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Sleep in Disorders of Consciousness: A Brief Overview on a Still under Investigated Issue

Consciousness is a multifaceted concept, involving both wakefulness, i.e., a condition of being alert that is regulated by the brainstem, and awareness, a subjective experience of any thoughts or perception or emotion. Recently, the European Academy of Neurology has published international guideline...

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Autores principales: Raciti, Loredana, Raciti, Gianfranco, Militi, David, Tonin, Paolo, Quartarone, Angelo, Calabrò, Rocco Salvatore
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9954700/
https://www.ncbi.nlm.nih.gov/pubmed/36831818
http://dx.doi.org/10.3390/brainsci13020275
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author Raciti, Loredana
Raciti, Gianfranco
Militi, David
Tonin, Paolo
Quartarone, Angelo
Calabrò, Rocco Salvatore
author_facet Raciti, Loredana
Raciti, Gianfranco
Militi, David
Tonin, Paolo
Quartarone, Angelo
Calabrò, Rocco Salvatore
author_sort Raciti, Loredana
collection PubMed
description Consciousness is a multifaceted concept, involving both wakefulness, i.e., a condition of being alert that is regulated by the brainstem, and awareness, a subjective experience of any thoughts or perception or emotion. Recently, the European Academy of Neurology has published international guidelines for a better diagnosis of coma and other disorders of consciousness (DOC) through the investigation of sleep patterns, such as slow-wave and REM, and the study of the EEG using machine learning methods and artificial intelligence. The management of sleep disorders in DOC patients is an increasingly hot topic and deserves careful diagnosis, to allow for the most accurate prognosis and the best medical treatment possible. The aim of this review was to investigate the anatomo-physiological basis of the sleep/wake cycle, as well as the main sleep patterns and sleep disorders in patients with DOC. We found that the sleep characteristics in DOC patients are still controversial. DOC patients often present a theta/delta pattern, while epileptiform activity, as well as other sleep elements, have been reported as correlating with outcomes in patients with coma and DOC. The absence of spindles, as well as REM and K-complexes of NREM sleep, have been used as poor predictors for early awakening in DOC patients, especially in UWS patients. Therefore, sleep could be considered a marker of DOC recovery, and effective treatments for sleep disorders may either indirectly or directly favor recovery of consciousness.
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spelling pubmed-99547002023-02-25 Sleep in Disorders of Consciousness: A Brief Overview on a Still under Investigated Issue Raciti, Loredana Raciti, Gianfranco Militi, David Tonin, Paolo Quartarone, Angelo Calabrò, Rocco Salvatore Brain Sci Review Consciousness is a multifaceted concept, involving both wakefulness, i.e., a condition of being alert that is regulated by the brainstem, and awareness, a subjective experience of any thoughts or perception or emotion. Recently, the European Academy of Neurology has published international guidelines for a better diagnosis of coma and other disorders of consciousness (DOC) through the investigation of sleep patterns, such as slow-wave and REM, and the study of the EEG using machine learning methods and artificial intelligence. The management of sleep disorders in DOC patients is an increasingly hot topic and deserves careful diagnosis, to allow for the most accurate prognosis and the best medical treatment possible. The aim of this review was to investigate the anatomo-physiological basis of the sleep/wake cycle, as well as the main sleep patterns and sleep disorders in patients with DOC. We found that the sleep characteristics in DOC patients are still controversial. DOC patients often present a theta/delta pattern, while epileptiform activity, as well as other sleep elements, have been reported as correlating with outcomes in patients with coma and DOC. The absence of spindles, as well as REM and K-complexes of NREM sleep, have been used as poor predictors for early awakening in DOC patients, especially in UWS patients. Therefore, sleep could be considered a marker of DOC recovery, and effective treatments for sleep disorders may either indirectly or directly favor recovery of consciousness. MDPI 2023-02-07 /pmc/articles/PMC9954700/ /pubmed/36831818 http://dx.doi.org/10.3390/brainsci13020275 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Raciti, Loredana
Raciti, Gianfranco
Militi, David
Tonin, Paolo
Quartarone, Angelo
Calabrò, Rocco Salvatore
Sleep in Disorders of Consciousness: A Brief Overview on a Still under Investigated Issue
title Sleep in Disorders of Consciousness: A Brief Overview on a Still under Investigated Issue
title_full Sleep in Disorders of Consciousness: A Brief Overview on a Still under Investigated Issue
title_fullStr Sleep in Disorders of Consciousness: A Brief Overview on a Still under Investigated Issue
title_full_unstemmed Sleep in Disorders of Consciousness: A Brief Overview on a Still under Investigated Issue
title_short Sleep in Disorders of Consciousness: A Brief Overview on a Still under Investigated Issue
title_sort sleep in disorders of consciousness: a brief overview on a still under investigated issue
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9954700/
https://www.ncbi.nlm.nih.gov/pubmed/36831818
http://dx.doi.org/10.3390/brainsci13020275
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