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Sleep Study - Spindles


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#1 Moss92

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Posted 06 July 2009 - 12:18 PM

Hello,
I've a question for sleepgeeks :) - I had increased spindling in a sleep study and was wondering about what else causes it. I read it's what our brains do to "shock absorb" sensory stimuli, to help keep us asleep when we're in stage 2 NREM. And I found some research saying that PWN and with idiopathic hypersomnia have more spindles, or have them arranged differently so they could be scored that way on a sleep study. Some of psychiatric conditions - lots of the ones we're most at risk for getting misdiagnosed with - cause less spindling or normal spindling, but has anyone heard of any psychiatric problems, or other neuro damage, or sleep disorders causing increased spindling?
Thanks,
Moss

#2 Irishhh

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Posted 06 July 2009 - 12:27 PM

Hmmm... I've never looked into spindling. This will be a new research topic for me. I don't know anything about it, but thanks for bringing this up. I'd like to know as well. My sleep doctor didn't talk to me about this, so I don't know if it came up with me or not.

#3 Moss92

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Posted 09 July 2009 - 03:31 PM

Hmmm... I've never looked into spindling. This will be a new research topic for me. I don't know anything about it, but thanks for bringing this up. I'd like to know as well. My sleep doctor didn't talk to me about this, so I don't know if it came up with me or not.


Hi Irishhh,

My sleep doctor didn't mention it to me either. Do you think more information on this could be any use to PWN who've had unclear sleep studies - something you can point to on the results page to say - that happens in N, and helps us rule out a few of these other dx.

So far I've got Increased number of spindles in- Narcolepsy, Idiopathic Hypersomnia, transient noise early on in the night, several types of dystonias, diazepam, learning - simple motor procedural memory (?), some comas,

Decreased No of spindles in - certain strokes, some other brain injuries, schizophrenia, unipolar and bipolar depression, fibromyalgia

And normal number of spindles in PTSD, chronic psychological insomnia.

It'd be good to know what happens with spindles when we've got N and fibro or N and bipolar. Any help with the lists'd be lovely.

#4 sleepless sleeper

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Posted 23 July 2009 - 11:42 PM

I'm so happy that I read this because I've got an appt with my sleep doctor tomorrow. I will try my best to take this info with me to ask him. If I do, then I'll report back what I learn.

#5 Moss92

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Posted 24 July 2009 - 10:14 AM

Hi Sleepless,
It'd be good to hear what he said.
found something today , it's only from one bit of research but they're saying there's significant changes to the timing of sleep spindles in narcolepsy. So that could maybe help too, if it showed on someone's PSG.
Hope it went well with the doctor, and the journey there and back.

#6 Bafflegab

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Posted 24 July 2009 - 03:38 PM

Hello,
I've a question for sleepgeeks :) - I had increased spindling in a sleep study and was wondering about what else causes it. I read it's what our brains do to "shock absorb" sensory stimuli, to help keep us asleep when we're in stage 2 NREM. And I found some research saying that PWN and with idiopathic hypersomnia have more spindles, or have them arranged differently so they could be scored that way on a sleep study. Some of psychiatric conditions - lots of the ones we're most at risk for getting misdiagnosed with - cause less spindling or normal spindling, but has anyone heard of any psychiatric problems, or other neuro damage, or sleep disorders causing increased spindling?
Thanks,
Moss


There are a number of things that can increase sleep spindles. Abnormalities in the thalamus can cause an increase in sleep spindles. So can damage done to the cerebrum (the thalamus and cerebral cortex are interconnected so it makes sense that what affects one will affact the other). Central nervous system depressants can increase sleep spindles, as well (they also decrease the amount of time spent in REM sleep). Blindness and deafness can cause increased sleep spindles. Torsion dystonia can sometimes cause an increase in sleep spindles, but not commonly.

Disease or disorders aren't the only thing that can increase the number sleep spindles, however. A number of studies have reported that sleep spindles increase in number and power after spatial or intensive verbal learning, and it is believed by at least some researchers that there is a correlation between the organization of sleep oscillations and intelligence. What is generally acknowledged is that there is evidential support for the idea that experience (while awake) not only affects sleep, but can bring about structural changes in the brain. All of this is explained in the book, Rhythyms of the Brain, by Gyorgy Buzsaki (available at Barnes and Noble, Amazon.com, Powells.com--Powells Books provided Amazon.com all the books Amazon sold when it first opened for business, and other fine book-selling establishments).

