1
|
Wüst LN, Capdevila NC, Lane LT, Reichert CF, Lasauskaite R. Impact of one night of sleep restriction on sleepiness and cognitive function: A systematic review and meta-analysis. Sleep Med Rev 2024; 76:101940. [PMID: 38759474 DOI: 10.1016/j.smrv.2024.101940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/24/2024] [Accepted: 04/16/2024] [Indexed: 05/19/2024]
Abstract
Detrimental consequences of chronic sleep restriction on cognitive function are well established in the literature. However, effects of a single night of sleep restriction remain equivocal. Therefore, we synthesized data from 44 studies to investigate effects of sleep restriction to 2-6 h sleep opportunity on sleepiness and cognition in this meta-analysis. We investigated subjective sleepiness, sustained attention, choice reaction time, cognitive throughput, working memory, and inhibitory control. Results revealed a significant increase in subjective sleepiness following one night of sleep restriction (Standardized Mean Difference (SMD) = 0.986, p < 0.001), while subjective sleepiness was not associated with sleep duration during sleep restriction (β = -0.214, p = 0.039, significance level 0.01). Sustained attention, assessed via common 10-min tasks, was impaired, as demonstrated through increased reaction times (SMD = 0.512, p < 0.001) and attentional lapses (SMD = 0.489, p < 0.001). However, the degree of impaired attention was not associated with sleep duration (ps > 0.090). We did not find significant effects on choice reaction time, cognitive throughput, working memory, or inhibitory control. Overall, results suggest that a single night of restricted sleep can increase subjective sleepiness and impair sustained attention, a cognitive function crucial for everyday tasks such as driving.
Collapse
Affiliation(s)
- Larissa N Wüst
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland; Research Cluster Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.
| | - Noëmi C Capdevila
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland; Research Cluster Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Lina T Lane
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland; Research Cluster Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Carolin F Reichert
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland; Research Cluster Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Ruta Lasauskaite
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland; Research Cluster Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| |
Collapse
|
2
|
Lacaux C, Strauss M, Bekinschtein TA, Oudiette D. Embracing sleep-onset complexity. Trends Neurosci 2024; 47:273-288. [PMID: 38519370 DOI: 10.1016/j.tins.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/17/2024] [Accepted: 02/07/2024] [Indexed: 03/24/2024]
Abstract
Sleep is crucial for many vital functions and has been extensively studied. By contrast, the sleep-onset period (SOP), often portrayed as a mere prelude to sleep, has been largely overlooked and remains poorly characterized. Recent findings, however, have reignited interest in this transitional period and have shed light on its neural mechanisms, cognitive dynamics, and clinical implications. This review synthesizes the existing knowledge about the SOP in humans. We first examine the current definition of the SOP and its limits, and consider the dynamic and complex electrophysiological changes that accompany the descent to sleep. We then describe the interplay between internal and external processing during the wake-to-sleep transition. Finally, we discuss the putative cognitive benefits of the SOP and identify novel directions to better diagnose sleep-onset disorders.
Collapse
Affiliation(s)
- Célia Lacaux
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Institut du Cerveau (Paris Brain Institute), Institut du Cerveau et de la Moelle Épinière (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Sorbonne Université, Paris 75013, France.
| | - Mélanie Strauss
- Neuropsychology and Functional Neuroimaging Research Group (UR2NF), Center for Research in Cognition and Neurosciences (CRCN), Université Libre de Bruxelles, B-1050 Brussels, Belgium; Departments of Neurology, Psychiatry, and Sleep Medicine, Hôpital Universitaire de Bruxelles, Site Erasme, Université Libre de Bruxelles, B-1070 Brussels, Belgium
| | - Tristan A Bekinschtein
- Cambridge Consciousness and Cognition Laboratory, Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
| | - Delphine Oudiette
- Institut du Cerveau (Paris Brain Institute), Institut du Cerveau et de la Moelle Épinière (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Sorbonne Université, Paris 75013, France; Assistance Publique - Hopitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil, National Reference Centre for Narcolepsy, Paris 75013, France.
