[Show abstract][Hide abstract] ABSTRACT: Idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) is a well-documented risk factor for synucleinopathies such as Parkinson disease (PD) and dementia with Lewy bodies (DLB). Moreover, approximately 50% of iRBD patients have mild cognitive impairment (MCI). The purpose of our study was to investigate waking electroencephalogram (EEG) abnormalities specific to iRBD patients with MCI.
Forty-two polysomnographically confirmed iRBD patients, including 23 iRBD [+]MCI patients 19 patients without MCI (iRBD [-]MCI), and 37 healthy subjects participated in the study. All participants underwent a complete neuropsychologic assessment for MCI diagnosis and a waking quantitative EEG recording.
iRBD [+]MCI patients had a higher slow-to-fast frequency ratio than iRBD [-]MCI patients and controls in the parietal, temporal, and occipital regions. iRBD [+]MCI patients also had higher relative θ power in the parietal, temporal, and occipital regions and lower relative α power in the occipital region compared to iRBD [-]MCI patients and controls. Moreover, iRBD [+]MCI patients had higher relative θ power in the frontal and central areas and lower relative β power in the central, parietal, and temporal regions compared to controls. The dominant occipital frequency also was slower in iRBD [+]MCI patients compared to controls. No between-group differences were observed between iRBD [-]MCI patients and controls.
In iRBD patients, only those with concomitant MCI showed waking EEG slowing in the posterior cortical regions, providing a potential marker for an increased risk for developing DLB or PD.
[Show abstract][Hide abstract] ABSTRACT: Sleepwalkers often complain of excessive daytime somnolence (EDS). Our retrospective study aimed to document the presence of EDS in a substantial sample of sleepwalkers and to explore the contribution of other sleep disorders, nocturnal sleep disruption, and sleep depth to the alteration of their daytime vigilance.
Seventy adult sleepwalkers and 70 control subjects completed the Epworth Sleepiness Scale (ESS). Sleepwalkers also were studied for one night in the sleep laboratory. We compared the sleep profiles of 32 somnolent vs 38 nonsomnolent sleepwalkers and investigated the relationship between ESS scores and sleep-related variables.
No differences were found in polysomnographic (PSG) parameters. Slow-wave activity (SWA) also was similar in the two subgroups. Sleepwalkers' ESS scores were not correlated with their body mass index (BMI) or periodic limb movements during sleep (PLMS) index, but they tended to be negatively correlated with indices of respiratory events.
The EDS reported by adult sleepwalkers does not appear to be explained by the presence of concomitant sleep disorders or PSG signs of nocturnal sleep disruption. These results raise the possibility that EDS is part of the sleepwalking phenotype and that it is linked to its underlying pathophysiology.
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVES:To determine the relative contributions of genetic and environmental factors on daytime and nighttime continuous sleep duration at 6, 18, 30, and 48 months of age, and to identify different subgroups of children who followed different daytime and nighttime sleep duration trajectories and to investigate their etiology.METHODS:The current study included 995 twins (405 monozygotic and 586 dizygotic) of the Quebec Newborn Twin Study recruited from the birth records of the Quebec Statistics Institute. Daytime and nighttime sleep was assessed through maternal reports at 6, 18, 30, and 48 months of age. A semiparametric modeling strategy was used to estimate daytime and nighttime sleep duration trajectories. Quantitative genetic models were used to examine to what extent genetic and environmental factors influenced daytime and nighttime continuous sleep duration.RESULTS:Genetic modeling analyses revealed environmental influences for all daytime sleep duration trajectories. In contrast, strong genetic influences were found for consolidated nighttime sleep duration (except at 18 months and for the short-increasing sleep duration trajectory).CONCLUSIONS:This is the first indication that early childhood daytime sleep duration may be driven by environmental settings, whereas the variance in consolidated nighttime sleep duration is largely influenced by genetic factors with a critical environmental time-window influence at ∼18 months.
[Show abstract][Hide abstract] ABSTRACT: Somnambulism, or sleepwalking, can give rise to a wide range of adverse consequences and is one of the leading causes of sleep-related injury. Accurate diagnosis is crucial for proper management and imperative in an ever-increasing number of medicolegal cases implicating sleep-related violence. Unfortunately, several widely held views of sleepwalking are characterised by key misconceptions, and some established diagnostic criteria are inconsistent with research findings. The traditional idea of somnambulism as a disorder of arousal might be too restrictive and a comprehensive view should include the idea of simultaneous interplay between states of sleep and wakefulness. Abnormal sleep physiology, state dissociation, and genetic factors might explain the pathophysiology of the disorder.