Neurologic disorders affect the spinal cord and the brain. The part of the body that connects these two separate but inter-dependent (for optimal health anyway) body systems is the thalamus, and there are over 600 neurologic disorder. Many of those 600-plus disorders are mental illnesses that are strictly neurologic in nature, so asking what neurologic disfunction can increase (the question of the organization of sleep spindles alone can fill a book) spindling is a huge question--a really good one, but huge.

Have you gone over the results of the PSG with your doctor, yet? If so, what did he or she think about it?

#7 Moss92

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Posted 25 July 2009 - 06:25 AM

There are a number of things that can increase sleep spindles. Abnormalities in the thalamus can cause an increase in sleep spindles. So can damage done to the cerebrum (the thalamus and cerebral cortex are interconnected so it makes sense that what affects one will affact the other). Central nervous system depressants can increase sleep spindles, as well (they also decrease the amount of time spent in REM sleep). Blindness and deafness can cause increased sleep spindles. Torsion dystonia can sometimes cause an increase in sleep spindles, but not commonly.

Disease or disorders aren't the only thing that can increase the number sleep spindles, however. A number of studies have reported that sleep spindles increase in number and power after spatial or intensive verbal learning, and it is believed by at least some researchers that there is a correlation between the organization of sleep oscillations and intelligence. What is generally acknowledged is that there is evidential support for the idea that experience (while awake) not only affects sleep, but can bring about structural changes in the brain. All of this is explained in the book, Rhythyms of the Brain, by Gyorgy Buzsaki (available at Barnes and Noble, Amazon.com, Powells.com--Powells Books provided Amazon.com all the books Amazon sold when it first opened for business, and other fine book-selling establishments).

Neurologic disorders affect the spinal cord and the brain. The part of the body that connects these two separate but inter-dependent (for optimal health anyway) body systems is the thalamus, and there are over 600 neurologic disorder. Many of those 600-plus disorders are mental illnesses that are strictly neurologic in nature, so asking what neurologic disfunction can increase (the question of the organization of sleep spindles alone can fill a book) spindling is a huge question--a really good one, but huge.

Have you gone over the results of the PSG with your doctor, yet? If so, what did he or she think about it?



Hi Bafflegab, Thank's, that's good to know it's much the same list in the book as I got from the literature - I've no useful treatment and I'm never sure of having stayed awake enough to be reading it right.

In the last few days, I found a few more bits and pieces on it - this is how bored I am!! in people with some types of Parkinson's spindling density is decreased. And increased in some people with Tourette's and Huntington's disease and another thing I've forgotten the name of by now, has acanth ... osis? in it. And relatives of people with cortical cerebellar atrophy. And when there's damage to a bit of the dorsal white matter in the spinal cord bringing sensory information up to the brain. Yes, it does look like it's the same cluster of pathways affecting this.

I was trying to think of situations where this'd maybe be practically useful like

1) When someone with N symptoms has inconclusive sleep study and is getting written off as mentally ill.

2) If someone had narcolepsy without cataplexy, or wasn't believed about the cataplexy, then doctors could think it was idiopathic hypersomnia if the sleep study was unclear. But the pattern of spindling is different in IH.

3)Or if someone had a messy combination of brain injury problems - There can be damage to another sleep regulating area, interacting with secondary N. So the symptoms and test results won't be standard for N.
There's disagreement over how often sleep spindles are affected in severe torsion dystonia. But torsion dystonia and secondary dystonias with similar symptoms are associated with damage to areas also involved in REM regulation.
And there's EDS in some dystonias. And dystonias especially after head injury are as underdiagnosed as N.
Same areas of damage are often involved in Parkinson's and PSP, affecting REM sleep and control of skeletal muscles (but obviously different connections damaged)
MRIs are crappy for finding this kind of damage and for seeing much clearly in this area of the brain. so spindling and other PSG details could be useful for untangling some sleep and brain and spine injury issues. That'd all take more research.

So far, from what I've read, all of the conditions and environmental factors that increase spindling, have a different pattern of spindling (differences in timing, frequency changes etc). So it'd be about getting a sleep center to look at this kind of detail, and do those bits of arithmetic.
You sound like you've got a good head for these details, and I'm out of my depth with all this - if I stay awake enough to get it written out properly, would you feel OK checking through it for me?

#8 sleepless sleeper

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Posted 25 July 2009 - 03:06 PM

hey there

got back from doctor. he touched on a lot of what y'all discuss here, except he says that he is not ready to use spindles for dx. i don't remember everything that he said because we talked about a lot and i wrote nothing down. the main gist that i got from what he said was that there is still too much cross over for spindles to be reliable.

