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      Comparison of Bispectral Index™ values during the flotation restricted environmental stimulation technique and results for stage I sleep: a prospective pilot investigation

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          Abstract

          Objective

          To determine whether Bispectral Index™ values obtained during flotation-restricted environment stimulation technique have a similar profile in a single observation compared to literature-derived results found during sleep and other relaxation-induction interventions.

          Results

          Bispectral Index™ values were as follows: awake-state, 96.6; float session-1, 84.3; float session-2, 82.3; relaxation-induction, 82.8; stage I sleep, 86.0; stage II sleep, 66.2; and stages III–IV sleep, 45.1. Awake-state values differed from float session-1 (%difference 12.7%; Cohen’s d = 3.6) and float session-2 (%difference 14.8%; Cohen’s d = 4.6). Relaxation-induction values were similar to float session-1 (%difference 1.8%; Cohen’s d = 0.3) and float session-2 (%difference 0.5%; Cohen’s d = 0.1). Stage I sleep values were similar to float session-1 (%difference 1.9%; Cohen’s d = 0.4) and float session-2 (%difference 4.3%; Cohen’s d = 1.0). Stage II sleep values differed from float session-1 (%difference 21.5%; Cohen’s d = 4.3) and float session-2 (%difference 19.6%; Cohen’s d = 4.0). Stages III–IV sleep values differed from float session-1 (%difference 46.5%; Cohen’s d = 5.6) and float session-2 (%difference 45.2%; Cohen’s d = 5.4). Bispectral Index™ values during flotation were comparable to those found in stage I sleep and nadir values described with other relaxation-induction techniques.

          Electronic supplementary material

          The online version of this article (10.1186/s13104-017-2947-4) contains supplementary material, which is available to authorized users.

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          Most cited references53

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          The visual scoring of sleep in adults.

          The 1968 Rechtschaffen and Kales (R & K) sleep scoring manual was published 15 years after REM sleep was discovered. Advances in the ensuing 28 years warranted a re-look at visual scoring of sleep stages. This paper describes the work of the AASM Visual Scoring Task Force, including methodology, a literature review and the rationale behind the new rules. Reliability studies of R & K scoring were reviewed; reliability was low for stage one and moderate for slow wave sleep. Evidence indicated that K complexes and slow waves are expressed maximal frontally, spindles centrally and alpha rhythm over the occipital region. Three derivations of EEG, two of electro-oculography, and one of chin EMG were recommended. Scoring by 30-second epochs was retained. New terminology for sleep stages was proposed. Attenuation of alpha rhythm was determined to be the most valid electrophysiological marker of sleep onset. Alternative measures were proposed for non-alpha generating subjects. K complexes associated with arousals were determined to be insufficient alone to define the new stage N2. No evidence was found to justify dividing slow wave sleep into two stages. No reasons were found to alter the current slow wave amplitude criteria at any age. The phenomena of REM sleep were defined. The rules for defining onset and termination of REM sleep periods were simplified. Movement time was eliminated and major body movements defined. Studies are needed to test the reliability of the new rules. Future advances in technology may require modification of these rules with time.
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            An introduction to bispectral analysis for the electroencephalogram.

            The goal of much effort in recent years has been to provide a simplified interpretation of the electroencephalogram (EEG) for a variety of applications, including the diagnosis of neurological disorders and the intraoperative monitoring of anesthetic efficacy and cerebral ischemia. Although processed EEG variables have enjoyed limited success for specific applications, few acceptable standards have emerged. In part, this may be attributed to the fact that commonly used signal processing tools do not quantify all of the information available in the EEG. Power spectral analysis, for example, quantifies only power distribution as a function of frequency, ignoring phase information. It also makes the assumption that the signal arises from a linear process, thereby ignoring potential interaction between components of the signal that are manifested as phase coupling, a common phenomenon in signals generated from nonlinear sources such as the central nervous system (CNS). This tutorial describes bispectral analysis, a method of signal processing that quantifies the degree of phase coupling between the components of a signal such as the EEG. The basic theory underlying bispectral analysis is explained in detail, and information obtained from bispectral analysis is compared with that available from the power spectrum. The concept of a bispectral index is introduced. Finally, several model signals, as well as a representative clinical case, are analyzed using bispectral analysis, and the results are interpreted.
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              Response of bispectral index to neuromuscular block in awake volunteers.

              The bispectral index (BIS) monitor is a quantitative electroencephalographic (EEG) device that is widely used to assess the hypnotic component of anaesthesia, especially when neuromuscular blocking drugs are used. It has been shown that the BIS is sensitive to changes in electromyogram (EMG) activity in anaesthetized patients. A single study using an earlier version of the BIS showed that decreased EMG activity caused the BIS to decrease even in awake subjects, to levels that suggested deep sedation and anaesthesia.
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                Author and article information

                Contributors
                330-480-3907 , dunham.michael@sbcglobal.net
                jessevmcclain@aol.com
                ALBurger@mercy.com
                Journal
                BMC Res Notes
                BMC Res Notes
                BMC Research Notes
                BioMed Central (London )
                1756-0500
                29 November 2017
                29 November 2017
                2017
                : 10
                : 640
                Affiliations
                [1 ]GRID grid.451516.2, Trauma, Critical Care, and General Surgery Services, , St. Elizabeth Youngstown Hospital, ; 1044 Belmont Ave., Youngstown, OH 44501 USA
                [2 ]Advanced Neurology Associates, Inc, 1340 Belmont Ave., Youngstown, OH 44504 USA
                [3 ]Behavioral Medicine, St. Elizabeth Family Medicine Residency, 1053 Belmont Ave., Youngstown, OH 44504 USA
                Author information
                http://orcid.org/0000-0002-7842-9750
                Article
                2947
                10.1186/s13104-017-2947-4
                5707909
                29187246
                efb0bc23-2461-4341-ba6c-f1caf7f6f76a
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 13 October 2017
                : 20 November 2017
                Categories
                Research Note
                Custom metadata
                © The Author(s) 2017

                Medicine
                flotation-rest,flotation-tank,sensory isolation,relaxation,bispectral index,bis monitor,depth of sleep,perception of sleep,sleep eeg

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