Editorial

3 pages, 188 KiB

Open AccessEditorial

The Mechanisms of Sleep Function and Regulation for Health and Cognitive Performance

by Marco Fabbri

Brain Sci. 2023, 13(12), 1680; https://doi.org/10.3390/brainsci13121680 - 06 Dec 2023

Viewed by 918

Although we spend about one third of our life sleeping, the function and regulation of sleep remain scientific enigmas [...] Full article

(This article belongs to the Special Issue The Mechanisms of Sleep Function and Regulation for Health and Cognitive Performance)

Research

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12 pages, 8233 KiB

Open AccessArticle

Electrophysiological and Neuropsychological Indices of Cognitive Dysfunction in Patients with Chronic Insomnia and Severe Benzodiazepine Use Disorder

by Anna Castelnovo, Silvia Miano, Raffaele Ferri, Alberto Raggi, Michelangelo Maestri, Valentina Bottasini, Matteo Anelli, Marco Zucconi, Vincenza Castronovo, Luigi Ferini-Strambi and Mauro Manconi

Brain Sci. 2023, 13(3), 375; https://doi.org/10.3390/brainsci13030375 - 21 Feb 2023

Cited by 1 | Viewed by 1271

Abstract

Benzodiazepine (BDZ) misuse is a growing health problem, with 1–2% of patients under BDZ treatment meeting the criteria for use disorder or dependence. Although BDZ addiction potential has been known for decades, much remains unknown its effects on brain functions. The aim of [...] Read more.

Benzodiazepine (BDZ) misuse is a growing health problem, with 1–2% of patients under BDZ treatment meeting the criteria for use disorder or dependence. Although BDZ addiction potential has been known for decades, much remains unknown its effects on brain functions. The aim of this study was to assess the neuropsychological and neurophysiological profile of a group of chronic insomniacs taking long-term high doses of benzodiazepine. We recruited 17 consecutive patients admitted to our third-level Sleep Medicine Unit for drug discontinuation (7 males, mean age 49.2 ± 11.2 years, mean education 13.7 ± 3.9 years, mean daily diazepam-equivalent BDZ: 238.1 ± 84.5 mg) and 17 gender/age-matched healthy controls (7 males, mean age 46.8 ± 14.1 years, mean education 13.5 ± 4.5 years). We performed a full neuropsychological evaluation of all subjects and recorded their scalp event-related potentials (Mismatch-Passive Oddball-Paradigm and Active Oddball P300 Paradigm). Patients with chronic insomnia and BDZ use disorder showed a profound frontal lobe executive dysfunction with significant impairment in the cognitive flexibility domain, in face of a preserved working, short and long-term memory. In patients, P300 amplitude tended to be smaller, mainly over the frontal regions, compared to controls. BDZ use disorder has a severe cognitive impact on chronic insomnia patients. Long-term high-dose BDZ intake should be carefully evaluated and managed by clinicians in this specific patient population, especially in relation to risky activities. Full article

(This article belongs to the Special Issue The Mechanisms of Sleep Function and Regulation for Health and Cognitive Performance)

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14 pages, 588 KiB

Open AccessArticle

Habitual Videogame Playing Does Not Compromise Subjective Sleep Quality and Is Associated with Improved Daytime Functioning

by Oreste De Rosa, Francesca Conte, Paolo D’Onofrio, Serena Malloggi, Anna Alterio, Marissa Lynn Rescott, Fiorenza Giganti and Gianluca Ficca

Brain Sci. 2023, 13(2), 279; https://doi.org/10.3390/brainsci13020279 - 07 Feb 2023

Cited by 1 | Viewed by 1766

Abstract

Research on the effects of videogames (VGs) on health has produced mixed results. Here, we assess the relationships of VG playing with sleep; chronotype; sleepiness; and levels of depression, anxiety, and stress; and how they are modulated by the level of exposure to [...] Read more.

