Journal articles on the topic 'Arousal'
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1
Prendergast, Brian J., David A. Freeman, Irving Zucker, and Randy J. Nelson. "Periodic arousal from hibernation is necessary for initiation of immune responses in ground squirrels." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 282, no. 4 (April 1, 2002): R1054—R1062. http://dx.doi.org/10.1152/ajpregu.00562.2001.
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Golden-mantled ground squirrels ( Spermophilus lateralis) undergo seasonal hibernation during which core body temperature (Tb) values are maintained 1–2°C above ambient temperature. Hibernation is not continuous. Squirrels arouse at ∼7-day intervals, during which Tbincreases to 37°C for ∼16 h; thereafter, they return to hibernation and sustain low Tbs until the next arousal. Over the course of the hibernation season, arousals consume 60–80% of a squirrel's winter energy budget, but their functional significance is unknown and disputed. Host-defense mechanisms appear to be downregulated during the hibernation season and preclude normal immune responses. These experiments assessed immune function during hibernation and subsequent periodic arousals. The acute-phase response to bacterial lipopolysaccharide (LPS) was arrested during hibernation and fully restored on arousal to normothermia. LPS injection (ip) resulted in a 1–1.5°C fever in normothermic animals that was sustained for >8 h. LPS was without effect in hibernating squirrels, neither inducing fever nor provoking arousal, but a fever did develop several days later, when squirrels next aroused from hibernation; the duration of this arousal was increased sixfold above baseline values. Intracerebroventricular infusions of prostaglandin E2provoked arousal from hibernation and induced fever, suggesting that neural signaling pathways that mediate febrile responses are functional during hibernation. Periodic arousals may activate a dormant immune system, which can then combat pathogens that may have been introduced immediately before or during hibernation.
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Ward, Sally L. Davidson, Daisy B. Bautista, and Thomas C. Keens. "Hypoxic Arousal Responses in Normal Infants." Pediatrics 89, no. 5 (May 1, 1992): 860–64. http://dx.doi.org/10.1542/peds.89.5.860.
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Failure to arouse in response to hypoxia has been described in infants at increased risk for sudden infant death syndrome (SIDS) and has been suggested as a possible mechanism for SIDS. However, most SIDS victims are not in a high-risk group before death. Thus, if a hypoxic arousal disorder is an important contributor to SIDS, normal infants might fail to arouse from sleep in response to hypoxia. To test this hypothesis, the authors studied hypoxic arousal responses in 18 healthy term infants younger than 7 months of age (age 12.1 ± 1.7 [SEM] weeks; 56% girls). Hypoxic arousal challenges were performed during quiet sleep by rapidly decreasing inspired oxygen tension (Pio2) to 80 mm Hg for 3 minutes or until arousal (eye opening, agitation, and crying) occurred. Tests were performed in duplicate when possible. Only 8 infants (44%) aroused in response to one or more hypoxic challenges; arousal occurred during 8 (32%) of 25 trials. There were no significant differences in lowest Pio2 or arterial oxygen saturation during hypoxia between those infants who aroused and those who failed to arouse. All 18 infants had a fall in their end-tidal carbon dioxide tension during hypoxia, suggesting that each had a hypoxic ventilatory response despite failure to arouse in the majority. Periodic breathing occurred following hypoxia in only 1 (13%) of the 8 trials that resulted in arousal, compared with 16 (94%) of 17 trials without arousal (P < .005). It is concluded that the majority of normal infants younger than 7 months of age fail to arouse from quiet sleep in response to hypoxia, despite the apparent presence of a hypoxic ventilatory response.
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Zsok, F., and D. S. Fleischman. "The Effect of Sexual Arousal on Women´S Disgust Reactions: Facial Attractiveness and Disease Cues." Klinička psihologija 9, no. 1 (June 13, 2016): 127. http://dx.doi.org/10.21465/2016-kp-p-0001.
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Objective: Disgust and sexual arousal are two opposing states. One motivates avoidance, while the other elicits approaching behaviour. Former research has found that a person is harder to sexually arouse if disgusted. In turn, the effects of sexual arousal on disgust are more differentiated. A general trend shows that people are less disgust sensitive when they are sexually aroused, but this appears to depend on what elicits the disgust. This study is supposed to explore what exactly becomes less disgusting when women are sexually aroused. Design and Method: Female undergraduates are going to participate in an experiment from their personal computer at home. They are going to be shown a video, either a sexually arousing one or a neutral one. Then, they will be asked to rate their disgust towards increasingly sexual behaviours with six men on pictures. The pictures will consist of attractive, unattractive, and blemished and unblemished faces. That way the effects and interactions of sexual arousal, attractiveness, and disease cues (blemishes) can be explored. Results: The study is currently running and should be completed at the end of February. We expect results to show that sexually aroused women feel less disgusted towards activities with attractive males. Disease cues should dampen the effect of sexual arousal on disgust. Conclusions: Expected results would support the evolutionary view that disgust is only reduced by sexual arousal if the mating encounter seems beneficial for the female.
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Burke, P. G. R., S. G. Carter, F. Knapman, J. Patti, M. Butlin, S. C. Gandevia, J. E. Butler, D. J. Eckert, and L. E. Bilston. "Nocturnal swallowing augments arousal intensity and arousal tachycardia." Proceedings of the National Academy of Sciences 117, no. 15 (March 30, 2020): 8624–32. http://dx.doi.org/10.1073/pnas.1907393117.
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Cortical arousal from sleep is associated with autonomic activation and acute increases in heart rate. Arousals vary considerably in their frequency, intensity/duration, and physiological effects. Sleep and arousability impact health acutely (daytime cognitive function) and long-term (cardiovascular outcomes). Yet factors that modify the arousal intensity and autonomic activity remain enigmatic. In this study of healthy human adults, we examined whether reflex airway defense mechanisms, specifically swallowing or glottic adduction, influenced cardiac autonomic activity and cortical arousal from sleep. We found, in all subjects, that swallows trigger rapid, robust, and patterned tachycardia conserved across wake, sleep, and arousal states. Tachycardia onset was temporally matched to glottic adduction—the first phase of swallow motor program. Multiple swallows increase the magnitude of tachycardia via temporal summation, and blood pressure increases as a function of the degree of tachycardia. During sleep, swallows were overwhelmingly associated with arousal. Critically, swallows were causally linked to the intense, prolonged cortical arousals and marked tachycardia. Arousal duration and tachycardia increased in parallel as a function of swallow incidence. Our findings suggest that cortical feedback and tachycardia are integrated responses of the swallow motor program. Our work highlights the functional influence of episodic, involuntary airway defense reflexes on sleep and vigilance and cardiovascular function in healthy individuals.
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Eckert, Danny J., and Magdy K. Younes. "Arousal from sleep: implications for obstructive sleep apnea pathogenesis and treatment." Journal of Applied Physiology 116, no. 3 (February 1, 2014): 302–13. http://dx.doi.org/10.1152/japplphysiol.00649.2013.
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Historically, brief awakenings from sleep (cortical arousals) have been assumed to be vitally important in restoring airflow and blood-gas disturbances at the end of obstructive sleep apnea (OSA) breathing events. Indeed, in patients with blunted chemical drive (e.g., obesity hypoventilation syndrome) and in instances when other defensive mechanisms fail, cortical arousal likely serves an important protective role. However, recent insight into the pathogenesis of OSA indicates that a substantial proportion of respiratory events do not terminate with a cortical arousal from sleep. In many cases, cortical arousals may actually perpetuate blood-gas disturbances, breathing instability, and subsequent upper airway closure during sleep. This brief review summarizes the current understanding of the mechanisms mediating respiratory-induced cortical arousal, the physiological factors that influence the propensity for cortical arousal, and the potential dual roles that cortical arousal may play in OSA pathogenesis. Finally, the extent to which existing sedative agents decrease the propensity for cortical arousal and their potential to be therapeutically beneficial for certain OSA patients are highlighted.
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McNamara, Frances, and Colin E. Sullivan. "Effects of nasal CPAP therapy on respiratory and spontaneous arousals in infants with OSA." Journal of Applied Physiology 87, no. 3 (September 1, 1999): 889–96. http://dx.doi.org/10.1152/jappl.1999.87.3.889.
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Obstructive sleep apnea (OSA) in infants has been shown to resolve frequently without a cortical arousal. It is unknown whether infants do not require arousal to terminate apneas or whether this is a consequence of the OSA. We studied the apnea and arousal patterns of eight infants with OSA before and after treatment with nasal continuous positive airway pressure (CPAP). These infants were age matched to eight untreated infants with OSA and eight normal infants. Polysomnographic studies were performed on each infant. We found that the majority of central and obstructive apneas were terminated without arousal in all OSA infants. After several weeks of nasal CPAP treatment, the proportion of apneas terminating with an arousal during rapid-eye-movement sleep increased in treated infants compared with untreated infants. Spontaneous arousals during rapid-eye-movement sleep were reduced in all OSA infants; however, during CPAP treatment, the spontaneous arousals increased to the normal control level. We conclude that OSA in infants possibly depresses the arousal response and treatment of these infants with nasal CPAP partially reverses this depression.
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Suzuki, Yoko, Chihiro Suzuki, and Takashi Abe. "0089 Examination of Post-arousal Hypersynchrony in the First-night Effect." SLEEP 47, Supplement_1 (April 20, 2024): A40. http://dx.doi.org/10.1093/sleep/zsae067.0089.
