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Gradwohl G, Snipes S, Walitza S, Huber R, Gerstenberg M. Timing and cortical region matter: theta power differences between teenagers affected by Major Depression and healthy controls. J Neural Transm (Vienna) 2024; 131:1105-1115. [PMID: 39105815 PMCID: PMC11365826 DOI: 10.1007/s00702-024-02810-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 07/15/2024] [Indexed: 08/07/2024]
Abstract
In adults affected by Major Depressive Disorder (MDD), most findings point to higher electroencephalographic (EEG) theta power during wake compared to healthy controls (HC) as a potential biomarker aiding the diagnostic process or subgrouping for stratified treatment. Besides these group differences, theta power is modulated by time of day, sleep/wake history, and age. Thus, we aimed at assessing if the time of recording alters theta power in teenagers affected by MDD or HC. Standardized wake EEG power was assessed with high-density EEG in 15 children and adolescents with MDD and in 15 age- and sex-matched HC in the evening and morning. Using a two-way ANOVA, group, time, and their interaction were tested. In patients, the current severity of depression was rated using the Children's Depression Rating Scale. Broadband EEG power was lower in the morning after sleep, with a significant interaction (group x time) in central regions in the 4-6 Hz range. In MDD relative to HC, theta power was decreased over occipital areas in the evening and increased over frontal areas in the morning. A higher frontal theta power was correlated with more severe depressive mood in the morning but not in the evening. This was a cross-sectional study design, including patients on antidepressant medication. In conclusion, depending on time of recording, region-specific opposite differences of theta power were found between teenagers with MDD and HC. These findings stress the importance of the time of the recording when investigating theta power's relationship to psychopathology.
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Affiliation(s)
- Gideon Gradwohl
- Lev Academic Center, Department of Computer Sciences, Jerusalem College of Technology, Jerusalem, Israel
| | - Sophia Snipes
- Child Development Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscicence Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Reto Huber
- Child Development Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscicence Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Miriam Gerstenberg
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Department of Child and Adolescent Psychiatry and Psychotherapy, Outpatient Services Winterthur, Psychiatric University Hospital Zurich, Albanistrasse 24, Winterthur, 8400, Switzerland.
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Ayas S, Donmez B, Tang X. Drowsiness Mitigation Through Driver State Monitoring Systems: A Scoping Review. HUMAN FACTORS 2024; 66:2218-2243. [PMID: 37982386 PMCID: PMC11344370 DOI: 10.1177/00187208231208523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 09/26/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVE To explore the scope of available research and to identify research gaps on in-vehicle interventions for drowsiness that utilize driver monitoring systems (DMS). BACKGROUND DMS are gaining popularity as a countermeasure against drowsiness. However, how these systems can be best utilized to guide driver attention is unclear. METHODS A scoping review was conducted in adherence to PRISMA guidelines. Five electronic databases (ACM Digital Library, Scopus, IEEE Xplore, TRID, and SAE Mobilus) were systematically searched in April 2022. Original studies examining in-vehicle drowsiness interventions that use DMS in a driving context (e.g., driving simulator and driver interviews) passed the screening. Data on study details, state detection methods, and interventions were extracted. RESULTS Twenty studies qualified for inclusion. Majority of interventions involved warnings (n = 16) with an auditory component (n = 14). Feedback displays (n = 4) and automation takeover (n = 4) were also investigated. Multistage interventions (n = 12) first cautioned the driver, then urged them to take an action, or initiated an automation takeover. Overall, interventions had a positive impact on sleepiness levels, driving performance, and user evaluations. Whether interventions effective for one type of sleepiness (e.g., passive vs. active fatigue) will perform well for another type is unclear. CONCLUSION Literature mainly focused on developing sensors and improving the accuracy of DMS, but not on the driver interactions with these technologies. More intervention studies are needed in general and for investigating their long-term effects. APPLICATION We list gaps and limitations in the DMS literature to guide researchers and practitioners in designing and evaluating effective safety systems for drowsy driving.
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Affiliation(s)
- Suzan Ayas
- University of Toronto, Toronto, ON, Canada
| | | | - Xing Tang
- University of Toronto, Toronto, ON, Canada
- Northwestern Polytechnical University, Xi'an, China
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Thomas DC, Somaiya T, Meira E Cruz M, Kodaganallur Pitchumani P, Ardeshna A, Ravi A, Prabhakar S. The enigma of sleep: Implications of sleep neuroscience for the dental clinician and patient. J Am Dent Assoc 2024; 155:735-746. [PMID: 39007793 DOI: 10.1016/j.adaj.2024.05.007] [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: 12/30/2023] [Revised: 05/14/2024] [Accepted: 05/28/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Sleep disturbances have been shown to result in considerable morbidity and mortality. It is important for dental clinicians to understand the neuroscience behind sleep disorders. TYPES OF STUDIES REVIEWED The authors conducted a search of the literature published from January 1990 through March 2024 of sleep medicine-related articles, with a focus on neuroscience. The authors prioritized articles about the science of sleep as related to dental medicine. RESULTS The authors found a proliferation of articles related to sleep neuroscience along with its implications in dental medicine. The authors also found that the intricate neuroscientific principles of sleep medicine are being investigated robustly. The salient features of, and the differences between, central and obstructive sleep apneas have been elucidated. Sleep genes, such as CRY, PER1, PER2, and CLOCK, and their relationship to cancer and neurodegeneration are also additions to this rapidly developing science. CONCLUSIONS AND PRACTICAL IMPLICATIONS The dental clinician has the potential to be the first to screen patients for possible sleep disorders and make prompt referrals to the appropriate medical professionals. This can be lifesaving as well as minimize potential future morbidity for the patient.