Research on the effects of videogames (VGs) on health has produced mixed results. Here, we assess the relationships of VG playing with sleep; chronotype; sleepiness; and levels of depression, anxiety, and stress; and how they are modulated by the level of exposure to VGs. Four hundred-and two adult participants (age = 26.2 ± 7.84; 227 F) completed an online survey including questions on VG use and a set of standardized questionnaires. The sample was divided into three groups: habitual gamers (HGs, 42.2%), nonhabitual gamers (NHGs, 36.5%), and non-gamers (NGs, 21.3%). No between-group differences emerged in sleepiness (Epworth Sleepiness Scale) or Pittsburgh Sleep Quality Index measures except the sleep disturbances subscore, which was higher in NHGs. HGs showed delayed bed- and risetimes and higher eveningness (reduced Morningness–Eveningness Questionnaire). HGs and NHGs showed higher depression subscores (Depression Anxiety Stress Scale) but remained in the subclinical range. Moreover, hours/week of VG playing predicted delayed sleep timing, lower daytime dysfunction, and lower sleepiness. Our data suggest that VG playing does not necessarily compromise sleep quality and may even benefit daytime functioning, underlining the need to reconsider the relationships between VG use and health by taking into account possible modulating factors such as habitual VG exposure. Full article

(This article belongs to the Special Issue The Mechanisms of Sleep Function and Regulation for Health and Cognitive Performance)

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10 pages, 284 KiB

Open AccessArticle

Cognitive Reserve in Isolated Rapid Eye-Movement Sleep Behavior Disorder

by Giada D’Este, Francesca Berra, Giulia Carli, Caterina Leitner, Sara Marelli, Marco Zucconi, Francesca Casoni, Luigi Ferini-Strambi and Andrea Galbiati

Brain Sci. 2023, 13(2), 176; https://doi.org/10.3390/brainsci13020176 - 20 Jan 2023

Cited by 2 | Viewed by 1508

Abstract

Isolated rapid-eye-movement sleep behaviour disorder (RBD) is considered the prodromal stage of α-synucleinopathies (e.g., Parkinson’s disease and dementia with Lewy bodies); however, iRBD patients show a wide variety in the progression timing (5–15 years). The model of cognitive reserve (CR) might contribute to [...] Read more.

Isolated rapid-eye-movement sleep behaviour disorder (RBD) is considered the prodromal stage of α-synucleinopathies (e.g., Parkinson’s disease and dementia with Lewy bodies); however, iRBD patients show a wide variety in the progression timing (5–15 years). The model of cognitive reserve (CR) might contribute to explaining this phenomenon. Our exploratory study aimed to evaluate, for the first time, the impact of CR level on cognitive performance in polysomnography-confirmed iRBD patients. Fifty-five iRBD patients (mean age ± SD: 66.38 ± 7.51; M/F 44/11) underwent clinical and neuropsychological evaluations at the time of diagnosis. The CR Index questionnaire was part of the clinical assessment. We found that iRBD patients with high levels of CR showed: (i) the lowest percentage of mild cognitive impairment (10%), and (ii) the best performance in visuo-constructive and verbal memory functions (i.e., the recall of the Rey–Osterrieth complex figure test). Our results suggest that CR might help iRBD patients better cope with the cognitive decline related to the neurodegenerative process, providing the first preliminary findings supporting CR as a possible protective factor in this condition. This might pave the way for future longitudinal studies to evaluate the role of CR as a modulating factor in the timing of iRBD conversion and cognitive deterioration development. Full article

(This article belongs to the Special Issue The Mechanisms of Sleep Function and Regulation for Health and Cognitive Performance)

12 pages, 1343 KiB

Open AccessEditor’s ChoiceArticle

Cognitive Performance in Short Sleep Young Adults with Different Physical Activity Levels: A Cross-Sectional fNIRS Study

by Yanwei You, Jianxiu Liu, Dizhi Wang, Yingyao Fu, Ruidong Liu and Xindong Ma

Brain Sci. 2023, 13(2), 171; https://doi.org/10.3390/brainsci13020171 - 19 Jan 2023

Cited by 21 | Viewed by 2630

Abstract

Short sleep is a common issue nowadays. The purpose of this study was to investigate prefrontal cortical hemodynamics by evaluating changes in concentrations of oxygenated hemoglobin (HbO) in cognitive tests among short-sleep young adults and to explore the relationship between sleep duration, physical [...] Read more.