The Lancet Neurology 03/2013; 12(3):285-94. · 21.82 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Sex differences in the effects of sleep duration on dietary intake and eating behaviours were examined prospectively in relation to overweight/obesity at ages 6 and 7. Using data from a representative sample (QLSCD 1998-2010) of children born in the province of Québec (Canada), 1106 children were followed to age 6 and 1015 to 7years. Average nocturnal sleep duration was surveyed annually from 2.5-6years, food-frequency and eating behaviour questionnaires were administered at age 6, and body weight and height were measured at 6 and 7years. Associations were examined longitudinally and mediation examined with adjustments for potential confounders. In boys and girls, shorter sleep duration patterns were associated significantly with less favourable dietary intakes at 6years: boys consumed vegetables and fruits less frequently and meats/alternatives more frequently than boys with longer sleep patterns; and girls consumed vegetables, fruits and milk products less frequently and soft-drinks more frequently than girls with longer sleep patterns. However, boys with shorter sleep patterns were also more likely to eat at irregular hours or to eat too much/fast at 6years. These behaviours, and not dietary intake, mediated an inverse association between sleep duration and overweight/obesity in boys. Sleep duration did not associate with any problem eating behaviours or overweight/obesity in girls. Shorter sleep in early childhood appears to associate with problematic eating behaviours in boys and diet quality in both sexes, regardless of an association with overweight/obesity. This is important for public health and should be considered in relation to other diet-related diseases.
Journal of Sleep Research 12/2011; 21(4):448-60. · 2.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Short sleep duration is associated with incidence of overweight and obesity in preadolescent children. The authors performed regression analyses on data from the Quebec Longitudinal Study of Kindergarten Children (1986-1987), a prospective cohort study comprising 1,916 preadolescent children in Canada. The aim was to assess associations between time spent in bed and body mass index reported by mothers after adjusting for numerous confounding factors, such as pubertal status. Time-in-bed and body mass index trajectories were computed using a semiparametric model mixture. Time-in-bed trajectories were classified as short (15% of the preadolescents), 10.5-hour (68%), and 11-hour (17%) sleep-duration trajectories, decreasing over time. Body mass index trajectories were classified as normal weight (68% of the preadolescents), overweight (27%), and obese (5%). The short sleep trajectory was associated with an increased odds ratio of being in the overweight body mass index trajectory (odds ratio (OR)=1.55, 95% confidence interval (CI): 1.39, 1.71) or in the obese body mass index trajectory (OR=3.26, 95% CI: 3.20, 3.29) compared with the 11-hour trajectory. One hour less of sleep per night at 10 years of age was associated with an increased odds ratio of being overweight (OR=1.51, 95% CI: 1.28, 1.76) or obese (OR=2.07; 95% CI: 1.51, 2.84) at 13 years of age.
American journal of epidemiology 02/2011; 173(6):621-9. · 4.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The objectives were (1) to assess associations between sleep consolidation at 6, 18 and 30 months and language skills at 18, 30, and 60 months; and (2) to investigate the genetic/environmental etiology of these associations.
Longitudinal study of a population-based twin cohort.
1029 twins from the Quebec Newborn Twin Study.
Sleep consolidation was derived from parental reports of day/night consecutive sleeping durations. Language skills were assessed with the MacArthur Communicative Development Inventory at 18 and 30 months and the Peabody Picture Vocabulary Test at 60 months. The day/night sleep ratio decreased significantly from 6 to 30 months. The 6- and 18-month ratios were negatively correlated with subsequent language skills. Children with language delays at 60 months had less mature sleep consolidation at both 6 and 18 months than children without delays and those with transient early delays. Genetic and regression analyses revealed that the sleep ratio at 6 months was highly heritable (64%) and predicted 18-month (B = -0.06) and 30-month language (B = -0.11) mainly through additive genetic influences (R(Gs) = 0.32 and 0.33, respectively). By contrast, the sleep ratio at 18 months was mainly due to shared environment influences (58%) and predicted 60-month language (B = -0.08) through shared environment influences (R(Cs) = 0.24).
Poor sleep consolidation during the first 2 years of life may be a risk factor for language learning, whereas good sleep consolidation may foster language learning through successive genetic and environmental influences.
[Show abstract][Hide abstract] ABSTRACT: A close temporal relationship was shown between the onset of melatonin secretion at night and the worsening of restless legs syndrome (RLS) symptoms, suggesting that melatonin may play a role in the genesis of this phenomenon. To test this hypothesis we studied the effects of the administration of exogenous melatonin and, conversely, the suppression of endogenous melatonin secretion by bright light exposure on the severity of RLS symptoms.