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Grant LK, Gonsalvez I, Cohn AY, Nathan MD, Harder JA, Klerman EB, Scheer FAJL, Kaiser UB, Crawford S, Luo T, Wiley A, Rahman SA, Joffe H. The effect of experimentally induced sleep fragmentation and estradiol suppression on neurobehavioral performance and subjective sleepiness in premenopausal women. Sleep 2024; 47:zsae130. [PMID: 38874415 PMCID: PMC11321839 DOI: 10.1093/sleep/zsae130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/02/2024] [Indexed: 06/15/2024] Open
Abstract
STUDY OBJECTIVES Menopause is associated with nighttime sleep fragmentation, declining estradiol, and impaired cognition. In a model of pharmacologically induced estradiol suppression mimicking menopause, we examined the impact of menopause-pattern sleep fragmentation on daytime neurobehavioral performance and sleepiness in premenopausal women. METHODS Twenty premenopausal women completed two five-night inpatient studies in the mid-to-late follicular phase (estrogenized) and after pharmacological estradiol suppression (hypo-estrogenized). During each study, participants had an uninterrupted 8-hour sleep opportunity for two nights, followed by three nights where sleep was experimentally fragmented to mimic menopause-pattern sleep disturbance, and during which the sleep opportunity was extended to prevent shortening of the sleep duration. Neurobehavioral performance and subjective sleepiness were measured using the Psychomotor Vigilance Task and Karolinska Sleepiness Scale (KSS). RESULTS Compared to unfragmented sleep, sleep fragmentation increased attentional lapses (+ 0.6 lapses, p < .05), slowed reaction time (+ 9.4 milliseconds, p < .01), and increased daytime sleepiness (+ 0.5 KSS score, p < .001). Estradiol suppression increased attentional lapses (+ 0.8; p < .001) and reaction time (+ 12.3, p < .01) but did not significantly affect daytime sleepiness. The effect of sleep fragmentation on neurobehavioral performance differed by estradiol state, such that the adverse effects of sleep fragmentation on attentional lapses (+ 0.9, trend p = .06) and reaction time (+ 15, p < .05) were observed only when estrogenized. CONCLUSIONS Menopause-pattern sleep fragmentation and estradiol suppression worsened neurobehavioral performance and daytime sleepiness, even while sleep duration was not reduced. The adverse effects of sleep fragmentation in the context of an adequate sleep duration highlight the importance of sleep continuity as a vital aspect of good sleep health.
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Affiliation(s)
- Leilah K Grant
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Irene Gonsalvez
- Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Aviva Y Cohn
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Margo D Nathan
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Jessica A Harder
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Frank A J L Scheer
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Ursula B Kaiser
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Sybil Crawford
- University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Tianyu Luo
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Aleta Wiley
- Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Shadab A Rahman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Hadine Joffe
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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McCauley ME, McCauley P, Kalachev LV, Riedy SM, Banks S, Ecker AJ, Dinges DF, Van Dongen HPA. Biomathematical modeling of fatigue due to sleep inertia. J Theor Biol 2024; 590:111851. [PMID: 38782198 PMCID: PMC11179995 DOI: 10.1016/j.jtbi.2024.111851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 04/13/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024]
Abstract
Biomathematical models of fatigue capture the physiology of sleep/wake regulation and circadian rhythmicity to predict changes in neurobehavioral functioning over time. We used a biomathematical model of fatigue linked to the adenosinergic neuromodulator/receptor system in the brain as a framework to predict sleep inertia, that is, the transient neurobehavioral impairment experienced immediately after awakening. Based on evidence of an adenosinergic basis for sleep inertia, we expanded the biomathematical model with novel differential equations to predict the propensity for sleep inertia during sleep and its manifestation after awakening. Using datasets from large laboratory studies of sleep loss and circadian misalignment, we calibrated the model by fitting just two new parameters and then validated the model's predictions against independent data. The expanded model was found to predict the magnitude and time course of sleep inertia with generally high accuracy. Analysis of the model's dynamics revealed a bifurcation in the predicted manifestation of sleep inertia in sustained sleep restriction paradigms, which reflects the observed escalation of the magnitude of sleep inertia in scenarios with sleep restriction to less than ∼ 4 h per day. Another emergent property of the model involves a rapid increase in the predicted propensity for sleep inertia in the early part of sleep followed by a gradual decline in the later part of the sleep period, which matches what would be expected based on the adenosinergic regulation of non-rapid eye movement (NREM) sleep and its known influence on sleep inertia. These dynamic behaviors provide confidence in the validity of our approach and underscore the predictive potential of the model. The expanded model provides a useful tool for predicting sleep inertia and managing impairment in 24/7 settings where people may need to perform critical tasks immediately after awakening, such as on-demand operations in safety and security, emergency response, and health care.
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Affiliation(s)
- Mark E McCauley
- Sleep and Performance Research Center, Washington State University, 412 E. Spokane Falls Blvd., Spokane, WA 99202-2131, USA; Department of Translational Medicine and Physiology, Washington State University Health Sciences Spokane, 412 E. Spokane Falls Blvd., Spokane, WA 99202, USA.
| | - Peter McCauley
- Sleep and Performance Research Center, Washington State University, 412 E. Spokane Falls Blvd., Spokane, WA 99202-2131, USA
| | - Leonid V Kalachev
- Department of Mathematical Sciences, University of Montana, Mathematics Building, Missoula, MT 59812, USA.
| | - Samantha M Riedy
- Sleep and Performance Research Center, Washington State University, 412 E. Spokane Falls Blvd., Spokane, WA 99202-2131, USA
| | - Siobhan Banks
- Behaviour-Brain-Body Research Centre, University of South Australia, Adelaide, SA 5048, Australia.
| | - Adrian J Ecker
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, University of Pennsylvania Perelman School of Medicine, 1013 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA.
| | - David F Dinges
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, University of Pennsylvania Perelman School of Medicine, 1013 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA.
| | - Hans P A Van Dongen
- Sleep and Performance Research Center, Washington State University, 412 E. Spokane Falls Blvd., Spokane, WA 99202-2131, USA; Department of Translational Medicine and Physiology, Washington State University Health Sciences Spokane, 412 E. Spokane Falls Blvd., Spokane, WA 99202, USA.