Short sleep is a common issue nowadays. The purpose of this study was to investigate prefrontal cortical hemodynamics by evaluating changes in concentrations of oxygenated hemoglobin (HbO) in cognitive tests among short-sleep young adults and to explore the relationship between sleep duration, physical activity level, and cognitive function in this specific population. A total of 46 participants (25 males and 21 females) were included in our study, and among them, the average sleep duration was 358 min/day. Stroop performance in the short sleep population was linked to higher levels cortical activation in distinct parts of the left middle frontal gyrus. This study found that moderate-to-vigorous physical activity (MVPA) was significantly associated with lower accuracy of incongruent Stroop test. The dose-response relationship between sleep duration and Stroop performance under different levels of light-intensity physical activity (LPA) and MVPA was further explored, and increasing sleep time for different PA level was associated with better Stroop performance. In summary, this present study provided neurobehavioral evidence between cortical hemodynamics and cognitive function in the short sleep population. Furthermore, our findings indicated that, in younger adults with short sleep, more MVPA was associated with worse cognitive performance. Short sleep young adults should increase sleep time, rather than more MVPA, to achieve better cognitive function. Full article

(This article belongs to the Special Issue The Mechanisms of Sleep Function and Regulation for Health and Cognitive Performance)

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10 pages, 1420 KiB

Open AccessArticle

Reduced Sleep Amount and Increased Sleep Latency in Prisoners: A Pilot Study in an Italian Jail

by Giulia D’Aurizio, Beatrice Tosti, Daniela Tempesta, Lucia Avvantaggiato, Alessandra Splendiani, Simona Sacco, Laura Mandolesi and Giuseppe Curcio

Brain Sci. 2023, 13(1), 132; https://doi.org/10.3390/brainsci13010132 - 12 Jan 2023

Cited by 3 | Viewed by 1416

Abstract

Several previous subjective- or interview-based reports indicated a reduced sleep quality and quantity as well as a great incidence of insomnia troubles in prisoners living in jail. The aim of the present study is to assess the quality and quantity of sleep by [...] Read more.

Several previous subjective- or interview-based reports indicated a reduced sleep quality and quantity as well as a great incidence of insomnia troubles in prisoners living in jail. The aim of the present study is to assess the quality and quantity of sleep by using, for the first time, actigraphy. A total of thirty male prisoners and thirty male control volunteers accepted to participate in this study: to this end, they filled in some questionnaires to assess state and trait anxiety, depression, sleep quality, and insomnia severity. In addition, their sleep was actigraphically recorded for seven consecutive nights. The main results indicate a worsened mood in prisoners than in controls (with increased anxiety and depression) as well as a subjectively reported low sleep quality (higher scores at PSQI) with a clinical presence of insomnia complaints (as indicated by ISI scores). Moreover, objectively assessed sleep by means of actigraphy exhibited some worrying results, namely a longer sleep onset and a reduced total sleep time was seen in prisoners with respect to controls. The results have been discussed in the light of potential effects of sleep quality and quantity as well as of mood symptoms on cognitive functioning, as well as with respect to prisoners’ health and well-being. Full article

(This article belongs to the Special Issue The Mechanisms of Sleep Function and Regulation for Health and Cognitive Performance)

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17 pages, 641 KiB

Open AccessArticle

Attentional Bias for Sleep-Related Words as a Function of Severity of Insomnia Symptoms

by Marco Fabbri, Luca Simione, Laura Catalano, Marco Mirolli and Monica Martoni

Brain Sci. 2023, 13(1), 50; https://doi.org/10.3390/brainsci13010050 - 27 Dec 2022

Cited by 1 | Viewed by 1897

Abstract

Attentional bias to sleep-related information is thought to be a core feature for developing and/or maintaining insomnia. This study used a hallmark measure of attentional bias, the dot-probe task, to determine whether this bias toward sleep-related stimuli was a function of the severity [...] Read more.

