Published Research - General Sleep and RLS (WED)

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Polar Bear
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Re: Published Research - General Sleep and WED (RLS)

Post by Polar Bear »

So if someone can only get 2 or 3 or 4 hours sleep per night...... Not much time for a general cleanup.
Betty
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Re: Published Research - Auditory startle reflex

Post by Chipmunk »

The auditory startle reflex has more to do with how quickly your body goes into freak-out mode. You startle more easily in a scary situation, and less easily when you are relaxed and comfortable.

I found this article which summarizes all the known disorders with exaggerated auditory startle reflexes. I wonder which one WED is related to, if any.
Clinical Neurophysiology January 2012, Volume 123, Issue 1, Pages 34-44.
Exaggerated startle reactions
Yasmine E.M. Dreissen, Mirte J. Bakker, Johannes H.T.M. Koelman, Marina A.J. Tijssen

From P07.20 Auditory startle reflex disinhibition in idiopathic restless legs syndrome
Clinical Neurophysiology, Volume 117, Supplement 1, September 2006, Pages 166-167
M. Kofler, B. Frauscher, W. Löscher, B. Högl, W. Poewe
Background: Recent neuropathological examination in restless legs syndrome (RLS) revealed basal ganglia involvement, particularly in the substantia nigra. In other disorders with substantia nigra pathology, e.g. multiple system atrophy, auditory startle reflexes (ASRs) were exaggerated.
Conclusion: Our data suggest disinhibition of reticulo-spinal pathways in idiopathic RLS, likely originating rostral to the brainstem. Basal ganglia involvement may contribute to increased ASRs in RLS.


I'm guessing we don't actually have damage to that part of the brain, but instead are deficient in the neurotransmitters which ferry and/or inhibit signals to our brains.
Tracy

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badnights
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Re: Published Research - myelin sheath

Post by badnights »

rustsmith wrote:Beth, could you provide more information about this study on myelin damage and WED? Myelin damage sounds more like MS, a topic that I am much more familiar with thanks to serving as caretaker on my wife's case for 40 yrs.
The study abstract is below:

Sleep Med. 2011 Jun;12(6):614-9. Epub 2011 May 12.
Postmortem and imaging based analyses reveal CNS decreased myelination in restless legs syndrome.
Connor JR, Ponnuru P, Lee BY, Podskalny GD, Alam S, Allen RP, Earley CJ, Yang QX.
Source
Department of Neurosurgery, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, PA 17033-0850, USA. jconnor@hmc.psu.edu
Abstract
BACKGROUND:
Restless legs syndrome (RLS) is a neurological disorder characterized by a strong urge to move the legs and has been shown in many studies with abnormally low brain iron. Iron deficiency is associated with hypomyelination in brains of animals. Therefore we hypothesized that a myelin deficit should be present in the brains of patients with RLS.
METHODS:
We performed Western blot analysis on myelin isolated from RLS (n=11) and control (n=11) brain tissue obtained at autopsy for the expression of the integral myelin proteins, myelin basic protein (MBP), and proteolipid protein (PLP) and the oligodendrocyte specific enzyme 3'5'-cyclic nucleotide phosphohydrolase (CNPase). To expand the postmortem findings to in vivo, we analyzed the brains of RLS patients (n=23) and controls (n=23) using voxel-based morphometry (VBM).
RESULTS:
The expression of MBP, PLP and CNPase in the myelin from RLS was decreased by approximately 25% (p<0.05) compared to controls. The amounts of transferrin (Tf) and H-ferritin (H-Frt) in the myelin fraction were also significantly decreased in RLS compared to controls. The imaging analysis revealed significant small decreases in white matter volume in RLS patients compared to controls in the corpus callosum, anterior cingulum and precentral gyrus.
CONCLUSION:
A decrease in myelin similar to that reported in animal models of iron deficiency was found in the brains of individuals with RLS. The evidence for less myelin and loss of myelin integrity in RLS brains, coupled with decreased ferritin and transferrin in the myelin fractions, is a compelling argument for brain iron insufficiency in RLS. These data also indicate the need to look beyond the sensorimotor symptoms that typically define the syndrome and its assumed relation to the dopaminergic system. Understanding the full range of RLS pathology may help us better understand the complex, intermittent nature and diversity of the clinical features of RLS and expand our consideration of treatment options for RLS.
Copyright © 2011 Elsevier B.V. All rights reserved.
PMID:
21570342
[PubMed - in process]
PMCID: PMC3110510
[Available on 2012/6/1]
Beth - Wishing you a restful sleep tonight
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badnights
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Re: Published Research - myelin sheath

