持续正压通气治疗睡眠呼吸暂停低通气综合征的接受意向调查

探讨影响持续气道内正压通气(CPAP)治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的接受性的非技术因素。设计OSAHS认知度和CPAP意向调查表、信赖他人量表,60例OSAHS患者经健康教育后,100例健康志愿者随机填表,结果做统计分析。两组中43.3%和5%基本了解OSAHS(P<0.01);10%和5%表示接受CPAP(P>0.05);85%和90%认为CPAP机价格高(P>0.05)。量表得分:两组得分分布近似,高分比例大,添加题90%和80%选择负性答案。目前公众对OSAHS认知差,对医生的信任度低,而CPAP机价格高,患者对CPAP接受性差。     

睡眠对恐惧学习的影响及其认知神经机制

睡眠问题可能会诱发恐惧相关情绪障碍(焦虑、创伤性应激障碍、恐怖症等),研究睡眠影响恐惧学习的认知神经机制,有助于增强对恐惧相关情绪障碍的预测、诊断和治疗。以往研究表明睡眠剥夺影响恐惧习得和消退主要是通过抑制vmPFC活动,阻碍其与杏仁核的功能连接,从而导致恐惧习得增强或是消退学习受损。进一步研究发现睡眠不同阶段对恐惧学习相关脑区有独特的影响:剥夺(缺乏)快速眼动睡眠会抑制vmPFC活动、增强杏仁核、海马激活,导致恐惧习得增强,消退学习受损,此外边缘皮层的功能连接减少破坏了记忆巩固(恐惧记忆和消退记忆);而慢波睡眠主要与海马变化有关,慢波睡眠期间进行目标记忆重激活可促进恐惧消退学习。未来研究需要增加睡眠影响恐惧泛化的神经机制研究、及昼夜节律中断对恐惧消退的影响,以及关注动物睡眠研究向人类睡眠研究转化中存在的问题。     

睡眠的同步EEG-fMRI研究述评

同步EEG-fMRI利用了脑电和功能磁共振在时空分辨率上的互补优势,为睡眠研究提供了多模态的无创手段.这使得睡眠的神经成像研究可以借助电生理方法进行睡眠分期和特殊脑电事件研究,为探讨不同意识状态下神经活动动态过程提供了条件.本评述从自发脑活动和睡眠中的知觉过程两方面介绍了目前该领域的最新进展,结合硬件构成、被试安全和数据质量等问题总结了同步记录应用于睡眠的优缺点.同步EEG-fMRI技术在睡眠研究中的应用对于阐明意识状态转换的神经机制具有深刻意义,并有可能为临床睡眠障碍的诊断和治疗提供全新的思路.     

FUNCTIONAL ANALYSIS AND TREATMENT OF ESCAPE-MAINTAINED AGGRESSION CORRELATED WITH SLEEP DEPRIVATION

Functional analysis identified the consequences that maintained aggressive behavior and the relationship between those consequences and sleep deprivation for an individual with severe mental retardation. Results showed that aggression was maintained by negative reinforcement contingencies (escape from demand) and that aggression was more severe when sleep deprivation was present. A multicomponent intervention resulted in reductions of aggression for up to 7 months.     

Comparative optimism and well-being during the COVID-19 pandemic

Past research suggests that being comparatively optimistic about one's risk for disease is associated with benefits to mental health, such as lowered stress and anxiety. However, few studies have longitudinally examined whether comparative optimism has the same protective benefits during the COVID-19 pandemic. The current study examined levels of comparative optimism, changes in comparative optimism over time, and the association between comparative optimism and COVID-related mental and physical health outcomes among a US adult sample during the COVID-19 pandemic. Participants completed online surveys at four timepoints, over the course of four weeks in May and June of 2020. Results from paired-samples t-tests revealed that comparative optimism was present, such that participants estimated their risk for COVID-19 as being significantly lower than that of others their age and sex. Results from linear mixed models suggested that people who were more comparatively optimistic reported lower anxiety, depression, and stress. However, at times when people were more comparatively optimistic, they also reported greater depression and poorer sleep quality. Together, the findings suggest that the relationship between comparative optimism and health may be more complex than previously anticipated and further research is needed to examine the potential pathways through which comparative optimism affects health.     