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Ma Z, Fan Y, Yu Z, Wu W, Zhang X, Li H, Zhao S, Li Y, Li Y, Wang D, Fan F. Cross-Lagged Panel Networks of Sleep Inertia Across Its Distinct Change Patterns Among Intern Nurses with Shift Work in China. Nat Sci Sleep 2024; 16:1201-1212. [PMID: 39131164 PMCID: PMC11316483 DOI: 10.2147/nss.s467433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/27/2024] [Indexed: 08/13/2024] Open
Abstract
Purpose Although experimental psychopathology using PET, EEG, and fMRI is at the forefront of understanding the underlying mechanisms of sleep inertia, many questions concerning causality remain unanswerable due to ethical constraints and the use of small and heterogeneous samples in experimental methods. There is a pressing need for a novel perspective in a large and relatively homogeneous population to fully capture and elucidate longitudinal processes and dynamic causality that culminate in episodes of sleep inertia over time. Therefore, this study aimed to reveal the causal relationships between symptoms of sleep inertia across its distinct patterns. Patients and Methods A total of 1636 intern nurses participated in the first survey (94.1% validity rate), then 1277 intern nurses were followed up (82.9% tracing rate). Symptoms of sleep inertia were self-reported using the Sleep Inertia Questionnaire. The cross-lagged panel network models were used to examine unique longitudinal relationships between symptoms of sleep inertia across distinct trajectories. Results Four distinct trajectories of sleep inertia were established. Additionally, we found differences in those symptoms with the highest influence on other symptoms at the subsequent point across the networks of four trajectories, particularly, "Difficulty in concentrating" in the persistent-high group and "Feeling tense" in the deteriorating groups. Conclusion The current study highlights changes in sleep inertia based on the long-term course over time. Notably, symptoms of "Difficulty in concentrating" and "Feeling tense" are imperative to address these specific symptoms within subpopulations.
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Affiliation(s)
- Zijuan Ma
- Center for Studies of Psychological Application, School of Psychology, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People’s Republic of China
| | - Yunge Fan
- Center for Studies of Psychological Application, School of Psychology, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People’s Republic of China
| | - Zhijun Yu
- Center for Studies of Psychological Application, School of Psychology, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People’s Republic of China
| | - Wenxuan Wu
- Center for Studies of Psychological Application, School of Psychology, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People’s Republic of China
| | - Xiangting Zhang
- Center for Studies of Psychological Application, School of Psychology, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People’s Republic of China
| | - Huolian Li
- Center for Studies of Psychological Application, School of Psychology, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People’s Republic of China
| | - Shaochen Zhao
- Research Center for Guangdong-Hong Kong-Macao Policing Model Innovation, China People’s Police University, Guangzhou, People’s Republic of China
| | - Yang Li
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - Yuanyuan Li
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Dongfang Wang
- Center for Studies of Psychological Application, School of Psychology, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People’s Republic of China
| | - Fang Fan
- Center for Studies of Psychological Application, School of Psychology, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People’s Republic of China
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Fudge JE, Peterson ET, Koe SLM, Dringenberg HC. The Impact of Lunch Timing on Nap Quality. Clocks Sleep 2024; 6:402-416. [PMID: 39189194 PMCID: PMC11348025 DOI: 10.3390/clockssleep6030027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 07/23/2024] [Accepted: 07/31/2024] [Indexed: 08/28/2024] Open
Abstract
PURPOSE Previous research has established that food intake is a biological regulator of the human sleep-wake cycle. As such, the timing of eating relative to sleep may influence the quality of sleep, including daytime naps. Here, we examine whether the timing of lunch (1 h vs. 2 h interval between lunch and a napping opportunity) impacts the quality of an afternoon nap. METHODS Using a randomized within-subject design over two separate experimental sessions (7 days apart), participants (n = 40, mean age = 25.8 years) consumed lunch 1 h and 2 h prior to an afternoon nap opportunity. Polysomnography and subjective self-reports were used to assess sleep architecture, sleepiness levels, and nap quality. RESULTS Results revealed no significant differences in subjective ratings of sleep quality and sleepiness, or in sleep architecture (total sleep time, sleep efficiency, sleep onset latency, sleep stages) between the 1 h and 2-h lunch conditions. CONCLUSIONS All sleep measures were similar when napping followed eating by either 1 h or 2 h, suggesting that eating closer to nap onset may not negatively impact sleep architecture and quality. Future research should continue to identify conditions that improve nap quality, given the well-documented benefits of naps to reduce sleep pressure and improve human performance.
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Affiliation(s)
- Jennifer E. Fudge
- Department of Psychology, Queen’s University, Kingston, ON K7L 3N6, Canada; (E.T.P.); (S.-L.M.K.)
| | | | | | - Hans C. Dringenberg
- Department of Psychology, Queen’s University, Kingston, ON K7L 3N6, Canada; (E.T.P.); (S.-L.M.K.)
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Roth T. Letter to the Editor regarding: "Implications of Oxybate Dosing Regimen for Sleep, Sleep Architecture, and Disrupted Nighttime Sleep in Patients with Narcolepsy: A Commentary" by R. Rosenberg et al. Neurol Ther 2024; 13:1303-1305. [PMID: 38795308 PMCID: PMC11263268 DOI: 10.1007/s40120-024-00613-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/22/2024] [Indexed: 05/27/2024] Open
Affiliation(s)
- Thomas Roth
- Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA.