Attentional bias to sleep-related information is thought to be a core feature for developing and/or maintaining insomnia. This study used a hallmark measure of attentional bias, the dot-probe task, to determine whether this bias toward sleep-related stimuli was a function of the severity of insomnia symptoms. A sample of 231 volunteers (175 females; mean age of 26.91 ± 8.05 years) participated in this online study, filling out the Insomnia Severity Index (ISI) and performing a visual dot-probe task. After categorizing individuals based on the ISI score into normal, subclinical, and moderate/severe sleep groups, we only found a marginally significant interaction between sleep groups and the type of stimuli on RTs, suggesting that subclinical and moderate/severe sleep groups reported slower RTs for sleep-related words than for neutral words. When we calculated the attentional bias score (ABS), we found that ABS significantly differed from zero in the moderate/severe sleep group only, suggesting a disengagement for sleep-related information as a function of the severity of insomnia symptoms. This finding seems to suggest that insomnia is related to greater difficulties in shifting away from sleep-related stimuli. Full article

(This article belongs to the Special Issue The Mechanisms of Sleep Function and Regulation for Health and Cognitive Performance)

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11 pages, 854 KiB

Open AccessArticle

Facial Emotion Recognition Deficit in Children with Moderate/Severe Obstructive Sleep Apnea

by Fu-Jun Zhao, Qing-Wei Chen, Yunxiao Wu, Xiaohong Xie, Zhifei Xu and Xin Ni

Brain Sci. 2022, 12(12), 1688; https://doi.org/10.3390/brainsci12121688 - 08 Dec 2022

Cited by 1 | Viewed by 1479

Abstract

Although previous studies have reported a facial expression classification deficit among adults with SDB, we do not know whether these findings can be generalized to children. In our study, children with sleep-disordered breathing (SDB) were divided into three groups: primary snoring (n [...] Read more.

Although previous studies have reported a facial expression classification deficit among adults with SDB, we do not know whether these findings can be generalized to children. In our study, children with sleep-disordered breathing (SDB) were divided into three groups: primary snoring (n = 51), mild obstructive sleep apnea (OSA) (n = 39), and moderate/severe OSA (n = 26). All participants, including 20 healthy controls, underwent an overnight polysomnography recording and the Emotional Expression Recognition Task. Psychosocial problems were evaluated using the parent-reported Strengths and Difficulties Questionnaire (SDQ). There was a borderline significant interaction between expression category and group on reaction times. Further analysis revealed that positive classification advantage (PCA) disappeared in the moderate/severe OSA group, whereas it persisted in the control, primary snoring, and mild OSA groups. Emotional symptoms were positively correlated with OAHI. In both the happy and sad conditions, RT was negatively related to age and body mass index (BMI) but was independent of the obstructive apnea-hypopnea index (OAHI), arterial oxygen (SaO₂) and total sleep time. The accuracy of identifying a sad expression was negatively related to conduct problems. Children with moderate/severe OSA exhibited dysfunction in facial expression categorization, which could potentially affect social communication ability. Full article

(This article belongs to the Special Issue The Mechanisms of Sleep Function and Regulation for Health and Cognitive Performance)

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9 pages, 432 KiB

Open AccessArticle

Assessment of Executive and Cognitive Functions in Children with Restless Sleep Disorder: A Pilot Study

by Lourdes M. DelRosso, German Vega-Flores, Raffaele Ferri, Maria P. Mogavero and Adele Diamond

Brain Sci. 2022, 12(10), 1289; https://doi.org/10.3390/brainsci12101289 - 24 Sep 2022

Cited by 4 | Viewed by 1906

Abstract

Restless sleep disorder affects children and is characterized by frequent nocturnal movements, iron deficiency, and daytime symptoms such as poor school performance or behavioral problems. Although sleep parameters have been thoroughly studied and daytime sleepiness has been previously assessed, neurocognitive and executive functions [...] Read more.

Restless sleep disorder affects children and is characterized by frequent nocturnal movements, iron deficiency, and daytime symptoms such as poor school performance or behavioral problems. Although sleep parameters have been thoroughly studied and daytime sleepiness has been previously assessed, neurocognitive and executive functions have not. In this study, we evaluated neurocognitive functions in a group of 13 children diagnosed with restless sleep disorder using the National Institute of Health Toolbox (NIH toolbox). The mean age was 10.62 (S.D. 2.785). Among them, seven were male and six were female. The fully corrected T-scores (adjusted for demographic variables: age, ethnicity, and education level) showed the lowest values for the Flanker test (selective attention) and dimensional change card sorting test (cognitive flexibility and inhibitory control), with a very large effect size vs. the corresponding expected frequencies. For all the other tests, the average scores were 50; however, individual children scored low on pattern recognition and two composite scores (fluid and total). In conclusion, these data support the fact that cognitive functions are affected in children with restless sleep disorder, especially selective attention. Clinicians must recognize sleep disorders and daytime impairment in order to promptly intervene and prevent cognitive impairments. Full article

