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4 results

  • Patterns of polysomnography parameters in 27 neuropsychiatric diseases: an umbrella review
  • Ye Zhang, Rong Ren, Linghui Yang, Haipeng Zhang, Yuan Shi, Michael V. Vitiello, Larry D. Sanford, Xiangdong Tang
  • Journal: Psychological Medicine , First View
  • Published online by Cambridge University Press: 15 November 2022, pp. 1-21
  • View abstract
    Background

    We provide an umbrella review of the reported polysomnographic changes in patients with neuropsychiatric diseases compared with healthy controls.

    Methods

    An electronic literature search was conducted in EMBASE, MEDLINE, All EBM databases, CINAHL, and PsycINFO. Meta-analyses of case–control studies investigating the polysomnographic changes in patients with neuropsychiatric diseases were included. For each meta-analysis, we estimated the summary effect size using random effects models, the 95% confidence interval, and the 95% prediction interval. We also estimated between-study heterogeneity, evidence of excess significance bias, and evidence of small-study effects. The levels of evidence of polysomnographic changes in neuropsychiatric diseases were ranked as follows: not significant, weak, suggestive, highly suggestive, or convincing.

    Results

    We identified 27 articles, including 465 case–control studies in 27 neuropsychiatric diseases. The levels of evidence of polysomnographic changes in neuropsychiatric diseases were highly suggestive for increased sleep latency and decreased sleep efficiency (SE) in major depressive disorder (MDD), increased N1 percentage, and decreased N2 percentage, SL and REML in narcolepsy, and decreased rapid eye movement (REM) sleep percentage in Parkinson's disease (PD). The suggestive evidence decreased REM latency in MDD, decreased total sleep time and SE in PD, and decreased SE in posttraumatic stress disorder and in narcolepsy.

    Conclusions

    The credibility of evidence for sleep characteristics in 27 neuropsychiatric diseases varied across polysomnographic variables and diseases. When considering the patterns of altered PSG variables, no two diseases had the same pattern of alterations, suggesting that specific sleep profiles might be important dimensions for defining distinct neuropsychiatric disorders.

  • 12 - Amygdalar regulation of REM sleep
  • from Section III - Neuronal regulation
  • Edited by Birendra N. Mallick, Jawaharlal Nehru University, S. R. Pandi-Perumal , Robert W. McCarley, Harvard University, Massachusetts, Adrian R. Morrison, University of Pennsylvania
  • Book: Rapid Eye Movement Sleep
  • Published online: 07 September 2011
  • Print publication: 14 July 2011, pp 110-120
  • View extract

    Summary

    Summary

    The amygdala has a long-recognized role in emotion, and a growing body of work demonstrates that it plays an important part in the regulation of arousal state. Primary findings are that the amygdala, especially its central nucleus, is a strong regulator of rapid eye movement sleep (REMS) and related phenomena, though a smaller body of research indicates a role for the amygdala in regulating non-REM (NREM). Considering its vital place in the limbic circuitry that controls emotion, it is likely that the amygdala mediates fear- and stress-induced alterations in sleep, and investigations in animals have begun to provide confirmatory evidence. In particular, GABAergic regulation of the central nucleus of the amygdala appears to play a significant role in stress-induced reductions in REM. In humans, neuroimaging studies suggest that the pathophysiological mechanisms of narcolepsy and post-traumatic stress disorder (PTSD), two central nervous system disorders with a prominent emotional component and a demonstrated abnormality of REM, involve an amygdalar-mediated reorganization of fundamental REM systems.