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Kang J, Kim J, Lee J, Yeo H, Hwang Y, Lee S, Jeon S, Kim SJ. Sleep Inertia and Its Associates in Shift and Non-Shift Workers. Psychiatry Investig 2024; 21:905-911. [PMID: 39086166 PMCID: PMC11321878 DOI: 10.30773/pi.2024.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 06/02/2024] [Accepted: 06/13/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE We investigated the difference in sleep inertia between shift workers (SWs) and non-shift workers (NSWs) and the effects of depressive symptoms, sleepiness, insomnia, and chronotype on sleep inertia in SWs and NSWs. METHODS Altogether, 4,561 SWs (2,142 men and 2,419 women, aged 36.99±9.84 years) and 2,093 NSWs (999 men and 1,094 women, aged 37.80±9.73 years) participated in the current study. All participants completed the Sleep Inertia Questionnaire (SIQ), Epidemiological Studies Depression Scale (CESD), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and Morningness-Eveningness Questionnaire (MEQ) through an online survey. RESULTS SWs reported higher SIQ scores than NSWs after controlling for CESD, ESS, ISI, or MEQ. The CESD, ESS, ISI, and MEQ predicted SIQ in both SWs and NSWs. The effects of CESD and MEQ on SIQ were stronger in SWs and NSWs, respectively. The indirect effects of CESD and MEQ on SIQ via ESS were significantly moderated by work schedules. CONCLUSION SWs showed higher sleep inertia than NSWs. The effect of chronotypes on sleep inertia was more prominent in NSWs than in SWs. However, the effect of depressive symptoms on sleep inertia was more prominent in SWs than in NSWs. Moreover, the effect of depressive symptoms or chronotypes on sleep inertia was mediated by sleepiness, and such indirect effects were significantly different among the participants stratified by work schedules.
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Affiliation(s)
- Juseung Kang
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jichul Kim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | | | - Hyewon Yeo
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yunjee Hwang
- Department of Brain & Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Somi Lee
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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Basquin L, Maruani J, Leseur J, Mauries S, Bazin B, Pineau G, Henry C, Lejoyeux M, Geoffroy PA. Study of the different sleep disturbances during the prodromal phase of depression and mania in bipolar disorders. Bipolar Disord 2024; 26:454-467. [PMID: 38653574 DOI: 10.1111/bdi.13429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND One of the challenges in bipolar disorder (BD) lies in early detection of the illness and its recurrences, to improve prognosis. Sleep disturbances (SD) have been proposed as reliable predictive markers of conversion. While preliminary studies have explored the relationship between SD and the onset of mood episodes, the results remain heterogeneous and a few have specifically examined patients' perception of prodromal symptoms and their progression until the episode occurs. Identifying prodromes represents a crucial clinical challenge, as it enables early intervention, thereby reducing the severity of BD. Therefore, the objective of this study is to better characterize and evaluate the progressive nature of SD as prodromal symptoms of mood episodes, and patients' perception of it. METHODS Patients diagnosed with BD, either hospitalized or seeking treatment for a (hypo)manic or depressive episode benefited from standardized questionnaires, structured interviews, and self-report questionnaires to evaluate SD prior to the current episode, as well as sociodemographic and clinical information. RESULTS Out of the 41 patients included, 59% spontaneously reported SD prior to the episode, appearing 90 days before depression and 35 days before mania (pre-indexed/spontaneous reports: 51.22% insomnia complaints, 4.88% hypersomnolence complaints, 7.32% parasomnias, 2.44% sleep movements). After inquiry about specific SD, the percentage of patients reporting prodromal SD increased significantly to 83%, appearing 210 days before depression and 112.5 days before mania (post-indexed reports: 75.61% presented with insomnia complaints appearing 150 days before depression and 20 days before mania, 46.34% had hypersomnolence complaints appearing 60 days before depression, 43.9% had parasomnias appearing 210 days before depression and 22.5 days before mania, 36.59% had sleep movements appearing 120 days before depression and 150 days before mania). Of note, bruxism appeared in 35% of patients before mania, and restless legs syndrome in 20% of patients before depression. CONCLUSION This study highlights the very high prevalence of SD prior to a mood episode in patients with BD with differences between depressive and manic episodes. The more systematic screening of sleep alterations of the prodromal phase improved the recognition and characterization of different symptoms onset by patients. This underscores the need for precise questioning regarding sleep patterns in patients, to better identify the moment of transition toward a mood episode, referred to as "Chronos syndrome". The study emphasizes the importance of educating patients about the disorder and its sleep prodromal symptoms to facilitate early intervention and prevent recurrences.
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Affiliation(s)
- Louise Basquin
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
| | - Julia Maruani
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
- GHU Paris - Psychiatrie & Neurosciences, Paris, France
| | - Jeanne Leseur
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
| | - Sibylle Mauries
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
- GHU Paris - Psychiatrie & Neurosciences, Paris, France
| | | | - Guillaume Pineau
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
| | - Chantal Henry
- GHU Paris - Psychiatrie & Neurosciences, Paris, France
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, Paris, France
- Université de Paris, Paris, France
| | - Michel Lejoyeux
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
- GHU Paris - Psychiatrie & Neurosciences, Paris, France
| | - Pierre A Geoffroy
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
- GHU Paris - Psychiatrie & Neurosciences, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
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11
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Aria M, Khazim I, Ilyas M, Kekalih A, Fuady A. Work-Related Fatigue Among Indonesian Offshore Oil and Gas Workers. Occup Med (Lond) 2024; 74:364-369. [PMID: 38809608 DOI: 10.1093/occmed/kqae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Work-related fatigue, combined with shift work and prolonged work hours, has a significant effect, contributing to increasing accident rate by 50-100%. AIMS To assess the level of work-related fatigue over a 4-week work period among offshore rig oil and gas workers in Indonesia. METHODS This cohort study evaluated acute fatigue, chronic fatigue, and intershift recovery scores among offshore oil and gas rig workers using the Occupational Fatigue Exhaustion Recovery 15 (OFER15) questionnaire. Fatigue levels were assessed weekly throughout the study duration, which was 4-week work period. Additionally, at the fourth week, participants were asked about psychosocial factors that could be potentially related to fatigue. RESULTS Of 67 participants, the average scores of acute and chronic fatigue were 30.0 and 33.3, and the scores had significantly increased over 4 weeks (P < 0.001). The intershift recovery scores statistically significantly decreased over 4 weeks (P < 0.001), and the differences between weeks (Week 1 versus 2, Week 1 versus 3 and Week 1 versus 4) were also statistically significant (P < 0.001). Acute and chronic fatigue scores had a significant positive correlation with psychological job demands and negatively correlated with influence at work and job satisfaction. Over 4 weeks, acute fatigue augmented chronic fatigue, while acute and chronic fatigue demanded a longer recovery. CONCLUSIONS Workers at the offshore rig experienced work fatigue during their on-duty periods, with the level of fatigue significantly increasing over the 4 weeks. Comprehensive fatigue management at offshore rigs is vital to mitigate work fatigue and minimize the risk of work-related accidents.
