Impairment of the Production of Delta Sleep in Anorectic Adolescents

Nobili, Lino; Baglietto, M. G.; Beelke, Manolo; Carli, Fabrizio De; Comite, R. Di; Fiocchi, Isabella; Rizzo, Pierpaolo; Veneselli, Edvige; Savoini, M.; Zanotto, E.; Ferrillo, Franco

doi:10.1093/sleep/27.8.1553

Cited by 27 publications

(23 citation statements)

References 21 publications

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“…Leptin has been postulated to play a role in cognition 113 and could accordingly also have implications for AN patients, among whom cognitive functions are particularly reduced in severely emaciated patients. AN patients show an increase of wakefulness after sleep onset, a higher number of arousals and a reduction of slow-wave sleep and slow-wave activity; 114 in ob/ob mice sleep regulation is altered. 115 Exogeneous application of leptin to leptin-deficient human adults was shown to have sustained effects on tissue composition in the human brain.…”

Section: Molecular Psychiatrymentioning

confidence: 98%

The role of leptin in anorexia nervosa: clinical implications

et al. 2006

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Leptin is a hormone with pleiotropic functions affecting several tissues. Because leptin has a crucial role in the adaptation of an organism to semi-starvation, anorexia nervosa (AN) serves as a model disorder to elucidate the functional implications of hypoleptinaemia; vice versa, several symptoms in patients with this eating disorder are related to the low leptin levels, which are characteristic of acute AN. Weight gain in AN patients can induce relative hyperleptinaemia in comparison to controls matched for body mass index; circulating leptin concentrations in AN patients thus transverse from subnormal to supranormal levels within a few weeks. We review findings on leptin secretion in AN and focus on implications, particularly for the hypothalamus-pituitary-gonadal axis, bone mineral density and physical hyperactivity. Undoubtedly, the elucidation of leptin's function as a trigger of diverse neuroendocrine adaptations to a restricted energy intake has substantially advanced our knowledge of the pathogenesis of distinct symptoms of AN, including amenorrhoea that represents one of the four diagnostic criteria. The fact that hypoleptinaemia can induce hyperactivity in a rat model for AN has led to a series of studies in AN patients, which support the notion that application of leptin to severely hyperactive patients might prove beneficial.

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Section: Molecular Psychiatrymentioning

confidence: 98%

The role of leptin in anorexia nervosa: clinical implications

et al. 2006

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“…↓ Sleep efficiency (Crisp, et al, 1971;Delvenne et al, 1992;Lacey et al, 1975;Neil et al, 1980;Nobili et al, 1999) ↑ REM latency ) ↓ REM latency (Katz et al, 1984;Neil et al, 1980;Walsh et al, 1985) ↑ REM density (Katz et al, 1984;Neil et al, 1980) ↓ REM density Neil et al, 1980) ↓ Total sleep time (Levy et al, 1988;Nobili et al, 2004;Walsh et al, 1985) ↓ Slow wave sleep (SWS) (Delvenne et al, 1992;Lacey et al, 1975;Lauer et al, 1988;Levy et al, 1987;Neil et al, 1980;Nobili et al, 1999;Nobili et al, 2004) 1988; Neil et al, 1980;Nobili et al, 1999;Walsh et al, 1985), increased amount of stage 1 sleep, increased number of awakenings/increased intermittent wake time and wakefulness after sleep onset (WASO) in AN patients (Crisp, 1967;Delvenne et al, 1992;Kim et al, 2010;Lacey et al, 1975;Lacey et al, 1976;Levy et al, 1987;Neil et al, 1980;Nobili et al, 1999Nobili et al, , 2004Walsh et al, 1985). Moreover, in AN the total sleep time is reduced compared with healthy controls (Benca et al, 1992).…”

Section: Total Sleep Time Sleep Continuity and Sleep Maintenancementioning

confidence: 99%

“…AN is characterised by both serious psychiatric symptoms and organic alterations in addition to functional and anatomic alterations in the brain of these patients (Nobili et al, 2004). The integrity of thalamocortical and cortical circuitry is essential for SWA production (Nobili et al, 2004).…”

Section: Morphologic and Functional Alterations Of The Brainmentioning

confidence: 99%

“…The integrity of thalamocortical and cortical circuitry is essential for SWA production (Nobili et al, 2004).…”

Section: Morphologic and Functional Alterations Of The Brainmentioning

confidence: 99%

“…Sleep architecture in individuals with AN (restricting type) was characterised by a reduced amount of SWS and SWA (Delvenne et al, 1992;Lacey et al, 1975;Lauer et al, 1988;Levy et al, 1987;Nobili et al, 1999;Nobili et al, 2004). A reduction in cerebral metabolism both during wake and sleep periods could itself explain a decrease in SWA production during sleep (Feinberg & March, 1995).…”

Section: Morphologic and Functional Alterations Of The Brainmentioning

confidence: 99%

See 2 more Smart Citations

Sleep disturbances in anorexia nervosa

Padez-Vieira

Afonso

2016

Advances in Eating Disorders

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Sleep disturbances in anorexia nervosa

Burger,

Bos,

Maas

et al. 2024

Euro Eating Disorders Rev

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IntroductionSleep is crucial for physical and psychological health, and disturbances are closely linked to psychiatric disorders, making their management essential for improving treatment outcomes and preventing relapse. Although sleep disturbances are implicated in psychopathology of eating disorders, its role in anorexia nervosa (AN) remains unclear. This review aimed to characterise sleep in AN.MethodsA systematic search was conducted in four scientific databases, including papers from inception to 25 May 2024. A machine learning algorithm (ASReview) was utilised to screen titles and abstracts for eligibility. Sleep quantity, architecture, and quality were investigated. Meta‐analyses were conducted to investigate the difference between patients with AN and healthy controls (HC) in total sleep time (TST), wake after sleep onset (WASO), sleep onset latency (SOL), sleep efficiency, Sleep Stage 1, 2, slow wave sleep, rapid eye movement (REM) sleep and REM latency. Certainty of evidence was assessed using the GRADE approach.ResultsOut of 67 potentially eligible papers, 31 were included in this review, with 15 in the meta‐analyses. Statistically significant average mean differences were found for TST (−32.1 min [95% CI: −50.9, −13.4]), WASO (19.0 min [95% CI: −2.4, 40.3]), and sleep efficiency (−4.4% [95% CI: −7.9, −0.9]). Additionally, Sleep stage 1 was significantly increased (2.4% [95%‐CI: 0.05, 4.7]), while REM sleep was reduced (−2.1% [95%‐CI: −4.2, −0.02]). Subgroup analysis showed that TST and WASO did not improve significantly after weight restoration.ConclusionSleep in patients with AN is impaired, with lower TST and sleep efficiency, higher WASO, more time in stage 1 sleep, and less in REM. Weight restoration alone may not improve sleep. While more research is needed, substantial accompanying sleep disturbances in AN justifies addressing these in current treatment practice, also because of the chronic character of AN and importance of sleep for long term (mental) health.

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Impairment of the Production of Delta Sleep in Anorectic Adolescents

Cited by 27 publications

References 21 publications

The role of leptin in anorexia nervosa: clinical implications

The role of leptin in anorexia nervosa: clinical implications

Sleep disturbances in anorexia nervosa

Sleep disturbances in anorexia nervosa

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