Pupil miosis within 5 minutes in darkness is a valid and sensitive quantitative measure of alertness: Application in daytime sleepiness associated with sleep apnea

Sleep

Volumn 29, Issue 11, 2006, Pages 1482-1488

  Bitsios, Panos ^a,b   Schiza, Sophia E ^a   Giakoumaki, Stella G ^a   Savidou, Kyriaki ^a   Alegakis, Athanasios K ^b   Siafakas, Nikolaos ^a  

^a UNIVERSITY OF CRETE   (Greece)

^b UNIVERSITY OF CRETE   (Greece)

Author keywords

Arousal; Excessive daytime sleepiness; Pupil; Sleep apnea

Indexed keywords

ADULT; ALERTNESS; AROUSAL; ARTICLE; CIRCADIAN RHYTHM; CLINICAL ARTICLE; CONTROLLED STUDY; DARKNESS; DAYTIME SOMNOLENCE; DISEASE ASSOCIATION; DISEASE SEVERITY; EPWORTH SLEEPINESS SCALE; HUMAN; LOCUS CERULEUS; MALE; MIOSIS; OXYGEN SATURATION; POLYSOMNOGRAPHY; PRIORITY JOURNAL; PUPIL; QUANTITATIVE DIAGNOSIS; SLEEP APNEA SYNDROME;

EID: 33751086161     PISSN: 01618105     EISSN: None     Source Type: Journal    
DOI: 10.1093/sleep/29.11.1482     Document Type: Article

References (47)