| |
Collapse
|
3
|
Andrillon T, Taillard J, Strauss M. Sleepiness and the transition from wakefulness to sleep. Neurophysiol Clin 2024; 54:102954. [PMID: 38460284 DOI: 10.1016/j.neucli.2024.102954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/02/2024] [Accepted: 02/03/2024] [Indexed: 03/11/2024] Open
Abstract
The transition from wakefulness to sleep is a progressive process that is reflected in the gradual loss of responsiveness, an alteration of cognitive functions, and a drastic shift in brain dynamics. These changes do not occur all at once. The sleep onset period (SOP) refers here to this period of transition between wakefulness and sleep. For example, although transitions of brain activity at sleep onset can occur within seconds in a given brain region, these changes occur at different time points across the brain, resulting in a SOP that can last several minutes. Likewise, the transition to sleep impacts cognitive and behavioral levels in a graded and staged fashion. It is often accompanied and preceded by a sensation of drowsiness and the subjective feeling of a need for sleep, also associated with specific physiological and behavioral signatures. To better characterize fluctuations in vigilance and the SOP, a multidimensional approach is thus warranted. Such a multidimensional approach could mitigate important limitations in the current classification of sleep, leading ultimately to better diagnoses and treatments of individuals with sleep and/or vigilance disorders. These insights could also be translated in real-life settings to either facilitate sleep onset in individuals with sleep difficulties or, on the contrary, prevent or control inappropriate sleep onsets.
Collapse
Affiliation(s)
- Thomas Andrillon
- Paris Brain Institute, Sorbonne Université, Inserm-CNRS, Paris 75013, France; Monash Centre for Consciousness & Contemplative Studies, Monash University, Melbourne, VIC 3800, Australia
| | - Jacques Taillard
- Univ. Bordeaux, CNRS, SANPSY, UMR 6033, F-33000 Bordeaux, France
| | - Mélanie Strauss
- Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), CUB Hôpital Érasme, Services de Neurologie, Psychiatrie et Laboratoire du sommeil, Route de Lennik 808 1070 Bruxelles, Belgium; Neuropsychology and Functional Neuroimaging Research Group (UR2NF), Center for Research in Cognition and Neurosciences (CRCN), Université Libre de Bruxelles, B-1050 Brussels, Belgium.
| |
Collapse
|
4
|
Ochab JK, Szwed J, Oleś K, Bereś A, Chialvo DR, Domagalik A, Fąfrowicz M, Ogińska H, Gudowska-Nowak E, Marek T, Nowak MA. Observing changes in human functioning during induced sleep deficiency and recovery periods. PLoS One 2021; 16:e0255771. [PMID: 34469434 PMCID: PMC8409667 DOI: 10.1371/journal.pone.0255771] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 07/25/2021] [Indexed: 11/18/2022] Open
Abstract
Prolonged periods of sleep restriction seem to be common in the contemporary world. Sleep loss causes perturbations of circadian rhythmicity and degradation of waking alertness as reflected in attention, cognitive efficiency and memory. Understanding whether and how the human brain recovers from chronic sleep loss is important not only from a scientific but also from a public health perspective. In this work we report on behavioral, motor, and neurophysiological correlates of sleep loss in healthy adults in an unprecedented study conducted in natural conditions and comprising 21 consecutive days divided into periods of 4 days of regular life (a baseline), 10 days of chronic partial sleep restriction (30% reduction relative to individual sleep need) and 7 days of recovery. Throughout the whole experiment we continuously measured the spontaneous locomotor activity by means of actigraphy with 1-minute resolution. On a daily basis the subjects were undergoing EEG measurements (64-electrodes with 500 Hz sampling frequency): resting state with eyes open and closed (8 minutes long each) followed by Stroop task lasting 22 minutes. Altogether we analyzed actigraphy (distributions of rest and activity durations), behavioral measures (reaction times and accuracy from Stroop task) and EEG (amplitudes, latencies and scalp maps of event-related potentials from Stroop task and power spectra from resting states). We observed unanimous deterioration in all the measures during sleep restriction. Further results indicate that a week of recovery subsequent to prolonged periods of sleep restriction is insufficient to recover fully. Only one measure (mean reaction time in Stroop task) reverted to baseline values, while the others did not.