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Affiliation(s)
- M Aria
- Faculty of Medicine, Universitas Indonesia, Jakarta 10320, Indonesia
| | - I Khazim
- Faculty of Medicine, Universitas Indonesia, Jakarta 10320, Indonesia
| | - M Ilyas
- Faculty of Medicine, Universitas Indonesia, Jakarta 10320, Indonesia
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta 10320, Indonesia
| | - A Kekalih
- Faculty of Medicine, Universitas Indonesia, Jakarta 10320, Indonesia
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta 10320, Indonesia
| | - A Fuady
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta 10320, Indonesia
- Evidence-Based Health Policy Centre, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia
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12
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He S, Liu X, Wang J, Ge H, Long K, Huang H. Influence of conventional driving habits on takeover performance in joystick-controlled autonomous vehicles: A low-speed field experiment. Heliyon 2024; 10:e31975. [PMID: 38882282 PMCID: PMC11177126 DOI: 10.1016/j.heliyon.2024.e31975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/08/2024] [Accepted: 05/24/2024] [Indexed: 06/18/2024] Open
Abstract
Takeover is a critical factor in the safety of autonomous driving. Takeover refers to the action of a human driver assuming control of an autonomous vehicle from its automated driving system. This can occur when the vehicle encounters a situation it cannot handle, when the system requests the driver to take control, or when the driver chooses to intervene for safety or other reasons. This study explored how traditional steering-wheel driving habits affect takeover performance in joystick-controlled autonomous vehicles. We conducted an experiment using a joystick-controlled Dongfeng Sharing-VAN autonomous vehicle in a low-speed campus environment. The participants were divided into three groups based on their driving experience: the individuals who have no licence and no experience (NN Group), the drivers who have licence but not experienced (HN Group), and the drivers who have licence and have been experienced (HH Group), representing varying levels of driving habits. The experiment focused on two takeover tasks: passive takeover and active takeover. We evaluated takeover performance using takeover time and takeover quality as key metrics. The results from the passive takeover task indicated that traditional driving habits had a significant negative impact on takeover performance. The HH Group took 2.65 s longer to complete the task compared to the NN Group, while the HN Group took 3.78 s longer. When we analyzed takeover time in stages, the initial stage showed the most significant difference in takeover time among the three groups. In the active takeover task, driving habits did not significantly affect takeover braking in front of obstacles in a low-speed driving environment. These findings suggest that conventional driving habits can hinder passive takeover in joystick-controlled autonomous vehicles. This insight can be valuable for developing training programs and guidelines for drivers transitioning from conventional to autonomous driving.
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Affiliation(s)
- Shijian He
- School of Traffic and Transportation Engineering, Changsha University of Science & Technology, Changsha 410114, China
| | - Xinyi Liu
- School of Traffic and Transportation Engineering, Changsha University of Science & Technology, Changsha 410114, China
| | - Jie Wang
- School of Traffic and Transportation Engineering, Changsha University of Science & Technology, Changsha 410114, China
| | - Hongcheng Ge
- Key Laboratory of Road and Traffic Engineering of the Ministry of Education, Tongji University, Shanghai, China
| | - Kejun Long
- School of Traffic and Transportation Engineering, Changsha University of Science & Technology, Changsha 410114, China
| | - Helai Huang
- School of Traffic and Transportation Engineering, Central South University, Changsha 410018, China
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13
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Tononi G, Boly M, Cirelli C. Consciousness and sleep. Neuron 2024; 112:1568-1594. [PMID: 38697113 PMCID: PMC11105109 DOI: 10.1016/j.neuron.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 05/04/2024]
Abstract
Sleep is a universal, essential biological process. It is also an invaluable window on consciousness. It tells us that consciousness can be lost but also that it can be regained, in all its richness, when we are disconnected from the environment and unable to reflect. By considering the neurophysiological differences between dreaming and dreamless sleep, we can learn about the substrate of consciousness and understand why it vanishes. We also learn that the ongoing state of the substrate of consciousness determines the way each experience feels regardless of how it is triggered-endogenously or exogenously. Dreaming consciousness is also a window on sleep and its functions. Dreams tell us that the sleeping brain is remarkably lively, recombining intrinsic activation patterns from a vast repertoire, freed from the requirements of ongoing behavior and cognitive control.
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Affiliation(s)
- Giulio Tononi
- Department of Psychiatry, University of Wisconsin, Madison, WI 53719, USA.
| | - Melanie Boly
- Department of Neurology, University of Wisconsin, Madison, WI 53719, USA
| | - Chiara Cirelli
- Department of Psychiatry, University of Wisconsin, Madison, WI 53719, USA
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14
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Martinec Nováková L, Miletínová E, Kliková M, Bušková J. Nocturnal exposure to a preferred ambient scent does not affect dream emotionality or post-sleep core affect valence in young adults. Sci Rep 2024; 14:10369. [PMID: 38710748 DOI: 10.1038/s41598-024-60226-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 04/19/2024] [Indexed: 05/08/2024] Open
Abstract
Emotions experienced within sleep mentation (dreaming) affect mental functioning in waking life. There have been attempts at enhancing dream emotions using olfactory stimulation. Odors readily acquire affective value, but to profoundly influence emotional processing, they should bear personal significance for the perceiver rather than be generally pleasant. The main objective of the present sleep laboratory study was to examine whether prolonged nocturnal exposure to self-selected, preferred ambient room odor while asleep influences emotional aspects of sleep mentation and valence of post-sleep core affect. We asked twenty healthy participants (12 males, mean age 25 ± 4 years) to pick a commercially available scented room diffuser cartridge that most readily evoked positively valenced mental associations. In weekly intervals, the participants attended three sessions. After the adaptation visit, they were administered the odor exposure and odorless control condition in a balanced order. Participants were awakened five minutes into the first rapid eye movement (REM) stage that took place after 2:30 a.m. and, if they had been dreaming, they were asked to rate their mental sleep experience for pleasantness, emotional charge, and magnitude of positive and negative emotions and also to evaluate their post-sleep core affect valence. With rs < 0.20, no practically or statistically significant differences existed between exposure and control in any outcome measures. We conclude that in young, healthy participants, the practical value of olfactory stimulation with self-selected preferred scents for enhancement of dream emotions and post-sleep core affect valence is very limited.