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Abstract Introduction The first-night effect (FNE) is a sleep disturbance caused by sleeping in a new environment. FNE observed on polysomnography includes increased wakefulness and sleep instability. Post-arousal hypersynchrony (PAH) is an arousal subtype with a post-arousal delta wave burst that antagonizes arousal and maintains sleep (Suzuki et al., 2021). Furthermore, we have shown that PAH correlates with the number of arousals; increased arousals increases PAH. Therefore, we hypothesized that the FNE would increase arousal and PAH. Methods Fifteen healthy adults (five women, mean ± standard deviation 21.7 ± 1.6 years) undergoing first-time polysomnography were included. After three days of sleep-wake cycle control before measurement, four nights of polysomnography were performed in the laboratory. A registered polysomnographic technologist blindly scored the participants’ sleep stages and analyzed PAH. Linear mixed models and non-parametric tests were performed on sleep variables and PAH for changes from the first to fourth measurement night. Results Sleep variables did not change significantly with the number of measurements. Contrary to our hypothesis, there was no FNE on the number of arousals. The number of PAH had a significant main effect on the number of measurements, showing a significant decrease on the fourth night compared to the first night. Conclusion Sleep variables, including arousal, were not affected by the FNE, whereas PAH was. The lack of a FNE on the sleep variables may be due to a ceiling effect caused by sleep in young healthy adults. Since the number of arousals showed no changes, the FNE of PAH could not be explained regarding inhibition on arousal, such as a role in sleep maintenance. The decreased number of PAH sleep measurements may indicate sleep stabilization. Support (if any) This study was supported by JSPS KAKENHI under grant number JP 23K14436 and Japan Agency for Medical Research and Development under grant number JP21zf0127005.
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Younes, Magdy, and Patrick J. Hanly. "Immediate postarousal sleep dynamics: an important determinant of sleep stability in obstructive sleep apnea." Journal of Applied Physiology 120, no. 7 (April 1, 2016): 801–8. http://dx.doi.org/10.1152/japplphysiol.00880.2015.
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Arousability from sleep is increasingly recognized as an important determinant of the clinical spectrum of sleep disordered breathing (SDB). Patients with SDB display a wide range of arousability. The reason for these differences is not known. We hypothesized that differences in the speed with which sleep deepens following arousals/awakenings (postarousal sleep dynamics) is a major determinant of these differences in arousability in patients with SDB. We analyzed 40 preexisting clinical polysomnography records from patients with a range of SDB severity (apnea-hypopnea index 5-135/h). Sleep depth was determined every 3 s using the odds ratio product (ORP) method, a continuous index of sleep depth (0 = deep sleep, 2.5 = full wakefulness) that correlates strongly ( r = 0.98) with arousability (Younes M, Ostrowski M, Soiferman M, Younes H, Younes M, Raneri J, and Hanly P. Sleep 38: 641–654, 2015). Time course of ORP was determined from end of arousal until the next arousal. All arousals were analyzed (142 ± 65/polysomnogram). ORP increased from 0.58 ± 0.32 during sleep to 1.67 ± 0.35 during arousals. ORP immediately (first 9 s) following arousals/awakenings (ORP-9) ranged from 0.21(very deep sleep) to 1.71 (highly arousable state) in different patients. In patients with high ORP-9, sleep deepened slowly (over minutes) beyond 9 s but only if no arousals/awakenings recurred. ORP-9 correlated strongly with average non-rapid eye movement sleep depth ( r = 0.87, P < 2E-13), the arousal/awakening index ( r = 0.68, P < 5E-6), and with the apnea-hypopnea index ( r = 0.60, P < 0.001). ORP-9 was consistent within each patient and did not change on continuous positive airway pressure despite marked improvement in sleep architecture. We conclude that postarousal sleep dynamics are highly variable among patients with sleep-disordered breathing and largely determine average sleep depth and continuity.
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Huo, Jiayan, Stuart F. Quan, Janet Roveda, and Ao Li. "Coupling analysis of heart rate variability and cortical arousal using a deep learning algorithm." PLOS ONE 18, no. 4 (April 6, 2023): e0284167. http://dx.doi.org/10.1371/journal.pone.0284167.
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Frequent cortical arousal is associated with cardiovascular dysfunction among people with sleep-disordered breathing. Changes in heart rate variability (HRV) can represent pathological conditions associated with autonomic nervous system dysfunction. Previous studies showed changes in cardiac activity due to cortical arousals. However, few studies have examined the instantaneous association between cortical arousal and HRV in an ethnically diverse population. In this study, we included 1,069 subjects’ full night ECG signals from unattended polysomnography in the Multi-Ethnic Study of Atherosclerosis dataset. An automated deep learning tool was employed to annotate arousal events from ECG signals. The etiology (e.g., respiratory, or spontaneous) of each arousal event was classified through a temporal analysis. Time domain HRVs and mean heart rate were calculated on pre-, intra-, and post-arousal segments of a 25-s period for each arousal event. We observed that heart rate and HRVs increased during the arousal onsets in the intra-arousal segments, regardless of arousal etiology. Furthermore, HRVs response to cortical arousal occurrence differed according to gender and the sleep stages in which arousal occurred. The more intense HRVs variation due to arousal in females can contribute to a potentially stronger association between arousal burden and long-term mortality. The excessive abrupt sympathetic tone elevation in REM caused by arousal may provide insights on the association between sleep and sudden cardiac death.
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Ward, Sally L. Davidson, Bruce G. Nickerson, Andre van der Hal, Antonio M. Rodriguez, Robert A. Jacobs, and Thomas G. Keens. "Absent Hypoxic and Hypercapneic Arousal Responses in Children With Myelomeningocele and Apnea." Pediatrics 78, no. 1 (July 1, 1986): 44–50. http://dx.doi.org/10.1542/peds.78.1.44.
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Hypoxic and hypercapneic arousal responses from quiet sleep were tested in seven infants with myelomeningocele and Arnold-Chiari malformation who were symptomatic with apnea and/or hypoventilation. All infants with myelomeningocele required tracheostomy and posterior fossa decompression. Responses were compared with those of nine healthy control infants. To assess hypoxic arousal, inspired Po2 was decreased until the end-tidal (alveolar) Po2 reached 45 mm Hg for a maximum of three minutes. Eleven studies were performed in seven infants with myelomeningocele, and arousal occurred in only two studies (18.2%). Eight of nine control infants aroused to hypoxia (89%). To test hypercapneic arousal, inspired Pco2 was increased until end-tidal Pco2 reached 60 mm Hg for a maximum of three minutes. Eight studies were performed on six infants with myelomeningocele, and arousal occurred in three studies (37.5%). All seven control infants studied aroused to hypercapnea (100%). Three infants with myelomeningocele subsequently died. Infants with myelomeningocele, Arnold-Chiari malformation, and apnea or hypoventilation have arousal deficits to respiratory stimuli.
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Schwartz, Christine, Mallory A. Ballinger, and Matthew T. Andrews. "Melatonin receptor signaling contributes to neuroprotection upon arousal from torpor in thirteen-lined ground squirrels." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 309, no. 10 (November 15, 2015): R1292—R1300. http://dx.doi.org/10.1152/ajpregu.00292.2015.
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The brain of mammalian hibernators is naturally protected. Hibernating ground squirrels undergo rapid and extreme changes in body temperature and brain perfusion as they cycle between lengthy torpor bouts and brief periods of euthermia called interbout arousals (IBAs). Arousal from torpor to IBA occurs rapidly, but there is no evidence of brain injury accompanying this extreme physiological transition. Production of the hormone melatonin accompanies arousal, suggesting that it plays a protective role at this time. Here, we investigated mechanisms of melatonin receptor-mediated protection in the brain of the hibernating ground squirrel. We administered the competitive melatonin receptor antagonist luzindole (30 mg/kg ip) to ground squirrels at the predicted end of a torpor bout, triggering an arousal. We found that luzindole-treated animals exhibited caspase-3 activity two times higher than vehicle-treated animals in the hypothalamus at midarousal ( P = 0.01), suggesting that melatonin receptor signaling is important for protection in this brain region. We also found a 30% decline in succinate-fueled mitochondrial respiration in luzindole-treated animals compared with vehicle-treated animals ( P = 0.019), suggesting that melatonin receptor signaling is important for optimal mitochondrial function during arousal from torpor. The mitochondrial effects of luzindole treatment were seen only during the hibernation season, indicating that this effect is specifically important for arousal from torpor. These data provide evidence for the protective role of melatonin receptor signaling during the extreme physiological transition that occurs when a hibernating mammal arouses from torpor and provide further evidence for regional and seasonal changes in the hibernator brain.
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Currie, Shannon E., Kodie Noy, and Fritz Geiser. "Passive rewarming from torpor in hibernating bats: minimizing metabolic costs and cardiac demands." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 308, no. 1 (January 1, 2015): R34—R41. http://dx.doi.org/10.1152/ajpregu.00341.2014.
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Endothermic arousal from torpor is an energetically costly process and imposes enormous demands on the cardiovascular system, particularly during early stage arousal from low body temperature (Tb). To minimize these costs many bats and other heterothermic endotherms rewarm passively from torpor using solar radiation or fluctuating ambient temperature (Ta). Because the heart plays a critical role in the arousal process in terms of blood distribution and as a source of heat production, it is desirable to understand how the function of this organ responds to passive rewarming and how this relates to changes in metabolism and Tb. We investigated heart rate (HR) in hibernating long-eared bats ( Nyctophilus gouldi) and its relationship to oxygen consumption (V̇o2) and subcutaneous temperature (Tsub) during exposure to increasing Ta compared with endogenous arousals at constant low Ta. During passive rewarming, HR and V̇o2 remained low over a large Tsub range and increased concurrently with increasing Ta (Q10 2.4 and 2.5, respectively). Absolute values were higher than during steady-state torpor but below those measured during torpor entry. During active arousals, mean HR and V̇o2 were substantially higher than during passive rewarming at corresponding Tsub. In addition, partial passive rewarming reduced the cost of arousal from torpor by 53% compared with entirely active arousal. Our data show that passive rewarming considerably reduces arousal costs and arousal time; we suggest this may also contribute to minimizing exposure to oxidative stresses as well as demands on the cardiovascular system.
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Behbahani, S., E. Staykov, D. Wilson, T. Leppänen, D. Mann, and P. Terrill. "O040 Assessment of Heart Rate Variability During Respiratory Events and Arousals Using Symbolic Dynamics." Sleep Advances 4, Supplement_1 (October 1, 2023): A15. http://dx.doi.org/10.1093/sleepadvances/zpad035.040.
