Local body cooling to improve sleep quality and thermal comfort in a hot environment

Passive and low-energy strategies to improve sleep thermal comfort and energy resilience during heat waves and cold snaps

Sleep is a pillar of human health and wellbeing. In high- and middle-income countries, there is a great reliance on heating, ventilation, and air conditioning systems (HVAC) to control the interior thermal environment in the bedroom. However, these systems are expensive to buy, maintain, and operate while being energy and environmentally intensive-problems that may increase due to climate change. Easily-accessible passive and low-energy strategies, such as fans and electrical heated blankets, address these challenges but their comparative effectiveness for providing comfort in sleep environments has not been studied. We used a thermal manikin to experimentally show that many passive and low-energy strategies are highly effective in supplementing or replacing HVAC systems during sleep. Using passive strategies in combination with low-energy strategies that elevate air movement like ceiling or pedestal fans enhances the cooling effect by three times compared to using fans alone. We extrapolated our experimental findings to estimate heating and cooling effects in two historical case studies: the 2015 Pakistan heat wave and the 2021 Texas power crisis. Passive and low-energy strategies reduced sleep-time heat or cold exposure by 69-91%. The low-energy strategies we tested require one to two orders of magnitude less energy than HVAC systems, and the passive strategies require no energy input. These strategies can also help reduce peak load surges and total energy demand in extreme temperature events. This reduces the need for utility load shedding, which can put individuals at risk of hazardous heat or cold exposure. Our results may serve as a starting point for evidence-based public health guidelines on how individuals can sleep better during heat waves and cold snaps without relying on HVAC.

Sleeping for One Week on a Temperature-Controlled Mattress Cover Improves Sleep and Cardiovascular Recovery

Body temperature should be tightly regulated for optimal sleep. However, various extrinsic and intrinsic factors can alter body temperature during sleep. In a free-living study, we examined how sleep and cardiovascular health metrics were affected by sleeping for one week with (Pod ON) vs. without (Pod OFF), an active temperature-controlled mattress cover (the Eight Sleep Pod). A total of 54 subjects wore a home sleep test device (HST) for eight nights: four nights each with Pod ON and OFF (>300 total HST nights). Nightly sleeping heart rate (HR) and heart rate variability (HRV) were collected. Compared to Pod OFF, men and women sleeping at cooler temperatures in the first half of the night significantly improved deep (+14 min; +22% mean change; p = 0.003) and REM (+9 min; +25% mean change; p = 0.033) sleep, respectively. Men sleeping at warm temperatures in the second half of the night significantly improved light sleep (+23 min; +19% mean change; p = 0.023). Overall, sleeping HR (-2% mean change) and HRV (+7% mean change) significantly improved with Pod ON (p < 0.01). To our knowledge, this is the first study to show a continuously temperature-regulated bed surface can (1) significantly modify time spent in specific sleep stages in certain parts of the night, and (2) enhance cardiovascular recovery during sleep.

Gender differences in thermal sensation and skin temperature sensitivity under local cooling

Local cooling has proven to be an alternative to traditional comfort air conditioning to ensure users' thermal comfort while conserving energy. Few studies have investigated the gender differences in the applicable cooling temperatures and the applicable cooling locations and the differences in the sensitivity of skin temperature to thermal sensation under local cooling. Based on the design of orthogonal experiment, nine chamber experiments were conducted through different combinations of ambient temperature, cooling temperature, and cooling location. The subjective questionnaires and objective measurements were obtained in each experimental case. The results showed that the ambient temperature and the cooling location significantly affect the human overall thermal sensation of both genders under local cooling, while cooling temperature and cooling location significantly affect the local thermal sensation. For female, a neutral thermal sensation can be achieved by cooling the back at 24-26 °C when the ambient temperature is 31 °C. Back cooling at 22-26 °C is effective for male when the ambient temperature is 28 °C and 31 °C, and sole cooling with a higher cooling temperature is more acceptable at 34 °C. Moreover, female skin temperature is more sensitive to thermal sensation than that of males under local cooling. The upper arm skin temperature is most sensitive to thermal sensations for female, while the forearm skin temperature is most sensitive for male.

