Please use this identifier to cite or link to this item: http://hdl.handle.net/10995/103331
Title: Sleep in disorders of consciousness: behavioral and polysomnographic recording
Authors: Mertel, I.
Pavlov, Y. G.
Barner, C.
Müller, F.
Diekelmann, S.
Kotchoubey, B.
Issue Date: 2020
Publisher: BioMed Central Ltd
Citation: Sleep in disorders of consciousness: behavioral and polysomnographic recording / I. Mertel, Y. G. Pavlov, C. Barner, et al. — DOI 10.1186/s12916-020-01812-6 // BMC Medicine. — 2020. — Vol. 18. — Iss. 1. — 350.
Abstract: Background: Sleep-wakefulness cycles are an essential diagnostic criterion for disorders of consciousness (DOC), differentiating prolonged DOC from coma. Specific sleep features, like the presence of sleep spindles, are an important marker for the prognosis of recovery from DOC. Based on increasing evidence for a link between sleep and neuronal plasticity, understanding sleep in DOC might facilitate the development of novel methods for rehabilitation. Yet, well-controlled studies of sleep in DOC are lacking. Here, we aimed to quantify, on a reliable evaluation basis, the distribution of behavioral and neurophysiological sleep patterns in DOC over a 24-h period while controlling for environmental factors (by recruiting a group of conscious tetraplegic patients who resided in the same hospital). Methods: We evaluated the distribution of sleep and wakefulness by means of polysomnography (EEG, EOG, EMG) and video recordings in 32 DOC patients (16 unresponsive wakefulness syndrome [UWS], 16 minimally conscious state [MCS]), and 10 clinical control patients with severe tetraplegia. Three independent raters scored the patients’ polysomnographic recordings. Results: All but one patient (UWS) showed behavioral and electrophysiological signs of sleep. Control and MCS patients spent significantly more time in sleep during the night than during daytime, a pattern that was not evident in UWS. DOC patients (particularly UWS) exhibited less REM sleep than control patients. Forty-four percent of UWS patients and 12% of MCS patients did not have any REM sleep, while all control patients (100%) showed signs of all sleep stages and sleep spindles. Furthermore, no sleep spindles were found in 62% of UWS patients and 21% of MCS patients. In the remaining DOC patients who had spindles, their number and amplitude were significantly lower than in controls. Conclusions: The distribution of sleep signs in DOC over 24 h differs significantly from the normal sleep-wakefulness pattern. These abnormalities of sleep in DOC are independent of external factors such as severe immobility and hospital environment. © 2020, The Author(s).
Keywords: EEG
MINIMALLY CONSCIOUS STATE
POLYSOMNOGRAPHY
SLEEP
UNRESPONSIVE WAKEFULNESS
VEGETATIVE STATE
ANTICONVULSIVE AGENT
CENTRAL STIMULANT AGENT
MUSCLE RELAXANT AGENT
SEDATIVE AGENT
ADULT
AGED
ARTICLE
BEHAVIOR ASSESSMENT
BRAIN HYPOXIA
CIRCADIAN RHYTHM
CLINICAL ARTICLE
CONSCIOUSNESS
CONSCIOUSNESS DISORDER
CONTROLLED STUDY
DISEASE SEVERITY
ELECTROENCEPHALOGRAPHY
ELECTROMYOGRAPHY
ELECTROOCULOGRAPHY
ENCEPHALITIS
ENVIRONMENTAL FACTOR
FEMALE
HUMAN
IMMOBILITY
MALE
MIDDLE AGED
MINIMALLY CONSCIOUS STATE
NEUROPHYSIOLOGY
NIGHT
POLYSOMNOGRAPHY
QUADRIPLEGIA
QUANTITATIVE ANALYSIS
REM SLEEP
SCORING SYSTEM
SLEEP
SLEEP DISORDER
SLEEP SPINDLE
SLEEP STAGE
SLEEP TIME
SLEEP WAKING CYCLE
SUBARACHNOID HEMORRHAGE
TRAUMATIC BRAIN INJURY
UNRESPONSIVE WAKEFULNESS SYNDROME
VIDEORECORDING
YOUNG ADULT
ADOLESCENT
COMPLICATION
CONSCIOUSNESS DISORDER
POLYSOMNOGRAPHY
PROCEDURES
PROGNOSIS
SLEEP DISORDER
ADOLESCENT
ADULT
AGED
CONSCIOUSNESS DISORDERS
FEMALE
HUMANS
MALE
MIDDLE AGED
POLYSOMNOGRAPHY
PROGNOSIS
SLEEP WAKE DISORDERS
YOUNG ADULT
URI: http://hdl.handle.net/10995/103331
Access: info:eu-repo/semantics/openAccess
SCOPUS ID: 85096332531
PURE ID: 20117905
b283a640-c385-4cdc-94a4-b07ce8aad569
ISSN: 17417015
DOI: 10.1186/s12916-020-01812-6
metadata.dc.description.sponsorship: The study was supported by the German Research Society (Deutsche Forschungsgemeinschaft, DFG), grant KO-1753/13.
Appears in Collections:Научные публикации, проиндексированные в SCOPUS и WoS CC

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