Loss of Slow-Wave Sleep

Abstract

A 40-year-old Hispanic American male, who weighed 165 lb and was 5'11" tall, consented to participate in a 3-day sleep protocol and was admitted to the UCLA General Clinical Research Center. The patient complained of fatigue during the day and difficulty initiating sleep, along with 3 to 4 awakenings per night. He denied snoring and having any difficulty breathing during sleep. A 2-week sleep diary confirmed his sleep-wake pattern. The patient also denied any history of head injury, epilepsy, or anoxia and the use of any over-the-counter or prescription medication use for the previous month. A diagnosis of current depression was ruled out, though he reported having been treated for depression with Paxil 2 years ago, when he took his last dose of Paxil. The patient reported alcohol consumption of 10 drinks per day, 12 days per month, with last his drink 18 days prior to study admission to the research center. Sleep StudyOvernight polysomnography was carried out over 3 nights using a computerized system (Somnologica, Flaga hf, Medical Devices, Iceland). The first night assessed the presence of sleep apnea and nocturnal myoclonus. The patient's apnea-hypopnea index was within normal limits (< 1.5/h), as was his periodic leg movement index (< 10/h). Oxygen saturation fluctuated between 91% and 95% throughout the night. During the third night, polysomnography showed that the patient slept for 403.5 minutes, with a sleep onset of 39.9 minutes and an overall sleep efficiency of 84.1%. Out of his total sleep time, he spent 12.1% (49 minutes) in stage 1, 61.7% (249 minutes) in stage 2, and 26% (105.5 minutes) in rapid eye movement sleep (Figure 1). No stage 3 or 4 sleep was noted. The patient experienced spontaneous arousals and microarousals throughout the night, with an index of 7.2. Disclosure StatementThis was not an industry supported study. Drs. Eljammal, Valladares, and Irwin have indicated no financial conflicts of interest.

Polysomnographic Sleep Dysregulation in Cocaine Dependence

“…Morgan and colleagues and Valladares et al were among the first to report loss of slow wave sleep. It is an interesting finding, because both studies excluded participants with a history of head injury, which could have been a confounding factor [27]. This loss of slow wave sleep could be considered as premature aging, being that loss of slow wave sleep is noted in the elderly [28,29,30].…”