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Abstract Introduction Beat-to-beat heart rate dynamics vary during obstructive respiratory events and in both respiratory and spontaneous arousals. However, conventional quantifications of heart rate variability (HRV) require segments of data substantially longer than the typical respiratory event or arousal. Subsequently, previous studies investigating dynamics in these significantly shorter segments have utilised simple quantifications such as peak heart rate. This study aimed to more-richly characterise HRV during obstructive respiratory events and arousals using symbolic dynamics. Methods One hundred individuals with suspected obstructive sleep apnoea (55 male, 57.1±12.9 years) were studied with diagnostic polysomnography, including electrocardiography. R-wave intervals were calculated and extracted during respiratory events terminating with/without arousals and during spontaneous and respiratory arousals. The symbolic dynamics tool “heart rate fragmentation” was applied to quantify HRV during the events, whereby the percentage of inflection points (PIP), defined as beat-to-beat transitions from heart-rate acceleration to heart-rate deceleration, were calculated. Statistical analysis was conducted with the Wilcoxon rank sum test. Results PIP was higher during respiratory events terminated with arousal compared with those without arousal (52.9±6.4% vs. 48.5±6.7%, P<0.05). PIP was also higher during spontaneous arousals than during respiratory arousals (51.3±6.1% vs. 45.8±6.7%, P<0.05). Discussion Previous mechanistic experiments have associated increased PIP with greater parasympathetic activity. Thus, our preliminary results suggest greater parasympathetic activity during respiratory events terminated by arousal than those without; and during spontaneous arousals compared with respiratory arousals. Further work is required to understand the pathophysiology underlying this and other similar metrics, potentially leading to novel obstructive sleep apnoea-related cardiorespiratory pathology biomarkers.
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Cori, Jennifer M., Christian L. Nicholas, Shaira Baptista, Ivan Huynh, Peter D. Rochford, Fergal J. O'Donoghue, John A. Trinder, and Amy S. Jordan. "Inspiratory-resistive loading increases the ventilatory response to arousal but does not reduce genioglossus muscle activity on the return to sleep." Journal of Applied Physiology 113, no. 6 (September 15, 2012): 909–16. http://dx.doi.org/10.1152/japplphysiol.00608.2012.
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Arousals from sleep are thought to predispose to obstructive sleep apnea by causing hyperventilation and hypocapnia, which reduce airway dilator muscle activity on the return to sleep. However, prior studies of auditory arousals have not resulted in reduced genioglossus muscle activity [GG-electromyogram (EMG)], potentially because airway resistance prior to arousal was low, leading to a small ventilatory response to arousal and minimal hypocapnia. Thus we aimed to increase the ventilatory response to arousal by resistive loading prior to auditory arousal and determine whether reduced GG-EMG occurred on the return to sleep. Eighteen healthy young men and women were recruited. Subjects were instrumented with a nasal mask with a pneumotachograph, an epiglottic pressure catheter, and intramuscular GG-EMG electrodes. Mask CO2 levels were monitored. Three- to 15-s arousals from sleep were induced with auditory tones after resting breathing (No-Load) or inspiratory-resistive loading (Load; average 8.4 cmH2O·l−1·s−1). Peak minute ventilation following arousal was greater after Load than No-Load (mean ± SE; 8.0 ± 0.6 vs. 7.4 ± 0.6 l/min, respectively). However, the nadir end tidal partial pressure of CO2 did not differ between Load conditions (43.1 ± 0.6 and 42.8 ± 0.5 mmHg, respectively), and no period of reduced GG activity occurred following the return to sleep (GG-EMG baseline, minimum after Load and No-Load = 2.9 ± 1.2%, 3.1 ± 1.3%, and 3.0 ± 1.3% max, respectively). These findings indicate that the hyperventilation, which occurs following tone-induced arousal, is appropriate for the prevailing level of respiratory drive, because loading did not induce marked hypocapnia or lower GG muscle activity on the return to sleep. Whether similar findings occur following obstructive events in patients remains to be determined.
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Rechul, D., and K. Rechul. "0164 Evidence Suggesting Early Airway Collapse as Cause of Spontaneous Arousals." Sleep 43, Supplement_1 (April 2020): A64. http://dx.doi.org/10.1093/sleep/zsaa056.162.
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Abstract Introduction Spontaneous arousals can occur in response to a number of stimuli like noise, movement, hypoxia, or airway obstruction. Some arousals occur “spontaneously” and in individuals donning a hyper-arousable phenotype, spontaneous arousals can dominate the sleep architecture. While arousal mechanisms for some stimuli have been well described, there is a profound lack of knowledge to explain spontaneous arousals. During clinical testing of a device that was designed by SleepMethods, Inc. to anticipate obstructive sleep apnea events by the ability to sense minute airway caliber changes, it was noted, incidentally that the device would signal impeding airway collapse but a spontaneous arousal followed the signal before an obstructive airway event ever developed. This phenomenon was observed many times within and between subjects, suggesting the possibility that very early airway changes are causing “spontaneous arousals” Methods Ten adults (7M;3F) aged 18-80y/o (avg. 54.7y/o) with a known AHI ≥ 15/hr (avg. AHI = 42.6/hr) underwent 1 overnight PSG recording while wearing the device. Patients were required to forego their usual CPAP therapy on the night of study in efforts to expose the device to an adequate number of total obstructive events (defined as apneas and hypopneas; RERAs and snores were excluded). Standard PSG analysis was performed. Scoring rules were applied to determine whether signals were true/false positives and/or true/false negatives based on pre-clinical data showing anticipation accuracy for up to 45 seconds prior to an obstructive airway event. Signals designed to herald obstructive events were noted, incidentally, appearing prior to spontaneous arousals. Results Preliminary results suggest that early phases of airway collapse, as the airway progresses from patency to clinically significant obstruction, are causing EEG arousals which, by current standards, are considered “spontaneous”. Because these findings were incidental to another primary purpose of the clinical study, data analysis is in early stages but currently suggesting at least an associative relationship. Conclusion If final data analysis shows statistically significant correlation between early airway collapse and “spontaneous arousals”, it may have tremendous implications for patients with hyper-arousability, insomnia, and/or pathologically elevated spontaneous arousal indices by proposing therapies aimed at airway patency maintenance. Support N/A
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Al-Shawwa, Baha, Kerri Fields, and David Ingram. "0848 The Utility of Pulse Wave Amplitude to Improve Interscorer Reliability." SLEEP 47, Supplement_1 (April 20, 2024): A363—A364. http://dx.doi.org/10.1093/sleep/zsae067.0848.
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Abstract Introduction While accurate scoring of arousals is crucial for identification of disrupted sleep architecture and hypopnea scoring, achieving acceptable interscorer reliability represents a major challenge. The drop in pulse wave amplitude (PWA) signal is a sensitive marker for arousals and is readily available in most conventional polysomnogram software. The aim of the current study was to examine interscorer agreement in scoring cortical arousals using EEG alone versus utilizing PWA drop signal as surrogate marker. Methods Arousals were scored using the same data on duplicate studies by the sleep laboratory medical director and education coordinator who is registered polysomnographic technologist (RPSGT). The first study was scored according to the American Academy of Sleep Medicine (AASM) arousal rule only. The second study used the drop in PWA as a marker for a possible cortical arousal in conjunction with the AASM arousal rule. A drop in PWA signal of at least 30% that lasted for 3 seconds was needed to identify possible arousals. Interscorer agreement and Cohen’s Kappa were calculated as measures of reliability. Results When scored using conventional EEG arousal criteria alone, there was an overall 90.3% agreement for all epochs with a corresponding Cohen’s Kappa of 0.642 (95% CI: 0.580-0.704), representing substantial agreement. When PWA assistance was utilized, agreement was significantly improved to 96.5% overall with a corresponding Cohen’s Kappa of 0.878 (95% CI: 0.840-0.917), representing almost perfect agreement. Conclusion Pulse wave amplitude may hold promise as a surrogate tool for identifying cortical arousals and improving interscorer reliability. Support (if any)
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Horne, R. S., N. D. De Preu, P. J. Berger, and A. M. Walker. "Arousal responses to hypertension in lambs: effect of sinoaortic denervation." American Journal of Physiology-Heart and Circulatory Physiology 260, no. 4 (April 1, 1991): H1283—H1289. http://dx.doi.org/10.1152/ajpheart.1991.260.4.h1283.
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Newborn lambs were subjected to hypertensive stimuli of 1-min duration to examine features of hypertension-induced arousal from sleep. Reflex mechanisms involved were studied by performing the same tests after sinoaortic denervation (SAD). In intact lambs, hypertension increased the probability of arousal from both quiet sleep (QS) and rapid-eye-movement (REM) sleep. Hypertension resulted in arousal in 51% (QS) and 50% (REM) of tests. Arousal time was significantly longer in REM (29.3 +/- 0.9 s, mean +/- SE) than in QS (22.6 +/- 0.6 s, P less than 0.01). Arterial oxygen saturation (So2) and partial pressure of oxygen (Po2) measured at the point of arousal, or after 60 s if arousal failed to occur, were unchanged from control values. After SAD hypertension did not increase the probability of arousal. Arousals significantly decreased (P less than 0.001) to 31% (QS) and 10% (REM). These findings indicate that acute hypertension, mediated via arterial baroreceptors, is a potent stimulus for arousal. In intact lambs, the arousal probability increased and arousal time decreased with increasing stimulus strength (1-30 mmHg), but the arousal time difference between QS and REM remained constant. Consideration of these findings in terms of a simple baroreflex threshold model suggests that the slower response in REM sleep is explained by slower neural processes after the achievement of a critical arousal input rather than by a higher threshold for baroreceptor input in this state.
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Delcea, Cristian. "Arousal disorder in women." International Journal of Advanced Studies in Sexology 1, no. 2 (December 1, 2019): 78–83. http://dx.doi.org/10.46388/ijass.2019.12.11.124.
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Recurrent / persistent inability to attain/ maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual arousal. Recurrent inability to get aroused. Your response to stimulation is physiologically / somatically maladaptive. And your perceptions about your inability to get aroused are distorted. The disturbance causes distress. The disturbance causes marked distress or interpersonal difficulty. Worldwide prevalence of arousal disorder in women is 26-43% and can be maintained depending on partner, stimulation, situation or regardless partner, stimulation, situation etc. The disorder may emerge from the beginning of the sexual life or begin after a period of relatively normal sexual function. Keywords: arousal disorder in women, s-on, therapy, testing, evaluation, sexual disorders.