Post by badnights »

Beth, could you provide more information about this study on myelin damage and WED? Myelin damage sounds more like MS, a topic that I am much more familiar with thanks to serving as caretaker on my wife's case for 40 yrs.
Also of potential interest is this letter to the editor of the journal Sleep Medicine, 2011, v.12, p.198–199:
Morelli+ 2011 _Myelin sheath in sleep.pdf
(35.62 KiB) Downloaded 74 times
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badnights
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Re: Published Research - Auditory startle reflex

Post by badnights »

ellephant wrote:I'm specifically curious if the disinhibited physiological startle response implies that RLS patients are more sensitive and perceptive to sounds in general, or if it's just that the sounds are perceived the same as non-RLS patients, but the body physically responds much quicker and more intensely. Would an RLS patient be significantly more bothered by a television that was constantly playing too loudly than an non-RLS patient, or is the increased sensitivity only seen in response to sudden, startling sounds and in the form of the physical reaction?

I'm also very curious to know if this implies that RLS patients are more sensitive to background noise when sleeping. Are RLS patients lighter sleepers when it comes to external noise?
I don't think it implies that, but I'm not sure if there might be a link. I had assumed startle reflexes are quite separate from normal sensory circuits including those for hearing; but on consideration, I don't have any firm basis for that assumption.

It's an interesting question, because there was a point in my life, about 20 years before the WED flared up bad, when I became a light sleeper. It was just after I had babies, so I attribute it to that, but it has persisted.

I've never been able to read when the TV or radio is playing, or even if music with words (singing) is playing. My grandfather was so sensitive to sound he moved his entire family numerous times to what he always hoped would be a quieter place.

At the same time my WED became bad, as near as I can recall, I developed a heightened auditory startle reflex. I jump at any noise behind me. Sometimes, I have no physiological reaction other than the jump, the sudden contraction of muscles; it's unaccompanied by anxiety or elevated heart rate or the usual things one would expect while the person who made the noise behind me has been startled by my jump and has the expected elevated heart and respiration rate, etc. It's like my body contracts but my mind is not affected.
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badnights
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Re: Published Research - blink reflex & other sensitivities

Post by badnights »

On the topic of reflexes, WED patients not only have a stronger startle response to sudden sound, we also have some kind of subtle impairment of the eye-blinking reflex. The authors suggest that in WED there is something wrong with the cerebellar - brainstem circuits.
Altered eyeblink re.ex conditioning in restless legs syndrome patients by Matthew D. McEchron, Danielle N. Alexander, Michael E. Smith, Deborah L. Hoffman, Gerald D. Podskalny, James R. Connor
Restless legs syndrome (RLS) is characterized by abnormal leg sensations and an uncontrol­lable urge to move the lower extremities during rest periods. Evidence suggests that re.ex tasks that involve sensory–motor integration may be altered in RLS patients. This led us to determine if RLS patients show alterations in a sensory–motor re.ex conditioning task called differential eyeblink conditioning. Methods: RLS subjects were washed out of treatment medication for 7 days prior to testing. Subjects (20 RLS and 19 Control) received 120 discrimination conditioning trials consisting of 60 CS+ trials (i.e., an auditory stimulus paired with the airpuff-US separated by a silent 900 ms trace interval) and 60 CS-tri­als (i.e., a different auditory stimulus that was NOT paired with the US). Results: Control subjects showed normal differential responding to the CS+ and CS-, but the RLS patients showed little or no differential responding. A post-test questionnaire provides evidence that symptom­atic interference was not responsible for the eyeblink conditioning de.cits in the RLS subjects, and fur­ther suggests that neurophysiological factors were responsible for these de.cits. Conclusions: Together these results suggest that de.cits in eyeblink conditioning are related to the path­ophysiology of RLS. The eyeblink conditioning test may also be useful for supporting a clinical diagnosis or treatment strategy for RLS.