(This article belongs to the Special Issue The Mechanisms of Sleep Function and Regulation for Health and Cognitive Performance)

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6 pages, 469 KiB

Open AccessArticle

Time Course of Motor Sleep Inertia Dissipation According to Age

by Lorenzo Tonetti, Marco Fabbri, Sara Giovagnoli, Monica Martoni, Miranda Occhionero and Vincenzo Natale

Brain Sci. 2022, 12(4), 424; https://doi.org/10.3390/brainsci12040424 - 23 Mar 2022

Cited by 4 | Viewed by 1787

Abstract

Sleep inertia (SI) refers to a complex psychophysiological phenomenon observed after morning awakening that can be described as the gradual recovery of waking-like status after a night of sleep. The time course of SI dissipation in an everyday life condition is little studied. [...] Read more.

Sleep inertia (SI) refers to a complex psychophysiological phenomenon observed after morning awakening that can be described as the gradual recovery of waking-like status after a night of sleep. The time course of SI dissipation in an everyday life condition is little studied. The present study aims to investigate the SI dissipation in motor activity, as a function of age, upon spontaneous morning awakening after a usual night-time sleep. To this end, we performed a retrospective study in a naturalistic setting in a wide life span sample: 382 healthy participants (219 females) from middle childhood (9 years old) to late adulthood (70 years old). Participants were required to wear the actigraph on the non-dominant wrist for at least seven consecutive nights. Results show that SI of motor activity is dissipated in 70 min. Mean motor activity in such a time window was significantly modulated by age: lower age corresponded to higher motor activity. Full article

(This article belongs to the Special Issue The Mechanisms of Sleep Function and Regulation for Health and Cognitive Performance)

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Review

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14 pages, 340 KiB

Open AccessReview

Is REM Density a Measure of Arousal during Sleep?

by Giuseppe Barbato

Brain Sci. 2023, 13(3), 378; https://doi.org/10.3390/brainsci13030378 - 21 Feb 2023

Cited by 2 | Viewed by 2318

Abstract

Rapid eye movements (REMs), an expression of REM sleep phasic activity, occur against a stable background of cortical desynchronization and the absence of axial tone. The significance of REMs during the sleep period was initially attributed to the mental content of dreams, linking [...] Read more.

Rapid eye movements (REMs), an expression of REM sleep phasic activity, occur against a stable background of cortical desynchronization and the absence of axial tone. The significance of REMs during the sleep period was initially attributed to the mental content of dreams, linking the REMs to the dream scenario. Although fascinating, the so-called “scanning hypothesis” has not been supported by consistent evidence, and thus an alternative hypothesis is necessary to understand REMs significance during sleep. Some data suggest that the frequency of REMs during the REM sleep period, known as REM density, might be related to sleep depth or arousal during sleep. REM density increases across the night concomitantly with the progressive reduction in sleep pressure, and consistently it is higher at the circadian time when arousal appears to be higher, and it is decreased in those conditions, such as after sleep deprivation, which produce increased sleep pressure. REM density is also increased in major affective disorders, and it has been suggested either as a risk factor to develop the illness or as a predictive index of response to drug treatment. Disfunction of the neurotransmitter systems involved in arousal mechanisms and wake/sleep control might underlie the altered REM density described in depression. Understanding of the REM density mechanisms could help to untangle functional significance and regulation of REM sleep. Following the seminal idea of Aserinsky that REM density is an index of sleep satiety, it may also provide a sensitive measure of sleep homeostasis in addition to, or even as an alternative to, the consolidated analysis of slow wave activity. REM density can also be utilized to explore those mechanisms which end sleep, and considered a physiological marker which indicate during sleep the “time to wake”. Full article

(This article belongs to the Special Issue The Mechanisms of Sleep Function and Regulation for Health and Cognitive Performance)

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