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Affiliation(s)
- Lenka Martinec Nováková
- Department of Chemical Education and Humanities, University of Chemistry and Technology, Prague, Technická 5, 16628, Prague 6 - Dejvice, Czech Republic.
| | - Eva Miletínová
- National Institute of Mental Health, Topolová 748, 25067, Klecany, Czech Republic
- 3rd Faculty of Medicine, Charles University, Ruská 87, 10000, Prague 10, Czech Republic
| | - Monika Kliková
- National Institute of Mental Health, Topolová 748, 25067, Klecany, Czech Republic
- 3rd Faculty of Medicine, Charles University, Ruská 87, 10000, Prague 10, Czech Republic
| | - Jitka Bušková
- National Institute of Mental Health, Topolová 748, 25067, Klecany, Czech Republic
- 3rd Faculty of Medicine, Charles University, Ruská 87, 10000, Prague 10, Czech Republic
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15
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Sundelin T, Landry S, Axelsson J. Is snoozing losing? Why intermittent morning alarms are used and how they affect sleep, cognition, cortisol, and mood. J Sleep Res 2024; 33:e14054. [PMID: 37849039 DOI: 10.1111/jsr.14054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 10/19/2023]
Abstract
Pressing the snooze button is a common way to start the day, but little is known about this behaviour. Through two studies we determined predictors and effects of snoozing. In Study 1 (n = 1732) respondents described their waking habits, confirming that snoozing is widespread, especially in younger individuals and later chronotypes. Morning drowsiness and shorter sleep were also more common for those who snooze. Study 2 was a within-subjects laboratory study (with polysomnography) on habitual snoozers (n = 31), showing that 30 min of snoozing improved or did not affect performance on cognitive tests directly upon rising compared to an abrupt awakening. Bayes factors indicate varying strengths of this evidence. Snoozing resulted in about 6 min of lost sleep, while preventing awakenings from slow-wave sleep (N3). There were no clear effects of snoozing on the cortisol awakening response, morning sleepiness, mood, or overnight sleep architecture. A brief snooze period may thus help alleviate sleep inertia, without substantially disturbing sleep, for late chronotypes and those with morning drowsiness.
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Affiliation(s)
- Tina Sundelin
- Department of Psychology, Stockholm University, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Shane Landry
- Department of Physiology, Biomedical Discovery Institute, Monash University, Melbourne, Victoria, Australia
| | - John Axelsson
- Department of Psychology, Stockholm University, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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16
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Ruby P, Evangelista E, Bastuji H, Peter-Derex L. From physiological awakening to pathological sleep inertia: Neurophysiological and behavioural characteristics of the sleep-to-wake transition. Neurophysiol Clin 2024; 54:102934. [PMID: 38394921 DOI: 10.1016/j.neucli.2023.102934] [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: 09/30/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 02/25/2024] Open
Abstract
Sleep inertia refers to the transient physiological state of hypoarousal upon awakening, associated with various degrees of impaired neurobehavioral performance, confusion, a desire to return to sleep and often a negative emotional state. Scalp and intracranial electro-encephalography as well as functional imaging studies have provided evidence that the sleep inertia phenomenon is underpinned by an heterogenous cerebral state mixing local sleep and local wake patterns of activity, at the neuronal and network levels. Sleep inertia is modulated by homeostasis and circadian processes, sleep stage upon awakening, and individual factors; this translates into a huge variability in its intensity even under physiological conditions. In sleep disorders, especially in hypersomnolence disorders such as idiopathic hypersomnia, sleep inertia may be a daily, serious and long-lasting symptom leading to severe impairment. To date, few tools have been developed to assess sleep inertia in clinical practice. They include mainly questionnaires and behavioral tests such as the psychomotor vigilance task. Only one neurophysiological protocol has been evaluated in hypersomnia, the forced awakening test which is based on an event-related potentials paradigm upon awakening. This contrasts with the major functional consequences of sleep inertia and its potentially dangerous consequences in subjects required to perform safety-critical tasks soon after awakening. There is a great need to identify reproducible biomarkers correlated with sleep inertia-associated cognitive and behavioral impairment. These biomarkers will aim at better understanding and measuring sleep inertia in physiological and pathological conditions, as well as objectively evaluating wake-promoting treatments or non-pharmacological countermeasures to reduce this phenomenon.
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Affiliation(s)
- Perrine Ruby
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR 5292, Lyon, France
| | - Elisa Evangelista
- Sleep disorder Unit, Carémeau Hospital, Centre Hospitalo-universitaire de Nîmes, France; Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Hélène Bastuji
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR 5292, Lyon, France; Centre for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France
| | - Laure Peter-Derex
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR 5292, Lyon, France; Centre for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France.
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17
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Campanella C, Byun K, Senerat A, Li L, Zhang R, Aristizabal S, Porter P, Bauer B. The Efficacy of a Multimodal Bedroom-Based 'Smart' Alarm System on Mitigating the Effects of Sleep Inertia. Clocks Sleep 2024; 6:183-199. [PMID: 38534801 DOI: 10.3390/clockssleep6010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/28/2024] Open
Abstract
Previous work has demonstrated the modest impact of environmental interventions that manipulate lighting, sound, or temperature on sleep inertia symptoms. The current study sought to expand on previous work and measure the impact of a multimodal intervention that collectively manipulated light, sound, and ambient temperature on sleep inertia. Participants slept in the lab for four nights and were awoken each morning by either a traditional alarm clock or the multimodal intervention. Feelings of sleep inertia were measured each morning through Psychomotor Vigilance Test (PVT) assessments and ratings of sleepiness and mood at five time-points. While there was little overall impact of the intervention, the participant's chronotype and the length of the lighting exposure on intervention mornings both influenced sleep inertia symptoms. Moderate evening types who received a shorter lighting exposure (≤15 min) demonstrated more lapses relative to the control condition, whereas intermediate types exhibited a better response speed and fewer lapses. Conversely, moderate evening types who experienced a longer light exposure (>15 min) during the intervention exhibited fewer false alarms over time. The results suggest that the length of the environmental intervention may play a role in mitigating feelings of sleep inertia, particularly for groups who might exhibit stronger feelings of sleep inertia, including evening types.
