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Deep Sleep

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Example sleep reports from two PTSD sleepers, one with adequate Lo Deep sleep (upper report) and one with Lo Deep deficiency (lower report). The top panel of each report is a spectrogram of the overnight power in frequencies between 0.1 and 150 Hz, with the mean log-power across the entire night subtracted from each frequency band. To better visualize the sleep architecture across the night, the middle panel shows a dot at each time point indicating the frequency with the highest relative power. The bottom panel of each report shows the automatically generated hypnogram with sleep stages Wake, REM, Light, Hi Deep and Lo Deep. Vertical yellow lines indicate lower algorithm certainty. Red vertical lines indicate the algorithm's approximation of when sleep began. Cyan vertical lines indicate times of large EEG fluctuations usually consistent with movement. Red asterisks indicate automated switches from an initial Lo Deep designation by the algorithm to REM because REM can sometimes contain low frequency power due to eye movements; lowered spindle power is used to confirm a REM designation in these cases. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Auditory evoked potentials (AEPs) to clicks of moderate intensity were studied in 130 normal sleeping children from 10 days to 3 years of age. Latencies of the principal response components were found to decrease with log age, i.e., change was most rapid during the first year of life. From 15 days of age to 3 years, mean latencies decreased as follows: P2 from 230 to 150, N2 from 535 to 320 and P3 from 785 to 625 msec. Variance was quite high, especially at younger ages. The fact that decreases in the latencies of the various components proceeded at different rates suggest that the components reflect quasi-independent neural substrates. The components of shortest latency displayed the weakest relationship to age. Findings with respect to latency for the subset of data obtained during stage 2 sleep were similar to those for the total population which contained responses recorded during several sleep stages. The amplitude of AEP components increased with age with the exception of N1P2 which decreased. Observations with regard to amplitude held both for the overall data recorded during several sleep stages and stage 2 data for components N0P1, N1P2 and N2P3. The amplitude trends for P1N1 and P2N2 were, however, not significant for the stage 2 subset. The maturation of the morphology of the AEP was characterized by a relative increase in the prominence of long latency components. The most striking change was the development of P3. High amplitude, V shaped P3 waves were also associated with stage 3-4 sleep. The changes which were delineated by this study for infancy and early childhood appear to be continuations of developmental trends reported for premature infants and neonates. AEPs are a reliable elicited measure which correlate well with maturation. They, therefore, can be a useful tool both in the study of central nervous system development and in the diagnosis of sensory and neurologic abnormalities.

The additional data presented at ACR Convergence 2022 showing top-of-the range improvements in all key manifestations of disease, including arthritis, psoriasis, dactylitis, nail psoriasis adds to the evidence of differentiated efficacy in enthesitis previously reported at the 2022 European Alliance of Associations for Rheumatology (EULAR) Congress. The clinical improvements in these hard-to-treat areas, along with consistent, clinically important and statistically significant disease activity improvements as measured by ACR50, PASI75, DAS-28, Minimal Disease Activity, and DAPSA predictably led to important improvements in patient-reported Quality of life (QoL) on the SF-36, HAQ-DI and PsA-specific validated instrument, the PsAID, across all domains including pain, sleep disturbance, physical functi


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