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sommeil de l'adolescent / sommeil des pilotes / epilepsie, processus cognitif et sommeil

Une revue de la littérature issue du journal Developemental  Medicine and Child Neurology tente de caractériser les liens physiopathologiques possibles entre épilepsie, cognition, sommeil et troubles du sommeil afin d'isoler les effets respectifs du sommeil et du trouble épileptique sur le processus cognitif de l’enfant épileptique.
Médecine du travail
La revue Ergonomics publie une étude sur le sommeil des pilotes effectuant de longs trajets intitulée « How well do pilots sleep during long-haul flights? »Les usages de 301pilotes d’avion en termes de rythmes veille / sommeil ont été ainsi appréhendés sur une période d’au moins de semaines.
La revue Chronobiology International (2010 Aug.;27(7):1469-1492) publie une étude sur les rythmes de l’adolescent et notamment sur le  « sommeil de rattrapage ». Les adolescents en effet disent le plus souvent profiter des week-ends pour compenser une dette de sommeil accumulée, en semaine, en période scolaire. Cette étude évalue l’impact  sur le système circadien de ces levers plus tardifs le week-end et met à l’épreuve l’hypothèse de ces modifications du temps de sommeil et d’une exposition spécifique à la lumière le week end, comme susceptibles de stabiliser le système circadien.
La revue Alcoholism, Clinical and Experimental Research publie une étude interrogeant les corrélations entre développement à la puberté, habitudes de sommeil, troubles du sommeil et consommation d’alcool sur un échantillon de 431 jeunes adolescents.
La Bioorganic Medicinal Chemistry  Letters (sept 2010) attire l’attention sur la pertinence d’un dérivé d’imidazo-benzodiazepine dans le cadre du traitement des troubles du sommeil.