A Multimethod Examination of the Effect of Insomnia Symptoms on Anxious Responding to a Social Stressor

A growing number of studies identify insomnia symptoms as a potential risk factor for the development of anxiety disorders. However, little research has examined potential mechanisms through which insomnia could confer increased risk for anxiety. A separate line of literature suggests sleep is necessary for adaptive emotional and behavioral responding to stressors, a potential mechanism linking insomnia symptoms to anxiety risk. To test whether insomnia symptoms affect emotional and behavioral responding to an anxiety-relevant stressor, the current study recruited a sample of 99 undergraduates with varying levels of insomnia symptoms. Participants completed self-report and psychophysiological measures before, during, and after an impromptu speech task. Results indicated that, after covarying for negative affectivity, increased insomnia symptoms were significantly associated with elevated anticipatory anxiety and skin conductance response prior to the speech, and increased skin conductance response, emotion regulation difficulties, and safety aid use during the speech. Taken together, results provide evidence for the notion that insomnia symptoms are associated with maladaptive emotional and behavioral responding to an anxiety-relevant stressor.     

Remote treatment of sleep‐related trichotillomania and trichophagia

We used a biobehavioral treatment consisting of melatonin and a standardized bed and wake time to decrease one girl's head and mouth touches associated with sleep‐related trichotillomania and trichophagia. We remotely coached the girl's caregiver to implement all procedures and monitored response to treatment using a DropCam Pro video camera equipped with night‐vision capabilities. Head and mouth touches decreased, and her sleep pattern improved with the combination of treatment strategies. We discuss our use of a novel mode of service delivery to treat sleep‐related problem behavior.     

Targeted Memory Reactivation During Sleep,But Not Wake,Enhances Sensorimotor Skill Performance: A Pilot Study

The benefits of sleep on memory consolidation have been enhanced for declarative and motor sequence learning through replaying classically conditioned auditory stimuli during sleep, known as targeted memory reactivation (TMR). However, it is unknown if TMR can influence performance of a sensorimotor skill, in the absence of the cognitive requirements of sequence learning. Here, young adults performed a nondominant arm throwing task separated by a full night of sleep or a full day of wake, with half of all participants receiving TMR between sessions. Participants who received TMR during sleep demonstrated enhanced sensorimotor performance relative to all other groups. In conclusion, this pilot study indicates that it is feasible to influence sensorimotor skill performance through TMR during sleep and may serve as a future adjunct to physical rehabilitation. Future studies will aim to confirm the present results with a larger sample size as well as investigate the effects of TMR during sleep on older adults both with and without a history of stroke.     

Sleep deprivation and hallucinations. A qualitative study of military personnel

Much anecdotal evidence suggests that sleep deprivation not only impairs performance, but also brings about other extraordinary effects like hallucinations. However, knowledge about how sleep deprivation may trigger hallucinations is limited. To qualitatively describe hallucinatory experiences during sleep deprivation 12 male military officers from the Norwegian Armed Forces who all had experienced at least one sleep loss-induced hallucinatory experience were recruited. Data were collected and analyzed by semi-structured interviews and thematic analysis. This resulted in the identification of three distinct main themes: (1) Modalities, (2) circumstances/triggers and (3) reactions to hallucinations. Hallucinations were experienced in several modalities (visual, auditory and multi-modality), although visual hallucinations seemed to dominate. Typical reported circumstances/triggers were sleep loss, physical exhaustion, time-of-day, low calorie intake, mental exhaustion and lack of external stimuli (low sensory and social input, boring situations, and monotonous activity). Negative emotions were dominant during the hallucinatory episodes. Often some reasoning and checking on behalf of the officers were necessary to differentiate between real percepts and hallucinations. In some cases the hallucinations caused erroneous actions. Retrospectively, most officers viewed their hallucinatory experiences in light of positive emotions and several emphasized having learned something from them. The results are discussed in relation to the existing literature and suggestions for future studies are outlined.