Objective markers for sleep propensity: comparison between the Multiple Sleep Latency Test and the Vigilance Algorithm Leipzig

Abstract

SUMMARYThe regulation of wakefulness is important for high-order organisms. Its dysregulation is involved in the pathomechanism of several psychiatric disorders. Thus, a tool for its objective but little time-consuming assessment would be of importance. The Vigilance Algorithm Leipzig allows the objective measurement of sleep propensity, based on a single resting state electroencephalogram. To compare the Vigilance Algorithm Leipzig with the standard for objective assessment of excessive daytime sleepiness, a four-trial Multiple Sleep Latency Test in 25 healthy subjects was conducted. Between the first two trials, a 15-min, 25-channel resting electroencephalogram was recorded, and Vigilance Algorithm Leipzig was used to classify the sleep propensity (i.e. type of vigilance regulation) of each subject. The results of both methods showed significant correlations with the Epworth Sleepiness Scale (q = À0.70; q = 0.45, respectively) and correlated with each other (q = À0.54). Subjects with a stable electroencephalogram-vigilance regulation yielded significant increased sleep latencies compared with an unstable regulation (multiple sleep latency 898.5 s versus 549.9 s; P = 0.03). Further, Vigilance Algorithm Leipzig classifications allowed the identification of subjects with average sleep latencies <6 min with a sensitivity of 100% and a specificity of 77%. Thus, Vigilance Algorithm Leipzig provides similar information on wakefulness regulation in comparison to the much more cost-and time-consuming Multiple Sleep Latency Test. Due to its high sensitivity and specificity for large sleep propensity, Vigilance Algorithm Leipzig could be an effective and reliable alternative to the Multiple Sleep Latency Test, for example for screening purposes in large cohorts, where objective information about wakefulness regulation is needed. IN TROD UCTI ONThe regulation of wakefulness from high alertness to relaxed quiet waking to drowsiness until sleep onset is of fundamental importance for all high-order organisms. This regulation is both a stable individual trait (Tucker et al., 2007;Van Dongen et al., 2005) and dependent on a variety of state factors, such as sleep deficits, recreational drugs and psychopharmacological treatment. Among the medical disorders affecting the wakefulness regulation are sleep disorders, such as narcolepsy (Guilleminault and Brooks, 2001), but also affective disorders and attention deficit hyperactivity disorder (Hegerl and Hensch, 2014).The Vigilance Algorithm Leipzig (VIGALL) has been developed to get an objective parameter of this regulation of wakefulness.

Efficacy of Low Adjunctive Quetiapine Administration in Control of Hypomanic State in Bipolar Affective Disorder Captured by EEG

“…The effect on the psychiatric symptoms therefore might be less attributable to the psychopharmacological impact on central active neurotransmitters, but on the normalization of sleep rhythms and consecutive change at the behavioural level as suggested by the "vigilance framework" [2]. Interestingly, within the presented case, not only CNS but also ANS parameters showed levels of higher arousal, which might be interpreted in line with the close association between ANS and CNS arousal markers [5,7,25]. Further, quetiapine has been shown to reduce HRV measures and thereby probably increase sympathetic tone in a psychiatric cohort [26].…”

“…Eye-movement artefacts were removed using an independent component approach (ICA). CNS-arousal was assessed for each 1-second segment using the vigilance algorithm Leipzig (VIGALL) [5][6][7]. The same computer based algorithm assessed the alpha peak frequency for each recording.…”

Automatic detection of microsleep episodes with feature-based machine learning

“…vigilance regulation) in health and disease. 24,25 After artefact removal, 1-s EEG segments of multiple channels were classified into 7 different stages of vigilance reaching from fully awake to sleep. Sleep latency in the MSLT was correlated with the vigilance score predicted by the VIGALL measured in the wake EEG recording after the MSLT, showing a moderate correlation between these two measures.…”

The Big Five personality traits and CNS arousal in the resting state

“…Noteworthy, by applying VIGALL, a number of empirical studies addressing arousal in depressive, bipolar, and ADHD patients have provided supportive evidence for the assumptions of the arousal regulation model (Hegerl et al, 2012;Strauß et al, 2018;Ulke et al, 2017;Ulke, Wittekind, et al, 2019;Wittekind et al, 2016). In addition, VIGALL has been validated in an fMRI and PET study (Guenther et al, 2011;Olbrich et al, 2009), against evoked potentials and parameters of the autonomous nervous system (Huang et al, 2017(Huang et al, , 2018Olbrich et al, 2011), against the Multiple Sleep Latency Test (Olbrich et al, 2015), and in a large study addressing the agreement with subjective ratings (Jawinski et al, 2017). These previous encouraging results raise the question, whether the application of VIGALL may leverage investigations on the role of arousal in human personality.…”