Tesis sobre el tema "Dette chronique de sommeil"
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Melone, Marie-Anne. "Diagnοstic and therapeutic strategies οf circadian and sleep/wake rhythm disοrders in at-risk pοpulatiοns". Electronic Thesis or Diss., Normandie, 2024. http://www.theses.fr/2024NORMR023.
Texto completoSleep health guidelines advocate for 7 to 9 hours of nightly sleep for the general population, yet sleep debt persists, presenting significant health risks, including metabolic, cardiac, mental, and neurocognitive diseases. This widespread sleep debt is often attributed to the conflict between modern lifestyles—characterized by artificial lighting, shift work, and social obligations—and our innate circadian rhythms, leading to a condition known as circadian dysrhythmia. Circadian rhythms are the natural oscillations in physiological processes that are essential for aligning genetic, physiological, and behavioral patterns with solar time to anticipate changes in our environment. The misalignment of these rhythms is increasingly linked to various health disorders. Diagnosing circadian rhythms and sleep/wake disorders poses challenges, as part of its definition relies on subjective assessments and clinical evaluations of sleep quality. Moreover, sleep/wake timing or chronotype questionnaires, although validated, may not accurately reflect individual circadian clocks. While melatonin measurement is considered the gold standard, its practical implementation is difficult, making actigraphy and sleep logs more common tools for identifying circadian rhythms and sleep/wake disorders. This highlights the need for improved diagnostic methods. Potential therapeutic interventions could help improve circadian dysrhythmias related health outcomes. In this context, this manuscript delves into the prevalence, risk factors, and consequences of circadian rhythms and sleep/wake disorders, particularly focusing on at-risk populations like student-athletes and critically ill patients, where misaligned zeitgebers exacerbate health risks. This work includes three studies’ findings and one narrative review on circadian rhythm and sleep/wake disorders, their risk factors, consequences, and potential treatments in populations prioritizing performance (student-athletes) and recovery (critically ill patients)
PAYEN, PACCARD CHRISTINE. "La ronchopathie chronique". Lyon 1, 1990. http://www.theses.fr/1990LYO1M290.
Texto completoLaroche, Liny. "Relation entre l'insomnie chronique et le fonctionnement immunitaire". Master's thesis, Université Laval, 1999. http://hdl.handle.net/20.500.11794/53135.
Texto completoFrançois, Thierry. "Sommeil paradoxal, dépression et antidépresseurs : effets d'une administration chronique d'antidépresseurs tricycliques sur le sommeil paradoxal de patients déprimés". Besançon, 1991. http://www.theses.fr/1991BESAM067.
Texto completoBeaulieu, Philippe Ortho Marie-Pia d'. "Traitement cognitivo-comportemental de l'insomnie chronique". Créteil : Université de Paris-Val-de-Marne, 2006. http://doxa.scd.univ-paris12.fr:80/theses/th0243099.pdf.
Texto completoPittaras, Elsa. "Marqueurs comportementaux et neurochimiques individuels de la prise de décision chez la souris et effets d'une dette de sommeil". Thesis, Université Paris-Saclay (ComUE), 2016. http://www.theses.fr/2016SACLS122/document.
Texto completoAffective abilities that rely on the integrity of several neural circuits. In healthy subjects, inter-individual variability during decision-making exists due to genetic, epigenetic and environmental factors. Moreover, many psychiatric and neurobiological disorders are characterized by poor decision-making processes. Therefore, determining behavioral traits and neurobiological substrates involved in these processes is of major interest to unravel markers that could predict the emergence of neuropathologies.Based on the Iowa Gambling Task in humans, we developed a decision-making task in mice that assesses their ability to choose between several conflicting options under uncertainty. Thanks to a differential approach of mice’s behavior, we show that decision-making skills differed between mice: some mice exhibit a rigid behavior and avoid penalty (safe mice); others maintained exploratory behavior even if they took risks (risky mice); a majority of mice exhibit an intermediate behavior (average mice). We found that a combination of behavioral characteristics related to different psychopathologies in humans were specifically associated with extreme behavior in mice: safe mice exhibited a more anxious behavior, a lower prefrontal activation after the MGT than others subgroups of performance together with a lower basal rate of serotonin in the prefrontal cortex. Risky mice displayed a riskier behavior in various behavioral tasks, were less sensitive to reward, and had a lower basal rate of serotonin in the orbitofrontal cortex as well as a higher basal rate of serotonin, dopamine and noradrenaline in the hippocampus.To investigate the consequences of environmental changes on decision-making individual profiles, we performed the MGT on groups of mice either under Acute Sleep Dept (ASD) or under chronic sleep debt (CSD). We show that CSD didn't play any apparent effect but that ASD emphasized decision-making profiles: safe mice became drastically more rigid and avoided penalty; and risky mice chose systematically riskier options and developed rigid and unefficient decisions. These behavioral data could be explained by a decreased serotonin metabolism in the orbitofrontal cortex, an increase in the hippocampus and a high level of dopamine in the caudate putamen, the key brain area of habits.Therefore, in healthy inbred mice the MGT reveals individual inadapted decision-making strategies which are characterized by behavioral and neurobiological substrates exacerbated by an environmental stress. This paradigm also allows the determination of mice vulnerability to develop psychopathologies (e.g. depression, addiction) for which sleep debt could a trigger or a magnifier
Chenuel, Bruno Haouzi Philippe. "Etude des mécanismes physiopathologiques impliqués dans les apnées centrales du sommeil associées à l'insuffisance cardiaque chronique : données expérimentales animales et applications à l'Homme". [S.l.] : [s.n.], 2006. http://www.scd.uhp-nancy.fr/docnum/SCD_T_2006_0237_CHENUEL.pdf.
Texto completoLANDART, FREDERIQUE. "Decouverte d'episodes de desaturation en oxygene lors du sommeil chez un bronchopathe chronique a l'occasion de crises convulsives". Amiens, 1991. http://www.theses.fr/1991AMIEM078.
Texto completoJounieaux, Vincent. "Les evenements respiratoires du sommeil des bronchopneumopathies chroniques obstructives : etude comparative des patients (pa 02 comprise entre 60 et 70 mm hg) avec un groupe de sujets temoins". Amiens, 1988. http://www.theses.fr/1988AMIEM055.
