An introduction to the clinical correlates of disrupted slow-wave sleep

Ruth M. Benca, MD, PhD

Professor, Department of Psychiatry and Psychology
Director, Center for Sleep Medicine and Sleep Research
University of Wisconsin-Madison
Madison, Wisconsin

Several medical and psychiatric conditions (eg, obstructive sleep apnea, insomnia, mood disorders, schizophrenia, alcoholism) are associated with changes in slow-wave sleep (SWS). In addition to cognitive dysfunction, pathophysiologic effects that accompany decreases in SWS may include reduced growth hormone release in men, glucose intolerance, and possible increased risk of diabetes. Interestingly, arousal indices in SWS are significantly higher as is reported in patients with sleep disordered breathing for example, which is significantly reduced using continuous positive airway pressure. The extent of the effects of increased arousal indices in SWS is not completely understood, however may be related with daytime cognitive, behavioral, and performance impairments. Thus, therapies that normalize SWS in these patients may be critical to optimize patient outcomes. Here, Dr. Benca discusses SWS deficits and abnormalities, and their association with major depression, insomnia, and sleep apnea. She also poses the clinically relevant question of the possible relationship of reduced SWS to neurobehavioral abnormalities observed while awake.

References

Roth T, Benca RM, Erman M. An Introduction to the Clinical Correlates of Disrupted Slow-Wave Sleep. J Clin Psychlopedia. 2009.
Ondze B, Espa F, Dauvilliers Y, et al. Sleep architecture, slow wave activity and sleep spindles in mild sleep disordered breathing. Clin Neurophysiol. 2003;114(5):867–874.
Benca RM, Obermeyer WH, Thisted RA, et al. Sleep and psychiatric disorders: a meta-analysis. Arch Gen Psychiatry. 1992;49:651–668.

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