Moderate muscle cooling induced by single and intermittent/prolonged cold-water immersions differently affects muscle contractile function in young males

Background: We investigated the impact of moderate muscle cooling induced by single and intermittent/prolonged cold-water immersions (CWI) on muscle force and contractility in unfatigued state and during the development of fatigue resulting from electrically induced contractions. Methods: Twelve young males participated in this study consisting of two phases [single phase (SP) followed by intermittent/prolonged phase (IPP)], with both phases including two conditions (i.e., four trials in total) performed randomly: control passive sitting (CON) and cold-water immersions (10°C). SP-CWI included one 45 min-bath (from 15 to 60 min). IPP-CWI included three baths (45 min-bath from 15 to 60 min, and 15 min-baths from 165 to 180 min and from 255 to 270 min), with participants sitting at room temperature the rest of the time until 300 min. Blood pressure and intramuscular (Tmu) temperature were assessed, and neuromuscular testing was performed at baseline and 60 min after baseline during SP, and at baseline, 60, 90, 150 and 300 min after baseline during IPP. A fatiguing protocol (100 electrical stimulations) was performed after the last neuromuscular testing of each trial. Results: In unfatigued state, SP-CWI and IPP-CWI reduced electrically induced torque at 100 Hz (P100) but not at 20 Hz (P20), and increased P20/P100 ratio. The changes from baseline for P100 and P20/P100 ratio were lower in IPP-CWI than SP-CWI. Both cold-water immersion conditions slowed down muscle contraction and relaxation, and reduced maximal isokinetic contraction torque, but the changes from baseline were lower after IPP-CWI than SP-CWI. cold-water immersions did not impair maximal voluntary isometric contraction. During the fatiguing protocol, torque fatigue index and the changes in muscle contractile properties were larger after IPP-CWI than SP-CWI, but were in the same range as after CON conditions. The differences of muscle contractile function between SP-CWI and IPP-CWI were accompanied by a lower reduction of superficial Tmu and a smaller increase in systolic blood pressure after IPP-CWI than SP-CWI. Conclusion: IPP-CWI induces a less pronounced fast-to-slow contractile transition compared to SP-CWI, and this may result from the reduced vasoconstriction response and enhanced blood perfusion of the superficial muscle vessels, which could ultimately limit the reduction of superficial Tmu.

"Leave your smartphone out of bed": quantitative analysis of smartphone use effect on sleep quality

Smartphones have become an integral part of people's everyday lives. Smartphones are used across all household locations, including in the bed at night. Smartphone screens and other displays emit blue light, and exposure to blue light can affect one's sleep quality. Thus, smartphone use prior to bedtime could disrupt the quality of one's sleep, but research lacks quantitative studies on how smartphone use can influence sleep. This study combines smartphone application use data from 75 participants with sleep data collected by a wearable ring. On average, the participants used their smartphones in bed for 322.8 s (5 min and 22.8 s), with an IQR of 43.7-456. Participants spent an average of 42% of their time in bed using their smartphones (IQR of 5.87-55.5%). Our findings indicate that smartphone use in bed has significant adverse effects on sleep latency, awake time, average heart rate, and HR variability. We also find that smartphone use does not decrease sleep quality when used outside of bed. Our results indicate that intense smartphone use alone does not negatively affect well-being. Since all smartphone users do not use their phones in the same way, extending the investigation to different smartphone use types might yield more information than general smartphone use. In conclusion, this paper presents the first investigation of the association between smartphone application use logs and detailed sleep metrics. Our work also validates previous research results and highlights emerging future work.