Texto completoChenuel, Bruno. "Etude des mécanismes physiopathologiques impliqués dans les apnées centrales du sommeil associées à l'insuffisance cardiaque chronique : données expérimentales animales et applications à l'Homme". Nancy 1, 2006. http://docnum.univ-lorraine.fr/public/SCD_T_2006_0237_CHENUEL.pdf.
Texto completoDuring sleep, control of breathing is greatly influenced by metabolic information. Whether this chemical control of ventilation is involved in the genesis of central sleep apneas with CheyneStokes respiration in severe congestive heart patients is unknown and the subject of our work. It includes three series of experiments in animal models to clarify the mechanisms involved in the hypocapnia-induced apneas, the anatomical structures mediating such a ventilatory response and the specific effects of heart failure on the control of breathing, leading to an increased susceptibility to central apneas. More specifically a sleeping dog model was used, allowing the study of periodic breathing induced by a transient hyperventilation, with and without any acute pulmonary vascular congestion. We were interested in conditions capable of changing the apneic threshold defined as the arterial or end-expiratory partial carbon dioxide pressure below which ventilation ceases. Two mechanisms possibly involved in human pathology were investigated : 1- changes in the activity of the peripheral chemoreceptors 2- pulmonary vascular congestion. Whereas the arterial chemoreceptors are involved in the genesis of hypocapnia-induced apneas and the cardio-respiratory structures activated by a pulmonary edema facilitate the occurrence of central apneas, these mechanisms were not able to fully explain the description of the Cheyne-Stokes respiration in Humans. The relevance of these results must be evaluated in Human and the role played by the non-chemical information of the control of breathing in the genesis of central apneas must be more precisely studied
Duchesne, Pérusse Alexandra. "Insomnie chronique : mesures des siestes, du sommeil paradoxal et du contenu onirique comme indicateurs potentiels d'hyperactivation". Doctoral thesis, Université Laval, 2015. http://hdl.handle.net/20.500.11794/26505.
Texto completoChronic insomnia is one of the most prevalent sleep disorders which generates important daily consequences. Hyperarousal is a central component of chronic insomnia, and even though it has been previously studied with different measures, some aspects of hyperarousal remain unknown. The main objective of this thesis was to find novel potential indicators of hyperarousal in chronic insomnia by exploring naps, REM sleep and dream activity. First (Article # 1), diurnal sleep parameters during naps following a sustained cognitive effort were evaluated in good sleepers and different types of chronic insomnia sufferers (psychophysiological and paradoxical). In this investigation, results revealed that good sleepers slept more efficiently during the day than insomnia sufferers, even though the latter group tended to be subjectively sleepier, suggesting the importance of hyperarousal during napping. Second (Article # 2), some REM sleep macrostructure (proportion and duration, latency, number of periods and their duration) and microstructure variables (rapid eye movements, wake intrusions and arousals) were explored in psychophysiological and paradoxical insomnia sufferers as well as in good sleepers. No intergroup difference was observed for any of the REM sleep macrostructure variables, but REM sleep wake intrusions were significantly greater in psychophysiological insomnia sufferers, possibly reflecting their hyperarousal. This result could eventually help differentiating insomnia types. Third (Articles # 3 and 4), REM dream activity was studied in good sleepers and chronic insomnia sufferers. The feasibility of in-lab dream collection was demonstrated with insomnia sufferers, as well as its positive effects on subjective sleep quality. Also, insomnia sufferers’ dreams were characterized by fewer positive emotions, subjectively and objectively, compared to good sleepers, and their dreams contained more negative elements than positive ones. Considering results from the investigations of this thesis, sleep parameters during napping, wake intrusions in REM sleep and dream activity seem to act as potential indicators of hyperarousal in insomnia. However, REM sleep macrostructure and few other variables of its microstructure (rapid eye movements and arousals) do not reflect this state of hyperarousal. Altogether, more studies are required to clarify the role of hyperarousal and its manifestations in chronic insomnia.
FEUILLET, JEAN. "Etude de la respiration nocturne chez l'enfant atteint de bronchopathie chronique obstructive au cours de la mucoviscidose". Lyon 1, 1988. http://www.theses.fr/1988LYO1M048.
Texto completoGiroux, Isabelle. "Les effets d'une thérapie par le rire sur le sommeil de personnes âgées souffrant d'insomnie psychophysiologique chronique". Sherbrooke : Université de Sherbrooke, 2000.
Buscar texto completoGiroux, Isabelle. "Les effets d'une thérapie par le rire sur le sommeil de personnes âgées souffrant d'insomnie psychophysiologique chronique". Mémoire, Université de Sherbrooke, 2000. http://savoirs.usherbrooke.ca/handle/11143/2255.
Texto completoDebellemanière, Eden. "Optimiser le sommeil lent profond par des méthodes innovantes et non-invasives : mise au point technique, applicabilité et conséquences chez le sujet sain en restriction chronique de sommeil". Thesis, Sorbonne Paris Cité, 2018. https://wo.app.u-paris.fr/cgi-bin/WebObjects/TheseWeb.woa/wa/show?t=2369&f=17185.
Texto completoNo abstract
Bosquillon, de Jenlis Aymar. "Effets d'une exposition chronique aux ondes radiofréquences sur le système immunitaire et le sommeil, modèle de rat juvénile". Thesis, Amiens, 2018. http://www.theses.fr/2018AMIE0012/document.
Texto completoWith the development of wireless technologies, electromagnetic fields became an important environmental constraint. However, some people attribute symptoms to electromagnetic fields exposure. The results of experimental studies remain controversial due to contradictory results. The aim of this work is to evaluate the effects of a co-exposure between electromagnetic fields and noise. The hypothesis is that co-exposure led to an exacerbation of the electromagnetic fields effects. This work focused on different physiological functions in a juvenile population: sleep, immune system, food intake, respiratory parameters and behavior. The results showed a higher anxious behavior, a decrease of locomotor parameters and an increase in the weight of the animals, associated with variations in the food intake pattern. Sleep is slightly altered in animals exposed to electromagnetic fields. The immune system of animals exposed to electromagnetic fields exhibits alterations in the adaptive immune system by a redistribution of lymphocyte subpopulations in favor of cell activation and humoral immunity, but without variation of the innate immune system. The alteration of immune system was observed during the co-exposure with a different way than noise exposure. This work was the first study to show a variation of immune parameters in juveniles chronically exposed to electromagnetic fields
Mauvieux, Benoit. "Effets d’un entrainement physique et sportif régulier, chronique ou temporaire, sur les rythmes biologiques du travailleur de nuit". Caen, 2004. http://www.theses.fr/2004CAEN2063.
