Review Article

Spindle Oscillations in Sleep Disorders: A Systematic Review

Table 1

Insomnia.

StudySampleDemographicsMeds at StudyMeasurementTarget variablesResults

Event analysis-visual
Bastien et al., 2009 [67]Clinical: psychophysiological insomnia (PI),
Control:
Clinical:  yr, ?% ♂
Control:  yr, 36% ♂
NoThree all-night PSGs (1 adaptation); SR = ?; spindles on C3 from nights 2 & 3Number and density of spindles (12–14 Hz activity, >0.5 sec, 20–40 μV) during NREM2 No group differences

Spectral analysis
Freedman, 1986 [68]Clinical: idiopathic sleep-onset (SO) insomnia,
Control:
Clinical: (20–53) yr, 8% ♂
Control: (19–56) yr, 33% ♂
NoThree all-night PSGs (1 adaptation); SR = 128 Hz; FFT on C3 and O1 from night 3EEG power spectra from 1–30 Hz during the first unambiguous minute of each sleep stage (1) No group differences during NREM; (2) insomnia group had higher 16 Hz activity during REM on O1
Merica et al., 1998 [66]Clinical: SO/sleep maintenance (SM) insomnia ( idiopathic, PI)
Control:
Clinical: (20–47) yr, 40% ♂
Control: (20–35) yr, 47% ♂
NoThree all-night PSGs (1 adaptation); SR = 128 Hz; FFT w/avg of 5 4-sec eph on F4 from night 2Absolute sigma power (12.5–14.75 Hz) across the first four NREM-REM cycles(1) Insomnia group had slower sigma rise rate and attenuated power curve in NREM cycles 3 and 4; (2) insomnia group had higher sigma power curve across all 4 REM cycles
Krystal et al., 2002 [69]Clinical: persistent primary SM insomnia ( “SI”, “OI”)
Control:
Clinical: (40–80) yr, 40% ♂
Control: (40–80) yr, 40% ♂
NoOne ambulatory PSG; SR = 128 Hz; FFT w/2-sec eph on C3Absolute and relative sigma power (12.5–16 Hz) during NREM2/NREM3 and REM(1) Higher absolute and relative sigma in SI versus OI and in OI vs. controls during NREM2/NREM3; (2) no group differences during REM
Bastien et al., 2003 [70]Clinical 1: PI,
Clinical 2: benzo-medicated PI,
Control:
Clinical 1:  yr, 53% ♂
Clinical 2:  yr, 47% ♂
Control:  yr, 60% ♂
Only benzodiazepine in the medicated groupThree all-night PSGs (1 adaptation); SR = 200 Hz; FFT w/2.56-sec eph on C3 from night 2Absolute sigma power (11.7–14.04 Hz) during the first four NREM cycles and total sleepNo group differences
Staner et al., 2003 [71]Clinical 1: PI,
Clinical 2: depressed PI
Control:
Clinical 1:  yr, 52% ♂
Clinical 2:  yr, 52% ♂
Control:  yr, 52% ♂
NoThree all-night PSGs (1 adaptation); SR = 128 Hz; FFT w/2-sec eph on C3 from night 3Spindle frequency activity (SFA: 11.5–15 Hz) for the 1st NREM cycle divided into 10 intervals, expressed as % relative to total/undivided NREM cycleNo group differences
Buysse et al., 2008 [72]Clinical: PI,
Control:
Clinical:  yr, 40% ♂
Control:  yr, 40% ♂
NoThree all-night PSGs (1 adaptation); SR = 256 Hz; FFT w/4-sec eph on C3 and C4 from night 2Absolute and relative sigma power (12–16 Hz) during individual NREM cycles and total NREM (1) No overall group differences during each NREM cycle and during total NREM sleep; (2) group sex interaction, with higher absolute sigma in female insomniacs during total NREM
Forget et al., 2011 [73]Clinical: primary SM insomnia,
Control:
Clinical:  yr, 42% ♂
Control:  yr, 42% ♂
NoFour all-night PSGs (1 adaptation); SR = 512 Hz; FFT w/1-sec eph on Fz from nights 3 & 4Relative sigma power (12–14 Hz) before and after spontaneous and evoked K-complexes No group differences
Spiegelhalder et al., 2012 [74]Clinical: PI ( “SI”, and “OI”),
Control:
Clinical:  yr, 36% ♂
Control:  yr, 38% ♂
NoOne all-night PSG; SR = 200 Hz; FFT w/30-sec eph on C3Absolute sigma power (12–16 Hz) during NREM2 and REM(1) Total insomnia group had higher sigma during NREM2, but not during REM; (2) no group differences between SI and OI subtypes during NREM2
Israel et al., 2012 [75]Clinical: primary SM insomnia,
Control:
Clinical:  yr, 44.4% ♂
Control:  yr, 13.6% ♂
NoThree all-night PSGs; SR = 256 Hz; FFT w/4-sec eph on C3 and C4Mean relative sigma power (12–16 Hz) during NREMNo group differences (adjusting for age, sex)
St-Jean et al., 2013 [48]Clinical 1: SI,
Clinical 2: OI,
Control:
Clinical 1:  yr, 30% ♂
Clinical 2:  yr, 46% ♂
Control:  yr, 43% ♂
NoFour all-night PSGs; SR = 512 Hz; FFT w/4-sec eph on F3, F4, Fz, C3, C4, Cz, P3, P4, Pz from nights 2 & 3Absolute and relative sigma power (11–14 Hz) during selected portions of stable, consolidated, and artefact-free periods of NREM1–4 (“NREM”) and REM (1) SI had higher absolute sigma versus OI on F3 and F4 during NREM; (2) SI had lower relative sigma versus OI on F3 and F4 during REM; (3) SI had lower relative sigma versus controls on all frontal and central derivations during REM; (4) SI had lower relative sigma versus OI and versus controls on F3, F4, and Fz during NREM-REM cycle 4
Wu et al., 2013 [76]Clinical: PI,
Control:
Clinical:  yr, 50% ♂
Control:  yr, 40.6% ♂
NoThree all-night PSGs (1 adaptation); SR = 256 Hz; FFT w/4-sec eph on C3 and C4 from night 2Absolute and relative sigma power (12–16 Hz) during the first NREM period and total NREMNo group differences
Cervena et al., 2014 [77]Clinical 1: primary SO insomnia,
Clinical 2: primary SM insomnia,
Control:
Clinical 1:  yr, 70% ♂
Clinical 2:  yr, 60% ♂
Control:  yr, 50% ♂
NoThree all-night PSGs (1 night for controls); SR = 256 Hz; FFT w/15 4-sec eph on C3 from night 2Absolute sigma power (12–14.75 Hz) during the 5 mins before and after sleep-onset divided into 1-min intervalsNo group differences
Maes et al., 2014 [78]Clinical: primary SO insomnia,
Control:
Clinical: (19–53) yr, 0% ♂
Control: (21–59) yr, 0% ♂
NoRetrospective analysis of one all-night PSG; SR = 250 Hz; FFT w/4-sec eph on C4Relative sigma power (12–16 Hz) during sleep-onset, first SWS cycle, and within 1 sec of a NREM2 K-complex No group differences

?: unmentioned; ♂: male; Meds at Study: participants taking medication at time of sleep study; eph: epoch; sec: second; min: minute; SR: sampling rate; Hz: Hertz; PI: primary/psychophysiological insomnia; SI: subjective insomnia; OI: objective insomnia; SO: sleep-onset; SM: sleep maintenance.