Effects of covid-induced lockdown on inhabitants' perception of indoor air quality in naturally ventilated homes

The intensified indoor living during the spring 2020 lockdown, with enhanced user awareness of the prevailing conditions in their homes, constituted a natural stress test for the housing design in place today. Surveys conducted during this period have yielded lessons for designing better intervention strategies for the residential sector, taking into account the systematic morphological and economic limitations of the buildings concerned. These considerations should inform the development of policies and strategies for improving environmental quality compatible with lower residential energy consumption and higher quality of life. This study explores the effect of occupant behaviour on home ventilation and the perception of the impact of indoor air quality on user health before and during lockdown. The method deployed consisted in monitoring environmental variables and conducting user surveys before and after restrictions came into force. The findings showed that prior to lockdown, occupants were unaware of or paid little heed to changes in indoor air quality, failed to perceive stuffiness, and, as a rule, reported symptoms or discomfort only at night during the summer months. During lockdown, however, users came to attach greater importance to air quality, and a greater sensitivity to odours and a heightened awareness of CO2 concentration prompted them to ventilate their homes more frequently. In the spring of 2020, occupants also indicated a wider spectrum of indisposition, in particular in connection with sleep patterns.

Objective sleep assessments for healthy people in environmental research: A literature review

To date, although many studies had focused on the impact of environmental factors on sleep, how to choose the proper assessment method for objective sleep quality was often ignored, especially for healthy subjects in bedroom environment. In order to provide methodological guidance for future research, this paper reviewed the assessments of objective sleep quality applied in environmental researches, compared them from the perspective of accuracy and interference, and statistically analyzed the impact of experimental type and subjects' information on method selection. The review results showed that, in contrast to polysomnography (PSG), the accuracy of actigraphy (ACT), respiratory monitoring-oxygen saturation monitoring (RM-OSM), and electrocardiograph (ECG) could reach up to 97%, 80.38%, and 79.95%, respectively. In terms of sleep staging, PSG and ECG performed the best, ACT the second, and RM-OSM the worst; as compared to single methods, mix methods were more accurate and better at sleep staging. PSG interfered with sleep a great deal, while ECG and ACT could be non-contact, and thus, the least interference with sleep was present. The type of experiment significantly influenced the choice of assessment method (p < 0.001), 85.3% of researchers chose PSG in laboratory study while 82.5% ACT in field study; moreover, PSG was often used in a relatively small number of young subjects, while ACT had a wide applicable population. In general, researchers need to pay more attention at selection of assessments in future studies, and this review can be used as a reliable reference for experimental design.

Automatic Detection of the Cyclic Alternating Pattern of Sleep and Diagnosis of Sleep-Related Pathologies Based on Cardiopulmonary Resonance Indices

The cyclic alternating pattern is the periodic electroencephalogram activity occurring during non-rapid eye movement sleep. It is a marker of sleep instability and is correlated with several sleep-related pathologies. Considering the connection between the human heart and brain, our study explores the feasibility of using cardiopulmonary features to automatically detect the cyclic alternating pattern of sleep and hence diagnose sleep-related pathologies. By statistically analyzing and comparing the cardiopulmonary characteristics of a healthy group and groups with sleep-related diseases, an automatic recognition scheme of the cyclic alternating pattern is proposed based on the cardiopulmonary resonance indices. Using the Hidden Markov and Random Forest, the scheme combines the variation and stability of measurements of the coupling state of the cardiopulmonary system during sleep. In this research, the F1 score of the sleep-wake classification reaches 92.0%. In terms of the cyclic alternating pattern, the average recognition rate of A-phase reaches 84.7% on the CAP Sleep Database of 108 cases of people. The F1 score of disease diagnosis is 87.8% for insomnia and 90.0% for narcolepsy.

