From the midnight sun to the longest night: sleep in Antarctica

Sleep disturbances are the main health complaints from personnel deployed in Antarctica. The current paper presents a systematic review of research findings on sleep disturbances in Antarctica. The available sources were divided in three categories: results based on questionnaire surveys or sleep logs, studies using actigraphy, and data from polysomnography results. Other areas relevant to the issue were also examined. These included chronobiology, since the changes in photoperiod have been known to affect circadian rhythms; mood disturbances; exercise, sleep and hypoxia; countermeasure investigations in Antarctica; and other locations lacking a normal photoperiod

Development and Pilot Testing of 24/7 In-Ambulance Telemedicine for Acute Stroke:Prehospital Stroke Study at the Universitair Ziekenhuis Brussel-Project

Background: In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study at the Universitair Ziekenhuis Brussel (PreSSUB) to facilitate a wider spread of the knowledge regarding this technique. Methods: Successful execution of the project involved the development and validation of a novel stroke scale, design and creation of specific hardware and software solutions, execution of field tests for mobile internet connectivity, design of new care processes and information flows, recurrent training of all professional caregivers involved in acute stroke management, extensive testing on healthy volunteers, organisation of a 24/7 teleconsultation service by trained stroke experts and 24/7 technical support, and resolution of several legal issues. Results: In all, it took 41 months of research and development to confirm the safety, technical feasibility, reliability, and user acceptance of the PreSSUB approach. Stroke-specific key information can be collected safely and reliably before and during ambulance transportation and can adequately be communicated with the inhospital team awaiting the patient. Conclusion: This paper portrays the key steps required and the lessons learned for successful implementation of a 24/7 expert telemedicine service supporting patients with acute stroke during ambulance transportation to the hospital. (C) 2016 S. Karger AG, Base

Temporal and spatial organization of gait-related electrocortical potentials

To advance gait rehabilitation research it is of great importance to understand the supraspinal control of walking. In this study, the temporal and spatial characteristics of averaged electrocortical activity during treadmill walking in healthy subjects was assessed. Electroencephalography data were recorded from 32 scalp locations, averaged across trials, and related to phases of the gait cycle based on the detection of left heel strike. A characteristic temporal pattern of positive and negative potentials, similar to movement-related cortical potentials, and related to the gait cycle was observed over the cortical leg representation area. Source localization analysis revealed that mainly the primary somatosensory, somatosensory association, primary motor and cingulate cortex were activated during walking. The negative peaks of the gait-related cortical potential were associated with activity predominantly in the cingulate and prefrontal cortex, while the primary motor, primary somatosensory and somatosensory association cortex were mainly active during the positive peaks. This study identified gait-related cortical potentials during walking. The results indicate a widely distributed cortical network involved in gait control

Human-robot interaction: does robotic guidance force affect gait-related brain dynamics during robot-assisted treadmill walking?

In order to determine optimal training parameters for robot-assisted treadmill walking, it is essential to understand how a robotic device interacts with its wearer, and thus, how parameter settings of the device affect locomotor control. The aim of this study was to assess the effect of different levels of guidance force during robot-assisted treadmill walking on cortical activity. Eighteen healthy subjects walked at 2 km.h-1 on a treadmill with and without assistance of the Lokomat robotic gait orthosis. Event-related spectral perturbations and changes in power spectral density were investigated during unassisted treadmill walking as well as during robot-assisted treadmill walking at 30%, 60% and 100% guidance force (with 0% body weight support). Clustering of independent components revealed three clusters of activity in the sensorimotor cortex during treadmill walking and robot-assisted treadmill walking in healthy subjects. These clusters demonstrated gait-related spectral modulations in the mu, beta and low gamma bands over the sensorimotor cortex related to specific phases of the gait cycle. Moreover, mu and beta rhythms were suppressed in the right primary sensory cortex during treadmill walking compared to robot-assisted treadmill walking with 100% guidance force, indicating significantly larger involvement of the sensorimotor area during treadmill walking compared to robot-assisted treadmill walking. Only marginal differences in the spectral power of the mu, beta and low gamma bands could be identified between robot-assisted treadmill walking with different levels of guidance force. From these results it can be concluded that a high level of guidance force (i.e., 100% guidance force) and thus a less active participation during locomotion should be avoided during robot-assisted treadmill walking. This will optimize the involvement of the sensorimotor cortex which is known to be crucial for motor learning

Altitude and Seasonality Impact on Sleep in Antarctica

BACKGROUND: This study investigates the effects of seasonality and altitude on sleep in extreme Antarctic conditions. METHODS: During summer and winter periods, 24 h of actimetric recordings were obtained at two different research stations, Dumont d'Urville (sea level altitude) and Concordia (corrected altitude 12,467 ft or 3800 m). RESULTS: During daytime, there were no altitude- or season-related differences in time spent at work, energy expenditure, or number of walking steps. During the nighttime however, total sleep time was longer (m = 427.4; SD = 42.4), sleep efficiency higher (m = 90; SD = 4.8), and wake after sleep onset shorter (m = 42.2; SD = 28.7) at sea level. Additionally, sleep fragmentation episodes and energy expenditure were higher during summer than winter periods. DISCUSSION: Our results show that dramatic variations in light exposure are not the only main factor affecting sleep quality in Antarctica, as altitude also markedly impacted sleep in these conditions. The effect of altitude-induced hypoxia should be taken into account in future investigations of sleep in extreme environments.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