Collapse
Affiliation(s)
- Jeremi K. Ochab
- Institute of Theoretical Physics, Jagiellonian University, Kraków, Poland
- M. Kac Complex Systems Research Center, Jagiellonian University, Kraków, Poland
| | - Jerzy Szwed
- Institute of Theoretical Physics, Jagiellonian University, Kraków, Poland
- M. Kac Complex Systems Research Center, Jagiellonian University, Kraków, Poland
| | - Katarzyna Oleś
- Institute of Theoretical Physics, Jagiellonian University, Kraków, Poland
| | - Anna Bereś
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Kraków, Poland
| | - Dante R. Chialvo
- Center for Complex Systems & Brain Sciences (CEMSC3), Universidad Nacional de San Martín, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
| | - Aleksandra Domagalik
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Kraków, Poland
| | - Magdalena Fąfrowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Kraków, Poland
| | - Halszka Ogińska
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Kraków, Poland
| | - Ewa Gudowska-Nowak
- Institute of Theoretical Physics, Jagiellonian University, Kraków, Poland
- Małopolska Center of Biotechnology, Jagiellonian University, Kraków, Poland
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Kraków, Poland
- Małopolska Center of Biotechnology, Jagiellonian University, Kraków, Poland
| | - Maciej A. Nowak
- Institute of Theoretical Physics, Jagiellonian University, Kraków, Poland
- M. Kac Complex Systems Research Center, Jagiellonian University, Kraków, Poland
| |
Collapse
|
5
|
Anniss AM, Young A, O'Driscoll DM. Microsleep assessment enhances interpretation of the Maintenance of Wakefulness Test. J Clin Sleep Med 2021; 17:1571-1578. [PMID: 33729911 DOI: 10.5664/jcsm.9250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The Maintenance of Wakefulness Test (MWT) is used to objectively evaluate an individual's ability to remain awake; however, microsleeps are not included in the assessment. We aimed to determine if microsleep data prior to sleep onset assisted in interpretation of ability to maintain wakefulness across a range of typical patient groups. METHODS Forty-eight patients referred for overnight polysomnography and subsequent MWT were included. Patients were divided into 3 groups (treated obstructive sleep apnea [OSA], untreated OSA, or treated idiopathic hypersomnia or narcolepsy) based on prior medical diagnosis. Demographics, clinical characteristics, polysomnography, and MWT variables, including frequency, distribution, duration, and latency of microsleeps were compared between groups. RESULTS Microsleeps were observed in MWT trials significantly more frequently in patients with treated idiopathic hypersomnia/narcolepsy over the course of the day (0.34 ± 0.06 vs 0.07 ± 0.02 microsleeps/min; P < .001) and in patients with untreated OSA toward the end of the day (0.31 ± 0.06 vs 0.05 ± 0.02 microsleeps/min; P < .001) compared to the group with treated OSA. Microsleeps were often observed in series and earlier in patients with treated idiopathic hypersomnia/narcolepsy (10.9 ± 1.6 minutes) and those with untreated OSA (16.2 ± 2.7 minutes) compared to the group with treated OSA (24.9 ± 3.0 minutes; P < .05), and, if taken into consideration, would increase the proportion of patients demonstrating inability to maintain wakefulness by 33% and 22%, respectively. CONCLUSIONS MWT performance varies significantly across patient groups. Microsleep analysis prior to sleep onset may be a more sensitive measure of patient daytime wakefulness than sleep latency alone and should be considered in MWT assessment. CITATION Anniss AM, Young A, O'Driscoll DM. Microsleep assessment enhances interpretation of the Maintenance of Wakefulness Test. J Clin Sleep Med. 2021;17(8):1571-1578.