Eight RLS subjects were studied in three conditions: at baseline, after administration of melatonin and during bright light exposure. The severity of RLS symptoms was assessed by the suggested immobilization test (SIT), which allows quantification of both sensory and motor manifestations (SIT-PLM) of RLS.
Analyses showed a significant increase of SIT-PLM index when subjects received exogenous melatonin compared to both baseline and bright light conditions, but bright light exposure had no effect on leg movements compared to the baseline condition. Analyses also revealed a small but significant decrease in sensory symptoms with bright light exposure compared to baseline.
Exogenous melatonin may have a detrimental effect on motor symptoms, and bright light exposure produced small but significant improvement of leg discomfort. The study shows the interest of using the SIT to measure outcome of intervention in RLS. Further studies will be needed to assess the therapeutic value of bright light in RLS.
Sleep Medicine 03/2010; 11(4):351-5. · 3.10 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Our objectives were to investigate the developmental trajectories of nighttime sleep duration and hyperactivity over the preschool years and to identify the risk factors associated with short nighttime sleep duration and high hyperactivity scores.
Nighttime sleep duration and hyperactivity were measured yearly by questionnaires administered to mothers of 2057 children from age 1.5 to 5 years. Developmental trajectories of nighttime sleep duration and hyperactivity throughout early childhood were analyzed to determine interassociations. A multinomial logistic regression was performed to determine which factors among selected child, maternal, and family characteristics and parental practices surrounding sleep periods in early childhood were associated with short nighttime sleep duration and high hyperactivity scores.
The trajectories of nighttime sleep duration and hyperactivity were significantly associated. The odds ratio (OR) of reporting short nighttime sleep duration was 5.1 for highly hyperactive children (confidence interval [CI]: 3.2-7.9), whereas the OR of reporting high hyperactivity scores was 4.2 for persistently short sleepers (CI: 2.7-6.6). The risk factors for reporting short nighttime sleep duration and high hyperactivity scores were (1) being a boy, (2) having insufficient household income, (3) having a mother with a low education, and (4) being comforted outside the bed after a nocturnal awakening at 1.5 years of age.
The risk of short nighttime sleep duration in highly hyperactive children is greater than the risk of high hyperactivity scores in short sleepers. Preventive interventions that target boys living in adverse familial conditions could be used to address these concomitant behavioral problems.
[Show abstract][Hide abstract] ABSTRACT: Dyssomnias are largely under-diagnosed in infants and toddlers. This literature review proposes an integrative model based on empirical data on determinants and consequences of sleep disturbances occurring in early life. This model proposes that parental behaviors that impede the child's autonomy toward sleep periods are primary grounds for the development of dyssomnias, e.g., parental presence until the child falls asleep, and putting an already sleeping child to bed. The model also indicates the serious potential consequences of a modest but chronic loss of sleep in childhood. At least three developmental domains could be directly affected: behavioral/social competence, cognitive performance, and physical condition. Thus, children with short nocturnal sleep duration before age 3.5 years show increased risk of high hyperactivity-impulsivity scores and low cognitive performance at 6 years compared to children who sleep 11 h per night, after controlling for potentially confounding variables. Moreover, persistent short sleep duration in early infancy increased the risk of suffering of obesity at 6 years of age, after controlling for potentially confounding variables. Finally, the importance of allowing the child to sleep at least 10 h per night in early childhood is stressed, as the National Sleep Foundation Poll suggests, for optimal child development.
Sleep Medicine Reviews 02/2009; 13(5):355-61. · 9.14 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: There is growing evidence that genetic factors are involved in the occurrence of sleep terrors. Twin studies provide invaluable information regarding genetic and environmental factors that can affect the manifestation of the disease; however, most previous twin studies on sleep terrors were performed retrospectively or with a sample that was too small to yield conclusive results. The aim of this large prospective study was to clarify the genetic and environmental contributions to sleep terrors in childhood.
In all, 390 pairs of monozygotic and dizygotic twins were recruited at birth for a longitudinal study. The prevalence and frequency of sleep terrors were assessed at 18 and 30 months of age with a questionnaire administered to the biological mother of the twins. Zygosity was determined by a questionnaire and genotyping. The prevalence and polychoric correlation for each type of twins were calculated. Structural-equation modeling was used to determine the proportion of variance attributable to additive genetic, shared, and nonshared environmental factors.
