Related Experiment Video

Updated: Jun 4, 2025

A Chronic Sleep Fragmentation Model using Vibrating Orbital Rotor to Induce Cognitive Deficit and Anxiety-Like Behavior in Young Wild-Type Mice
06:23

A Chronic Sleep Fragmentation Model using Vibrating Orbital Rotor to Induce Cognitive Deficit and Anxiety-Like Behavior in Young Wild-Type Mice

Published on: September 22, 2020

5.3K

REM sleep atonia in patients with pediatric acute-onset neuropsychiatric syndrome: implications for pathophysiology

Patrizia Congiu1,2, Antonella Gagliano3, Sara Carucci4,5

  • 1Department of Medical Sciences and Public Health, Sleep Disorder Research Center, University of Cagliari, Cagliari, Italy.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|January 2, 2025
PubMed

Insights

Children with pediatric acute-onset neuropsychiatric syndrome have significantly reduced REM sleep atonia. This REM sleep motor disinhibition may indicate brainstem dysfunction in these patients.

Area of Science:

  • Neurology
  • Sleep Medicine
  • Pediatric Psychiatry

Background:

  • Sleep disorders are common in pediatric acute-onset neuropsychiatric syndrome (PANS), affecting up to 80% of children.
  • Rapid eye movement (REM) sleep motor disinhibition is a frequent feature in PANS.
  • Limited polysomnographic studies exist for PANS, particularly concerning REM sleep atonia.

Purpose of the Study:

  • To evaluate polysomnographic characteristics in children with PANS.
  • To specifically assess REM sleep without atonia using the REM atonia index (RAI).
  • To compare RAI in PANS patients with age- and sex-matched healthy controls.

Main Methods:

  • Sixty-nine children diagnosed with PANS underwent polysomnography.
  • Chin muscle tone during REM sleep was quantified using the REM atonia index (RAI).
  • Forty-four healthy children served as controls.

Main Results:

  • Patients with PANS had a significantly lower RAI compared to controls.
  • In controls, RAI increased with age; this trend was absent in PANS patients.
  • 25 out of 57 PANS patients (44%) had RAI below the normal range, versus 1 out of 43 controls (2%).

Conclusions:

  • REM sleep abnormalities are significant in pediatric acute-onset neuropsychiatric syndrome.
  • Reduced RAI and lack of age correlation suggest impaired brainstem regulation of REM sleep atonia in PANS.
  • Findings point to potential pathophysiology involving brainstem dysfunction in PANS.
Abstract

Keywords:
REM atonia indexREM sleep without atoniapediatric acute-onset neuropsychiatric syndromepolysomnography

More Related Videos

Measuring Neural Mechanisms Underlying Sleep-Dependent Memory Consolidation During Naps in Early Childhood08:20

Measuring Neural Mechanisms Underlying Sleep-Dependent Memory Consolidation During Naps in Early Childhood

Published on: October 2, 2019

11.9K
Noninvasive, High-throughput Determination of Sleep Duration in Rodents07:33

Noninvasive, High-throughput Determination of Sleep Duration in Rodents

Published on: April 18, 2018

7.8K

Related Concept Videos

REM Sleep Behavior Disorder01:15

REM Sleep Behavior Disorder

REM Sleep Behavior Disorder (RBD) is a sleep disorder characterized by the absence of muscle paralysis that normally occurs during the REM phase of sleep. This absence allows individuals to physically act out their dreams, which are often vivid and disturbing. Common behaviors exhibited during episodes include kicking, punching, and yelling. These actions can be dangerous, potentially leading to injuries for the person with RBD or their bed partner.
RBD is significantly associated with...
140
Sleep-Wake Cycles01:24

Sleep-Wake Cycles

Sleep is an essential physiological process vital to maintaining overall well-being. The reticular activating system (RAS), a network of neurons in the brainstem, regulates wakefulness and sleep. While it may seem passive, sleep consists of distinct cycles, each with its unique characteristics and functions. Two key sleep phases are non-rapid eye movement (NREM) and  rapid eye movement (REM).
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
1.2K
Narcolepsy01:07

Narcolepsy

Narcolepsy is a chronic sleep disorder characterized by pervasive, uncontrolled sleepiness and other sleep disturbances. One of its hallmark symptoms is an abrupt transition to REM sleep upon falling asleep, which causes symptoms typically associated with this phase to occur unexpectedly during wakefulness. These include the following symptoms, which typically last from a minute or two to half an hour.
89
Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
145
Stages of Sleep01:22

Stages of Sleep

Sleep progresses through distinct stages, each characterized by specific brain wave patterns and physiological responses ranging from wakefulness to stages of non-rapid eye movement, known as non-REM, to rapid eye movement, referred to as REM. Understanding these stages helps in recognizing how sleep supports various bodily and cognitive functions.
Before sleep begins, in wakefulness, the brain exhibits primarily beta waves, which are high in frequency and low in amplitude, indicating alertness...
170
Nightmares and Night Terrors01:18

Nightmares and Night Terrors

Nightmares and night terrors represent two distinct types of sleep disturbances that differ in timing, characteristics, and the sleeper's recall of the event. Nightmares are vivid, disturbing dreams that usually awaken the sleeper from REM sleep, a stage of sleep where brain activity is high, and dreams are most frequent. Upon awakening, individuals often have detailed recollections of their nightmares, which can include themes of threats to survival, security, or self-esteem.
Nightmares...
73