Texto completoNaeck, Roomila. "Evaluation de l'adaptation à la ventilation non invasive chez des patients atteints d'insuffisance respiratoire chronique". Rouen, 2011. http://www.theses.fr/2011ROUES042.
Texto completoThe aim of this work is to study the impact that the noninvasive ventilation (NIV) has on the organism of a patient having chronic respiratory failure. To do so, two studies based on polysomnography (PSG) were carried out. 1) Retrospective study: synoptics were made which allowed us to have a global visualization of the events occuring during the night, by the simultaneous representation of the recording variables during the PSG. We were then able to quantify the connections between the various patient-ventilator asynchronisms and the non-intentional leaks. Four different patient-ventilator types of interactions could be highlighted. 2) Prospective study: how patients can adapt themselves to NIV. Three PSG were performed: one was made under spontaneous breathing (J1), one was made during the second night after NIV initiation (J2) and the third one was made 15 days later (J15). An individual analysis could then be carried out, based on the interpretation of the synoptics of each patient, and a global analysis was performed as well through a statistic approach. A Shannon entropy calculated on recurrence plot, was also used to estimate the quality of sleep. During the initiation of long-term noninvasive ventilation, ventilatory parameters (oxymetry and capnography) were improved, patients showed a progressive increase of the time spent in REM sleep and the sleep fragmentation was reduced thanks to a correction of obstructive sleep apneas. Under noninvasive ventilation, cardiac variability, estimated with a Shannon entropy based on a symbolic dynamic, was significantly reduced. Only a few effects of the asynchronisms on ventilation quality were noticed in this study
Béguin, Pauline Ribuot Christophe. "Caractère biphasique de l'hypoxie intermittente mécanismes cardioprotecteurs induits par une exposition aiguë et conséquences inflammatoires d'une exposition chronique /". [s.l.] : [s.n.], 2006. http://tel.archives-ouvertes.fr/docs/00/14/93/55/PDF/manuscrit.pdf.
Texto completoPerraudin, Clémence. "Analyse économique et évaluation des pratiques du pharmacien d'officine : Application au dépistage d'une maladie chronique : Le syndrome d'apnées du sommeil". Phd thesis, Université Paris Sud - Paris XI, 2013. http://tel.archives-ouvertes.fr/tel-01003945.
Texto completoFEUILLADE, PHILIPPE. "L'interet des etudes polygraphiques de sommeil dans la depression : etude des effets de l'administration aigue et chronique de la quinupramine, la trimipramine et la viloxazine sur le sommeil du sujet sain et du sujet deprime". Nice, 1990. http://www.theses.fr/1990NICE6010.
Texto completoALFANDARY, DIDIER. "Bipap ou cpap dans le traitement des patients porteurs d'un syndrome de recouvrement (sas + bpco) : resultats de 55 polysomnographies en air ambiant, cpap, cpap + 02, bipap ; controle chez 11 patients". Amiens, 1994. http://www.theses.fr/1994AMIEM052.
Texto completoTremblay, Valérie. "Facteurs spécifiques et non spécifiques prédisant l'effet de la thérapie cognitivo-comportementale de l'insomnie chronique comorbide au cancer du sein". Thesis, Université Laval, 2008. http://www.theses.ulaval.ca/2008/25628/25628.pdf.
Texto completoHarvey, Marie-Philippe. "Améliorer la douleur et le sommeil chez les aînés souffrant de douleur chronique à l’aide de la stimulation transcrânienne par courant direct (tDCS)". Mémoire, Université de Sherbrooke, 2016. http://hdl.handle.net/11143/9529.
Texto completoAbstract : Introduction: Chronic pain and sleep problems have a significant impact on quality of life. The prevalence of these two conditions increases substantially with age. The objective of this study was to assess the feasibility of conducting a randomized sham-controlled trial and to collect preliminary data on the efficacy of transcranial direct current stimulation (tDCS) for reducing pain and improving sleep in older adults suffering from chronic musculoskeletal pain. Methods: Fourteen patients with chronic pain and sleep problems were randomized to receive five consecutive daily sessions of anodal tDCS applied to the primary motor cortex (2 mA, 20 minutes) or five sessions of sham tDCS. Pain intensity was measured with a visual analogue scale, and sleep parameters with actigraphy. Throughout the study, pain and sleep logbook were also used to measure the effect of tDCS on daily pain and sleep. Results: Our results indicate that the real tDCS causes greater pain relief than sham tDCS (59 % vs -19 %; p <0.05). By cons, no change was observed in sleep parameters (all p ≥ 0.18). Conclusion: Five sessions of anodal tDCS applied to the motor cortex seem to be effective to reduce pain in elderly individuals suffering of chronic pain, but not to improve their sleep. Future studies are needed to determine whether other stimulation parameters could have an impact on sleep and whether these results can be replicated using a larger number of patients.
Mentek, Marielle. "Impact de l'hypoxie intermittente chronique sur la rétine et le nerf optique du rat : aspects vasculaire et inflammatoire". Thesis, Université Grenoble Alpes (ComUE), 2015. http://www.theses.fr/2015GREAS032/document.
