Sleep Literature Updates

Effect of Sedative-Hypnotics, Anesthetics and Analgesics on Sleep Architecture in Obstructive Sleep Apnea

This article critically reviewed the literature relevant to preoperative screening for OSA, prevalence of OSA in surgical populations and changes in postoperative sleep architecture relevant to OSA patients … in regard to the effects of sedative-hypnotics, anesthetics and analgesics on sleep architecture, the underlying mechanisms and the relevance to OSA.

A Systematic Review of Peri-Operative Melatonin

A very importat review on the use of melatonin in perioperative setting. “Qualitative reviews suggested the melatonin improved sleep quality and emergence behaviour, and might be capable of reducing oxidative stress and anaesthetic requirements.”

A Critical Assessment of Monitoring Practices, Patient Deterioration, and Alarm Fatigue on Inpatient Wards: A Review

This review article discusses unexpected, potentially lethal respiratory complications known for being difficult to detect early, especially in postoperative patients recovering on hospital general care floors (GCF). The review also discuss currently available practices in general care floor monitoring that can both improve patient safety and significantly reduce monitor associated alarm fatigue.

The Relationship Between Hippocampal Volume and Cognition in Patients With Chronic Primary Insomnia

In this study the authors found that hippocampal volume (HV) in primary insomniacs (PI) was negatively correlated with the duration of insomnia and the arousal index. PIs exhibited significantly impaired attention, frontal lobe function, and memory, and their verbal and nonverbal memory scores were positively correlated with HV. These findings suggest that chronic sleep deprivation associated with insomnia impairs memory and frontal lobe function, and that insomnia duration and poor sleep quality contribute to a bilateral reduction in HV.

Seasonal Trends in Sleep-Disordered Breathing: Evidence from Internet Search Engine Query Data

In this study, internet search engine query data were retrieved from Google Trends over six years from 2012, from USA and Australia.  Authors found statistically significant seasonal effects were found using cosinor analysis in both USA and Australia for “snoring” (p<0.00001 for both countries). Similarly, seasonal patterns were observed for “sleep apnea” in the USA (p=0.001). Magnitude of seasonal effect raged from 5–50%. This indicates that there are significant trends for both snoring and sleep apnea internet search engine queries, with peaks in winter and early spring. Future studies may examine the mechanisms underlying these findings, and whether there is a clinical correlation or not.

Essential Thalamic Contribution to Slow Waves of Natural Sleep

These results demonstrate that the thalamus finely tunes the frequency of slow waves during non-REM sleep and anesthesia, and thus provide the first conclusive evidence that a dynamic interplay of the neocortical and thalamic oscillators of slow waves is required for the full expression of this key physiological EEG rhythm.

Decreased Connectivity Between the Thalamus and the Neocortex During Human Nonrapid Eye Movement Sleep

Results of this study provide evidence of a functional deafferentation of the neocortex during nonrapid eye movement (NREM) sleep in humans. … suggesting that changes in thalamocortical connectivity may act as a universal “control switch” for changes in consciousness that are observed in coma, general anesthesia, and natural sleep

Does One Hour of Bright or Short-Wavelength Filtered Tablet Screenlight Have a Meaningful Effect on Adolescents’ Pre-Bedtime Alertness, Sleep, and Daytime Functioning?

In this experimental study, 16 healthy adolescent volunteers were recruited to be exposed to a bright tablet screen, dim screen and a filtered short-wavelength screen for 1hr before their usual bedtime in a within-subjects protocol. Significant effects occurred between bright and dim screens for pre-sleep alertness (GO/NOGO speed and accuracy), although these were minor and may have little clinical significance. However, no significant effects were found for sleep onset latency, slow-rolling eye movements, or the number of SWS and REM minutes in the first two sleep cycles. More studies are required to examine effects of prolonged screen exposure on pre-sleep alertness and morning daytime functioning amongst vulnerable groups such as adolescents.