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      Performance of an Ambulatory Dry-EEG Device for Auditory Closed-Loop Stimulation of Sleep Slow Oscillations in the Home Environment

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          Abstract

          Recent research has shown that auditory closed-loop stimulation can enhance sleep slow oscillations (SO) to improve N3 sleep quality and cognition. Previous studies have been conducted in lab environments. The present study aimed to validate and assess the performance of a novel ambulatory wireless dry-EEG device (WDD), for auditory closed-loop stimulation of SO during N3 sleep at home. The performance of the WDD to detect N3 sleep automatically and to send auditory closed-loop stimulation on SO were tested on 20 young healthy subjects who slept with both the WDD and a miniaturized polysomnography (part 1) in both stimulated and sham nights within a double blind, randomized and crossover design. The effects of auditory closed-loop stimulation on delta power increase were assessed after one and 10 nights of stimulation on an observational pilot study in the home environment including 90 middle-aged subjects (part 2).The first part, aimed at assessing the quality of the WDD as compared to a polysomnograph, showed that the sensitivity and specificity to automatically detect N3 sleep in real-time were 0.70 and 0.90, respectively. The stimulation accuracy of the SO ascending-phase targeting was 45 ± 52°. The second part of the study, conducted in the home environment, showed that the stimulation protocol induced an increase of 43.9% of delta power in the 4 s window following the first stimulation (including evoked potentials and SO entrainment effect). The increase of SO response to auditory stimulation remained at the same level after 10 consecutive nights. The WDD shows good performances to automatically detect in real-time N3 sleep and to send auditory closed-loop stimulation on SO accurately. These stimulation increased the SO amplitude during N3 sleep without any adaptation effect after 10 consecutive nights. This tool provides new perspectives to figure out novel sleep EEG biomarkers in longitudinal studies and can be interesting to conduct broad studies on the effects of auditory stimulation during sleep.

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          Auditory closed-loop stimulation of the sleep slow oscillation enhances memory.

          Brain rhythms regulate information processing in different states to enable learning and memory formation. The <1 Hz sleep slow oscillation hallmarks slow-wave sleep and is critical to memory consolidation. Here we show in sleeping humans that auditory stimulation in phase with the ongoing rhythmic occurrence of slow oscillation up states profoundly enhances the slow oscillation rhythm, phase-coupled spindle activity, and, consequently, the consolidation of declarative memory. Stimulation out of phase with the ongoing slow oscillation rhythm remained ineffective. Closed-loop in-phase stimulation provides a straight-forward tool to enhance sleep rhythms and their functional efficacy. Copyright © 2013 Elsevier Inc. All rights reserved.
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            The role of sleep hygiene in promoting public health: A review of empirical evidence.

            The ineffectiveness of sleep hygiene as a treatment in clinical sleep medicine has raised some interesting questions. If it is known that, individually, each specific component of sleep hygiene is related to sleep, why wouldn't addressing multiple individual components (i.e., sleep hygiene education) improve sleep? Is there still a use for sleep hygiene? Global public health concern over sleep has increased demand for sleep promotion strategies accessible to the population. However, the extent to which sleep hygiene strategies apply outside clinical settings is not well known. The present review sought to evaluate the empirical evidence for sleep hygiene recommendations regarding exercise, stress management, noise, sleep timing, and avoidance of caffeine, nicotine, alcohol, and daytime napping, with a particular emphasis on their public health utility. Thus, our review is not intended to be exhaustive regarding the clinical application of these techniques, but rather to focus on broader applications. Overall, though epidemiologic and experimental research generally supported an association between individual sleep hygiene recommendations and nocturnal sleep, the direct effects of individual recommendations on sleep remains largely untested in the general population. Suggestions for clarification of sleep hygiene recommendations and considerations for the use of sleep hygiene in nonclinical populations are discussed.
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              Sleep and synaptic homeostasis: a hypothesis

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                Author and article information

                Contributors
                Journal
                Front Hum Neurosci
                Front Hum Neurosci
                Front. Hum. Neurosci.
                Frontiers in Human Neuroscience
                Frontiers Media S.A.
                1662-5161
                08 March 2018
                2018
                : 12
                : 88
                Affiliations
                [1] 1Rythm SAS , Paris, France
                [2] 2Unité Fatigue et Vigilance, Neurosciences et Contraintes Opérationnelles, Institut de Recherche Biomédicale des Armées , Brétigny-sur-Orge, France
                [3] 3EA7330 Vigilance Fatigue et Sommeil, Hôtel Dieu Paris, APHP, Université Paris Descartes , Paris, France
                [4] 4LTCI, Telecom ParisTech, Universitéaris-Saclay , Paris, France
                Author notes

                Edited by: Klaus Gramann, Technische Universität Berlin, Germany

                Reviewed by: Arcady A. Putilov, Institute of Molecular Biology and Biophysics (RAS), Russia; Emily B. J. Coffey, Universität Tübingen, Germany

                *Correspondence: Eden Debellemaniere eden@ 123456rythm.co
                Article
                10.3389/fnhum.2018.00088
                5853451
                29568267
                3e621ea9-33b8-4e23-b967-0d98ef0fa5fc
                Copyright © 2018 Debellemaniere, Chambon, Pinaud, Thorey, Dehaene, Léger, Chennaoui, Arnal and Galtier.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 27 September 2017
                : 23 February 2018
                Page count
                Figures: 12, Tables: 3, Equations: 3, References: 40, Pages: 15, Words: 10448
                Categories
                Neuroscience
                Original Research

                Neurosciences
                ambulatory sleep device,automatic sleep-staging,closed-loop stimulation,eeg wearable,sleep monitoring,sleep device,n3 sleep,slow-wave sleep

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