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Barrington, K. J., and R. G. Allen. "Comparison of arousal responses to tracheal and face mask occlusions in sleeping newborn piglets." Journal of Applied Physiology 72, no. 6 (June 1, 1992): 2482–86. http://dx.doi.org/10.1152/jappl.1992.72.6.2482.
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The arousal responses after occlusion of the airway at the mid-trachea were compared with the responses after occlusion of the airway in a face mask in chronically instrumented 3- to 5-day-old piglets. For each site of occlusion arousal latency was significantly longer from active sleep than from quiet sleep. There was a significant increase in the frequency of early arousals after face mask occlusions compared with tracheal occlusions in both sleep states. During quiet sleep the frequency of arousal by 1 s after occlusion was 0.55 with face mask occlusions compared with 0.28 with tracheal occlusion (P less than 0.01). During active sleep the frequency of arousal by 3 s after a face mask occlusion was 0.32 compared with 0.08 after tracheal occlusion (P less than 0.05). Arousal from quiet sleep occurred before changes in arterial oxygen saturation. During active sleep mean saturation at arousal was not different between face mask and tracheal occlusions. Exposure of the upper airway to the pressures generated during airway occlusions results in earlier arousal in both quiet and active sleep, indicating a potential role for upper airway mechanoreceptors in initiating arousal in the newborn piglet.
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Don, Garrick W., and Karen A. Waters. "Influence of sleep state on frequency of swallowing, apnea, and arousal in human infants." Journal of Applied Physiology 94, no. 6 (June 1, 2003): 2456–64. http://dx.doi.org/10.1152/japplphysiol.00361.2002.
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Apnea and arousal are modulated with sleep stage, and swallowing may interfere with respiratory rhythm in infants. We hypothesized that swallowing itself would display interaction with sleep state. Concurrent polysomnography and measurement of swallowing allowed time-matched analysis of 3,092 swallows, 482 apneas, and 771 arousals in 17 infants aged 1–34 wk. The mean rates of swallowing, apnea, and arousal were significantly different, being 23.3 ± 8.5, 9.4 ± 8.8, and 15.5 ± 10.6 h−1, respectively ( P < 0.001 ANOVA). Swallows occurred before 25.2 ± 7.9% and during 74.8 ± 6.3% of apneas and before 39.8 ± 6.0% and during 60.2 ± 6.0% of arousals. The frequencies of apneas and arousals were both strongly influenced by sleep state (active sleep > indeterminate > quiet sleep, P < 0.001), whether or not the events coincided with swallowing, but swallowing rate showed minimal independent interaction with sleep state. Interactions between swallowing and sleep state were predominantly influenced by the coincidence of swallowing with apnea or arousal.
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O'Driscoll, Denise M., Konstantinos Kostikas, Anita K. Simonds, and Mary J. Morrell. "Occlusion of the upper airway does not augment the cardiovascular response to arousal from sleep in humans." Journal of Applied Physiology 98, no. 4 (April 2005): 1349–55. http://dx.doi.org/10.1152/japplphysiol.00706.2004.
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The cardiovascular response to an arousal from sleep at the termination of an obstructive apnea is more than double that to a spontaneous arousal. We investigated the hypothesis that stimulation of respiratory mechanoreceptors, by inspiring against an occluded airway during an arousal from sleep, augments the accompanying cardiovascular response. Arousals (>10 s) from stage 2 sleep were induced by a 1-s auditory tone (85 dB) during a concomitant 1-s inspiratory occlusion (O) and without an occlusion [i.e., control arousal (C)] in 15 healthy men (mean ± SE: age, 25 ± 1 yr). Arousals were associated with a significant increase in mean arterial blood pressure (MAP) at 4 s ( P < 0.001) and a significant decrease in R-R interval at 3 s ( P < 0.001). However, the magnitude of the cardiovascular response was not different during C compared with O (MAP: C, 86 ± 3 to 104 ± 3 mmHg; O, 86 ± 3 to 105 ± 3 mmHg; P = 0.99. R-R interval: C, 1.12 ± 0.03 to 0.89 ± 0.04 s; O, 1.11 ± 0.02 to 0.87 ± 0.02 s, P = 0.99). Ventilation significantly increased during arousals under both conditions at the second breath ( P < 0.001); this increase was not different between the two conditions (C: 4.40 ± 0.29 to 6.76 ± 0.61 l/min, O: 4.35 ± 0.34 to 7.65 ± 0.73 l/min; P = 0.31). We conclude that stimulation of the respiratory mechanoreceptors by transient upper airway occlusion is unlikely to interact with the arousal-related autonomic outflow to augment the cardiovascular response in healthy young men.
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Nizielski, S. E., C. J. Billington, and A. S. Levine. "Brown fat GDP binding and circulating metabolites during hibernation and arousal." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 257, no. 3 (September 1, 1989): R536—R541. http://dx.doi.org/10.1152/ajpregu.1989.257.3.r536.
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The effect of hibernation and arousal on brown adipose tissue (BAT) cytochrome-c oxidase activity and GDP binding, as well-circulating metabolites, have been studied in the 13-lined ground squirrel. Control animals (warm adapted) were housed continuously at 23 degrees C, while the remaining animals were transferred into a cold room (4 degrees C) for 8 days to induce hibernation. Hibernating animals were killed while deeply hibernating. Aroused animals were manually stimulated to induce arousal or had spontaneously aroused on the day of the experiment. BAT weight as well as mitochondrial mass were increased in both groups of cold-adapted animals, relative to controls. A substantial increase in GDP binding, however, was seen only in aroused animals, an observation confirmed by Scatchard analysis. Arousal was also accompanied by marked alterations in the levels of several circulating metabolites. Plasma free fatty acids declined by approximately 20% despite a three- to fourfold increase in plasma glycerol concentrations. Plasma lactate levels increased eightfold, while concentrations of beta-hydroxybutyrate were five times lower during arousal than hibernation. These data are consistent with the idea that the oxidation of free fatty acids, glucose, and ketone bodies are all increased during arousal. In conclusion, we have found that cold adaptation and subsequent hibernation increases BAT thermogenic capacity in the 13-lined ground squirrel. However, this increase in thermogenic potential is not manifested as a substantial increase in BAT thermogenic activity until arousal is initiated.
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Spector, Andrew R. "Non–REM Sleep Parasomnias." CONTINUUM: Lifelong Learning in Neurology 29, no. 4 (August 2023): 1117–29. http://dx.doi.org/10.1212/con.0000000000001261.
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ABSTRACT OBJECTIVE Non–rapid eye movement (non-REM) parasomnias are common across the lifespan. This article describes the manifestations, diagnosis, and management of non-REM parasomnias in adults and discusses the social implications of these conditions. LATEST DEVELOPMENTS Non-REM parasomnias represent a hybrid state of wakefulness and sleep, often triggered by events that increase the frequency of arousals or make it more difficult to fully arouse from sleep. Sleep deprivation, certain medications, and untreated obstructive sleep apnea are known to provoke parasomnias, particularly in those who are genetically predisposed. Non-REM parasomnias include disorders of arousal (ie, sleepwalking, sleep terrors, and confusional arousals), sleep-related eating disorder, and exploding head syndrome. Clinical overlap exists between sleep-related eating disorder and disorders of arousal, suggesting that sleep-related eating disorder may be a fourth disorder of arousal or a manifestation of sleepwalking. Exploding head syndrome is a unique parasomnia of uncertain etiology. ESSENTIAL POINTS Non-REM parasomnias can range from minor nuisances to severe, life-altering events. While some patients with non-REM parasomnia experience significant consequences during sleep, wakefulness, or both, non-REM parasomnias do not pose a major risk to most patients. For all patients with non-REM parasomnias, safety should be explicitly discussed and addressed. Nonpharmacologic treatment should be prioritized, as increasing total sleep time, avoiding triggering substances, and treating comorbid sleep disorders is often sufficient for the management of non-REM parasomnias. If symptoms persist despite these interventions, treatment with clonazepam or other medications can be considered.
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Rodriguez, Antonio M., David Warburton, and Thomas G. Keens. "Elevated Catecholamine Levels and Abnormal Hypoxic Arousal in Apnea of Infancy." Pediatrics 79, no. 2 (February 1, 1987): 269–74. http://dx.doi.org/10.1542/peds.79.2.269.
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Arousal from quiet sleep in response to a hypoxic challenge fails to occur in many patients with apnea of infancy. It was hypothesized that catecholamine-mediated responses might be involved in the depressed hypoxic arousal response in apnea of infancy and that these differences would be reflected in serum catecholamine concentrations. Fifteen infants with a median age of 5.5 months and a history of unexplained apnea during sleep were studied. Two hypoxic challenges (PiO2, 80 mm Hg) were given for three minutes or until arousal from quiet sleep occurred. Of the 15 patients with apnea of infancy 11 (73%) did not arouse to hypoxia. These infants had serum epinephrine levels that were elevated 4.1-fold while awake (P < .05), 3.4-fold during quiet sleep (P < .02), and 3.5-fold during hypoxia (P < .05). They also had serum norepinephrine levels that were elevated threefold while awake (P < .05), 5.3-fold during quiet sleep (P < .001), 3.2-fold during hypoxia (P < .02), and 12-fold during recovery from hypoxia (P < .001) in comparison with the corresponding levels in the four (23%) infants who aroused normally to hypoxia. It is speculated that elevated circulating catecholarnines are associated with abnormal hypoxic arousal responses in children with apnea of infancy.
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Dawson, A., J. Avraam, C. Nicholas, A. Kay, J. Trinder, and A. Jordan. "O037 Genioglossus motor control following the return to sleep after brief arousal." SLEEP Advances 2, Supplement_1 (October 1, 2021): A16. http://dx.doi.org/10.1093/sleepadvances/zpab014.036.