We are also more sensitive to blunt pressure, pinprick, vibratory hyperesthesia, cold, & heat viewtopic.php?f=5&t=4749&p=63808#p63808
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Re: Mouse Model - Brain cleans itself during sleep

Post by badnights »

EDIT: I forget to mention that this response was to Views' Mouse-Study post and a following question by aveerik
"Do people with wed/rls have a higher incident in Alzheimers?"


Having our disease causes reduced sleep which may cause other neurodegenerative diseases because of toxin buildup - but what caused our disease in the first place? I don't think any research has related WED to an increased chance of developing a neurodegenerative disease like Alzheimer's.

I wonder if the glymphatic system will do brain clean-up during meditation? It might be a healthy substitute for sleep. Well, healthier than not doing either. Yogis say people who meditate need far less sleep; wonder if that's true.
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Rustsmith
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Re: Published Research - General Sleep and WED (RLS)

Post by Rustsmith »

Beth, thanks for all the great information. The abstract linking iron deficiency and a decrease in myelin is the first time I have seen anything proposing a mechanism for how low iron in the brain has an impact.

As for this link following your comment -
We are also more sensitive to blunt pressure, pinprick, vibratory hyperesthesia, cold, & heat


If I am reading their results correctly, we have increased sensitivity to cold but somewhat decreased sensitivity to heat. That would explain why I have always had "asbestos" fingers and have been able to pick things up that others found to be too hot (a trait that I inherited from my grandmother). As for the increased sensitivity to cold, that certainly applies but I had written that off to a combination of being very thin, having Raynaud's syndrome and living in a generally warm climate.

Steve
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Afib progression

Post by ViewsAskew »

http://www.familypracticenews.com/news/ ... 8c00f.html

Cardiovascular Disease
Number of restless leg movements during sleep may predict AFib progression

By: RICHARD FRANKI, Family Practice News Digital Network

In patients with restless legs syndrome, frequent leg movements during sleep were associated with the progression of atrial fibrillation, reported Dr. Mahek Mirza and her associates.

In their study, 205 patients with more than 35 leg movements per hour were more likely (odds ratio, 1.88) to experience progression of atrial fibrillation during a median of 33 months of follow-up, compared with 168 patients with atrial fibrillation who had a periodic movement index of 35 or less, reported Dr. Mirza of the center for integrative research on cardiovascular aging, Aurora Health Care, Milwaukee, Wis., and her associates.

In the group of patients with a high frequency of leg movements during sleep, those treated with dopaminergic drugs were less likely to experience atrial fibrillation progression (11.6%), compared with those who were not treated (32%). No treatment difference in progression was seen among patients with a low frequency of leg movements, the investigators reported (PLoS One 2013 Oct. 16;8:e78359 [doi:10.1371/journal.pone.0078359]).

Dr. Mirza and one of her associates were supported by grants from the National Heart, Lung, and Blood Institute. The investigators said they had no relevant financial disclosures.
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Re: Published Research - General Sleep and WED (RLS)

Post by badnights »

rustsmith wrote:The abstract linking iron deficiency and a decrease in myelin is the first time I have seen anything proposing a mechanism for how low iron in the brain has an impact
Ya, I like that too. I have heard more people say "since iron is required for dopamine metabolism, dopamine synthesis will be impaired in low-iron situations". I don't know if tha'ts anything more than an assumption.

I had heard that vitamin D was required to build mylelin sheath, so I hunted all over for a reference for that. I learned that no studies I could find linked lack of D directly with myelin loss; it was assumed to be involved because of the geographic distribution of MS patients (more at high latitudes).
That would explain why I have always had "asbestos" fingers and have been able to pick things up that others found to be too hot (a trait that I inherited from my grandmother). As for the increased sensitivity to cold, that certainly applies but I had written that off to a combination of being very thin, having Raynaud's syndrome and living in a generally warm climate.
I developed the ability to stick my hands in water that other people flinch from about 10 years before the WED. The cold hands and feet - and increasingly, an inability to regulate my body temperature (always COLD) - came the same winter the WED flared up. I thought they had to be related. Now I just don't think. lol
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ViewsAskew
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Re: Published Research - General Sleep and WED (RLS)

Post by ViewsAskew »

For years I've opined that I've become so intolerant to cold or hot temps and am intolerant of most of Chicago weather. I want it to stay no colder than 55 and no warmer than 75. Good luck with that here! When I get hot, I stay hot for a LONG time - my face is flushed and I look very overheated. I've had people come up to me at the gym and ask me if I'm OK. When I get cold, I can heap 5 blankets on me and still shiver for an hour. Pramipexole makes this MUCH worse at night, but even when I don't take it, it is an issue.

