Literature Updates from July 2013

Basolateral Amygdala and the Regulation of Fear-Conditioned Changes in Sleep: Role of Corticotropin-Releasing Factor

Corticotropin-releasing factor in the basolateral amygdala is involved in regulating stress-induced alterations in sleep and it plays a role in modulating how stressful memories influence sleep.

Sleep is Not Just for the Brain: Transcriptional Responses to Sleep in Peripheral Tissues

By using microarrays the authors compared gene expression in tissue from sleep and sleep deprived mice. The results support the notion that the molecular consequences of sleep/wake behavioral state extend beyond the brain to include peripheral tissues. Sleep state induces a highly overlapping response in both heart and lung.

Optogenetic Stimulation of Melanin Concentrating Hormone (MCH) Neurons Increases Sleep

MCH stimulation increased both non-REM and REM sleep against a very strong circadian waking drive. This has significant potential for the insomnia associated with shift-work and jet-lag, conditions where a strong waking drive blocks sleep onset

Screening of Pediatric Sleep-Disordered Breathing: A Proposed Unbiased Discriminative Set of Questions Using Clinical Severity Scales

…complaints can be ranked according to a severity hierarchy: shake child to breathe, apnea during sleep, struggle breathing when asleep, and breathing concerns while asleep, followed by loudness of snoring and snoring while asleep. As a result, the set of six hierarchically arranged questions will aid the screening of children at high risk for SDB but cannot be used as the sole diagnostic approach.

Rules for Scoring Respiratory Events in Sleep: Update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine

The goals of the task force were (1) to clarify and simplify the current scoring rules, (2) to review evidence for new monitoring technologies relevant to the scoring rules, and (3) to strive for greater concordance between adult and pediatric rules.

Cognitive Dysfunction and Obstructive Sleep Apnea: From Cradle to Tomb

Certain age groups (younger and older) are particularly susceptible to the negative effects of OSA on cognition. Other influences that increase the risk for cognitive dysfunction in OSA include premature birth, apolipoprotein e4 allele status and other genetic polymorphisms, lower socioeconomic status, fewer years of education, and ethnicity.

The STBUR Questionnaire for Predicting Perioperative Respiratory Adverse Events in Children at Risk for Sleep-Disordered Breathing

The STBUR questionnaire appears promising as a simple, clinically useful tool for identifying children at risk for PRAE. Further studies to validate the STBUR questionnaire as a diagnostic tool may be warranted.

Obstructive Sleep Apnea is a Predictor of Abnormal Glucose Metabolism in Chronically Sleep Deprived Obese Adults

Sleep duration and quality, OSA, and glucose metabolism were assessed in 96 obese individuals reporting to sleep less than 6.5 hrs on a regular basis. OSA severity was associated with higher fasting glucose and insulin. Those with moderate to severe OSA had higher glucose at 120 min while undergoing a glucose tolerance test.

Independent Association Between Nocturnal Intermittent Hypoxemia and Metabolic Dyslipidemia

In a sample of 2,018 patients who underwent measurement of fasting lipid levels and nocturnal recording for assessment of obstructive sleep apnea, total cholesterol and LDL were not associated with the oxygen desaturation index. However, nocturnal intermittent hypoxemia and OSA severity were associated with higher triglycerides and lower HDL-C, independent of confounders. This may provide a mechanism through which OSA is associated with cardiovascular risk.

Associations Between Change in Sleep Duration and Inflammation: Findings on C-Reactive Protein and Interleukin 6 in the Whitehall II Study

In a sample of 5,003 midlife men and women, shorter sleep (< 5 hours per night) was associated with higher levels of CRP and IL-6 and in longitudinal analyses, a greater increase in sleep duration was associated with a significant 5-year increase in CRP and IL-6.