EAMI: A qualitative quantification of periodic breathing based on amplitude of oscillations

Study Objectives: Periodic breathing is sleep disordered breathing characterized by instability in the respiratory pattern that exhibits an oscillatory behavior. Periodic breathing is associated with increased mortality, and it is observed in a variety of situations, such as acute hypoxia, chronic heart failure, and damage to respiratory centers. The standard quantification for the diagnosis of sleep related breathing disorders is the apnea-hypopnea index (AHI), which measures the proportion of apneic/hypopneic events during polysomnography. Determining the AHI is labor-intensive and requires the simultaneous recording of airflow and oxygen saturation. In this paper, we propose an automated, simple, and novel methodology for the detection and qualification of periodic breathing: the estimated amplitude modulation index (eAMI). Patients or Participants: Antarctic cohort (3,800 meters): 13 normal individuals. Clinical cohort: 39 different patients suffering from diverse sleep-related pathologies. Measurements and Results: When tested in a population with high levels of periodic breathing (Antarctic cohort), eAMI was closely correlated with AHI (r = 0.95, P < 0.001). When tested in the clinical setting, the proposed method was able to detect portions of the signal in which subclinical periodic breathing was validated by an expert (n = 93; accuracy = 0.85). Average eAMI was also correlated with the loop gain for the combined clinical and Antarctica cohorts (r = 0.58, P < 0.001). Conclusions: In terms of quantification and temporal resolution, the eAMI is able to estimate the strength of periodic breathing and the underlying loop gain at any given time within a record. The impaired prognosis associated with periodic breathing makes its automated detection and early diagnosis of clinical relevance.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Adult Female Sleep During Hypoxic Bed Rest

Purpose: Hypobaric hypoxic habitats are currently being touted as a potential solution to minimise decompression procedures in preparation for extra vehicular activities during future space missions. Since astronauts will live in hypoxic environments for the duration of such missions, the present study sought to elucidate the separate and combined effects of inactivity [simulated with the experimental bed rest (BR) model] and hypoxia on sleep characteristics in women. Methods: Twelve women (Age = 27 ± 3 year) took part in three 10-day interventions, in a repeated measures cross-over counterbalanced design: (1) normobaric normoxic BR (NBR), (2) normobaric hypoxic BR (HBR; simulated altitude of 4,000 m), and (3) normobaric hypoxic ambulatory (HAMB; 4,000 m) confinement, during which sleep was assessed on night 1 and night 10 with polysomnography. In addition, one baseline sleep assessment was performed. This baseline assessment, although lacking a confinement aspect, was included statistically as a fourth comparison (i.e. pseudo normobaric normoxic ambulatory; pNAMB) in the present study. Results: Hypoxia decreased sleep efficiency (p = 0.019), increased N1% sleep (p = 0.030), decreased N3 sleep duration (p = 0.003), and increased apnea hypopnea index (p < 0.001). BR impaired sleep maintenance, efficiency, and architecture [e.g. N2% sleep increased (p = 0.033)]. Specifically, for N3% sleep, the effects of partial pressure of oxygen and activity interacted. Hypoxia decreased N3% sleep both when active (pNAMB vs HAMB; p < 0.001) and inactive (NBR vs HBR; p = 0.021), however, this decrease was attenuated in the inactive state (–3.8%) compared to the active state (–10.2%). Conclusion: A 10-day exposure to hypoxia and BR negatively impacted sleep on multiple levels as in macrostructure, microstructure and respiratory functioning. Interestingly, hypoxia appeared to have less adverse effects on sleep macrostructure while the participants were inactive (bed ridden) compared to when ambulatory. Data were missing to some extent (i.e. 20.8%). Therefore, multiple imputation was used, and our results should be considered as exploratory.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Scalp map, PSD, dipole locations and ERSPs for cluster 12, located in the right S1.

<p>(A) Cluster average scalp projection; (B) Gait cycle PSD for G, 30% GF, 60% GF and 100% GF; (C) Dipole locations of cluster ICs (blue spheres) and cluster centroids (red sphere) visualized in the MNI brain volume in coronal and sagittal views; (D) average cluster ERSP (3–45 Hz) plots showing significant changes in spectral power relative to the full gait cycle baseline (p<.05) for G, 30% GF, 60% GF and 100% GF. Non-significant differences relative to the full gait cycle baseline (p<.05) are masked in green (0 dB). The gait cycle starts and ends with R HS (i.e., 0 and 100%), the vertical line at 50% of the gait cycle marks L HS.</p

Clusters of independent sources identified by ICA.

<p>Clusters of independent sources identified by ICA.</p

Scalp map, PSD, dipole locations and ERSPs for cluster 6, located in the left SA.

<p>(A) Cluster average scalp projection; (B) Gait cycle PSD for G, 30% GF, 60% GF and 100% GF; (C) Dipole locations of cluster ICs (blue spheres) and cluster centroids (red sphere) visualized in the MNI brain volume in coronal and sagittal views; (D) average cluster ERSP (3–45 Hz) plots showing significant changes in spectral power relative to the full gait cycle baseline (p<.05) for G, 30% GF, 60% GF and 100% GF. Non-significant differences relative to the full gait cycle baseline (p<.05) are masked in green (0 dB). The gait cycle starts and ends with R HS (i.e., 0 and 100%), the vertical line at 50% of the gait cycle marks L HS.</p