Collapse
Affiliation(s)
- Angela M Anniss
- Department of Respiratory and Sleep Medicine, Eastern Health, Box Hill, Victoria, Australia
| | - Alan Young
- Department of Respiratory and Sleep Medicine, Eastern Health, Box Hill, Victoria, Australia.,Eastern Health Clinical School, Monash University, Clayton, Victoria, Australia
| | - Denise M O'Driscoll
- Department of Respiratory and Sleep Medicine, Eastern Health, Box Hill, Victoria, Australia.,Eastern Health Clinical School, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
6
|
McMahon WR, Ftouni S, Diep C, Collet J, Lockley SW, Rajaratnam SMW, Maruff P, Drummond SPA, Anderson C. The impact of the wake maintenance zone on attentional capacity, physiological drowsiness, and subjective task demands during sleep deprivation. J Sleep Res 2021; 30:e13312. [PMID: 33734527 DOI: 10.1111/jsr.13312] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 11/30/2022]
Abstract
We aimed to investigate the impact of the Wake Maintenance Zone (WMZ) on measures of drowsiness, attention, and subjective performance under rested and sleep deprived conditions. We studied 23 healthy young adults (18 males; mean age = 25.41 ± 5.73 years) during 40 hr of total sleep deprivation under constant routine conditions. Participants completed assessments of physiological drowsiness (EEG-scored slow eye movements and microsleeps), sustained attention (PVT), and subjective task demands every two hours, and four-hourly ocular motor assessment of inhibitory control (inhibition of reflexive saccades on an anti-saccade task). Tests were analyzed relative to dim light melatonin onset (DLMO); the WMZ was defined as the 3 hr prior to DLMO, and the preceding 3 hr window was deemed the pre-WMZ. The WMZ did not mitigate the adverse impact of ~37 hr sleep deprivation on drowsiness, sustained attention, response inhibition, and self-rated concentration and difficulty, relative to rested WMZ performance (~13 hr of wakefulness). Compared to the pre-WMZ, though, the WMZ improved measures of sustained attention, and subjective concentration and task difficulty, during sleep deprivation. Cumulatively, these results expand on previous work by characterizing the beneficial effects of the WMZ on operationally-relevant indices of drowsiness, inhibitory attention control, and self-rated concentration and task difficulty relative to the pre-WMZ during sleep deprivation. These results may inform scheduling safety-critical tasks at more optimal circadian times to improve workplace performance and safety.
Collapse
Affiliation(s)
- William Ryan McMahon
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
| | - Suzanne Ftouni
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
| | - Charmaine Diep
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
| | - Jinny Collet
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
| | - Steven W Lockley
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
| | - Shantha M W Rajaratnam
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
| | - Paul Maruff
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia.,Cogstate Ltd., Melbourne, Victoria, Australia.,The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sean P A Drummond
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Clare Anderson
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
| |
Collapse
|
7
|
Bougard C, VanBeers P, Sauvet F, Drogou C, Guillard M, Dorey R, Gomez-Merino D, Dauguet J, Takillah S, Espié S, Chennaoui M, Léger D. Motorcycling performance and sleepiness during an extended ride on a dynamic simulator: relationship with stress biomarkers. Physiol Meas 2020; 41:104004. [PMID: 33164915 DOI: 10.1088/1361-6579/abb75e] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Powered two-wheelers (PTW) make up a large proportion of fatal accidents. The aim of this study was to investigate the effects of time-of-day and total sleep deprivation (SD) on simulated motorcycling performance during extended riding sessions (60 min), while evaluating stress mechanisms. APPROACH A