Which vestibular organ is stimulated depends on the movement trajectory shape (linear/rotational/combined) and the movement direction. It thus seems that rocking movements moderately influence various aspects of sleep, possibly depending on the applied stimulation and the study protocol. Sleep efficiency does not seem to be influenced by rocking movements. Also changes in sleep, which are not necessarily reflecting a promotion of sleep have been observed, including less time spent in N2 ( Woodward et al., 1990), increased number of rapid eye movements ( Woodward et al., 1990), increased synchronization of slow oscillations and sleep spindles ( Perrault et al., 2019), and more time spent in NREM sleep in a subset of aromatherapy tolerant participants ( Shibagaki et al., 2017). One study reported a trend toward more time spent in deep sleep ( p < 0.1) ( Shibagaki et al., 2017). An increased duration of deep sleep (N3) has been reported ( Perrault et al., 2019), concurrent with an increase in the number of slow oscillations typical for deep sleep ( Perrault et al., 2019). A higher total number of spindles was observed three times ( Bayer et al., 2011 Omlin et al., 2018 Perrault et al., 2019), twice associated with a higher spindle density ( Bayer et al., 2011 Perrault et al., 2019). Further, also a shorter duration of sleep stage N1 ( Bayer et al., 2011) has been reported as a faster transition from lighter to deeper sleep. This took the form of a shorter latency to sleep onset (first episode of N2) during the first ( Perrault et al., 2019) or second consecutive night ( Woodward et al., 1990) of sleep with rocking movement. Three out of five studies showed a facilitation of the wake-to-sleep transition. To our knowledge five studies have investigated the effect of rocking motions applied using a moving bed on nap or nighttime sleep in adults reporting different results ( Woodward et al., 1990 Bayer et al., 2011 Shibagaki et al., 2017 Omlin et al., 2018 Perrault et al., 2019). An improvement of sleep can be defined as one or several of the following changes: an increase in the total time asleep from the period in bed (sleep efficiency), a facilitation of the transition from wake to sleep (shorter sleep latency) or from lighter to deeper sleep stages, an increase in the amount or intensity of deep sleep (slow waves), and/or an increase in sleep spindles. When we fall asleep, we usually move from wake (W) into a transitional state (stage N1), followed by sleep (stage N2) which gradually deepens into deep sleep (stage N3). In adults, simultaneous measures of brain activity, eye movement and muscle tone (polysomnography, PSG) give objective insight into changes in sleep architecture and brain activity in relevant frequency bands. Most of these studies have been performed with infants, where quiet rest observed using video or motion tracking devices is taken as a proxy for sleep ( Barnard and Bee, 1983 Korner et al., 1990 Johnston et al., 1997). Several studies, investigating the relationship between vestibular stimulation and sleep, have suggested that motion can be used to alter and possibly promote sleep. Vestibular stimulation has been used as a soothing and calming intervention during the treatment of various psychiatric and neurological diseases ( Grabherr et al., 2015). Vestibular stimulation in the form of gentle rocking movements has been proposed as a promising non-pharmacological alternative. On the other hand, the success of psychological/behavioral highly depends on compliance ( Matthews et al., 2013) which restricts their application to a subset of the population. Current pharmacological therapies are not suited for long-term use due to changes in the dose responsiveness ( Vinkers and Olivier, 2012) as well as risk of addiction ( Konopka et al., 2016). Current therapies for sleep problems include pharmacological ( Wilson and Nutt, 2010) and psychological or behavioral therapies, including relaxation strategies ( Edinger et al., 2017 Morin et al., 2017). More than one third of the adult population suffers from insufficient sleep or impaired sleep quality ( Liu, 2016 Madrid-Valero et al., 2017), with significant consequences for our economy ( Hafner et al., 2017). Problems with sleep may severely impact our cognitive functioning ( Alhola and Polo-Kantola, 2007) and health ( Garbarino et al., 2016 Kecklund and Axelsson, 2016).
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