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Abstract Rationale Arousal from sleep has been shown to elicit a prolonged increase in genioglossus muscle activity that persists following the return to sleep and may protect against airway collapse. We hypothesised that this increased genioglossal activity following return to sleep after an arousal is due to persistent firing of inspiratory single motor units (SMUs) recruited during the arousal. Methods 34 healthy participants were studied overnight while wearing a nasal mask/pneumotachograph to measure ventilation and with 4 intramuscular genioglossus SMU electrodes. During stable N2 and N3 sleep, auditory tones were played to induce brief (3-15s) AASM arousals. Ventilation and genioglossus SMUs were quantified for 5 breaths before the tone, during the arousal and for 10 breaths after the return to sleep. Results A total of 1089 tones were played and gave rise to 236 SMUs recorded across arousal and the return to sleep in 20 participants (age 23±4.2 years and BMI 22.5±2.2kg/m2). Ventilation was elevated above baseline during arousal and the first post-arousal breath (p<0.001). The peak firing frequency of expiratory and tonic SMUs was unchanged during arousal and return to sleep, whereas inspiratory modulated SMUs were increased during the arousal and for 4 breaths following the return to sleep (p<0.001). Conclusions The prolonged increase in genioglossus activity that occurs on return to sleep after arousal is a result of persistent activity of inspiratory SMUs. Strategies to elevate inspiratory genioglossus SMU activity may be beneficial in preventing/treating obstructive sleep apnea.
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Younes, Magdy, Andrea H. S. Loewen, Michele Ostrowski, John Laprairie, Frances Maturino, and Patrick J. Hanly. "Genioglossus activity available via non-arousal mechanisms vs. that required for opening the airway in obstructive apnea patients." Journal of Applied Physiology 112, no. 2 (January 2012): 249–58. http://dx.doi.org/10.1152/japplphysiol.00312.2011.
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It is generally believed that reflex recruitment of pharyngeal dilator muscles is insufficient to open the airway of obstructive apnea (OSA) patients once it is closed and, therefore, that arousal is required. Yet arousal promotes recurrence of obstruction. There is no information about how much dilator [genioglossus (GG)] activation is required to open the airway (GG Opening Threshold) or about the capacity of reflex mechanisms to increase dilator activity before/without arousal (Non-Arousal Activation). The relationship between these two variables is important for ventilatory stability. We measured both variables in 32 OSA patients (apnea-hypopnea index 74 ± 42 events/h). GG activity was monitored while patients were on optimal continuous positive airway pressure (CPAP). Zopiclone was administered to delay arousal. Maximum GG activity (GGMAX) and airway closing pressure (PCRIT) were measured. During stable sleep CPAP was decreased to 1 cmH2O to induce obstructive events and the dial-downs were maintained until the airway opened with or without arousal. GG activity at the instant of opening (GG Opening Threshold) was measured. GG Opening Threshold averaged only 10.4 ± 9.5% GGMaxand did not correlate with PCRIT( r = 0.04). Twenty-six patients had >3 openings without arousal, indicating that Non-Arousal Activation can exceed GG Opening Threshold in the majority of patients. GG activity reached before arousal in Arousal-Associated Openings was only 5.4 ± 4.6% GGMAXbelow GG Opening Threshold. We conclude that in most patients GG activity required to open the airway is modest and can be reached by non-arousal mechanisms. Arousals occur in most cases just before non-arousal mechanisms manage to increase activity above GG Opening Threshold. Measures to reduce GG Opening Threshold even slightly may help stabilize breathing in many patients.
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Durand, E., F. Lofaso, S. Dauger, G. Vardon, C. Gaultier, and J. Gallego. "Intermittent hypoxia induces transient arousal delay in newborn mice." Journal of Applied Physiology 96, no. 3 (March 2004): 1216–22. http://dx.doi.org/10.1152/japplphysiol.00802.2003.
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Previous studies suggested that defective arousal might be a major mechanism in sleep-disordered breathing such as sudden infant death syndrome and obstructive sleep apnea. In this study, we examined the effects of intermittent hypoxia (IH) on the arousal response to hypoxia in 4-day-old mice. We hypothesized that IH would increase arousal latency, as previously reported in other species, and we measured the concomitant changes in ventilation to shed light on the relationship between breathing and arousal. Arousal was scored according to behavioral criteria. Breathing variables were measured noninvasively by use of whole-body flow plethysmography. In the hypoxic group ( n = 14), the pups were exposed to 5% O2 in N2 for 3 min and returned to air for 6 min. This test was repeated eight times. The normoxic mice ( n = 14) were constantly exposed to normoxia. The hypoxic mice showed a 60% increase in arousal latency ( P < 0.0001). Normoxic controls showed virtually no arousals. IH depressed normoxic ventilation below baseline prehypoxic levels, while preserving the ventilatory response to hypoxia. The breathing pattern and arousal responses recovered fully after 2 h of normoxia. We conclude that IH rapidly and reversibly depressed breathing and delayed arousal in newborn mice. Both effects may be due to hypoxia-induced release of inhibitory neurotransmitters acting concomitantly on both functions.
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Badiei, Afsoon, Saeed Meshgini, and Khosro Rezaee. "A Novel Approach for Sleep Arousal Disorder Detection Based on the Interaction of Physiological Signals and Metaheuristic Learning." Computational Intelligence and Neuroscience 2023 (January 13, 2023): 1–18. http://dx.doi.org/10.1155/2023/9379618.
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The vast majority of sleep disturbances are caused by various types of sleep arousal. To diagnose sleep disorders and prevent health problems such as cardiovascular disease and cognitive impairment, sleep arousals must be accurately detected. Consequently, sleep specialists must spend considerable time and effort analyzing polysomnography (PSG) recordings to determine the level of arousal during sleep. The development of an automated sleep arousal detection system based on PSG would considerably benefit clinicians. We quantify the EEG-ECG by using Lyapunov exponents, fractals, and wavelet transforms to identify sleep stages and arousal disorders. In this paper, an efficient hybrid-learning method is introduced for the first time to detect and assess arousal incidents. Modified drone squadron optimization (mDSO) algorithm is used to optimize the support vector machine (SVM) with radial basis function (RBF) kernel. EEG-ECG signals are preprocessed samples from the SHHS sleep dataset and the PhysioBank challenge 2018. In comparison to other traditional methods for identifying sleep disorders, our physiological signals correlation innovation is much better than similar approaches. Based on the proposed model, the average error rate was less than 2%–7%, respectively, for two-class and four-class issues. Additionally, the proper classification of the five sleep stages is determined to be accurate 92.3% of the time. In clinical trials of sleep disorders, the hybrid-learning model technique based on EEG-ECG signal correlation features is effective in detecting arousals.
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Issa, F. G., S. G. McNamara, and C. E. Sullivan. "Arousal responses to airway occlusion in sleeping dogs: comparison of nasal and tracheal occlusions." Journal of Applied Physiology 62, no. 5 (May 1, 1987): 1832–36. http://dx.doi.org/10.1152/jappl.1987.62.5.1832.
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Previous studies have shown that the arousal threshold to hypoxia, hypercapnia, and tracheal occlusions is greatly depressed in rapid-eye-movement (REM) sleep compared with slow-wave sleep (SWS). The aim of this study was to compare the arousal thresholds in SWS and REM sleep in response to an upper airway pressure stimulus. We compared the waking responses to tracheal (T) vs. nasal (N) occlusion in four unanesthetized, naturally sleeping dogs. The dogs either breathed through a tracheal fistula or through the snout using a fiberglass mask. A total of 295 T and 160 N occlusion tests were performed in SWS and REM sleep. The mean time to arousal during N and T tests was variable in the same dog and among the dogs. The mean time to arousal in SWS-tracheal occlusion was longer than that in N tests in only two of the four dogs. The total number of tests inducing arousal within the first 15 s of SWS-nasal occlusion tests was significantly more than that of T tests (N: 47%; T: 27%). There was a marked depression of arousal within the initial 15 s of REM sleep in T tests compared with N tests (N: 21%; T: 0%). The frequency of early arousals in REM tests was less than that of SWS for both N and T tests. The early arousal in N occlusion is in sharp contrast to the well-described depressed arousal responses to hypoxia, hypercapnia, and asphyxia. This pattern of arousal suggests that the upper airway mechanoreceptors may play an important role in the induction of an early arousal from nasal occlusion.
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KIM, MANHO, DAVID Q. BEVERSDORF, and KENNETH M. HEILMAN. "Arousal response with aging: Pupillographic study." Journal of the International Neuropsychological Society 6, no. 3 (March 2000): 348–50. http://dx.doi.org/10.1017/s135561770000309x.
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The performance of cognitive behaviors requires an activated, aroused cerebral cortex. Although studies have shown that there are decrements of cognitive functions in the elderly, changes in arousal with aging have not been fully studied. Our objective was to learn if there are attention–arousal changes associated with aging. Visual stimuli were presented to induce orienting responses or arousal reactions. Because changes in pupil size reflect changes in arousal, we recorded and compared pupillary responses of young and older normal participants using infared pupillography. During the 1 s that we recorded pupillary changes, we found major phases: a brief initial constriction (C1), then a maximal dilation (D1)—an arousal response, followed by constriction (C2), a habituation response. Although amplitude of these 3 phases was not different between the 2 groups, the interval between the D1 and C2 response was prolonged in the older group. Although the arousal response is not dramatically altered with aging, habituation appears to be delayed. (JINS, 2000, 6, 348–350.)
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McNamara, Frances, Faiq G. Issa, and Colin E. Sullivan. "Arousal pattern following central and obstructive breathing abnormalities in infants and children." Journal of Applied Physiology 81, no. 6 (December 1, 1996): 2651–57. http://dx.doi.org/10.1152/jappl.1996.81.6.2651.
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McNamara, Frances, Faiq G. Issa, and Colin E. Sullivan.Arousal pattern following central and obstructive breathing abnormalities in infants and children. J. Appl. Physiol. 81(6): 2651–2657, 1996.—We analyzed the polysomnographic records of 15 children and 20 infants with obstructive sleep apnea (OSA) to examine the interaction between central and obstructive breathing abnormalities and arousal from sleep. Each patient was matched for age with an infant or child who had no OSA. We found that the majority of respiratory events in infants and children was not terminated with arousal. In children, arousals terminated 39.3 ± 7.2% of respiratory events during quiet sleep and 37.8 ± 7.2% of events during active (rapid-eye-movement) sleep. In infants, arousals terminated 7.9 ± 1.0% of events during quiet sleep and 7.9 ± 1.2% of events during active sleep. In both infants and children, however, respiratory-related arousals occurred more frequently after obstructive apneas and hypopneas than after central events. Spontaneous arousals occurred in all patients with OSA during quiet and active sleep. The frequency of spontaneous arousals was not different between children with OSA and their matched controls. During active sleep, however, infants with OSA had significantly fewer spontaneous arousals than did control infants. We conclude that arousal is not an important mechanism in the termination of respiratory events in infants and children and that electroencephalographic criteria are not essential to determine the clinical severity of OSA in the pediatric population.