Functional links between thermoregulation and sleep in children with neurodevelopmental and chronic health conditions

The bi-directional relationship between sleep and wake is recognized as important for all children. It is particularly consequential for children who have neurodevelopmental disorders (NDDs) or health conditions which challenge their sleep and biological rhythms, and their ability to maintain rhythms of participation in everyday activities. There are many studies which report the diverse reasons for disruption to sleep in these populations. Predominantly, there is focus on respiratory, pharmaceutical, and behavioral approaches to management. There is, however, little exploration and explanation of the important effects of body thermoregulation on children's sleep-wake patterns, and associated behaviors. Circadian patterns of sleep-wake are dependent on patterns of body temperature change, large enough to induce sleep preparedness but remaining within a range to avoid sleep disturbances when active thermoregulatory responses against heat or cold are elicited (to maintain thermoneutrality). Additionally, the subjective notion of thermal comfort (which coincides with the objective concept of thermoneutrality) is of interest as part of general comfort and associated behavioral responses for sleep onset and maintenance. Children's thermoregulation and thermal comfort are affected by diverse biological functions, as well as their participation in everyday activities, within their everyday environments. Hence, the aforementioned populations are additionally vulnerable to disruption of their thermoregulatory system and their capacity for balance of sleep and wakefulness. The purpose of this paper is to present hitherto overlooked information, for consideration by researchers and clinicians toward determining assessment and intervention approaches to support children's thermoregulation functions and promote their subjective thermal comfort, for improved regulation of their sleep and wake functions.

Assessment of the Dynamics of Temperature Changes in the Knee Joint Area in Response to Selected Cooling Agents in Thermographic Tests

Although local cryotherapy (LC) is performed with various cooling agents (C_Ag) such as ice, water, and gasses, in clinical practice, it is mostly performed with cooling gasses. Presently, LC with cooling gasses is very popular but the inference about the thermal (stimulus) effect on the tissues is mainly based on research carried out using ice packs. The proposed objective of the study was to evaluate the dynamics of temperature changes in the knee joint area in response to a 3-min exposure to liquid nitrogen vapors (LNVs), cold air (CA) and ice bag (IB). The study group included 23 healthy volunteers with an average age of 26.67 ± 4.56. The exposed (ROI_E) and contralateral (ROI_NE) areas of the knee joint after exposure to C_Ag were observed. Immediately after 3 min of LC, the ROI_E temperature dropped by 10.11 ± 0.91 °C after LNV, 7.59 ± 0.14 °C after IB and 6.76 ± 1.3 °C after CA. Significant tissue cooling was maintained up to 15 min after LNV (p < 0.01), 10 min after IB (p < 0.05) and 5 min after CA (p < 0.05). LC causes significant temperature changes both in ROI_E and ROI_NE. The greatest cooling potential was demonstrated for LNV and the lowest for CA.

Experimental study on sleep quality affected by carbon dioxide concentration

This study comprehensively investigated the impact of indoor carbon dioxide (CO₂ ) concentration on sleep quality. Three experimental conditions (800, 1900, 3000 ppm) were created in chambers decorated as bedroom and other environmental parameters that may influence the sleep quality were under strict control. Sleep quality of 12 subjects (6 men and 6 women) was monitored for 54 consecutive days through sleep quality questionnaire and physiological measures. Both subjective and physiological results showed that sleep quality decreased significantly with the increase of CO₂ concentration, and the comprehensive questionnaire score at 3000 ppm was only 80.8% of that at 800 ppm. A linear positive correlation was found between sleep onset latency (SOL) and CO₂ concentration, while a linear negative correlation occurred between slow-wave sleep (SWS) and CO₂ concentration. In addition, in the same sleep environment, men had higher subjective questionnaire scores after wake-up, longer SWS and shorter SOL, which lead to a better sleep quality compared with women, and there was a significant gender difference in sleep quality at 800 ppm (P < .05).