The prevalence of sleep terrors was 36.9% at 18 months and 19.7% at 30 months; 49% of affected children were boys, and 51% were girls. At 18 months, the polychoric correlations were 0.63 for monozygotic and 0.36 for the dizygotic twins. These were 0.68 (monozygotic) and 0.24 (dizygotic) at 30 months. Our model-fitting analysis showed that sleep terrors were explained by a 2-component model at 18 months (43.7% additive genetic effects and 56.3% nonshared environment) and at 30 months (41.5% additive genetic effects and 58.5% nonshared environment).
These results strongly support the heritability of sleep terrors. There also seems to be continuity in genetic effects with the persistence of sleep-terror symptoms.
[Show abstract][Hide abstract] ABSTRACT: To investigate whether longitudinal sleep duration patterns during early childhood is a risk factor of overweight or obesity at school entry while controlling for a variety of obesogenic environmental factors.
This is a prospective cohort study (March-December 1998 to December 2004) of a representative sample of infants born in 1997-1998 in the Canadian province of Quebec. Body mass index (BMI) was measured at ages 2.5 and 6 years. Sleep duration was reported yearly from 2.5 to 6 years of age by their mothers. Prenatal, postnatal (5 and 29 months), and lifestyle (6 y) potentially confounding factors for excess weight were assessed by interviews, questionnaires and hospital records. A group-based semiparametric mixture model was used to estimate developmental patterns of sleep duration. The relationship between sleep duration patterns and BMI was tested using multivariate logistic regression models to control for potentially confounding factors on 1138 children.
Four sleep duration patterns were identified: short persistent (5.2%), short increasing (4.7%), 10-hour persistent (50.7%), and 11-hour persistent (39.4%). After controlling for potentially confounding factors, the risk for overweight or obesity was almost 4.2 times higher for short persistent sleepers (odds ratio [OR], 4.2; 95% confidence interval [CI], 1.6 to 11.1; P = 0.003) than for 11-hour persistent sleepers.
Persistently short sleep duration (<10 h) during early childhood significantly increases the risk of excess weight or obesity in childhood, and appears to be independent of other obesogenic factors.
[Show abstract][Hide abstract] ABSTRACT: To present a longitudinal overview of the sleep schedules during weekdays and the weekend in a large sample of children and to examine the sleep-wake schedules in relation to nocturnal sleep duration and birth season.
Longitudinal survey design.
Data were collected by home interviews and questionnaires.
Data for sleep schedules at the ages of 4, 5, and 6 years on weekdays were obtained for 1112 children. Data for bedtimes on the weekend were available for 1094 children, and data for wake times on the weekend were available for 1083 children.
Habitual bedtimes and wake times during weekdays and the weekend were reported by the mothers at the 3 ages. Nighttime sleep duration was calculated from bedtime to wake time. Birth characteristics came from medical records.
As children grow up, we found later bedtimes on the weekend for a given bedtime on weekdays. Interestingly, most children slept less during the weekend compared with weekdays. No significant difference (P > .10 for all) was found in the seasonal distribution of births in any of the sleep-wake schedules.
Despite a lack of a strong preference for sleep timing during childhood, the displacement of bedtime toward later hours during the weekend starts early in life. More important, sleep-wake patterns are associated with sleep duration and later bedtimes on the weekend seem to shorten sleep duration in most children.
[Show abstract][Hide abstract] ABSTRACT: This review presents sleep disturbances and their underlying pathophysiology in three categories of neurodegenerative disorders namely tauopathies, synucleinopathies, and Huntington's disease (HD) and prion-related diseases. Sleep abnormalities are a major and early feature of neurodegenerative disorders, especially for synucleinopathies, HD and prion-related diseases, in which the sleep-related brainstem regions are severely altered and impaired sooner than in most of the tauopathies. In synucleinopathies, HD and prion-related diseases, specific sleep disturbances, different from those observed in tauopathies, are considered as core manifestations of the disease and in some cases, as preclinical signs. For this reason, the evaluation of sleep components in these neurodegenerative disorders may be useful to make a diagnosis and to assess the efficacy of pharmacotherapy. Since sleep disruption may occur early in the course of neurodegeneration, sleep disturbance may serve as groundwork to study the efficacy of neuroprotective agents to prevent or delay the development of a full-blown neurodegenerative disorder. The cause of sleep disturbances in neurodegenerative disorders may be attributed to several factors, including age-related modifications, symptoms of the disease, comorbid conditions and the neurodegenerative process itself.
Current pharmaceutical design 02/2008; 14(32):3430-45. · 4.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Sleep and vigilance disorders are among the most commonly reported symptoms following a concussion. The aim of the study was thus to investigate the effects of sport-related concussions on subjective and objective sleep quality.
