When an episode of emotional significance is encountered, it often results in the formation of a highly resistant memory representation that is easily retrieved for many succeeding years. Recent research shows that beyond generic consolidation processes, rapid eye movement (REM) sleep importantly contributes to this effect. However, the boundary conditions of consolidation processes during REM sleep, specifically whether these extend to source memory, have not been examined extensively. The current study tested the effects of putative consolidation processes emerging during REM sleep and slow wave sleep (SWS) on item and source memory of negative and neutral images, respectively. Results demonstrate superior emotional relative to neutral item memory retention after both late night REM sleep and early night SWS. Emotional source memory, on the other hand, exhibited an attenuated decline following late night REM sleep, whereas neutral source memory was selectively preserved across early night SWS. This pattern of results suggests a selective preservation of emotional source memory during REM sleep that is functionally dissociable from SWS-dependent reprocessing of neutral source memory. This was further substantiated by a neurophysiological dissociation: Postsleep emotional source memory was selectively correlated with frontal theta lateralization (REM sleep), whereas postsleep neutral item memory was correlated with SWS spindle power. As such, the present results contribute to a more comprehensive characterization of sleep-related consolidation mechanisms underlying emotional and neutral memory retention. Subsidiary analysis of emotional reactivity to previously encoded material revealed an enhancing rather than attenuating effect of late night REM sleep on emotional responses.
Interactions between sleep and skin diseases are considered clinically relevant. Quality of sleep can positively or negatively influence the course of skin diseases. However, the impact of the interaction between dermatological diseases and sleep disturbance, especially with regard to chronicity, remains to be elucidated. The aim of this pilot study was to identify possible interactions between sleep disturbance and skin diseases, which may be an underestimated aetiopathological aspect. This study examined the relationship between insomnia and the frequent itching skin diseases, atopic dermatitis and chronic urticaria. Patients with chronic inflammatory dermatological diseases with pruritus were evaluated for insomnia (Insomnia Severity Index; ISI) and impairment in dermatological quality of life (Dermatology Life Quality Index; DLQI). Disease activity was measured using validated scores. A total of 61 patients participated in the study. Patients with atopic dermatitis had a mean ISI score of 8.7 before flares and 16 when a flare occurred. The mean DLQI score in atopic dermatitis was 11.4. The mean ISI score in patients with chronic urticaria was 6.8 before flares and 14.9 when a flare occurred. In patients with chronic urticaria the mean DLQI score was 8.5. An increase in insomnia during a disease flare was demonstrated in both groups. Thus, sleep is a factor to consider during treatment of itching skin diseases. The results of this pilot study indicate that pruritus may not be the only reason for insomnia in patients with atopic dermatitis or chronic urticaria.
These findings provide support for the utility of DSM-III-R sleep disorder diagnoses and for their retention in DSM-IV. These findings also accord well with a recent literature review of the DSM-III-R diagnosis of primary insomnia by the DSM-IV Work Group on Sleep Disorders. The good concordance between interview diagnoses and polysomnographic data suggests that a structured interview such as the SIS-D may be a useful screening instrument. The authors discuss the implications of these findings for the polysomnographic evaluation of chronic insomnia.
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Actigraphy has been used for more than 60 years to objectively measure sleep–wake rhythms. Improved modern devices are increasingly employed to diagnose sleep medicine disorders in the clinical setting. Although less accurate than polysomnography, the chief advantage of actigraphs lies in the cost-effective collection of objective data over prolonged periods of time under everyday conditions. Since the cost of wrist actigraphy is not currently reimbursed, this method has not enjoyed wide acceptance to date. The present article provides an overview of the main clinical applications of actigraphy, including the recommendations of specialist societies.
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