Texto completoObstructive sleep apnea (OSA) has recently been associated with the occurrence of optic neuropathies, especially acute non-arteritic anterior ischemic optic neuropathy (NAION). Among the mechanisms of NAION onset potentially associated with OSA, vascular dysregulation and inflammation may play a role. There is still no data on the effect of chronic intermittent hypoxia (IH) on vascular function of the eye. The purpose of this work was to develop techniques for assessing rat ocular vascular function and apply them to the study of the ocular vascular consequences of IH. Thus, two complementary models have been developed: 1) a laser Doppler flowmeter (LDF) prototype adapted for rodents, to evaluate in vivo retinal and optic nerve head (ONH) blood perfusion and 2) in vitro model of rat ophthalmic artery (OA) study by myography. Preliminary work on healthy rat enabled us to validate the relevance of retinal arteries LDF signal, but not that of the ONH. Retinal blood velocity (VelART) dropped by 17.0 ± 13.7% in response to pure oxygen inhalation. We did not observe any significant change in VelART signal after intracarotidian endothelin 1 (ET -1) injection, despite strong vasoconstriction of retinal vessels. OA reactivity study by myography in rats exposed to a 14-day IH showed increased contraction to ET-1, associated with an increased endothelin receptor A-mediated (ETRA) response and ETRA overexpression within the AO. NO-dependent relaxation is reduced in IH rats, and associated with a shift towards vasoconstrictive effects of cytochrome P450 products. These responses were associated with an increase in superoxide anions in the OA wall. Further studies are needed to explore the underlying mechanisms of these vascular changes, particularly the role of oxidative stress. Understanding of the LDF signal is partial and should be further explored to permit application to the study of IH rat
Rusnac, Natalia. "Comparaison sociale dans le contexte du risque chez des participants sains et en privation chronique de sommeil : impact sur l'auto-évaluation, les affects et le comportement". Thesis, Strasbourg, 2015. http://www.theses.fr/2015STRAG044/document.
Texto completoThe main goal of this PhD research was to study the consequences of social comparison on implicit and explicit self-evaluation in terms of cautiousness, on affect and on risk-taking behavior. In a series of studies, participants were exposed to a comparison standard who displayed either cautious (high standard) or reckless (low standard) drinking behavior. Results show that participants confronted with the high standard implicitly perceive themselves as more reckless and experience higher levels of anxiety than participants exposed to the low standard. On the other hand, the comparison standard does not influence explicit self-evaluation and controlled behaviors. These results indicate that there might be a dissociation between automatic (implicit) and controlled (explicit) processes involved in social comparison. On an applied level, regarding alcohol prevention campaigns, our findings suggest that it could be more effective to show a cautious standard rather than a reckless one
Béguin, Pauline. "Caractère biphasique de l'hypoxie intermittente : mécanismes cardioprotecteurs induits par une exposition aiguë et conséquences inflammatoires d'une exposition chronique". Phd thesis, Université Claude Bernard - Lyon I, 2006. http://tel.archives-ouvertes.fr/tel-00149355.
Texto completoLe but de ce travail est de caractériser d'une part, les effets sur la fonction cardiaque d'une exposition aiguë chez le rat, et d'autre part, les conséquences inflammatoires, marqueurs précoces de l'athérogenèse, d'une exposition chronique chez la souris.
24 h après une exposition aiguë à l'HI (4 h à 10% d'O2) une récupération fonctionnelle post-ischémique et une réduction de la nécrose cellulaire sont observées suite à une séquence d'ischémie-reperfusion dans un modèle de cœur isolé. Ces évènements reflètent un phénomène de protection myocardique retardée, encore appelé préconditionnement (PC) myocardique. Ce PC induit par l'HI, semble impliquer divers acteurs, la p38 MAP kinase et Erk1/2 comme initiateurs, la PKC, la iNOS et les canaux KATP mitochondriaux comme médiateurs. La compréhension du rôle de chacun de ces acteurs permettrait d'utiliser ces cibles potentielles afin de prévenir les maladies cardiovasculaires.
L'exposition chronique à l'HI (5, 14 et 35 jours à 5% d'O2), induit une augmentation de la prolifération cellulaire, des taux de chimiokines inflammatoires ainsi que du phénomène de «rolling» leucocytaire. L'analyse approfondie de ce phénotype inflammatoire chez l'animal, permettrait de comprendre dans une perspective thérapeutique, l'athérogenèse développée par les patients porteurs de SAOS.
Lefebvre, Blandine. "Syndrome d'apnées du sommeil et morbidité cardiovasculaire : étude des conséquences vasculaires d'une exposition chronique à l'hypoxie intermittente chez le rat et étude de la production de leucotriènes chez les patients apnéiques". Grenoble 1, 2008. http://www.theses.fr/2008GRE10055.
Texto completo'Obstructive sleep apnea (OSA) is associated with cardiovascular morbidity and mortality. Reccurent decrease of 02 partiel pressure seems to play a role in vascular alterations and inflammatory state observed in OSA. The development of animal models of OSA, as chronic intermittent hypoxia (CIH) exposure, allowed to isolate one feature of OSA and to study its consequences. Ln addition, leukotrienes (LTs) which are metabolites of 5-lipoxygenase pathway display vascular properties and are involved in atherosclerosis. Theses studies were performed to characterise cardiovascular effects of CIH in rat and to determine if L Ts production was increased in OSA. We observed an early vascular remodelling in rat after 14 or 35 days of CIH exposure that was compatible with adaptative mechanisms in response to the increase of parietal stress. These results could explain the absence ofhemodynamic and vascular reactivity changes. However, response to endothelin-l was increased in hypoxic rats. These result suggested that endothelin-l system was activated in CIH. Last, our results suggested a sensitisation effect of intermittent hpoxia on hypertension development in rat genetically predisposed to arterial hypertension. Further studies on longer exposure are required. LTs production was increased in OSA and was correlated with hypoxic severity. Moreover, L Ts production was correlated with subclinical atherosclerosis markers. These results suggested that L Ts may act in early vascular remodelling process in OSA. Experimental studies should be performed in order to determine whether 5-LO actors are surexpressed in CIH mode\
Perriot, Bruno. "Analyse de l’activité physique, de la position corporelle et de la qualité de sommeil chez les patients atteints de maladies chroniques : Traitement des signaux, fusion de données et stratégie de prise en charge". Thesis, Lyon, INSA, 2015. http://www.theses.fr/2015ISAL0069.