1. Bixler EO, Vgontzas AN, Lin HM, Calhoun SL, Vela-Bueno A, Kales A. Excessive daytime sleepiness in a general population sample: the role of sleep apnea, age, obesity, diabetes, and depression. J Clin Endocrinol Metab 2005;90:4510-5.
2. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230-5.
3. Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A. Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med 1998;157:144-8.
4. Bixler EO, Vgontzas AN, Lin HM, et al. Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med 2001;163:608-13.
5. Carskadon MA, Dement WC. Sleepiness and sleep state on a 90-minute schedule. Psychophysiology 1977;14:127-33.
6. Bonnet MH, Arand DL. Sleepiness as measured by modified multiple sleep latency testing varies as a function of preceding activity. Sleep 1998;21:477-83.
7. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991;14:540-5.
8. Johns MW. Sensitivity and specificity of the multiple sleep latency test (MSLT), the maintenance of wakefulness test and the Epworth sleepiness scale: failure of the MSLT as a gold standard. J Sleep Res 2000;9:5-11.
9. Chervin RD, Kraemer HC, Guilleminault C. Correlates of sleep latency on the multiple sleep latency test in a clinical population. Electroencephalogr Clin Neurophysiol 1995;95:147-53.
10. Lowenstein O, Feinberg R, Loewenfeld IE. Pupillary movements during acute and chronic fatigue. Invest Ophthalmol 1963;2:138-57.
11. Wilhelm B, Wilhelm H, Ludtke H, Streicher P, Adler M. Pupillographic assessment of sleepiness in sleep-deprived healthy subjects. Sleep 1998;21:258-65.
12. Wilhelm H, Ludtke H, Wilhelm B. Pupillographic sleepiness testing in hypersomniacs and normals. Graefes Arch Clin Exp Ophthalmol 1998;236:725-9.
13. Koss MC, Gherezghiher T, Nomura A. CNS adrenergic inhibition of parasympathetic oculomotor tone. J Auton Nerv Syst 1984;10:55-68.
14. Yu Y, Ramage AG, Koss MC. Pharmacological studies of 8-OH-DPAT-induced pupillary dilation in anesthetized rats. Eur J Pharmacol 2004;489:207-13.
15. 2- adrenoreceptors. J Psychopharmacol 1996;10:6-18.
16. Phillips MA, Szabadi E, Bradshaw CM. Comparison of the effects of clonidine and yohimbine on spontaneous papillary fluctuations in healthy human volunteers. Psychopharmacology 2000;150:85-9.
17. Foote SL, Aston Jones GS. Pharmacology and physiology of central noradrenergic systems. In: Bloom, FE, Kupfer, DJ eds. Psychopharmacology: the fourth generation of progress. New York: Raven Press, 1995:335-45.
18. Berridge CW, Waterhouse BD. The locus coeruleus-noradrenergic system: modulation of behavioral state and state-dependent cognitive processes. Brain Res Brain Res Rev 2003;42:33-84.
19. Nelson LE, Guo TZ, Lu J, Saper CB, Franks NP, Maze M. The sedative component of anesthesia is mediated by GABA(A) receptors in an endogenous sleep pathway. Nat Neurosci 2002;5:979-84.
20. 2- adrenoceptor agonist dexmedetomidine converges on an endogenous sleep-promoting pathway to exert its sedative effects. Anesthesiology 2003;98:428-36.
21. Loewenfeld IE. The Pupil: Anatomy, Physiology, and Clinical Applications. Boston: Butterworth Heinemann; 1999.
22. Lüdtke H, Wilhelm B, Adler M, Schaeffel F, Wilhelm H. Mathematical procedures in data recording and processing of pupillary fatigue waves. Vision Res 1998;38:2889-96.
23. Danker-Hopfe H, Kraemer S, Dorn H, Schmidt A, Ehlert I, Herrmann V. Time-of-day variations in different measures of sleepiness (MSLT, pupillography and SSS) and their interrelations. Psychophysiology 2001;38:828-35.
24. Pilcher JJ, Walters AS. How sleep deprivation affects psychological variables related to college students' cognitive performance. J Am Coll Health 1997;46:121-6.
25. Moldofsky H. Evaluation of daytime sleepiness. Clin Chest Med 1992;13:417-25.
26. Johns MW. Reliability and factor analysis of the Epworth sleepiness scale. Sleep 1992;15:376-81.
27. Rechtschafen A, Kales A. A Manual of Standardized Technology, Techniques, and Scoring System for Sleep Stages of Human Subjects. Los Angeles: UCLA Brain Information Service/Brain Research Institute; 1968.
28. Bonnete M, Carley D, Carskadon M. ASDA Report. EEG arousals: scoring rules and examples. Sleep 1992;15:173-84.
29. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999;22:667-89.
30. Merritt SL, Schnyders HC, Mercer P, Zhou X. The sensitivity of pupillography to circadian aspects of sleepiness. J Sleep Res 1998;7:176.
31. Clodore M, Benoit O, Foret J, Bouard G. The Multiple Sleep Latency Test: individual variability and time of day effect in normal young adults. Sleep 1990;13:385-94.
32. Vgontzas AN, Bixler EO, Tan TL, Kantner D, Martin LF, Kales A. Obesity without sleep apnea is associated with daytime sleepiness. Arch Intern Med 1998;158:1333-7.
33. Resta O, Foschino-Barbaro MP, Legari G, et al. Sleep-related breathing disorders, loud snoring and excessive daytime sleepiness in obese subjects. Int J Obes Relat Metab Disord 2001;25:669-75.
34. Resta O, Foschino-Barbaro MP, Bonfitto P, et al. Low sleep quality and daytime sleepiness in obese patients without obstructive sleep apnoea syndrome. J Intern Med 2003;253:536-43.
35. Levin BE. Obesity-prone and -resistant rats differ in their brain [3H]paraminoclonidine binding. Brain Res 1990;512:54-9.
36. Altomonte L, Zoli A, Mirone L, et al. Impaired growth hormone response to clonidine in obesity. Exp Clin Endocrinol 1988;92:231-4.
37. Manaye KF, McIntire DD, Mann DMA, German DC. Locus coeruleus cell loss in the aging human brain: A non-random process. J Comparat Neuro 1995;358:79-87.
38. Mouton PR, Pakkenberg B, Gundersen HJG, Price DL. Absolute number and size of pigmental locus coeruleus neurons in young and aged individuals. J Chem Neuroanat 1994;7:185-90.
39. Prettyman R, Bitsios P, Szabadi E. Altered pupil size and darkness and light reflexes in Alzheimer's disease. J Neurol Neurosurg Psychiatry 1997;62:665-8.
40. Zweig RM, Ross CA, Hedreen JC, et al. The neuropathology of aminergic nuclei in Alzheimer's disease. Ann Neurol 1988;24:33-42.
41. Palmer AM, DeKosky ST. Monoamine neurons in aging and Alzheimer's disease. J Neural Transm 1993;91:135-59.
42. Vgontzas AN, Papanikolaou DA, Bixler EO, Kales A, Tyson K, Chroussos GP. Elevation of cytokines in disorders of excessive daytime sleepiness: role of sleep disturbance and obesity. J Clin Endocrinol Metab 1997;82:1313-6.
43. Vgontzas AN, Papanikolaou DA, Bixler EO, et al. Sleep apnea and daytime sleepiness and fatigue: Relations with visceral obesity, insulin resistance, and hypercytokinemia. J Clin Endocrinol Metab 2000;85:1151-8.
44. Brebner K, Hayley S, Zacharko R, Merali Z, Anisman H. Synergistic effects of interleukin-1beta, interleukin-6, and tumor necrosis factor-alpha: central monoamine, corticosterone, and behavioral variations. Neuropsychopharmacology 2000;22:566-80.
45. Elenkov IJ, Kovacs K, Duda E, Stark E, Vizi ES. Presynaptic inhibitory effect of TNF-alpha on the release of noradrenaline in isolated median eminence. J Neuroimmunol 1992;41:117-20.
46. Johns M. Rethinking the assessment of sleepiness. Sleep Med Rev 1998;2:3-15.
47. Russo M, Thomas M, Thorne D, et al. Oculomotor impairment during chronic partial sleep deprivation. Clinical Neurophysio 2003;114:723-36.