotation. ⋯ Chronic sleep deficiency caused progressive degradation in residents' neurobehavioral performance and exacerbated the effects of acute sleep loss inherent in the 24- to 30-h EDWS that are commonly used in resident schedules.