Texto completoChronic diseases affecting the respiratory system require a long-term monitoring. Physical activity and cardiovascular parameters are essential in those pathologies. We focused on two of those diseases : COPD and obstructive sleep apnea. COPD is characterized by a downward cycle of inactivity : a respiratory impairment leads to a reduction of activity, whose in turn worsen the respiratory impairment by a conditioning loss. As a consequence, activity monitoring and SpO2 are essential for the monitoring of this pathology. Nocturnal oxygen desaturation are a main feature of sleep apnea. An actimeter allows for sleep quality evaluation, and is a logical choice for a complementary measure of this disease. Moreover, diurnal activity is an indicator of the degree of physical weakness that can occur as a consequence of sleep apnea. The main goal of the work has been the developement of a connected actimeter, able to monitor diurnal activity, estimate the duration of sleep and collect data from a pulse oximeter to synchronise the data. From 26 days of accelerometric measures, we designed and validated an algorithm that compute the time spend sitting, standing and lying. This algorithm has been designed to be embedded in a microcontroler with limited computing power. We also proposed a step detection algorithm validated on 5 hours of walking, on 22 different patients, against a visual count. Finally, we designed a method to detect the sitting-standing change of posture to monitor the 3-minutes chair stand test. On the nocturnal aspect, we designed an algorithm used to estimate the sleep duration during a night. It as been tested on 25 nights. We also proposed a pulse wave analysis method to extract the LF/HF ratio of cardiac variability, to detect REM sleep. We showed the result of the aggregation of the different parameters collected by the system composed of the actimeter and the oximeter during a monitored night, as a tool to the healthcare professional. The actimeter design in the context of this work and the associated signal processing methods are appropriate to the monitoring of respiratory pathologies with a light equipment. They also can be integrated into a telemedecine system through a gateway computer, allowing for a long-term monitoring
Beaulieu-Bonneau, Simon. "Somnolence, fatigue et fonctionnement attentionnel suite à un traumatisme craniocérébral". Thesis, Université Laval, 2012. http://www.theses.ulaval.ca/2012/29276/29276.pdf.
Texto completoThis doctoral dissertation focused on sleepiness, fatigue, sleep, and attention in the long term following traumatic brain injury (TBI). The study aimed to document the presence and severity of sleepiness, fatigue and sleep problems. Another objective was to assess the attentional aspects of speed of information processing, selective attention, and sustained attention. The dissertation was also intended to explore the relationships between sleepiness, fatigue, and sleep, on one hand, and attentional functioning, on the other hand. Twenty-two adults who had sustained a moderate to severe TBI between 1 and 11 years prior to their enrolment in the study were compared to 22 control participants matched on age, sex, and education. The main outcome measures included nighttime and daytime polysomnographic recordings, three neuropsychological tests of attention, a driving simulator task, and subjective measures of sleepiness, fatigue, and sleep. Results of the first empirical paper indicated a significantly higher level of fatigue in TBI participants compared to controls, whereas groups did not differ on objective or subjective sleepiness measures. The impact of sleepiness on general productivity, the time spent in bed at night, and the frequency and duration of daytime napping were greater in the TBI group. Results of the second empirical paper revealed a poorer performance in TBI compared to control individuals on measures tapping speed of information processing and sustained attention derived from the neuropsychological tests and the driving simulator task, while groups did not differ on selective attention. Significant correlations were observed between poorer attentional performance and poorer sleep continuity or higher levels of sleepiness, mainly in the TBI group. No relationship was found between cognitive performance and subjective fatigue. This dissertation suggests that fatigue is a more prominent symptom than sleepiness when assessed several years after TBI. The use of compensatory strategies such as increasing sleep opportunities appears to be a common practice. Results add to the existing evidence that speed of information processing is still impaired several years after TBI and indicate that sustained attention may also be compromised. Attention seems to be associated with sleep continuity and daytime sleepiness, suggesting that patients, clinicians, and researchers alike should take notice of this interaction.
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Clavel, Louis. "Analyse et modélisation de l'interaction posturo-ventilatoire en physiologie et application en pathologie respiratoire chronique Compensation of Respiratory-Related Postural Perturbation Is Achieved by Maintenance of Head-to-Pelvis Alignment in Healthy Humans Breathing through a spirometer perturbs balance". Thesis, Sorbonne université, 2019. http://www.theses.fr/2019SORUS061.
Texto completoIn physiology, postural and ventilatory functions are tightly linked. Some clinical postural dysfunctions have been described in chronic respiratory pathologies. These postural dysfunctions could stem from a degradation of posturo-ventilatory interaction, but their physiopathological mechanisms are still unclear. The main objective of the thesis project was to describe and model this coupling between postural and ventilatory functions, in healthy subjects and in patient with OSAS (obstructive sleep apnea syndrome). It is divided in two parts, both applied to the study of a population of 50 healthy subjects and 14 OSAS patients. First, the dynamic interaction between postural and ventilatory functions is analyzed, and its modifications of the kinematic chain responsible for balance, along various ventilatory conditions as well. Using a motion capture system, a kinematic analysis was performed, synchronized to a non-disruptive ventilatory assessment to study postural and ventilatory signals separately, before focusing on the posturo-ventilatory interaction. Then a structural analysis of the lung volume influences on the postural alignment and the rib cage has been studied. A 3D skeletal subject specific reconstruction was performed based on biplanar radiographies in standing position at different lung volumes, in order to model the structural modifications on the spine-pelvis complex and the rib cage deformations as a function of the lung volume
Jullian-Desayes, Ingrid. "Biomarqueurs du risque cardio-métabolique dans les pathologies respiratoires chroniques : impact de la prise en charge". Thesis, Université Grenoble Alpes (ComUE), 2017. http://www.theses.fr/2017GREAV020/document.
Texto completoObstructive sleep apnea (OSA) is associated with related metabolic and cardiovascular comorbidities. Chronic intermittent hypoxia the hallmark of OSA induces deleterious intermediary mechanisms such as oxidative stress, systemic inflammation, insulin resistance and dyslipidemia. Cardiovascular and metabolic comorbidities are also key features of other chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD) and obesity hypoventilation syndrome (OHS). Chronic hypoxia and deleterious intermediary mechanisms also trigger occurrence and progression of non alcoholic fatty liver disease. This link between chronic respiratory diseases and liver injury is observed through modifications of specific liver biomarkers in OSA and COPD. A variety of cardiometabolic biomarkers have been studied for stratification of cardio-metabolic risk and assessing treatment impact in chronic respiratory diseases. The first part of this PhD thesis is a systematic review of cardio-metabolic biomarkers in 3 respiratory diseases: OSA, COPD and OHS.Continuous positive airway pressure (CPAP) the first line therapy for OSA improves symptoms and quality of life. However, CPAP effects on cardio-metabolic consequences remains still debated. In the second part of the PhD thesis, we will address CPAP impact on different cardiometabolic biomarkers and more specifically in markers of liver injury by reporting original results of a randomized controlled trial (RCT).Polypharmacy is usual in patients with OSA, COPD or OHS. Beyond CPAP or non invasive ventilation treatment, it is essential address the contribution of associated medications. Indeed, pharmacological treatments can interfere with the severity of the disease and control of associated comorbidities. The third part of the thesis will present a RCT evaluating Bosentan in hypertensive OSA patients and will present how medications for comorbidities decrease bicarbonate diagnosis value for OHS.We will conclude by underlining the crucial importance of personalized medicine and integrated care in chronic respiratory diseases
El, Dirani Zeinab. "Effet de l’hypoxie intermittente et de l’entraînement physique intensif sur la structure et la fonction du tissu musculaire chez le rat". Thesis, Université Grenoble Alpes (ComUE), 2018. http://www.theses.fr/2018GREAV067/document.