total of 16 healthy males participated in four simulated motorcycling sessions at 07:00, 11:00, 15:00 and 19:00, including city (8 min), country (2 min) and highway pathways (40 min), after a normal night of sleep and after total SD (30 h), in a randomized counterbalanced order. The recorded motorcycle parameters included: variation of lateral position, number of inappropriate line crossings (ILC), falls, riding errors, speed and speed limit violations. Subject parameters included the number of microsleeps in each pathway, the number of lapses during the 3-min psychomotor vigilance task (PVT-Brief version), and the Karolinska sleepiness scale (KSS) score. Saliva samples were used to assess cortisol (sC), α-amylase (sAA), and chromogranin-A (sCgA). ANOVAs and Pearson's correlation analysis were performed between these variables. MAIN RESULTS Most parameters were influenced by an interaction effect between 'Motorcycling pathways' × 'SD' (speed (p < 0.05), legal speed violations (p < 0.01), variation of lateral position (p < 0.001), falls (p < 0.001), EEG-microsleeps (p < 005)). An interaction effect between 'SD' × 'Time-of-day' influenced the number of ILCs (p < 0.01), sC (p < 0.05) and sCgA (p < 0.05) levels. SD affected KSS scores (p < 0.001) and PVT lapses (p < 0.05). The highest disturbances were associated with highway motorcycling simulation. SIGNIFICANCE Sleepiness due to circadian or SD and fatigue effects significantly affect riding and increase the risks involved with PTWs. The activation of both stress systems seems not sufficient to alleviate these deleterious effects.
Collapse
Affiliation(s)
- C Bougard
- French Armed Forces Biomedical Research Institute (IRBA), Fatigue and Vigilance Unit, Brétigny sur Orge, France. Université de Paris, VIFASOM EA 7330, Vigilance Fatigue Sommeil et Santé Publique, Paris, France. GroupePSA, Centre technique de Vélizy, Vélizy-Villacoublay, Cedex, France
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Chen TL, Chang SC, Hsieh HF, Huang CY, Chuang JH, Wang HH. Effects of mindfulness-based stress reduction on sleep quality and mental health for insomnia patients: A meta-analysis. J Psychosom Res 2020; 135:110144. [PMID: 32590218 DOI: 10.1016/j.jpsychores.2020.110144] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Mindfulness-based stress reduction (MBSR) is a potentially effective supplement for the treatment of insomnia; however, there is no comprehensive review of its mental health effects among insomnia patients. This study aimed to synthesize relevant quantitative evidence and evaluate MBSR application and effectiveness for insomnia patients' sleep quality and mental health. METHODS A systematic search through eight databases from the earliest available dates until August 2019 was conducted. Randomized controlled trials assessing the effects of MBSR on sleep quality, anxiety, and depression as outcome measures among insomnia patients comprising patients aged above 18 years were included in this meta-analysis. Each study's quality was assessed using the modified Jadad quality scale. The Review Manager 5.3 software was used to calculate the standardized mean differences (SMD) with 95% confidence intervals (CIs) for the data analyses. RESULTS In total, data for 497 patients in seven randomized controlled trials were analyzed. The results revealed that compared to the control group, the MBSR group significantly improved in sleep quality (SMD = -0.69, 95% CI: -1.12~ - 0.26, Z = 3.16, p = .002), depression (SMD = -1.83, 95% CI: -2.81-0.84, Z = 3.63, p < .001), and anxiety (SMD = -1.74, 95% CI: -2.90-0.59, Z = 2.96, p = .003). A sensitivity analysis was undertaken. After carefully reviewing included trials, we can reasonably conclude that these heterogeneities did not impair the overall effect size of MBSR in the results. CONCLUSIONS MBSR significantly improved sleep quality and mental health. Future research is needed using standardized methods examining the long-term effects of MBSR on the mental health of individuals with insomnia.