#9 Andrea Egan

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Posted 26 July 2009 - 01:31 AM

Although polysomnographical findings like frequency of spindling, number of k-complexes, REM density, alpha intrusion, amount of SEM, etc. are interesting to researchers, they hold little weight in the clinical setting. A physician may make a casual observation about it and may use it as evidence to support a diagnosis--but never to base one off it. I'm surprised your doctor even mentioned it to you.

#10 Moss92

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Posted 26 July 2009 - 06:35 AM

Although polysomnographical findings like frequency of spindling, number of k-complexes, REM density, alpha intrusion, amount of SEM, etc. are interesting to researchers, they hold little weight in the clinical setting. A physician may make a casual observation about it and may use it as evidence to support a diagnosis--but never to base one off it. I'm surprised your doctor even mentioned it to you.



Yeh I sort of agree. if the questions about it were all settled and spindling patterns were used much in diagnosis in sleep medicine, we'd know about it. None of the sleep doctors I've seen have mentioned it to me. And yes, it would take loads more research before we know if differences in spindling patterns in different conditions are individual enough and reliable enough to know if they can be used for more than supportive evidence.

Even if someone pulled all the research together and find it suggests there are individual spindle-signatures for these conditions and influences - it's not going to impress many sleep doctors. But they aren't all the same, some might start thinking about it. With so many of us misdiagnosed for so many years, to me, it's worth turning over every stone to try to find out any things that can help make that process shorter and less painful , for others in the future. It's slow but some change can come from patients talking with (some) doctors on issues that aren't yet settled by research. Doctors see new connections and patterns and talk with researchers. this might go nowhere but it's worth asking about till we know.
I'm not totally anti doctor - they work with a lot of pressures. But the sleep doctors I've seen contradict the other sleep doctors, contradict the research, and the experiences of PWN and often themselves too. I understand they have to make firm decisions that have big impacts on peoples lives, based on what they know, but the knowledge base isn't too firm in places. asking questions feels useful.

yes, depending on your sleep doctor, at the moment the most spindling would be used for is a supportive bit of information, saying - this is something else that doesn't fit with this, this and this condition we'd suspected, but does happen in narcolepsy and IH, so we shouldn't write this patient off just yet.
Maybe in the future it can be more useful, or less if the research goes that way.

#11 Moss92

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Posted 26 July 2009 - 07:08 AM

hey there

got back from doctor. he touched on a lot of what y'all discuss here, except he says that he is not ready to use spindles for dx. i don't remember everything that he said because we talked about a lot and i wrote nothing down. the main gist that i got from what he said was that there is still too much cross over for spindles to be reliable.


makes sense they'd need more research, but it's good he would talk about it all with you, thank you!

#12 Moss92

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Posted 29 July 2009 - 05:25 AM

"Neurologic disorders affect the spinal cord and the brain. The part of the body that connects these two separate but inter-dependent (for optimal health anyway) body systems is the thalamus, and there are over 600 neurologic disorder. Many of those 600-plus disorders are mental illnesses that are strictly neurologic in nature, so asking what neurologic disfunction can increase (the question of the organization of sleep spindles alone can fill a book) spindling is a huge question--a really good one, but huge."



Bafflegab I was sleepy and didn't read your answer properly so didn't answer it, I think the reason I've got so optimistic(obsessive?) about it is that it looks like it's maybe just a few paths that go through the thalamus involved, from a few other areas, so we maybe wouldn't have to wait for them to check through every neuro condition or influence, or at least not more than for other factors used in dx. And there's been a lot of PSGs done and it's still a small list of conditions and influences that increase spindling, some with distinctive patterns. An area that is part of REM control and control of muscle tone is involved in some of these conditions. And changes in REM are involved in lots of the conditions and influences that increase and decrease spindles.
Anyway, that's why I'm ranting about how it could be relevant to N and some of the things that can look a bit like N. Reading research, and stubborn unrealistic optimism help me get by - but from reading here, it looks like being around other PWNs coping mechanisms can be hard work.

#13 Bafflegab

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Posted 29 July 2009 - 07:19 AM

... coping mechanisms can be hard work.


God-awful, hard work. But, without working hard I'd be walking the side of the road with a mortgage on a guilt I couldn't pay; and as difficult it is to live in poverty, I couldn't live with my self if the only thing I had going for me was an impoverished soul.