Texto completoObstructive sleep apnea syndrome (OSAS) is a chronic disease characterized by repeated interruptions of breathing during sleep due to the temporary closure of the upper airway. Its prevalence increases with the increasing in prevalence of obesity, especially in developed countries.Chronic intermittent hypoxia (IH) resulting from this transient closure of the upper airway is one of the major consequences of OSAS and is responsible of most of the complications related to this pathology, including hypertension, myocardial infarction, atherosclerosis and more generally cardiovascular remodeling.On the other hand, intensive physical training(IT) is well known to have benefits on cardiovascular system, thus we hypothesize that physical training can reverse the deleterious effects of IH on reactivity and vascular remodeling as well as intracellular calcium signaling in muscle cells.To answer this question, we chose the rat as an animal model to study the potential effect of IT in the prevention and reversal of deleterious (IH) effects in terms of reactivity and calcium signaling in muscle tissue.Rats were exposed for 21 days to intermittent hypoxia and housed in cages specially equipped to maintain an airflow alternating between 21% and 5% PO2 in cages containing hypoxic rats and 21% PO2 in cages containing the control rats. During the last two weeks of exposure to IH, a group of hypoxic rats and one of the normoxic rats underwent IT sessions on a treadmill at a speed of 16m / min to 30m / min.Physiological parameters were measured (blood pressure, heart rate, hematocrit), the aorta was removed to study the vascular reactivity, then vascular smooth muscle cells were removed and cultured to study calcium signaling by EPIfluorescence microscopy. Finally, the genes coding for the key mediators of the calcium signaling: RyR1, RyR2 RyR3, (ryanodine receptors), TRPV4 (transient receptor potential channel), SERCA1, SERCA2 (Sarco / Endoplasmic Reticulum Ca2 + -ATPase) and IP3R1 , 5-Trisphosphate Receptor) in various vascular and skeletal tissues were studied at the molecular level as mRNA by Q-PCR or as protein by Western Blot.Our results show that IH induces a significant increase in blood pressure and hematocrit and a decrease in acetylcholine-induced aortic relaxation pre-contracted with phenylnephrine. This was consistent with our observation that HI increases the level of intracellular calcium in cultured aortic smooth muscle. On the other hand, IT induced a significant decrease in hematocrit and aortic vasoconstriction induced by phenylnephrine and endothelial-1, consistant with the observation that IT reduces the IH-N difference in the calcium response. On the molecular scale, IH induces a significant increase in the expression of RyR1, RyR2, RyR3, SERCA1, SERCA2, TRPV4 and IP3R1 at the mRNA level in the tissues of all groups with a greater amount of RyR1,RyR2,& RyR3 higher in IH tissue of smooth muscles (mainly in the thoracic and abdominal aorta) and SERCA1 (9-fold higher in IH tissues) and SERCA2 (10-fold higher in IH tissues) in the skeletal muscles (Gastrocnemius, plantaris and soléus). In addition, IH induces a significant increase in RYR1, RYR2 and TRPV4 at the protein level in the thoracic and abdominal aorta; And IT reduces the difference in expression between animals N and IH.Our results suggest that IT is a promising, non-pharmacological or complementary treatment for limiting cardiovascular complications induced by IH and muscle remodeling in patients with OSAS
Minovés-Kotski, Mélanie. "Effets délétères de l’hypoxie intermittente associée au syndrome d’apnées obstructives du sommeil sur la croissance et la dissémination métastatique du cancer du sein : implication de la voie HIF1/VEGF/Endothéline". Thesis, Université Grenoble Alpes, 2021. https://thares.univ-grenoble-alpes.fr/2021GRALV001.pdf.
Texto completoObstructive Sleep Apnea Syndrome (OSA) is a prevalent disease characterised by the occurrence of repeated nocturnal episodes of apnea leading to recurrent cycles of hypoxia-reoxygenation called intermittent hypoxia (IH). Intermittent hypoxia is a chronic and systemic stimulus which is considered as the main factor responsible for the deleterious cardiovascular and metabolic effects induced by OSA. Recent clinicalstudies have showed OSA is associated with excess mortality due to cancer and preclinical studies have confirmed that OSA promote tumour development. In animals, exposure to intermittent hypoxia has been shown to promote primary and metastatic tumour growth, particularly in murin models of melanoma. To date, no study has evaluated the impact of intermittent hypoxia on growth and metastatic power of breast cancer in apreclinical study.The main objective of this thesis was to explore the impact of intermittent hypoxia on the development of breast cancer and to understand how the imbalance induced by intermittent hypoxia at the macro-environmental scale contributes to tumour development. Involvement of the endothelin pathway was evaluated by an ET-1 receptor antagonist.The experimental protocol was carried out on preclinical models combining a mouse model of orthotopic mammary tumour and two additional cell culture models. This mixed approach has been carried out thanks to the development of an in vitro device for cellular exposure to intermittent hypoxia.This cross-sectional work has shown that intermittent hypoxia induced by OSA leads to accelerated tumour growth and favours tumour dissemination in exposed animals and that this phenomenon involved the endothelin 1 pathway.Keywords: OSA, intermittent hypoxia, breast cancer, endothelin 1, macitentan, macroenvironment, preclinical studies
Yang, Tianxiang. "Influence of chronic intermittent hypoxia (CIH) in retinal neovascularization and vascular remodeling". Electronic Thesis or Diss., Sorbonne université, 2024. https://accesdistant.sorbonne-universite.fr/login?url=https://theses-intra.sorbonne-universite.fr/2024SORUS059.pdf.