Analysis of EEG, Cardiac Activity Status, and Thermal Comfort According to the Type of Cooling Seat during Rest in Indoor Temperature

In this study, electroencephalogram (EEG) and cardiac activity status of the human body while using various types of seats during rest were analyzed in indoor summer conditions. Thermal comfort was also evaluated through a subjective survey. The EEG, cardiac activity status, and subjective survey during rest indicated that the use of ventilation and cold water-cooling seats was effective. This effectiveness was because of the θ-wave and α-wave activation, sensorimotor rhythm, β-wave reduction, and left hemisphere activation, demonstrating that the conditions applied were suitable for rest. According to the analysis of the subjective questionnaire survey, the use of ventilation and cold water-cooling seats provided a more pleasant state than the basic seat, improving the subject’s warmth and comfort, and also the concentration. In addition, the use of a cold water-cooling seat provided the highest satisfaction level, being the most favorable condition for rest.

A field investigation of the thermal environment and adaptive thermal behavior in bedrooms in different climate regions in China

Sleep thermal environments substantially impact sleep quality. To study the sleep thermal environment and thermal comfort in China, this study carried out on-site monitoring of thermal environmental parameters in peoples' homes, including 166 households in five climate zones, for one year. A questionnaire survey on sleep thermal comfort and adaptive behavior was also conducted. The results showed that the indoor temperature for sleep in northern China was more than 4°C higher than that in southern China in winter, while the indoor temperatures for sleep were similar in summer. Furthermore, 70% of people were satisfied with their sleep thermal environment. Due to the use of air conditioning and window opening in various areas in summer, people were satisfied with their sleep thermal environments. Due to the lack of central heating in the southern region in winter, people feel cold and their sleep thermal environment needs further improvement. The bedding insulation in summer and winter in northern China was 1.83clo and 2.67clo, respectively, and in southern China was 2.21clo and 3.17clo, respectively. Both northern China and southern China used air conditioning only in summer. People in southern China opened their windows all year, while those in northern China opened their windows during the summer and transitional periods.

A comprehensive review of thermal comfort studies in urban open spaces

Urban open spaces provide various benefits to large populations in cities. Since thermally comfortable urban open spaces improve the quality of urban living, an increasing number of studies have been conducted to extend the existing knowledge of outdoor thermal comfort. This paper comprehensively reviews current outdoor thermal comfort studies, including benchmarks, data collection methods, and models of outdoor thermal comfort. Because outdoor thermal comfort is a complex issue influenced by various factors, a conceptual framework is proposed which includes physical, physiological and psychological factors as direct influences; and behavioral, personal, social, cultural factors, as well as thermal history, site, and alliesthesia, as indirect influences. These direct and indirect factors are further decomposed and reviewed, and the interactions among various factors are discussed. This review provides researchers with a systematic and comprehensive understanding of outdoor thermal comfort, and can also guide designers and planners in creating thermally comfortable urban open spaces.

Elevated airflow can maintain sleep quality and thermal comfort of the elderly in a hot environment

The effect of elevated airflow on sleep quality was investigated with 18 elderly. Three airflow conditions were set: ceiling fan/30°C/max.0.8 m/s and mean 0.7 m/s, task fan/30°C/max.0.8 m/s and mean 0.6 m/s, and thermally neutral /27°C/0.2 m/s. Sleep quality was evaluated objectively by analysis of electroencephalogram signals that were continuously monitored during the sleeping period. Urinary cortisol concentrations were analyzed to measure the activity of sympathetic nervous system. No significant difference in sleep quality, thermal comfort, or cortisol concentration was found between the ceiling fan and the neutral condition. The duration of total sleep time decreased by 35 minutes, the duration of REM sleep decreased by 15 minutes, and the cortisol concentration in the morning increased by 50 ng/mL in the task fan than the other two conditions. Compared with ceiling fan, less heat load was removed in the task fan condition, possibly due to the lower air speed. This study shows that even small heat load led to reduced sleep quality and overactive sympathetic nervous system of the elderly. By supplying an airflow of 0.8 m/s evenly over the human body, the elderly could maintain sleep quality and thermal comfort at an air temperature that was 3 K higher than the neutral temperature.