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Affiliation(s)
- Carolina Campanella
- Delos Living LLC, New York, NY 10014, USA
- Well Living Lab, Inc., Rochester, MN 55902, USA
| | - Kunjoon Byun
- Delos Living LLC, New York, NY 10014, USA
- Well Living Lab, Inc., Rochester, MN 55902, USA
| | - Araliya Senerat
- Well Living Lab, Inc., Rochester, MN 55902, USA
- International Society for Urban Health, New York, NY 10003, USA
| | - Linhao Li
- Delos Living LLC, New York, NY 10014, USA
- Well Living Lab, Inc., Rochester, MN 55902, USA
| | | | - Sara Aristizabal
- Delos Living LLC, New York, NY 10014, USA
- Well Living Lab, Inc., Rochester, MN 55902, USA
| | - Paige Porter
- Well Living Lab, Inc., Rochester, MN 55902, USA
- School of Environment and Sustainability, University of Michigan, Ann Arbor, MI 48109, USA
| | - Brent Bauer
- Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
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18
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Avidan AY. The Clinical Spectrum of the Parasomnias. Sleep Med Clin 2024; 19:1-19. [PMID: 38368057 DOI: 10.1016/j.jsmc.2023.12.003] [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] [Indexed: 02/19/2024]
Abstract
Parasomnias are defined as abnormal movements or behaviors that occur in sleep or during arousals from sleep. Parasomnias vary in frequency from episodic events that arise from incomplete sleep state transition. The framework by which parasomnias are categorized and diagnosed is based on the International Classification of Sleep Disorders-Third Edition, Text Revision (ICSD-3-TR), published by the American Academy of Sleep Medicine. The recent Third Edition, Text Revision (ICSD-3-TR) of the ICSD provides an expert consensus of the diagnostic requirements for sleep disorders, including parasomnias, based on an extensive review of the current literature.
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Affiliation(s)
- Alon Y Avidan
- Department of Neurology, UCLA Sleep Disorders Center, UCLA, David Geffen School of Medicine at UCLA, 710 Westwood Boulevard, RNRC, C153, Mail Code 176919, Los Angeles, CA 90095-1769, USA.
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19
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Wang ZJ, Lee HC, Chuang CH, Hsiao FC, Lee SH, Hsu AL, Wu CW. Traces of EEG-fMRI coupling reveals neurovascular dynamics on sleep inertia. Sci Rep 2024; 14:1537. [PMID: 38233587 PMCID: PMC10794702 DOI: 10.1038/s41598-024-51694-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024] Open
Abstract
Upon emergence from sleep, individuals experience temporary hypo-vigilance and grogginess known as sleep inertia. During the transient period of vigilance recovery from prior nocturnal sleep, the neurovascular coupling (NVC) may not be static and constant as assumed by previous neuroimaging studies. Stemming from this viewpoint of sleep inertia, this study aims to probe the NVC changes as awakening time prolongs using simultaneous EEG-fMRI. The time-lagged coupling between EEG features of vigilance and BOLD-fMRI signals, in selected regions of interest, was calculated with one pre-sleep and three consecutive post-awakening resting-state measures. We found marginal changes in EEG theta/beta ratio and spectral slope across post-awakening sessions, demonstrating alterations of vigilance during sleep inertia. Time-varying EEG-fMRI coupling as awakening prolonged was evidenced by the changing time lags of the peak correlation between EEG alpha-vigilance and fMRI-thalamus, as well as EEG spectral slope and fMRI-anterior cingulate cortex. This study provides the first evidence of potential dynamicity of NVC occurred in sleep inertia and opens new avenues for non-invasive neuroimaging investigations into the neurophysiological mechanisms underlying brain state transitions.
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Affiliation(s)
- Zhitong John Wang
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, 5 Floor, 301, Yuantong Rd., Zhonghe Dist, New Taipei, 235040, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chun-Hsiang Chuang
- Research Center for Education and Mind Sciences, College of Education, National Tsing Hua University, Hsinchu, Taiwan
| | - Fan-Chi Hsiao
- Department of Counseling, Clinical and Industrial/Organizational Psychology, Ming Chuan University, Taoyuan, Taiwan
| | - Shwu-Hua Lee
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, 259, Wenhua 1St Rd., Guishan Dist., Taoyuan, 33302, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ai-Ling Hsu
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, 259, Wenhua 1St Rd., Guishan Dist., Taoyuan, 33302, Taiwan.
- Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan.
| | - Changwei W Wu
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, 5 Floor, 301, Yuantong Rd., Zhonghe Dist, New Taipei, 235040, Taiwan.
- Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
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20
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Fedrigo V, Galizzi MM, Jenkins R, Sanders JG. Penumbral thoughts: Contents of consciousness upon waking. PLoS One 2023; 18:e0289654. [PMID: 38096272 PMCID: PMC10721006 DOI: 10.1371/journal.pone.0289654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/21/2023] [Indexed: 12/17/2023] Open
Abstract
Thoughts shape our experience, choice, and behaviour throughout the day. Yet the content of 'penumbral thoughts'-first thoughts upon waking-has received very little research attention. Across seven independent samples (total N = 829), we used recall and reflection methods, solicited the same day, to understand what individuals think as they regain consciousness. These penumbral thoughts show remarkable thematic consistency: individuals were most likely to reflect on their somatic or psychological state, focus on temporal orientation, and prioritise waking actions. Survey results demonstrate that temporal and spatial orientation are dominated by the current time and the day ahead, rather than the past or other future timescales. Our results provide some insight into the order of priority in consciousness. We conclude that establishing one's temporal position is important to the daily process of 'rebooting' conscious awareness.