Texto completoNeovascular retinopathies and edema are sight threatening complications of ischemic retinopathies, such as retinopathy of prematurity (ROP) and diabetic retinopathy (DR). Sleep apnea that leads to chronic intermittent hypoxia (CIH) is an independent risk factor for severe disease, but the underlying mechanisms are unknown. Here we show that experimental CIH during the ischemic phase of oxygen induced retinopathy in mice severely reduces beneficial revascularization of the ischemic retina, and increases neuronal loss and pathological neovascularization. Mechanistically we demonstrate that CIH reduces both colony stimulating factor 1 (CSF-1) expression and the ischemia-induced increase of retinal microglial cells that promotes the revascularization of the ischemic retina in the absence of CIH. Local CSF1R inhibition during ischemic retinopathy reduced the number of microglial cells, inhibited revascularization, and exacerbated pathological neovascularization, recapitulating several effects of CIH. Our findings provide a novel mechanism by which sleep apnea and CIH aggravate ischemic retinopathies, underscoring the importance of treating apnea in ROP and DR to help prevent sight threatening severe disease
Laniepce, Alice. "Modifications du sommeil associées à la consommation chronique et excessive d'alcool : liens avec les altérations cérébrales structurales et les troubles cognitifs Neuropsychological and neuroimaging examinations of self‐reported sleep quality in alcohol use disorder with and without Korsakoff's syndrome Sleep architecture and episodic memory performance in alcohol use disorder with and without Korsakoff syndrome The effect of alcohol withdrawal severity on sleep, brain and cognition Dissociating thalamic alterations in alcohol use disorder defines specificity of Korsakoff's syndrome Cerebellar hypermetabolism in alcohol use disorder: compensatory mechanism or maladaptive plasticity ? Alcohol use disorder : permanent and transient effects on the brain and neuropsychological functions Effects of sleep and age on prospective memory consolidation Troubles cognitifs dans l'alcoolodépendance Repérage des troubles cognitifs liés à l’alcool". Thesis, Normandie, 2019. http://www.theses.fr/2019NORMC039.
Texto completoWell before the development of severe alcohol-related neurological complications such as Korsakoff’s syndrome (KS), patients with Alcohol Use Disorder (AUD) exhibit variable brain damage and cognitive deficits, as well as sleep disturbances. Although it is well established that sleep contributes to brain and cognitive functioning, its involvement in brain damage and cognitive deficits in AUD remains poorly understood. The objective of this thesis was to investigate subjective and objective sleep quality in AUD and KS patients, and its relationships with brain structure and function. Our results show that sleep complaint must be interpreted with regard to the severity of brain alterations and cognitive impairments in AUD and KS patients. Moreover, we showed a high prevalence of sleep apnea in these patients. REM sleep abnormalities are specifically observed in KS patients and related to the severity of memory deficits. Regarding AUD patients, we highlight the contribution of the severity of withdrawal syndrome in slow wave sleep decrease, and its effects on brain and cognitive functioning. Hence, similarities and differences of sleep architecture have been found in the two clinical forms (AUD and KS). These sleep modifications could depend on the severity of alcohol withdrawal and be involved in the pathophysiology of alcohol-related structural brain damage and cognitive impairment. These results encourage evaluating and managing both alcohol withdrawal and sleep modifications to improve patients’ prognosis at discharge from Addiction department
Morand, Jessica. "Dysfonction cardiovasculaire et arythmies ventriculaires de l’ischémie-reperfusion : effets délétères de l’hypoxie intermittente et protecteurs de la supplémentation en zinc". Thesis, Université Grenoble Alpes (ComUE), 2017. http://www.theses.fr/2017GREAV015/document.
Texto completoObstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality. Intermittent hypoxia (IH), one of the major consequences of apneas, leads to oxidative stress, activation of HIF-1 (hypoxia inducible factor 1) and endothelin (ET-1) expression, all known to play an important role in the cardiovascular consequences of OSA.First, we have demonstrated that IH increases the incidence of ischemia-related lethal ventricular arrhythmias. Among the potential mechanisms involved, spectral analysis of heart rate and blood pressure variability and catecholamine assay, showed a sympathetic activation in animals exposed to IH. IH was also responsible for alterations in ventricular repolarisation (increased QTc and Tpeak-Tend intervals) and dispersion of the transmural gradient (increased endocardial action potential duration). These alterations were associated with increased expression of endocardial LTCC and TRPC calcium channels.The second part of the thesis aimed at investigating zinc homeostasis in response to the oxidative stress induced by ischemia-reperfusion (IR) or IH as well as the beneficial effects of zinc supplementation in this context. We observed that IR and IH induced a decrease in myocardial and plasma zinc concentrations, respectively. We also highlighted the protective effects of zinc supplementation during reperfusion against the ventricular arrhythmias and myocardial dysfunction induced by IR. Zinc administration during reperfusion also abolished the increase in infarct size induced by chronic IH exposure.Finally, we investigated the effects of zinc depletion in endothelial cells exposed to TPEN, a specific zinc chelator. We observed that TPEN induced a nuclear translocation of HIF-1α and an increase in ET-1 secretion with a resulting increase in endothelial cell migration. Thus, zinc depletion appears to promote activation of the HIF-1-ET-1 axis, known for its deleterious effects upon IH.In summary, chronic IH exposure enhances ventricular arrhythmias and increases infarct size upon myocardial I/R. Sympathetic activation, oxidative stress and alterations of zinc homeostasis appear to be contributing factors. Pharmacological targeting of these alterations should be performed in order to confirm their role as well as to potentially prevent the deleterious cardiovascular consequences of IH and OSA
Fradette, Lorraine. "Étude de la sensibilité baroréceptive en sommeil et à l’éveil dans l’insomnie primaire chronique". Thèse, 2008. http://hdl.handle.net/1866/3147.