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Wu, Aihua, and Gordon B. Drummond. "Sleep Arousal after Lower Abdominal Surgery and Relation to Recovery from Respiratory Obstruction." Anesthesiology 99, no. 6 (December 1, 2003): 1295–302. http://dx.doi.org/10.1097/00000542-200312000-00010.
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Background Hypoxemic episodes occur during sleep after abdominal surgery, possibly caused by airway obstruction. The authors found arousals from sleep more often than respiratory disturbances, so they related changes in sleep state (short arousals from sleep and longer periods of wakening) to the sudden increase in respiratory flow that indicates relief from complete or partial respiratory obstruction. Methods Sleep state and nasal flow were studied in 16 patients receiving patient-controlled morphine and oxygen by facemask on the night after routine gynecologic surgery. Traces were analyzed separately for sleep events and for sudden increases in respiratory flow. The authors noted sleep events (arousals from sleep and transition from sleep to wake) that occurred within 12 s of relief of obstruction. Results Sleep quality was poor, with only stage 2 sleep in most patients. Median sleep duration was 70% of the study period, with 15 arousals and 6 awakenings per hour of sleep. Only 30% of arousals and awakenings were associated with relief of obstruction. Relief of obstruction also occurred without arousal from sleep, with a median frequency of 38 (30-62) in each night. Relief of obstruction was more frequently associated with arousal from sleep after benzodiazepine premedication (33% vs. 28%; P = 0.012), but this allocation was not randomized. Conclusions Arousals from sleep are frequent after abdominal surgery and mostly not related to respiratory disturbance. Relief of respiratory obstruction can occur during sleep without sleep arousal and during wakefulness.
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Battacchi, M. W., D. Palomba, L. Stegagno, and B. Baldaro. "Arousal, perceived arousal and emotions." International Journal of Psychophysiology 7, no. 2-4 (August 1989): 134. http://dx.doi.org/10.1016/0167-8760(89)90080-9.
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Trinder, John, Marinella Padula, David Berlowitz, Jan Kleiman, Sibilah Breen, Peter Rochford, Christopher Worsnop, Bruce Thompson, and Robert Pierce. "Cardiac and respiratory activity at arousal from sleep under controlled ventilation conditions." Journal of Applied Physiology 90, no. 4 (April 1, 2001): 1455–63. http://dx.doi.org/10.1152/jappl.2001.90.4.1455.
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Arousal from sleep is associated with elevated cardiac and respiratory activity. It is unclear whether this occurs because of homeostatic mechanisms or a reflex activation response associated with arousal. Cardiorespiratory activity was measured during spontaneous arousals from sleep in subjects breathing passively on a ventilator. Under such conditions, homeostatic mechanisms are eliminated. Ventilation, end-tidal Pco 2, mask pressure, diaphragmatic electromyograph, heart rate, and blood pressure were measured in four normal subjects under two conditions: assisted ventilation and a normal ventilation control condition. In the control condition, there was a normal, sleep-related fall in ventilation and rise in end-tidal Pco 2. Subsequently, at an arousal, there was an increase in respiratory and cardiac activity. In the ventilator condition, a vigorous cardiorespiratory response to a spontaneous arousal from sleep remained. These results indicate that sleep-related respiratory stimuli are not necessary for the occurrence of elevated cardiorespiratory activity at an arousal from sleep and are consistent with the hypothesis that such activity is at least in part due to a reflex activation response.
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Kaur, S., R. C. Thomas, and C. B. Saper. "0148 Serotonergic Dorsal Raphe Neurons Regulate Hypercapnia Induced Arousal Through 5HT2A Receptors on the Parabrachial Neurons." Sleep 43, Supplement_1 (April 2020): A58—A59. http://dx.doi.org/10.1093/sleep/zsaa056.146.
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Abstract Introduction Serotoninergic dorsal raphe neurons (DRSert) are CO2 responsive, and mice lacking serotonin have impaired arousal to CO2. We showed that the neurons in external lateral parabrachial nucleus containing calcitonin gene related peptide (PBelCGRP), are required for CO2-arousal. PBelCGRP neurons also receive serotoninergic innervation from the DRSert. 5HT2A agonist restores CO2 responsiveness in mice lacking serotonin, suggesting that DRSert may modulate CO2 arousal by acting on 5HT2A receptors possibly on the PBel neurons. Methods We used serotonin transporter (Sert)-Cre mice to optogenetically inhibit DRSert neurons and their terminals in the PBel. We injected AAV-FLEX-ArchT into the DR and implanted an optical fiber just above it in one set of Sert-Cre mice and bilaterally in the PBel in another set. All mice were instrumented for sleep and optogenetics and were tested for EEG arousals to 10% CO2. Latencies of arousal were compared with optogenetic inhibition of either the DR neurons or their terminals in the PBel with a 593nm laser light. We further tested whether a 5HT2A agonist (TCB-2) can reverse blockade of CO2 arousal in mice where DRSert terminals in PBel were inhibited. Finally, TCB-2 was injected in mice with PBelCGRP deletions and arousal latency to CO2 was compared. Results Compared to the control (Laser-OFF) condition, arousal latency to CO2 was significantly increased by photoinhibition of either the DRSert neurons (n=6; latency- 40.9 ± 6.4 vs. 13.81± 0.69 sec; F3, 17= 11.5; P< 0.001) or their terminals in PBel (n=8; latency-34.9 ± 2.3 sec vs. 16.62 ± 0.97sec, F1, 14= 56.9; P< 0.001). This was reversed by the 5HT2A agonist TCB-2 (5mg/kg), as it reduced the latency to CO2 arousal in mice with photoinhibition of terminals in PBel from 35.48 ± 7.31 sec to 16.24 ± 1.06 sec (F3, 9= 8.05; P= 0.006), but had no effect in mice with PBelCGRP neurons deletions. Conclusion The serotonin system modulate CO2-arousals by the DRSert input to the PBel. TCB-2 reversed the effect of inhibition of DRSert terminals in the PBel, but not in mice with PBelCGRP deletions, suggests that DRSert modulate PBelCGRP neurons through 5HT2a receptors. Support NIH- 2P01 HL095491 and NS112175
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O'Driscoll, Denise M., Guy E. Meadows, Douglas R. Corfield, Anita K. Simonds, and Mary J. Morrell. "Cardiovascular response to arousal from sleep under controlled conditions of central and peripheral chemoreceptor stimulation in humans." Journal of Applied Physiology 96, no. 3 (March 2004): 865–70. http://dx.doi.org/10.1152/japplphysiol.00749.2003.
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The cardiovascular response to an arousal occurring at the termination of an obstructive apnea is almost double that to a spontaneous arousal. We investigated the hypothesis that central plus peripheral chemoreceptor stimulation, induced by hypercapnic hypoxia (HH), augments the cardiovascular response to arousal from sleep. Auditory-induced arousals during normoxia and HH (>10-s duration) were analyzed in 13 healthy men [age 24 ± 1 (SE) yr]. Subjects breathed on a respiratory circuit that held arterial blood gases constant, despite the increased ventilation associated with arousal. Arousals were associated with a significant increase in mean arterial blood pressure at 5 s ( P < 0.001) and with a significant decrease in the R-R interval at 3 s ( P < 0.001); however, the magnitude of the changes was not significantly different during normoxia compared with HH (mean arterial blood pressure: normoxia, 91 ± 4 to 106 ± 4 mmHg; HH, 91 ± 4 to 109 ± 5 mmHg; P = 0.32; R-R interval: normoxia, 1.12 ± 0.04 to 1.02 ± 0.05 s; HH, 1.09 ± 0.05 to 0.92 ± 0.04 s; P = 0.78). Mean ventilation increased significantly at the second breath postarousal for both conditions ( P < 0.001), but the increase was not significantly different between the two conditions (normoxia, 5.35 ± 0.40 to 9.57 ± 1.69 l/min; HH, 8.57 ± 0.63 to 11.98 ± 0.70 l/min; P = 0.71). We conclude that combined central and peripheral chemoreceptor stimulation with the use of HH does not interact with the autonomic outflow associated with arousal from sleep to augment the cardiovascular response.
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Davies, R. J., P. J. Belt, S. J. Roberts, N. J. Ali, and J. R. Stradling. "Arterial blood pressure responses to graded transient arousal from sleep in normal humans." Journal of Applied Physiology 74, no. 3 (March 1, 1993): 1123–30. http://dx.doi.org/10.1152/jappl.1993.74.3.1123.
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During obstructive sleep apnea, transient arousal at the resumption of breathing is coincident with a substantial rise in blood pressure. To assess the hemodynamic effect of arousal alone, 149 transient stimuli were administered to five normal subjects. Two electroencephalograms (EEG), an electrooculogram, a submental electromyogram (EMG), and beat-to-beat blood pressure (Finapres, Ohmeda) were recorded in all subjects. Stimulus length was varied to produce a range of cortical EEG arousals that were graded as follows: 0, no increase in high-frequency EEG or EMG; 1, increased high-frequency EEG and/or EMG for < 10 s; 2, increased high-frequency EEG and/or EMG for > 10 s. Overall, compared with control values, average systolic pressure rose [nonrapid-eye-movement (NREM) sleep 10.0 +/- 7.69 (SD) mmHg; rapid-eye-movement (REM) sleep 6.0 +/- 6.73 mmHg] and average diastolic pressure rose (NREM sleep 6.1 +/- 4.43 mmHg; REM sleep 3.7 +/- 3.02 mmHg) over the 10 s following the stimulus (NREM sleep, P < 0.0001; REM sleep, P < 0.002). During NREM sleep, there was a trend toward larger blood pressure rises at larger grades of arousal (systolic: r = 0.22, 95% confidence interval 0.02–0.40; diastolic: r = 0.48, 95% confidence interval 0.31–0.62). The average blood pressure rise in response to the grade 2 arousals was approximately 75% of that during obstructive sleep apnea. Arousal stimuli that did not cause EEG arousal still produced a blood pressure rise (mean systolic rise 8.6 +/- 7.0 mmHg, P < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
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Kesler, Branko, Amit Anand, Sandrine H. Launois, and J. Woodrow Weiss. "Drug-induced arterial pressure elevation is associated with arousal from NREM sleep in normal volunteers." Journal of Applied Physiology 87, no. 3 (September 1, 1999): 897–901. http://dx.doi.org/10.1152/jappl.1999.87.3.897.