Collapse
Affiliation(s)
- Tsai-Ling Chen
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Chen Chang
- Department of Nursing, Changhua Christian Hospital, Changhua, Taiwan
| | - Hsiu-Fen Hsieh
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chin-Yi Huang
- Research Department, Changhua Christian Hospital, Changhua, Taiwan
| | - Jui-Hsiang Chuang
- Department of Psychiatry, Luckang Christian Hospital, Changhua, Taiwan
| | - Hsiu-Hung Wang
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
| |
Collapse
|
9
|
Skorucak J, Hertig-Godeschalk A, Achermann P, Mathis J, Schreier DR. Automatically Detected Microsleep Episodes in the Fitness-to-Drive Assessment. Front Neurosci 2020; 14:8. [PMID: 32038155 PMCID: PMC6990913 DOI: 10.3389/fnins.2020.00008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 01/07/2020] [Indexed: 12/14/2022] Open
Abstract
Study Objectives: Microsleep episodes (MSEs) are short fragments of sleep (1–15 s) that can cause dangerous situations with potentially fatal outcomes. In the diagnostic sleep-wake and fitness-to-drive assessment, accurate and early identification of sleepiness is essential. However, in the absence of a standardised definition and a time-efficient scoring method of MSEs, these short fragments are not assessed in clinical routine. Based on data of moderately sleepy patients, we recently developed the Bern continuous and high-resolution wake-sleep (BERN) criteria for visual scoring of MSEs and corresponding machine learning algorithms for automatic MSE detection, both mainly based on the electroencephalogram (EEG). The present study aimed to investigate the relationship between automatically detected MSEs and driving performance in a driving simulator, recorded in parallel with EEG, and to assess algorithm performance for MSE detection in severely sleepy participants. Methods: Maintenance of wakefulness test (MWT) and driving simulator recordings of 18 healthy participants, before and after a full night of sleep deprivation, were retrospectively analysed. Performance of automatic detection was compared with visual MSE scoring, following the BERN criteria, in MWT recordings of 10 participants. Driving performance was measured by the standard deviation of lateral position and the occurrence of off-road events. Results: In comparison to visual scoring, automatic detection of MSEs in participants with severe sleepiness showed good performance (Cohen’s kappa = 0.66). The MSE rate in the MWT correlated with the latency to the first MSE in the driving simulator (rs = −0.54, p < 0.05) and with the cumulative MSE duration in the driving simulator (rs = 0.62, p < 0.01). No correlations between MSE measures in the MWT and driving performance measures were found. In the driving simulator, multiple correlations between MSEs and driving performance variables were observed. Conclusion: Automatic MSE detection worked well, independent of the degree of sleepiness. The rate and the cumulative duration of MSEs could be promising sleepiness measures in both the MWT and the driving simulator. The correlations between MSEs in the driving simulator and driving performance might reflect a close and time-critical relationship between sleepiness and performance, potentially valuable for the fitness-to-drive assessment.
Collapse
Affiliation(s)
- Jelena Skorucak
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland.,Sleep and Health Zurich, University of Zurich, Zurich, Switzerland.,Children's Hospital Zurich - Eleonore Foundation, Zurich, Switzerland
| | - Anneke Hertig-Godeschalk
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Peter Achermann
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland.,Sleep and Health Zurich, University of Zurich, Zurich, Switzerland.,The KEY Institute for Brain-Mind Research, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Johannes Mathis
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - David R Schreier
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| |
Collapse
|
10
|
Hertig-Godeschalk A, Skorucak J, Malafeev A, Achermann P, Mathis J, Schreier DR. Microsleep episodes in the borderland between wakefulness and sleep. Sleep 2019; 43:5536744. [DOI: 10.1093/sleep/zsz163] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 05/16/2019] [Indexed: 11/14/2022] Open
Abstract
AbstractStudy objectivesThe wake-sleep transition zone represents a poorly defined borderland, containing, for example, microsleep episodes (MSEs), which are of potential relevance for diagnosis and may have consequences while driving. Yet, the scoring guidelines of the American Academy of Sleep Medicine (AASM) completely neglect it. We aimed to explore the borderland between wakefulness and sleep by developing the Bern continuous and high-resolution wake-sleep (BERN) criteria for visual scoring, focusing on MSEs visible in the electroencephalography (EEG), as opposed to purely behavior- or performance-defined MSEs.MethodsMaintenance of Wakefulness Test (MWT) trials of 76 randomly selected patients were retrospectively scored according to both the AASM and the newly developed BERN scoring criteria. The visual scoring was compared with spectral analysis of the EEG. The quantitative EEG analysis enabled a reliable objectification of the visually scored MSEs. For less distinct episodes within the borderland, either ambiguous or no quantitative patterns were found.ResultsAs expected, the latency to the first MSE was significantly shorter in comparison to the sleep latency, defined according to the AASM criteria. In certain cases, a large difference between the two latencies was observed and a substantial number of MSEs occurred between the first MSE and sleep. Series of MSEs were more frequent in patients with shorter sleep latencies, while isolated MSEs were more frequent in patients who did not reach sleep.ConclusionThe BERN criteria extend the AASM criteria and represent a valuable tool for in-depth analysis of the wake-sleep transition zone, particularly important in the MWT.