Ten concussed athletes and 11 non-concussed athletes were included. Concussed athletes had a history of 4.6+/-2.1 concussions with at least one concussion during the last year. They were recorded for two consecutive nights in the laboratory and during a 10-min period of wakefulness. They completed questionnaires related to sleep quality and symptoms as well as neuropsychological tests and the CogSport computer battery.
Concussed athletes reported more symptoms and worse sleep quality than control athletes, but no between-group differences were found on polysomnographic variables or on REM and NREM sleep quantitative EEG variables. However, concussed athletes showed significantly more delta activity and less alpha activity during wakefulness than did control athletes.
In spite of the subjective complaints in sleep quality of concussed athletes, no change was observed in objective sleep characteristics. However, concussions were associated with an increase in delta and a reduction in alpha power in the waking EEG. Sport-related concussions are thus associated with wakefulness problems rather than sleep disturbances.
Sleep Medicine 02/2008; 10(1):35-46. · 3.10 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To determine the distribution of age-at-onset in a large cohort of patients with restless legs syndrome (RLS) and to compare clinical and polysomnographic characteristics of patients with early and late age-at-onset of RLS.
Two hundred and fifty patients with RLS were studied. Information on age-at-onset, etiology, familial history and symptoms severity of RLS was obtained. Age-at-onset density functions were determined from bootstrap methods and kernel density estimators.
Age-at-onset showed a significant bimodal distribution with a large peak occurring at 20 years of age and a smaller peak in the mid-40s. Early- and late-onset RLS could be separated with a cut-off at 36 years of age. Distributions of age-at-onset differed as a function of presence/absence of a familial history and etiology of RLS. Age-at-onset clearly differentiated patients with a primary RLS (early onset) from those with secondary RLS. Finally, early-onset RLS was associated with increased RLS severity with higher indices of periodic leg movements in sleep (PLMS) associated with microarousals and periodic leg movements during wakefulness (PLMW).
Early- and late-onset RLS could be distinguished depending on familial history and etiology of RLS. Our data suggest that different pathological processes are involved in these two groups, the early-onset group being highly genetically determined.
Sleep Medicine 01/2008; 9(1):54-9. · 3.10 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Patients with obstructive sleep apnea syndrome (OSAS) present cognitive deficits similar to those observed with aging. The aim of the study was to assess the effects of age on cognitive functions in OSAS patients. It was hypothesized that older OSAS patients will exhibit significant cognitive dysfunction relative to younger OSAS patients and controls.
Younger and older OSAS patients were compared to younger and older control subjects (age cut-off set at 50 yrs). Participants underwent a polysomnographic (PSG) and neuropsychological evaluation. Variables were analyzed by two-way analyses of variance (ANOVAs) with two factors: Group (control and OSAS) and Age (younger and older). Additionally, we evaluated the contribution of attentional deficits to cognitive dysfunction for each subgroup of patients by using Spearman correlation coefficients.
No Group-by-Age interaction was found for any neuropsychological variables (p<0.05). However, main Group and Age effects were found. Correlations indicated that attentional deficits contributed importantly to a poorer cognitive performance in younger OSAS patients only (p<0.01).
Our results are in agreement with those of the literature for both OSAS-related and aging-related cognitive deficits but did not demonstrate that age interacts with the effects of the OSAS condition to make those cognitive deficits worse.
Sleep Medicine 01/2008; 9(2):112-20. · 3.10 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The objectives of the study were to measure the prevalence of periodic leg movements during NREM and REM sleep (PLMS) and while awake (PLMW) and to assess the impact of PLMS on nocturnal sleep and daytime functioning in patients with narcolepsy. One hundred and sixty-nine patients with narcolepsy and 116 normal controls matched for age and gender were included. Narcoleptics with high and low PLMS indices were compared to assess the impact of PLMS on sleep and Multiple Sleep Latency Test (MSLT) variables. More narcoleptics than controls had a PLMS index greater than 5 per hour of sleep (67% versus 37%) and an index greater than 10 (53% versus 21%). PLMS indices were higher both in NREM and REM sleep in narcoleptic patients, but the between-group difference was greater for REM sleep. A significant increase of PLMS index was also found with aging in both narcoleptic patients and controls. PLMW indices were also significantly higher in narcoleptic patients. Patients with an elevated index of PLMS had a higher percentage of stage 1 sleep, a lower percentage of REM sleep, a lower REM efficiency and a shorter MSLT latency. The present study demonstrates a high frequency of PLMS and PLMW in narcolepsy, an association between the presence of PLMS and measures of REM sleep and daytime functioning disruption. These results suggest that PLMS represent an intrinsic feature of narcolepsy.
Journal of Sleep Research 10/2007; 16(3):333-9. · 2.95 Impact Factor