This just reminded me of a semester I spent working in a state mental health facility during my senior year of college. Along with 3 other students, I lived on the grounds of the facility (it had 25 buildings) in an unused wing of a building that housed teenagers who were in there because of drug/alcohol abuse along with behavior disorders. The wing had been a dormitory, so it had a large shower room, as in a gym. Interestingly, each shower had an attached thermometer. I routinely took (and still do) showers that other people couldn't even stick their hand into for a moment- between 116 and 119 F. The other students usually took ones around 105F.
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Re: Published Research - General Sleep and WED (RLS)

Post by Rustsmith »

I had heard that vitamin D was required to build mylelin sheath, so I hunted all over for a reference for that. I learned that no studies I could find linked lack of D directly with myelin loss; it was assumed to be involved because of the geographic distribution of MS patients (more at high latitudes).


You need to keep looking for the vitamin D correlation because the geographic tie to MS patients doesn't hold up anymore. Statistically, there are geographic clusters of MS patients that are based upon where the individual grew up. Most are in northern latitudes, but one is in the Florida Keys, hardly a low vitamin D location.

The correlation probably has more to do with genetics. Some of the genetic characteristics that are believed to be related to MS are tied to individuals whose original ancestry traces back to northern Germany. That has a lot to do why you find so many in the UK, Canada and the northern US. In my wife's case, she grew up in El Paso, TX (another high vitamin D location), but a large portion of both of her parent's ancestry is either British or what is now northern Germany.

As for the temperature issue, my stories have to do with the fact that I am an avid scuba diver. In all cases when I go diving, I wear a full wetsuit. I have been on trips where some of the women are just wearing small bikinis and think the water is warm. I come out shivering even though I have been clad in a thick rubber, full body suit. On the flip side of that, when I was in scuba class, someone forgot and left the pool heater too long on one evening. The water temp was 95F. Everyone else bailed from the class because it was too hot. It was the ONLY time in 25 yrs that I have been comfortable diving without my wetsuit.

Steve
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aveerik
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Re: Published Research - General Sleep and WED (RLS)

Post by aveerik »

Badnights thanks for the info regarding alzheimers and WED patients. I have heard that if you have MS you can't get Alheimers, anyone else hear that?

I have extreme sensitivity to cold, especially in my hands but I can practically stick my fingers in boiling water with little pain. I also take such hot showers and baths that no one else can ever join me, poor hubby :shock:

It seems we all have such weird neurological things going on along with our WED that it would be surprising if someone proved it was something totally not neurological. Unfortunately all the meds for neurological disorders are pretty bad.

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Re: Published Research - General Sleep and WED (RLS)

Post by ViewsAskew »

aveerik wrote:Badnights thanks for the info regarding alzheimers and WED patients. I have heard that if you have MS you can't get Alheimers, anyone else hear that?
.


A quick websearch shows that this is a fallacy. People with MS are no more or no less likely to have Alzheimer's than anyone else.

I love the internet - can't imagine my life without it! - but it's a breeding ground for the most inaccurate information. I usually search to find and read on multiple sources - and carefully judge the sources - before I come to a conclusion.
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Re: Published Research - General Sleep and WED (RLS)

Post by Rustsmith »

During my last visit with our neurologist, I was quizzing her about my possible future with Alzheimers since I have a family history. She made an offhand comment that Alzheimers was one thing that my wife did not have to worry about, which I assumed was a reference to a connection with MS. I asked my wife about it and she had never heard about anything like this from any of her previous physicians.

So, maybe there is a belief among some that there is a relationship. I am not quite sure how I would rate this particular doctor. She has been competent for most of our needs, but after all, 50% of the physicians were in the bottom half of their class at med school.
Steve

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