Collapse
Affiliation(s)
- Anneke Hertig-Godeschalk
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Jelena Skorucak
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Sleep and Health Zurich, University of Zurich, Zurich, Switzerland
| | - Alexander Malafeev
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Peter Achermann
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Sleep and Health Zurich, University of Zurich, Zurich, Switzerland
- KEY Institute for Brain Mind Research, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Zurich, Switzerland
| | - Johannes Mathis
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - David R Schreier
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Department of Medicine, Spital STS AG Thun, Thun, Switzerland
| |
Collapse
|
11
|
Sauvet F, Arnal PJ, Tardo-Dino PE, Drogou C, Van Beers P, Erblang M, Guillard M, Rabat A, Malgoyre A, Bourrilhon C, Léger D, Gomez-Mérino D, Chennaoui M. Beneficial effects of exercise training on cognitive performances during total sleep deprivation in healthy subjects. Sleep Med 2019; 65:26-35. [PMID: 31706189 DOI: 10.1016/j.sleep.2019.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Exercise training has been shown to improve learning and memory, and to protect against the negative impact of sleep deprivation. The aim of this study was to investigate the effects of seven weeks of moderate- and high-intensity interval exercise training on vigilance/sustained attention, inhibition processes and working memory during 40-h total sleep deprivation (TSD) in 16 healthy young men. METHODS The subjects were evaluated before (Baseline, BAS) and during TSD, and the day after a night of recovery sleep (Recovery, REC). RESULTS Exercise training significantly decreased errors and increased speed assessed by the psychomotor vigilance task (PVT) during TSD and REC while no difference was found in executive inhibition (Go-noGo task) and working memory (2-Back task) performances. The multiple sleep latency test results were higher during BAS and REC at Post-exercise training, and no difference occurred in subjective sleepiness and daytime microsleeps over the 40-h TSD. The PVT speed was positively correlated with maximal oxygen consumption and maximal aerobic power measured before entry in the in-laboratory TSD protocol, and stage 3 sleep duration measured during the first night in the in-laboratory TSD protocol (N-1). Exercise training effects on sleep were found during the night recovery with lower stage-3 sleep and higher rapid eye movement (REM) sleep durations. An exercise training effect was also found on free insulin-like growth factor I levels with lower levels during TSD at Post-exercise training. CONCLUSIONS In healthy young men, exercise training reduced sleep pressure at baseline and protected against sustained attention deficits induced by TSD with persistent effect after one night of recovery sleep. Nevertheless, exercise training was not effective in reducing deficits in executive inhibition and working memory induced by TSD.