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Abrupt changes in arterial pressure produce arousal in sleeping animals. To determine whether arterial pressure elevations can cause arousal from sleep in humans, we studied five healthy individuals without sleep complaints or cardiac abnormalities. Monitoring included electroencephalogram, electrooculogram, and electromyogram to determine stage sleep; finger cuff to measure arterial pressure; and electrocardiogram to measure heart rate. We administered intravenous bolus doses of either phenylephrine or saline after performing a dose-response curve to establish the amount of phenylephrine that produced a 20-mmHg increase in mean arterial pressure. Ten boluses of phenylephrine and ten boluses of saline were then administered in random order during stable non-rapid-eye-movement sleep. An observer blinded to the order of drug administration identified arousals using a standard definition. Arousals were five times more likely to occur after phenylephrine than after saline (58 vs. 12%; P = 0.0071). Phenylephrine administration produced heart rate slowing, indicative of baroreflex stimulation. We conclude that pharmacologically induced arterial pressure elevation is associated with arousal from sleep in normal volunteers.
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Graves, Wayne, and Denis J. Lynch. "Sexual Arousal and Aggression in a Free-Choice Situation." Psychological Reports 60, no. 1 (February 1987): 95–104. http://dx.doi.org/10.2466/pr0.1987.60.1.95.
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The effect of sexual arousal on the administration of pleasure or pain to a rat was studied. The subjects were 40 male college students, half were induced to sexual arousal through reading erotic passages while the rest read neutral passages. Subjects were placed in a simulated teaching situation, with a laboratory rat being the apparent learner. Pleasurable and painful stimulation were available as teaching aids. No differences between the aroused and nonaroused groups were noted in intensity of stimulation applied; however, aroused subjects administered pain of greater duration than nonaroused subjects. This finding was attributed to a disinhibition effect operating in the aroused group. Such a difference might lead the aroused subjects to be labelled as more aggressive.
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Marcus, Carole L., Janita Lutz, John L. Carroll, and Owen Bamford. "Arousal and ventilatory responses during sleep in children with obstructive sleep apnea." Journal of Applied Physiology 84, no. 6 (June 1, 1998): 1926–36. http://dx.doi.org/10.1152/jappl.1998.84.6.1926.
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Abnormal central regulation of upper airway muscles may contribute to the pathophysiology of the childhood obstructive sleep apnea syndrome (OSAS). We hypothesized that this was secondary to global abnormalities of ventilatory control during sleep. We therefore compared the response to chemical stimuli during sleep between prepubertal children with OSAS and controls. Patients with OSAS aroused at a higher[Formula: see text] (58 ± 2 vs. 60 ± 5 Torr, P < 0.05); those with the highest apnea index had the highest arousal threshold ( r = 0.52, P < 0.05). The hypercapnic arousal threshold decreased after treatment. For all subjects, hypoxia was a poor stimulus to arousal, whereas hypercapnia and, particularly, hypoxic hypercapnia were potent stimuli to arousal. Hypercapnia resulted in decreased airway obstruction in OSAS. Ventilatory responses were similar between patients with OSAS and controls; however, the sample size was small. We conclude that children with OSAS have slightly blunted arousal responses to hypercapnia. However, the overall ventilatory and arousal responses are normal in children with OSAS, indicating that a global deficit in respiratory drive is not a major factor in the etiology of childhood OSAS. Nevertheless, subtle abnormalities in ventilatory control may exist.
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Chien, Ying-Ren, Cheng-Hsuan Wu, and Hen-Wai Tsao. "Automatic Sleep-Arousal Detection with Single-Lead EEG Using Stacking Ensemble Learning." Sensors 21, no. 18 (September 9, 2021): 6049. http://dx.doi.org/10.3390/s21186049.
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Poor-quality sleep substantially diminishes the overall quality of life. It has been shown that sleep arousal serves as a good indicator for scoring sleep quality. However, patients are conventionally asked to perform overnight polysomnography tests to collect their physiological data, which are used for the manual judging of sleep arousals. Even worse, not only is this process time-consuming and cumbersome, the judgment of sleep-arousal events is subjective and differs widely from expert to expert. Therefore, this work focuses on designing an automatic sleep-arousal detector that necessitates only a single-lead electroencephalogram signal. Based on the stacking ensemble learning framework, the automatic sleep-arousal detector adopts a meta-classifier that stacks four sub-models: one-dimensional convolutional neural networks, recurrent neural networks, merged convolutional and recurrent networks, and random forest classifiers. This meta-classifier exploits both advantages from deep learning networks and conventional machine learning algorithms to enhance its performance. The embedded information for discriminating the sleep-arousals is extracted from waveform sequences, spectrum characteristics, and expert-defined statistics in single-lead EEG signals. Its effectiveness is evaluated using an open-accessed database, which comprises polysomnograms of 994 individuals, provided by PhysioNet. The improvement of the stacking ensemble learning over a single sub-model was up to 9.29%, 7.79%, 11.03%, 8.61% and 9.04%, respectively, in terms of specificity, sensitivity, precision, accuracy, and area under the receiver operating characteristic curve.
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Blasi, Anna, Javier Jo, Edwin Valladares, Barbara J. Morgan, James B. Skatrud, and Michael C. K. Khoo. "Cardiovascular variability after arousal from sleep: time-varying spectral analysis." Journal of Applied Physiology 95, no. 4 (October 2003): 1394–404. http://dx.doi.org/10.1152/japplphysiol.01095.2002.
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We performed time-varying spectral analyses of heart rate variability (HRV) and blood pressure variability (BPV) recorded from 16 normal humans during acoustically induced arousals from sleep. Time-varying autoregressive modeling was employed to estimate the time courses of high-frequency HRV power, low-frequency HRV power, the ratio between low-frequency and high-frequency HRV power, and low-frequency power of systolic BPV. To delineate the influence of respiration on HRV, we also computed respiratory airflow high-frequency power, the modified ratio of low-frequency to high-frequency HRV power, and the average transfer gain between respiration and heart rate. During cortical arousal, muscle sympathetic nerve activity and heart rate increased and returned rapidly to baseline, but systolic blood pressure, the ratio between low-frequency and high-frequency HRV power, low-frequency HRV power, the modified ratio of low-frequency to high-frequency HRV power, and low-frequency power of systolic BPV displayed increases that remained above baseline up to 40 s after arousal. High-frequency HRV power and airflow high-frequency power showed concommitant decreases to levels below baseline, whereas the average transfer gain between respiration and heart rate remained unchanged. These findings suggest that 1) arousal-induced changes in parasympathetic activity are strongly coupled to respiratory pattern and 2) the sympathoexcitatory cardiovascular effects of arousal are relatively long lasting and may accumulate if repetitive arousals occur in close succession.
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Mistlberger, R. E., M. C. Antle, I. C. Webb, M. Jones, J. Weinberg, and M. S. Pollock. "Circadian clock resetting by arousal in Syrian hamsters: the role of stress and activity." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 285, no. 4 (October 2003): R917—R925. http://dx.doi.org/10.1152/ajpregu.00222.2003.
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Circadian rhythms in the Syrian hamster can be markedly phase shifted by 3 h of wheel running or arousal stimulation during their usual daily rest period (“subjective day”). Continuous wheel running is predictive but not necessary for phase shifts of this “nonphotic” type; hamsters aroused by gentle handling without running can also show maximal shifts. By contrast, physical restraint, a standard stress procedure and thus presumably arousing, is ineffective. To resolve this apparent paradox, phase-shifting effects of 3-h sessions of restraint or other stress procedures were assessed. In a preliminary study, phase shifts to arousal by gentle handling were significantly potentiated by the cortisol synthesis inhibitor metyrapone, suggesting that stress-related cortisol release may inhibit phase shifts to arousal. Next, it was confirmed that restraint in the subjective day does not induce phase shifts, but behavioral observations revealed that it also does not sustain arousal. Restraint combined with noxious compressed air blasts did sustain arousal and induced a significant cortisol response compared with arousal by gentle handling but did not induce shifts. Restraint combined with continuous horizontal rotation was also ineffective, as was EEG-validated arousal via confinement to a pedestal over water. However, 3 h of resident-intruder interactions (an intense psychosocial stress) or exposure to an open field (a mild stress) did induce large shifts that were positively correlated with indexes of forward locomotion. The results indicate that large phase shifts associated with arousal in the usual sleep period are neither induced nor prevented by stress per se, but are dependent on the expression of at least low levels of locomotor activity. Sustained arousal alone is not sufficient.
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Marcus, Carole L., Gustavo A. Moreira, Owen Bamford, and Janita Lutz. "Response to inspiratory resistive loading during sleep in normal children and children with obstructive apnea." Journal of Applied Physiology 87, no. 4 (October 1, 1999): 1448–54. http://dx.doi.org/10.1152/jappl.1999.87.4.1448.
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The response to inspiratory resistance loading (IRL) of the upper airway during sleep in children is not known. We, therefore, evaluated the arousal responses to IRL during sleep in children with the obstructive sleep apnea syndrome (OSAS) compared with controls. Children with OSAS aroused at a higher load than did controls (23 ± 8 vs. 15 ± 7 cmH2O ⋅ l−1 ⋅ s; P < 0.05). Patients with OSAS had higher arousal thresholds during rapid eye movement (REM) vs. non-REM sleep ( P < 0.001), whereas normal subjects had lower arousal thresholds during REM ( P < 0.005). Ventilatory responses to IRL were evaluated in the controls. There was a marked decrease in tidal volume both immediately (56 ± 17% of baseline at an IRL of 15 cmH2O ⋅ l−1 ⋅ min; P < 0.001) and after 3 min of IRL (67 ± 23%, P < 0.005). The duty cycle increased. We conclude that children with OSAS have impaired arousal responses to IRL. Despite compensatory changes in respiratory timing, normal children have a decrease in minute ventilation in response to IRL during sleep. However, arousal occurs before gas-exchange abnormalities.
