Effect of nocturnal intravenous cannulation upon sleep-EEG measures

The effect of an indwelling intravenous cannula on sleep-EEG measures has not been extensively documented despite its relatively frequent use in a variety of clinical studies. When the sleep EEGs from 30 healthy subjects were critically examined, no changes in sleep architecture were found. However, there were significant differences in the distribution of sleep latency, maintenance, and efficiency, with many subjects showing a reduction in the latter two items on the night of cannulation. A decrease in sleep maintenance of greater than 7.5 on the night of cannulation has been used to operationally define an unsatisfactory cannulation study which accounted for 43% of our subjects. It was striking that this group could also be identified by having higher REM densities in each REM period on the previous two nights in the sleep laboratory. This was especially true for the second REM period on the second night when only three of those subjects with subsequent unsatisfactory studies had a REM density less than 0.9. When this criterion was applied to a new group of 19 subjects, 13 were correctly classified with respect to subsequent changes in sleep maintenance before the cannulation study was conducted. It therefore appears possible that REM-sleep measures can be used to predict which subjects will have disrupted sleep on a subsequent cannulation night. Since sleep disruption can significantly mask patterns of hormone secretion, it is essential to monitor the sleep-EEG during such studies.