Collapse
Affiliation(s)
- Fabien Sauvet
- Institut de recherche biomédicale des armées (IRBA), Brétigny-sur-Orge, France; EA 7330 VIFASOM, Université de Paris, France.
| | - Pierrick J Arnal
- Institut de recherche biomédicale des armées (IRBA), Brétigny-sur-Orge, France; EA 7330 VIFASOM, Université de Paris, France; Laboratoire de Physiologie de l'Exercice, Université de Lyon, Saint Etienne, France
| | | | - Catherine Drogou
- Institut de recherche biomédicale des armées (IRBA), Brétigny-sur-Orge, France; EA 7330 VIFASOM, Université de Paris, France
| | - Pascal Van Beers
- Institut de recherche biomédicale des armées (IRBA), Brétigny-sur-Orge, France; EA 7330 VIFASOM, Université de Paris, France
| | - Mégane Erblang
- Institut de recherche biomédicale des armées (IRBA), Brétigny-sur-Orge, France; EA 7330 VIFASOM, Université de Paris, France
| | - Mathias Guillard
- Institut de recherche biomédicale des armées (IRBA), Brétigny-sur-Orge, France; EA 7330 VIFASOM, Université de Paris, France
| | - Arnaud Rabat
- Institut de recherche biomédicale des armées (IRBA), Brétigny-sur-Orge, France; EA 7330 VIFASOM, Université de Paris, France
| | - Alexandra Malgoyre
- Institut de recherche biomédicale des armées (IRBA), Brétigny-sur-Orge, France
| | - Cyprien Bourrilhon
- Institut de recherche biomédicale des armées (IRBA), Brétigny-sur-Orge, France
| | - Damien Léger
- EA 7330 VIFASOM, Université de Paris, France; APHP, Hôtel Dieu, Centre du Sommeil et de la Vigilance, Paris, France
| | - Danielle Gomez-Mérino
- Institut de recherche biomédicale des armées (IRBA), Brétigny-sur-Orge, France; EA 7330 VIFASOM, Université de Paris, France
| | - Mounir Chennaoui
- Institut de recherche biomédicale des armées (IRBA), Brétigny-sur-Orge, France; EA 7330 VIFASOM, Université de Paris, France
| |
Collapse
|
12
|
Chattu VK, Manzar MD, Kumary S, Burman D, Spence DW, Pandi-Perumal SR. The Global Problem of Insufficient Sleep and Its Serious Public Health Implications. Healthcare (Basel) 2018; 7:healthcare7010001. [PMID: 30577441 PMCID: PMC6473877 DOI: 10.3390/healthcare7010001] [Citation(s) in RCA: 289] [Impact Index Per Article: 48.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 12/25/2022] Open
Abstract
Good sleep is necessary for good physical and mental health and a good quality of life. Insufficient sleep is a pervasive and prominent problem in the modern 24-h society. A considerable body of evidence suggests that insufficient sleep causes hosts of adverse medical and mental dysfunctions. An extensive literature search was done in all the major databases for “insufficient sleep” and “public health implications” in this review. Globally, insufficient sleep is prevalent across various age groups, considered to be a public health epidemic that is often unrecognized, under-reported, and that has rather high economic costs. This paper addresses a brief overview on insufficient sleep, causes, and consequences, and how it adds to the existing burden of diseases. Insufficient sleep leads to the derailment of body systems, leading to increased incidences of cardiovascular morbidity, increased chances of diabetes mellitus, obesity, derailment of cognitive functions, vehicular accidents, and increased accidents at workplaces. The increased usage of smart phones and electronic devices is worsening the epidemic. Adolescents with insufficient sleep are likely to be overweight and may suffer from depressive symptoms. The paper concludes by emphasizing sleep quality assessments as an important early risk indicator, thereby reducing the incidence of a wide spectrum of morbidities.
Collapse
Affiliation(s)
- Vijay Kumar Chattu
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.
| | - Md Dilshad Manzar
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah 11952, Saudi Arabia.
| | - Soosanna Kumary
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.
| | - Deepa Burman
- School of Medicine, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, USA.
| | | | | |
Collapse
|