Developemental  Medicine and Child Neurology. 2010 Sep;52(9):805-10. Epub 2010 Mar 29.
The relationship between sleep and epilepsy: the effect on cognitive functioning in children.
Parisi P, Bruni O, Pia Villa M, Verrotti A, Miano S, Luchetti A, Curatolo P.
Child Neurology and Sleep Paediatric Disorders Centre, II Faculty of Medicine, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
Aim The purpose of this review was to examine the possible pathophysiological links between epilepsy, cognition, sleep macro- and microstructure, and sleep disorders to highlight the contributions and interactions of sleep and epilepsy on cognitive functioning in children with epilepsy. Method PubMed was used as the medical database source. No language restriction was placed on the literature searches, and citations of relevant studies in the paediatric age range (0-18y) were checked. Studies including a mixed population but with a high percentage of children were also considered. Results The searches identified 223 studies. One reviewer scanned these to eliminate obviously irrelevant studies. Three reviewers scanned the remaining 128 studies and their relevant citations. The review showed that several factors could account for the learning impairment in children with epilepsy: aetiology, electroencephalographic (EEG) discharges, and persistence and circadian distribution of seizures, etc. EEG discharges may affect cognition and sleep, even in the absence of clinical or subclinical seizures. The sleep deprivation and/or sleep disruption affect the neurophysiological and neurochemical mechanisms important for the memory-learning process, but also influence the expression of EEG discharges and seizures. Learning and memory consolidation can take place over extended periods, and sleep has been demonstrated to play a fundamental role in these processes through neuroplastic remodelling of neural networks. Epilepsy and EEG paroxysms may affect sleep structure, interfering with these physiological functions. Interpretation Improvement in the long-term cognitive-behavioural prognosis of children with epilepsy requires both good sleep quality and good seizure control. The antiepileptic drug of choice should be the one that interferes least with sleep structure and has the best effect on sleep architecture - thus normalizing sleep instability, especially during non-rapid eye movement sleep.
PMID: 20370812 [PubMed - in process]
Chronobiology International 2010 Aug.;27(7):1469-1492.
Crowley SJ, Carskadon MA.
Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA.
Adolescents often report shorter time in bed and earlier wake-up times on school days compared to weekend days. Extending sleep on weekend nights may reflect a "recovery" process as youngsters try to compensate for an accumulated school-week sleep debt. The authors examined whether the circadian timing system of adolescents shifted after keeping a common late weekend "recovery" sleep schedule; it was hypothesized that a circadian phase delay shift would follow this later and longer weekend sleep. The second aim of this study was to test whether modifying sleep timing or light exposure on weekends while still providing recovery sleep can stabilize the circadian system. Two experiments addressed these aims. Experiment 1 was a 4-wk, within-subjects counterbalanced design comparing two weekend sleep schedule conditions, "TYPICAL" and "NAP." Compared to weeknights, participants retired 1.5 h later and woke 3 h later on TYPICAL weekends but 1 h later on NAP weekends, which also included a 2-h afternoon nap. Experiment 2 was a 2-wk, between-subjects design with two groups ("TYPICAL" or "LIGHT") that differed by weekend morning light exposure. TYPICAL and LIGHT groups followed the TYPICAL weekend schedule of Experiment 1, and the LIGHT group received 1 h of light (454-484 nm) upon weekend wake-up. Weekend time in bed was 1.5 h longer/night than weeknights in both experimental protocols. Participants slept at home during the study. Dim light melatonin onset (DLMO) phase was assessed in the laboratory before (Friday) and after (Sunday) each weekend. Participants were ages 15 to 17 yrs. Twelve participants (4 boys) were included in Experiment 1, and 33 (10 boys) were included in Experiment 2. DLMO phase delayed over TYPICAL weekends in Experiment 1 by (mean +/- SD) 45 +/- 31 min and Experiment 2 by 46 +/- 34 min. DLMO phase also delayed over NAP weekends (41 +/- 34 min) and did not differ from the TYPICAL condition of Experiment 1. DLMO phase delayed over LIGHT weekends (38 +/- 28 min) and did not differ from the TYPICAL group of Experiment 2. In summary, adolescents phase delay after keeping a commonly observed weekend sleep schedule. Waking earlier or exposure to short-wavelength light on weekend mornings, however, did not stabilize circadian timing in this sample of youngsters. These data inform chronotherapy interventions and underscore the need to test circadian phase-shifting responses to light in this age group. (Author correspondence: Stephanie_J_Crowley@rush.edu ).
Ergonomics. 2010 Sep;53(9):1072-5.
How well do pilots sleep during long-haul flights?
Roach GD, Darwent D, Dawson D.
Centre for Sleep Research, University of South Australia, Adelaide, SA, Australia.
It is imperative that shiftworkers in safety-critical workplaces obtain sufficient sleep to operate effectively. This presents a challenge to long-haul airline pilots who are required to supplement normal bed sleep with sleep on-board an aircraft during flight. In the current study, the sleep/wake behaviour of 301 airline pilots operating long-haul flight patterns was monitored for at least 2 weeks using self-report sleep diaries and wrist activity monitors. The data indicate that sleep opportunities in on-board rest facilities during long-haul flights result in a similar amount of sleep, but only 70% as much recovery, as duration-matched bed sleeps. Statement of Relevance: This study indicates that in-flight sleep provides airline pilots with 70% as much restoration as duration-matched bed sleep. To increase the restoration provided by in-flight sleep, airlines could take measures to improve the quality, or increase the amount, of sleep obtained by pilots during flights.
Alcoholism, Clinical and Experimental Research. 2010 Sep 1;34(9):1512-8. Epub 2010 Jun 21.
Puberty-dependent sleep regulation and alcohol use in early adolescents.
Pieters S, Van Der Vorst H, Burk WJ, Wiers RW, Engels RC.
From the Behavioural Science Institute (SA, HVDV, WJB, RCMEE), Radboud University Nijmegen, Nijmegen, the Netherlands; ADAPT Lab, Department of Psychology (RWW), University of Amsterdam, Amsterdam, the Netherlands.
Background: Research has shown a bi-directional relation between alcohol use and sleep regulation in adults. Much less is known about this association in early adolescents, while profound puberty-dependent transitions regarding sleep patterns take place in early adolescence. Moreover, puberty has been associated with an increase in alcohol use of adolescents. Methods: In this study, we investigated the associations between pubertal development, sleep preference, sleep problems, and alcohol use in 431 early adolescents (mean age: 13.66). Second, it was studied whether the associations changed when controlling for adolescent internalizing and externalizing problems. Furthermore, we included gender as a moderator on all the associations. Results: Results showed that pubertal development was positively associated with sleep problems and more evening-type tendencies (e.g., favoring later bedtimes), which in turn were positively related to alcohol use. Underlying psychopathology, gender and educational level did not change these relationships. Conclusions: From this study, it can be concluded that both puberty and sleep regulation are important factors in explaining alcohol use in early adolescence.
PMID: 20569245 [PubMed - in process]
Bioorganic Medicinal Chemistry  Letters 2010 Sep 1;20(17):5069-73. Epub 2010 Jul 11.
Novel imidazobenzazepine derivatives as dual H1/5-HT2A antagonists for the treatment of sleep disorders.
Gianotti M, Corti C, Delle Fratte S, Di Fabio R, Leslie CP, Pavone F, Piccoli L, Stasi L, Wigglesworth MJ.
Neurosciences CEDD, GlaxoSmithKline, Medicines Research Centre, Verona, Italy. massimo.gianotti@aptuit.com
A novel imidazobenzazepine template (5a) with potent dual H(1)/5-HT(2A) antagonist activity was identified. Application of a zwitterionic approach to this poorly selective and poorly developable starting point successfully delivered a class of high quality leads, 3-[4-(3-R(1)-2-R-5H-imidazo[1,2-b][2]benzazepin-11-yl)-1-piperazinyl]-2,2-dimethylpropanoic acids (e.g., 9, 19, 20, and 21), characterized by potent and balanced H(1)/5-HT(2A) receptor antagonist activities and good developability profiles.

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Groupe Santé Sommeil

Le groupe médical Santé Sommeil a pour vocation de diagnostiquer et traiter les troubles du sommeil et de la veille chez l’adulte et l’enfant.