J Neuropsychiatry Clin Neurosci 12:86-90, February 2000
© 2000 American Psychiatric Press, Inc.
Interrelationships Between Nocturnal Sleep, Daytime Alertness, and Sleepiness
Two Types of Alertness Proposed
Leonid Kayumov, Ph.D.,
Vadim Rotenberg, M.D., Ph.D.,
Kenneth Buttoo, M.D.,
Christine Auch, B.Sc.,
S.R. Pandi-Perumal, M.Sc. and
Colin M. Shapiro, M.D., Ph.D.
Received December 17, 1998; revised April 30, 1999; accepted May 20, 1999. From the Department of Psychiatry, University of Toronto, Playfair Neuroscience Unit, Toronto Western Hospital, MP 10-320, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada. Address correspondence to Dr. Kayumov. e-mail: Lkayumov{at}playfair.utoronto.ca
The authors studied daytime sleepiness and alertness (based on the Multiple Sleep Latency Test [MSLT] and Maintenance of Wakefulness Test [MWT]) and nocturnal sleep in 22 patients with depression/anxiety and in 47 nondepressed patients with sleep apnea. The patients underwent two overnight sleep studies followed by daytime tests. In depressed patients, MWT scores correlated negatively with total sleep time and stage 3. MSLT scores correlated negatively with total sleep time and with sleep efficiency. Apneic patients showed a negative correlation between MWT results and amount of stage 1 sleep. MSLT results correlated positively with sleep onset latency on the preceding overnight sleep study. Thus, in depressed patients, there is a paradox that with more disturbed sleep there is greater daytime alertness. In contrast, the more disturbed the sleep is in sleep apnea patients, the more difficult it is to maintain daytime alertness.
Key Words: Sleep Disorders • Alertness • Daytime Sleepiness
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