Sociodemographic and Job Characteristics Influence Environmental Strategies Used to Manage Workplace Sleepiness

OBJECTIVE

Suboptimal alertness and sleepiness impact work performance, health, and safety in many industries. We aimed to identify key environmental factors that workers view as supportive for reducing sleepiness and to examine the relationship between worker and job characteristics and identified sleepiness remedies.

METHODS

We conducted a mixed-method (qualitative and quantitative) cross-sectional study analyzing data from a representative sample of 496 workers in New York State.

RESULTS

Changing air ventilation (29.2%), natural lighting (17.1%), and room temperature (14.9%) were the environmental strategies deemed most important for managing workplace sleepiness. Strategy selection differed by sociodemographic (income and education) and job characteristics (indoor/outdoor, sedentary/mobile, and cognitive/physical labor).

CONCLUSIONS

Customization of workplace environmental factors in a manner cognizant of workers' needs and sociodemographic and job characteristics could increase the use of evidence-based strategies to reduce sleepiness.

Head cooling during sleep improves sleep quality in the luteal phase in female university students: A randomized crossover-controlled pilot study

Although selective head-cooling has been reported to decrease scalp and tympanic temperature and improve sleep quality, whether head-cooling during sleep can improve sleep quality in women during the luteal phase has not been elucidated. This randomized, controlled crossover open trial aimed to investigate the effect of head cooling during sleep on sleep quality in women during the luteal phase. Female university students aged 19–25 years with increased daytime sleepiness during the luteal phase were recruited by poster advertisement at their university from May to June 2016 and from May to June 2017. Fourteen women aged 19–22 years participated in this study. The temperature-controllable cooling sheet containing tubes filled with circulating water was used for head-cooling, and the head-cooling and the controlled temperature were set at 25°C and 35°C, respectively. Electroencephalogram data were obtained using a single-channel portable electroencephalogram device. The difference in sleep-related variables and tympanic temperature between head-cooling and control were analyzed using a linear mixed model. The proportion of arousal was lower with head cooling than with the control. In contrast, the proportion of non-REM3 and the delta power were higher with head cooling than with the control. The proportion of non-REM2 and non-REM3 among sleep EEG stages were positively and negatively correlated with the mean tympanic temperature during sleep, respectively. However, arousal and REM were not correlated with tympanic temperature. We considered the reduction of arousal time by head-cooling might be related to scalp temperature rather than tympanic temperature. Further, our results suggested that head-cooling also improved subjective sleep comfort. In conclusion, head-cooling during sleep could improve sleep quality in young women during the luteal phase.

Physiological and psychological reactions of sub-tropically acclimatized subjects exposed to different indoor temperatures at a relative humidity of 70

Thermal comfort, self-reported acute health symptoms, cognitive performance, and physiological reactions were examined at four temperatures (26, 30, 33, and 37°C) at a relative humidity of 70%. Thirty-two sub-tropically acclimatized subjects experienced each condition for 175 minute, in balanced order, in a climatic chamber. The perception of heat gradually increased with increasing temperature, but the subjects felt hot only at 37°C. The temperature of 33°C was on average rated as acceptable and only just uncomfortable. The acceptability of air quality decreased linearly with increasing temperature. The intensity of acute health symptoms reported by the subjects increased with increasing temperature, but it was no more than moderate even at the highest temperature; dryness of skin and eye were alleviated. The eardrum temperature, skin temperature and moisture, heart rate, end-tidal carbon dioxide, and weight loss increased significantly with increasing temperature, whereas the percentage of adjacent heart inter-beat intervals differing by >50 ms decreased significantly. These results suggest that the perceived heat, self-reported symptoms, and physiological reactions occurred concurrently. They show additionally that acclimatization to heat may shift the boundary of thermal discomfort to a higher temperature. The role of psychological adaptation and of the contextual aspects of this process still requires clarification in future experiments.