Texto completoInsomnia, one of the most common sleep complaint in the general population, is characterised firstly by a difficulty initiating or maintaining sleep and/or early awakenings or non-restorative sleep. Insomnia is defined as primary when not principally due to another medical or psychiatric condition or other sleep disorder, whereas a minimum of 6 months duration is required to define chronic insomnia. Some authors have hypothesized that insomnia is associated with a state of hyperarousal characterized by increased sympathetic activity during sleep and wakefulness. The arterial baroreflex is an important mechanism providing continuous short term regulation of heart rate and blood pressure (BP) by means of the autonomic nervous system influences over the pacemaker and the peripheral circulation. Baroreflex sensitivity (BRS) is the baroreflex’s capacity to react and control BP changes by adjusting the heart rate. BRS is known to be heightened during the night compared to daytime. Also, it seems that the baroreflex could be involved in the physiological day-to-night BP fall. Previous data from our laboratory demonstrated in subjects with chronic primary insomnia, higher night-time systolic BP and a significant attenuation of the physiologic day-to-night systolic BP fall compared to good sleepers. Besides, the baroreflex has been shown to be altered early in several cardiovascular diseases and to precede hypertension. Subjects with insomnia have been shown to have a higher likelihood to develop daytime hypertension. All of these findings point in the direction of altered BP regulatory mechanisms in insomnia. Furthermore, a reduction of BRS could be implicated in states where higher sympathetic autonomic activity is observed. We hypothesised that the baroreflex could be one of the BP control mechanisms which are altered in insomnia and could be involved in the heightened sympathetic activity observed in insomnia. To our knowledge, the baroreflex has never been investigated previously in insomnia. The primary goal of this study was to investigate non-invasively BRS during wakefulness and sleep in 11 subjects with chronic primary insomnia compared to 11 good sleepers. Baroreflex was investigated spontaneously by the sequence method and by the calculation of the alpha coefficient obtained by cross spectral analysis of RR interval and systolic BP. Simultaneously, RR interval variability components were also compared during wakefulness and sleep between the two groups. No significant differences were found for indices of BRS between insomniacs and good sleepers during wakefulness and sleep. However, slightly lower values of BRS during wakefulness and sleep were noted in insomniacs with poor sleep (sleep efficiency (SE) <85%) versus those with good sleep (SE≥ 85%) at the experimental night. As a secondary finding, no differences were found between the insomniacs and the good sleepers for any of the RR variability components considered (RR interval, PNN50, LF and HF in their normalized units). Indeed, insomniacs like good sleepers exhibited normal variation of autonomic activity during sleep as depicted by the RR variability components. Our preliminary results suggest that baroreflex mechanisms are preserved in subjects with a subjective complaint of chronic primary insomnia. Nevertheless, certain impairment may occur in insomniacs as a function of objective measures of poor sleep.
El-Khatib, Héjar. "Troubles du sommeil et de l’éveil dans la phase chronique d’un traumatisme craniocérébral modéré-sévère". Thesis, 2020. http://hdl.handle.net/1866/24816.
Texto completoModerate to severe traumatic brain injury (TBI) is a major cause of disability in young adults. It causes physiological, behavioral, cognitive and emotional sequelae that hinder functional and psychosocial outcomes. Disturbances in sleep quality and wakefulness are among the most common and persistent complaints in moderate to severe TBI survivors. However it is unclear if these complaints are associated with impaired sleep integrity. This question is crucial as sleep is central in wakefulness-promoting and optimal cognitive functioning, which is particularly essential when the brain is injured. This thesis aims to characterize the nature and correlates of sleep and wakefulness disturbances during the chronic phase of moderate to severe TBI. The association between post-TBI learning capacity and slow-wave activity, a sleep characteristic known to play a role in synaptic plasticity and memory, is also explored. To do this, objective (actigraphy, polysomnography) and subjective (sleep diary and questionnaires) sleep-wake measures were used in moderate to severe TBI survivors and healthy control subjects. The severity of the trauma, the presence of comorbidities (anxiety, depression, pain) and the use of psychotropic medications have also been documented. The first study showed that compared to controls, people with moderate to severe TBI reported significantly lower sleep quality, and higher levels of daytime sleepiness and fatigue. Yet, a seven-day actigraphy recording did not show any disturbances in the nighttime sleep efficiency. Rather, sleep duration over a 24h period was significantly increased in participants with TBI compared to controls, particularly in a subgroup of TBI who used psychotropic medications and suffered a more severe overall trauma. The presence of comorbidities was also associated with sleep-wake complaints in TBI group. In the second study, the sleep architecture as measured by polysomnography was evaluated. Again, the results indicated that despite significant sleep-wake complaints in TBI group, the macro- and micro-architecture of sleep measured in the TBI group were similar to those in the control group. However, an association between sleep quality and post-TBI cognition was shown, as higher slow-wave-activity sleep was associated with better memory performance the day after. This association was stronger following more severe TBI compared to milder TBI, suggesting that adults who sustained more severe TBI are more dependent on sleep slow-wave-activity for next- day memory function. iii This thesis brings new evidence that the injured brain following moderate to severe TBI appears to be able to produce sleep architecture comparable to healthy control subjects. Persistent sleep- wake complaints following moderate-to-severe TBI appear to be influenced by other factors, including the occurrence of more complex trauma requiring pharmacological management, as well as environmental and comorbid factors. In addition, this thesis supports the need to further explore the role of sleep in post-TBI cognitive abilities.
Beetz, Gabrielle. "Importance du sommeil chez des patients orthopédiques avec fracture, une revue de la littérature". Thesis, 2020. http://hdl.handle.net/1866/25182.
Texto completoSleep disturbances are highly relevant in the orthopedic field, as they can increase the risks of falls, decrease bone density, and lead to poor fracture and health outcomes in patients with fractures. It is estimated that between 20% to 40% of patients presenting one fracture will report difficulty to sleep 3 months following trauma. However, the impact of sleep in the acute phase following fracture is less studied. Therefore, this present thesis aimed to propose a clinical research project evaluating the impact of sleep on the recuperation of patients in the acute phase following fracture. To this end, we will use an actigraphy watch over a 14-day period following fracture to collect various sleep parameters, in combination with questionnaires on sleep quality, pain intensity and function of the fractured limb. A longitudinal follow-up (>3 months) will allow evaluating if sleep difficulties persist over time, using aforementioned questionnaires. The second part of this thesis presents a detailed narrative review of the literature describing the impact of sleep disturbances on falls, motor vehicle accidents and fractures in addition to their impact on fracture outcomes and the underlying physiopathological mechanisms. We observed that not only optimal sleep quality is essential in prevention of motor vehicule accident, but is also a key element to recovery after an orthopedic trauma. Futur research will allow a better understanding of sleep and bone relation.
El, Gewely Maryam. "Genetic risk factors of chronic insomnia disorder". Thèse, 2018. http://hdl.handle.net/1866/22309.
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