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Ming, Xue, Ye-Ming Sun, Roberto V. Nachajon, Michael Brimacombe, and Arthur S. Walters. "Prevalence of Parasomnia in Autistic Children with Sleep Disorders." Clinical medicine. Pediatrics 3 (January 2009): CMPed.S1139. http://dx.doi.org/10.4137/cmped.s1139.
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The prevalence of sleep related complaints is reported by questionnaire studies to be as high as 83.3% in children with autism spectrum disorders (ASD). Questionnaire studies report the presence of various parasomnia in ASD. However, no polysomnographic study reports non-REM parasomnias and only a single study reports REM related parasomnias in ASD. We investigated the prevalence and characteristics of sleep disorders by polysomnographic study and questionnaires in a cohort of 23 children with ASD and 23 age-matched children of a non-autistic comparison group. The results showed significantly more non-REM parasomnias in 14 children with ASD on polysomnograms (PSG) and 16 ASD children by questionnaire, a finding that was not associated with medication use, other comorbid medical or psychiatric disorders, or sleep disordered breathing. Of the 14 children with ASD who had PSG evidence of parasomnia, 11 of them had a history suggestive of parasomnia by questionnaire. There was a high sensitivity but a low specificity of parasomnia in ASD by questionnaire in predicting the presence of parasomnia in the PSG. Of the parasomnias recorded in the laboratory, 13 ASD children had Disorders of Partial Arousal, consistent with sleep terrors or confusional arousals. Furthermore, multiple episodes of partial arousal occurred in 11 of the 13 ASD children who had PSG evidence of Disorders of Partial Arousal. Of the 11 ASD children with multiple episodes of partial arousal, 6 ASD children had multiple partial arousals during both nights’ PSG study. Sleep architecture was abnormal in children with ASD, characterized by increased spontaneous arousals, prolonged REM latency and reduced REM percentage. These results suggest a high prevalence of parasomnia in this cohort of children with ASD and a careful history intake of symptoms compatible with parasomnia could be prudent to diagnose parasomnia in ASD children when performing a PSG is not possible.
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Lijowska, Anna S., Nevada W. Reed, Barbara A. Mertins Chiodini, and Bradley T. Thach. "Sequential arousal and airway-defensive behavior of infants in asphyxial sleep environments." Journal of Applied Physiology 83, no. 1 (July 1, 1997): 219–28. http://dx.doi.org/10.1152/jappl.1997.83.1.219.
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Lijowska, Anna S., Nevada W. Reed, Barbara A. Mertins Chiodini, and Bradley T. Thach. Sequential arousal and airway-defensive behavior of infants in asphyxial sleep environments. J. Appl. Physiol. 83(1): 219–228, 1997.—Infants are prone to accidental asphyxiation. Therefore, we studied airway-defensive behaviors and their relationship to spontaneous arousal behavior in 41 healthy sleeping infants (2–26 wk old), using two protocols: 1) infant was rebreathing expired air, face covered by bedding material; and 2) infant was exposed to hypercarbia, face uncovered. Multiple measurements of respiratory and motor activities were recorded (video, polygraph). The infants’ response to increasing hypercarbia consisted of four highly stereotyped behaviors: sighs (augmented breaths), startles, thrashing limb movements, and full arousal (eyes open, cry). These behaviors occurred abruptly in self-limited clusters of activity and always in the same sequence: first a sigh coupled with a startle, then thrashing, then full arousal. Incomplete sequences (initial behaviors only) occurred far more frequently than the complete sequence and were variably effective in removing the bedding covering the airway. In both protocols, as inspired CO2increased, incomplete arousal sequences recurred periodically and with increasing frequency and complexity until the infant either succeeded in clearing his/her airway or was completely aroused. Spontaneous arousal sequences, identical to those occurring during hypercarbia, occurred periodically during sleep. This observation suggests that the infant’s airway-defensive responses to hypercarbia consist of an increase in the frequency and complexity of an endogenously regulated, periodically occurring sequence of arousal behaviors.
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Jani, Alkesh, David J. Orlicky, Anis Karimpour-Fard, L. Elaine Epperson, Rae L. Russell, Lawrence E. Hunter, and Sandra L. Martin. "Kidney proteome changes provide evidence for a dynamic metabolism and regional redistribution of plasma proteins during torpor-arousal cycles of hibernation." Physiological Genomics 44, no. 14 (July 15, 2012): 717–27. http://dx.doi.org/10.1152/physiolgenomics.00010.2012.
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Hibernating ground squirrels maintain homeostasis despite extreme physiological challenges. In winter, these circannual hibernators fast for months while cycling between prolonged periods of low blood flow and body temperature, known as torpor, and short interbout arousals (IBA), where more typical mammalian parameters are rapidly restored. Here we examined the kidney proteome for changes that support the dramatically different physiological demands of the hibernator's year. We identified proteins in 150 two-dimensional gel spots that altered by at least 1.5-fold using liquid chromatography and tandem mass spectrometry. These data successfully classified individuals by physiological state and revealed three dynamic patterns of relative protein abundance that dominated the hibernating kidney: 1) a large group of proteins generally involved with capturing and storing energy were most abundant in summer; 2) a select subset of these also increased during each arousal from torpor; and 3) 14 spots increased in torpor and early arousal were enriched for plasma proteins that enter cells via the endocytic pathway. Immunohistochemistry identified α2-macroglobulin and albumin in kidney blood vessels during late torpor and early arousal; both exhibited regional heterogeneity consistent with highly localized control of blood flow in the glomeruli. Furthermore, albumin, but not α2-macroglobulin, was detected in the proximal tubules during torpor and early arousal but not in IBA or summer animals. Taken together, our findings indicate that normal glomerular filtration barriers remain intact throughout torpor-arousal cycles but endocytosis, and hence renal function, is compromised at low body temperature during torpor and then recovers with rewarming during arousal.
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Qian, Xiangyu, Ye Qiu, Qingzu He, Yuer Lu, Hai Lin, Fei Xu, Fangfang Zhu, et al. "A Review of Methods for Sleep Arousal Detection Using Polysomnographic Signals." Brain Sciences 11, no. 10 (September 26, 2021): 1274. http://dx.doi.org/10.3390/brainsci11101274.
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Multiple types of sleep arousal account for a large proportion of the causes of sleep disorders. The detection of sleep arousals is very important for diagnosing sleep disorders and reducing the risk of further complications including heart disease and cognitive impairment. Sleep arousal scoring is manually completed by sleep experts by checking the recordings of several periods of sleep polysomnography (PSG), which is a time-consuming and tedious work. Therefore, the development of efficient, fast, and reliable automatic sleep arousal detection system from PSG may provide powerful help for clinicians. This paper reviews the automatic arousal detection methods in recent years, which are based on statistical rules and deep learning methods. For statistical detection methods, three important processes are typically involved, including preprocessing, feature extraction and classifier selection. For deep learning methods, different models are discussed by now, including convolution neural network (CNN), recurrent neural network (RNN), long-term and short-term memory neural network (LSTM), residual neural network (ResNet), and the combinations of these neural networks. The prediction results of these neural network models are close to the judgments of human experts, and these methods have shown robust generalization capabilities on different data sets. Therefore, we conclude that the deep neural network will be the main research method of automatic arousal detection in the future.
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Gratton, Matt, Nancy Hamilton, Bethany Gerardy, Magdy Younes, and Diego Mazzotti. "0329 Wake Intrusions in the EEG: A Novel Application of the Odds Ratio Product in Identifying Subthreshold Arousals." SLEEP 46, Supplement_1 (May 1, 2023): A146—A147. http://dx.doi.org/10.1093/sleep/zsad077.0329.
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Abstract Introduction Arousal scoring is controversial, due to its lack of objectivity and dependency on other intrinsic characteristics of sleep. Conventional arousal measurements have not consistently predicted insomnia severity. The present study used a novel application of the Odds Ratio Product (ORP), a measure of sleep depth ranging from 0 (deep sleep) to 2.5 (fully awake), to identify subtle wake intrusions in sleep (i.e., subthreshold arousals). We assessed whether these intrusions are better predictors of frequent insomnia symptoms when compared to conventional arousal measurements. Methods Using cross-sectional data from the Sleep Heart Health Study with high-quality ORP data (SHHS1; n = 5,771), accessed through the National Sleep Research Resource, we defined ‘wake intrusions’ as the number of times the ORP spiked above a wake threshold of 2.0 (99% agreement in wake scoring among sleep scorers) during sleep. The wake intrusion index (WII) was derived by calculating the quotient of the number of intrusions by total sleep time. Insomnia was defined from self-reported frequency of >15x/month of insomnia symptoms: delayed sleep onset, difficulty maintaining sleep, and/or early morning awakenings (n = 617). Linear models were used to examine the associations between insomnia and WII, as well as arousal index. Analyses were adjusted for age, sex, body mass index (BMI), and apnea-hypopnea index (AHI). Results There was a weak, but significant correlation between conventional arousal index and WII (r=0.25, 95%CI [0.22, 0.27], p< 0.001). After adjusting for age, sex, BMI and AHI, frequent insomnia symptoms were associated with WII (β=9.47, 95%CI [2.07, 16.87], p=0.012), but not with arousal index (β=0.16, 95%CI [-0.59,0.91], p=0.217). Conclusion Results suggest that the ORP WII may be more sensitive than the arousal index. Moreover, frequent insomnia symptoms were independently associated with WII in adjusted analysis, while not with the arousal index. The role of the ORP WII as a potential physiological marker of insomnia deserves further investigation. Support (if any) NIH (U01HL53916, U01HL53931, U01HL53934, U01HL53937, U01HL64360, U01HL53938, U01HL53940, U01HL53941, U01HL63463, R24HL114473, 75N92019R002).
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Sartory, Gudrun, and G. Sartory. "Autonomic arousal: Emotion, arousal or information processing?" Biological Psychology 23, no. 1 (August 1986): 95–96. http://dx.doi.org/10.1016/0301-0511(86)90126-2.
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