Yulia V. Ukraintseva

Sleep disorders are a primary symptom of post-traumatic stress disorder (PTSD). Advances in computer technology have enabled the development of widely accessible wearable devices (WDs) that record objective parameters of patient activity and physiological functions. When integrated into telemedicine platforms, these devices facilitate patient access to diagnostic and treatment methods. This review summarizes the use of WDs, mobile, and web applications for diagnosing sleep disorders in PTSD and evaluating the effectiveness of therapeutic interventions. The application of modern technologies in research to establish new treatment approaches for PTSD and to translate scientific developments into clinical practice is discussed. The review also analyzes the use of computerized therapies that enable remote and largely autonomous treatment. Issues related to the use of digital technologies for diagnosing and treating PTSD are addressed, including confidentiality, security, and the need for careful interpretation of results, particularly for patients with mental disabilities and cognitive deficits.

Влияние заплывов в ледяной воде на проводящую систему сердца и вегетативную регуляцию У пловцов зимнего плавания

The review summarizes the results of sleep studies in patients with posttraumatic stress disorder (PTSD) and describes the specific features of nightmares as well as other sleep disturbances specific to this disease. Hypothetical mechanisms of impaired adaptive function of dreams and sleep-dependent reconsolidation of emotional memory in PTSD are addressed. The diagnostic value of dreams during the acute posttraumatic period is discussed. Modern methodological approaches to the treatment of PTSD and concomitant insomnia and nightmares are presented.

Establishing well-defined relationships between sleep features and memory consolidation is essential in comprehending the pathophysiology of cognitive decline commonly seen in patients with insomnia, depression, and other sleep-disrupting conditions. Twenty-eight volunteers participated in two experimental sessions: a session with selective SWS suppression during one night and a session with undisturbed night sleep (as a control condition). Fifteen of them also participated in a third session with REM suppression. Suppression was achieved by presenting an acoustic tone. In the evening and the morning, the participants completed procedural and declarative memory tasks and the Psychomotor vigilance task (PVT). Heart rate variability analysis and salivary cortisol were used to control possible stress reactions on sleep interference. SWS and REM suppression led to more than 50 percent reduction in amount of these stages. Neither vigilance nor memory consolidation was impaired after SWS or REM suppression. Unexpectedly, a beneficial effect of selective SWS suppression on PVT performance was found. Similarly, after a night with SWS suppression, the overnight improvement in procedural skills was higher than after a night with REM suppression and after a night with undisturbed sleep. Our data brings into question the extent to which SWS and REM are truly necessary for effective memory consolidation to proceed. Moreover, SWS suppression may even improve the performance of some tasks, possibly by reducing sleep inertia associated with undisturbed sleep. Highlights Our data brings into question the extent to which SWS and REM are truly necessary for effective memory consolidation to proceed. Provided that sleep disturbances do not cause stress, half the usual amount of SWS or REM is sufficient for procedural and declarative memory consolidation. Moreover, SWS suppression may even improve the performance of psychomotor vigilance task and finger sequence tapping task, possibly by reducing sleep inertia associated with undisturbed night sleep.

Objective. To compare the effect of stage 3 fragmentation and the paradoxical phase of night sleep on melatonin (MT) secretion, and to evaluate the effects of changes in autonomic balance and activation reactions that occur in the orthodox and paradoxical phases of sleep. Material and methods. Fifteen healthy men participated in three sessions: with stage 3 fragmentation, with fragmentation of paradoxical sleep, and in a control experiment in which sleep was not disturbed. In each experiment, 7 saliva samples were collected in the evening, at night and in the morning and the MT content was determined. Heart rate variability was analyzed using an electrocardiogram and autonomic balance was assessed. Results. Sleep fragmentation was accompanied by activation reactions and reduced the duration of stage 3 and paradoxical phase sleep by 50% and 51% in the corresponding sessions. Fragmentation of paradoxical sleep also led to an increase in the duration of night wakefulness. Sleep disturbances caused an increase in MT secretion in the second half of the night and in the morning, especially pronounced in sessions with fragmentation of paradoxical sleep, in which upon awakening MT was 1.8 times higher than in the control. Stage 3 fragmentation was accompanied by increased sympathetic activation, while fragmentation of paradoxical sleep did not cause autonomic shifts. The subjects were divided into 2 clusters: with high and low MT in night and morning saliva samples. In all sessions, subjects with high MT had 1.7—2 times longer duration of night wakefulness; in sessions with fragmentation, they had significantly more activations in the paradoxical phase of sleep. Conclusion. Night sleep disturbances cause an increase in MT secretion, especially pronounced during the fragmentation of the paradoxical phase. An increase in MT levels does not depend on changes in autonomic balance and is apparently associated with activation of the serotonergic system, which accompanies disturbances in the depth and continuity of sleep.

The recovery mechanisms of various forms of behavior upon awakening from sleep are still not well understood. In this work, we investigated the recovery of simple motor reactions to visual stimuli, fine hand-eye coordination, and abstract thinking upon awakening from the deepest, SWS stage of daytime sleep. Subjects were offered two types of tasks: visual-motor tasks in which it was necessary to control a moving object; and arithmetic, in which it was necessary to determine the correctness of the proposed equalities in wakefulness before sleep and during the first 2 minutes of awakening from sleep. The results obtained showed that the speed of a simple motor reaction to the appearance of a visual stimulus reached the wakefulness level almost immediately after awakening (within 4 seconds), while the restoration of the ability to determine the correctness or incorrectness of arithmetic equalities, as well as the ability to accurately control the trajectory of a moving object required much more time: about 40 seconds (in the arithmetic task) and 60 seconds (in the visual-motor task). The power of the alpha-rhythm upon awakening was higher than in wakefulness. Delta-rhythm power was increased only at the beginning of awakening while task performing was difficult, and in the second minute of awakening the delta-rhythm decreased when task performing was restored. Our data indicate that simple and complex forms of behavior upon awakening are not restored simultaneously.