1 / 22

The Measurement of Sleep: A Practical Workshop for Investigators Polysomnography

The Measurement of Sleep: A Practical Workshop for Investigators Polysomnography. Patrick J. Strollo M.D. Martica Hall, Ph.D. Neuroscience – Clinical & Translational Research Center Laboratory Team Pittsburgh Mind-Body Center on Sleep Workshop Pittsburgh, PA April 11, 2008. Agenda.

zaina
Download Presentation

The Measurement of Sleep: A Practical Workshop for Investigators Polysomnography

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The Measurement of Sleep: A Practical Workshop for InvestigatorsPolysomnography Patrick J. Strollo M.D. Martica Hall, Ph.D. Neuroscience – Clinical & Translational Research Center Laboratory Team Pittsburgh Mind-Body Center on Sleep Workshop Pittsburgh, PA April 11, 2008

  2. Agenda • Brief review of polysomnography (PSG) • Goal: Learn what is meant by poly (many) somnus (sleep) graphein (to write) • Tour of N-CTRC sleep laboratory • Goal: learn about the different types of studies that can be conducted in the N-CTRC • Meet sleep technician and sleep study “participant” to see what’s involved in using PSG to measure sleep • Goal: learn what all of the electrodes & monitors measure • Watch as signals are collected from participant and review how different signals change with behavior • Goal: learn what different signals look like • Review examples of sleep pathologies • Goal: learn about some of the signals that indicate sleep pathologies • Review two kinds of advanced signal processing • Goal: learn what is meant by spectral analysis of the EEG and EKG during sleep

  3. Advanced Signal Processing • Spectral analysis of signals collected during sleep studies • What is spectral analysis? • Decompose a complex, multi-determined signal • Move from time to frequency domain (power is variability2) • Spectral analysis of the EEG • Example: EEG profile in patients with insomnia differs by gender and across the night • Spectral analysis of heart rate variability • Example 1: Methods • Example 2: Lab stressor affects HRV during sleep

  4. Delta & REM Counts and vPSG Sleep Histogram Compute: Total power Relative power For: All Night Individual Sleep Cycles

  5. QEEG Bandwidths Delta .5 – 4 Hz. Theta 4 – 8 Hz. Alpha 8 - 12 Hz. Sigma 12 - 16 Hz. Beta 16 – 32 Hz.

  6. Delta Power and VPSG Sleep Histogram Compute: Total power Relative power For: All Night Individual Sleep Cycles Example…

  7. Frequency and time domain analysis of EEG power during NREM sleep in primary insomniaSupported by MH24652, RR024153, RR00052 (D. Buysse, PI) • Insomnia is a clinical disorder with sleep and waking symptoms • Etiology uncertain, but hyperarousal often felt to be a critical component • Subjective symptoms • Hypothalamic-pituitary-adrenal axis • Functional neuroanatomy using FDG PET studies • Beta power in quantitative EEG during NREM • Krystal SLEEP 2002; Perlis Sleep Med Rev 2001, Perlis J Sleep Res 2001; Merica Eur J Neurosci 1998)

  8. Participants • General • PI and GSC recruited in 3:1 ratio • Age 20-50 years, men and women • Medical history, psychiatric history (SCID), sleep disorders history, screening PSG (AHI, PLMAI < 15) • PI (n = 48) • DSM-IV Primary Insomnia • PSQI ≥ 7 • No specific quantitative criteria by diary or PSG • GSC (n = 25) • No sleep disorder • PSQI ≤ 5 • Equated for age and sex with PI

  9. Power-frequency plots: Whole night

  10. Power-frequency plots by NREM period: Women

  11. Power-frequency plots by NREM period: Men

  12. Heart Rate Variability: What is it? • Heart rate is rhythmic and varies dynamically in response to intrinsic and extrinsic inputs and demands (CNS activity, mechanical changes, reflex-related changes, behavior, psychological stress, affect). • Interbeat intervals (IBIs) refer to milliseconds between beats. Evaluate in the time domain or frequency domain. • Two main components of HRV • Low frequency changes (~3-9 cycles/min.) • Multiply-determined: input from PNS and SNS • High frequency changes (9-24 cycles/min.) • Related to PNS (‘vagal’ ‘RSA’) • Low-to-High frequency ratio • Index of sympatho-vagal activity

  13. Frequency Domain Estimates of HRV (QEKG) 60-minute IBI sequence 10 (shaded) minute IBI sequence Power spectral estimates of variability in 10-minute IBI epoch (raw, smoothed) IBI variability is partitioned along a frequency spectrum using frequency-modeling techniques (e.g., fast Fourier Transformations (FFTs), autoregressive spectral analyses). Amount of variability (spectral power) is estimated for given frequency components (bandwidths). Low Frequency = .05-.149 Hz, High Frequency = .15 - .40 Hz Slide courtesy of Julian F. Thayer

  14. Sleep SCORE: Study Protocol (HL076379, Investigators: K. Matthews, M. Hall, D. Buysse, P. Strollo, T. Kamarck, S. Reis) DAILY: Fill out Sleep Diary and Wear Wrist Actigraph PSG Sleep Study (2 nights) Ambulatory BP (48 hours) DAY 1 DAY 10 EEG, EMG, EOG, EKG GNT GMT SCORING PSG visual sleep stage scoring in 20 second epochs EKG HRV processing in 2-minute epochs

  15. Heart rate variability: Processing & linking HRV and vPSG data HRV records processed: 101 (Night 2) Mean sleep duration: 7 hours (420 minutes)  210 (2-minute) epochs  total number of epochs (101 x 210)  > 21,120 HRV Output: LF power, HF power, LF:HF Ratio, Respiration Rate, etc. vPSG HRV W W W W W W 2 3 3 4 4 3 WAKE NREM

  16. NREM differs from Wakefulness & REM HF Power LF:HF

  17. How Many HF HRV Epochs During NREM Sleep Are Enough? Number of HF HRV epochs during NREM for G = 0.8 NREM Whole Night = 5; NREM 1 = 7; NREM 2 = 7, NREM 3 = 6, NREM 4 = 3

  18. How Many LF:HF HRV Epochs During NREM Sleep Are Enough? Number of LF:HF HRV epochs during NREM for G = 0.8 NREM Whole Night = 13; NREM 1 = 13; NREM 2 = 15, NREM 3 = 17, NREM 4 = 7

  19. Does HF HRV During NREM Sleep Change Across The Night? Time F (3,100) = 2.43, p < .07 Time F(3,100)=2.43, p < .07 Time F(3,100)=2.43, p < .07

  20. Does LF:HF HRV During NREM Sleep Change Across The Night? Time F (3,99) = 3.99, p < .02

  21. STUDY 1: Acute Laboratory Stress Ambient Stress Acute Stress Heart Period Variability Sleep Quality Experimental Manipulation Sleep 8:00 p.m. a.m. SUBJECTS: 59 healthy undergraduate men and women (50% female, mean age = 19.6 years). Hall et al., Psychosomatic Medicine, 2004

  22. Parasympathetic Activity During NREM and REM Sleep NREM REM • Parasympathetic Activity = high frequency bandwidth (0.15-0.4 Hz)

More Related