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Affiliation(s)
- Virginia Fedrigo
- Department of Psychological and Behavioural Science, London School of Economics and Political Science, London, United Kingdom
| | - Matteo M. Galizzi
- Department of Psychological and Behavioural Science, London School of Economics and Political Science, London, United Kingdom
| | - Rob Jenkins
- Department of Psychology, University of York, York, United Kingdom
| | - Jet G. Sanders
- Department of Psychological and Behavioural Science, London School of Economics and Political Science, London, United Kingdom
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21
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Shriane AE, Rigney G, Ferguson SA, Bin YS, Vincent GE. Healthy sleep practices for shift workers: consensus sleep hygiene guidelines using a Delphi methodology. Sleep 2023; 46:zsad182. [PMID: 37429599 PMCID: PMC10710992 DOI: 10.1093/sleep/zsad182] [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: 11/27/2022] [Revised: 06/19/2023] [Indexed: 07/12/2023] Open
Abstract
STUDY OBJECTIVES The unique requirements of shift work, such as sleeping and working at variable times, mean that current sleep hygiene guidelines may be inappropriate for shift workers. Current guidelines may also contradict fatigue management advice (e.g. advising against daytime napping). The present study utilized a Delphi methodology to determine expert opinion regarding the applicability of current guidelines for shift workers, the appropriateness of the term "sleep hygiene," and develop tailored guidelines for shift workers. METHODS The research team reviewed current guidelines and existing evidence to draft tailored guidelines. Seventeen individual guidelines, covering sleep scheduling, napping, sleep environment, bedtime routine, substances, light exposure, diet, and exercise were drafted. Experts from sleep, shift work, and occupational health fields (n = 155) were invited to review the draft guidelines using a Delphi methodology. In each round, experts voted on individual guidelines, with 70% agreement considered consensus. Where consensus was not reached, written feedback from experts was discussed and incorporated into subsequent iterations. RESULTS Of the experts invited, 68 (44%) agreed to participate, with 55 (35%) completing the third (final) round. Most experts (84%) agreed that tailored guidelines were required for shift workers. Consensus was reached on all guidelines after three rounds. One additional guideline (sleep inertia) and an introductory statement were developed, resulting in a final set of 18 individual guidelines, termed "healthy sleep practices for shift workers." CONCLUSIONS This is the first study to develop tailored sleep hygiene guidelines for shift workers. Future research should investigate the acceptability and effectiveness of these guidelines amongst shift workers.
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Affiliation(s)
- Alexandra E Shriane
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Gabrielle Rigney
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Sally A Ferguson
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Yu Sun Bin
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Grace E Vincent
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
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22
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Song YM, Choi SJ, Park SH, Lee SJ, Joo EY, Kim JK. A real-time, personalized sleep intervention using mathematical modeling and wearable devices. Sleep 2023; 46:zsad179. [PMID: 37422720 DOI: 10.1093/sleep/zsad179] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/03/2023] [Indexed: 07/10/2023] Open
Abstract
The prevalence of artificial light exposure has enabled us to be active any time of the day or night, leading to the need for high alertness outside of traditional daytime hours. To address this need, we developed a personalized sleep intervention framework that analyzes real-world sleep-wake patterns obtained from wearable devices to maximize alertness during specific target periods. Our framework utilizes a mathematical model that tracks the dynamic sleep pressure and circadian rhythm based on the user's sleep history. In this way, the model accurately predicts real-time alertness, even for shift workers with complex sleep and work schedules (N = 71, t = 13~21 days). This allowed us to discover a new sleep-wake pattern called the adaptive circadian split sleep, which incorporates a main sleep period and a late nap to enable high alertness during both work and non-work periods of shift workers. We further developed a mobile application that integrates this framework to recommend practical, personalized sleep schedules for individual users to maximize their alertness during a targeted activity time based on their desired sleep onset and available sleep duration. This can reduce the risk of errors for those who require high alertness during nontraditional activity times and improve the health and quality of life for those leading shift work-like lifestyles.
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Affiliation(s)
- Yun Min Song
- Department of Mathematical Sciences, KAIST, Daejeon, Republic of Korea
- Biomedical Mathematics Group, Institute for Basic Science, Daejeon, Republic of Korea
| | - Su Jung Choi
- Graduate School of Clinical Nursing Science, Sungkyunkwan University, Seoul, Republic of Korea
| | - Se Ho Park
- Biomedical Mathematics Group, Institute for Basic Science, Daejeon, Republic of Korea
- Department of Mathematics, University of Wisconsin-Madison, Madison, WI, USA
| | - Soo Jin Lee
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Eun Yeon Joo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jae Kyoung Kim
- Department of Mathematical Sciences, KAIST, Daejeon, Republic of Korea
- Biomedical Mathematics Group, Institute for Basic Science, Daejeon, Republic of Korea
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23
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Miao X, Müller C, Lutz ND, Yang Q, Waszak F, Born J, Rauss K. Sleep consolidates stimulus-response learning. Learn Mem 2023; 30:175-184. [PMID: 37726140 PMCID: PMC10547380 DOI: 10.1101/lm.053753.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/15/2023] [Indexed: 09/21/2023]
Abstract
Performing a motor response to a sensory stimulus creates a memory trace whose behavioral correlates are classically investigated in terms of repetition priming effects. Such stimulus-response learning entails two types of associations that are partly independent: (1) an association between the stimulus and the motor response and (2) an association between the stimulus and the classification task in which it is encountered. Here, we tested whether sleep supports long-lasting stimulus-response learning on a task requiring participants (1) for establishing stimulus-classification associations to classify presented objects along two different dimensions ("size" and "mechanical") and (2) as motor response (action) to respond with either the left or right index finger. Moreover, we examined whether strengthening of stimulus-classification associations is preferentially linked to nonrapid eye movement (non-REM) sleep and strengthening of stimulus-action associations to REM sleep. We tested 48 healthy volunteers in a between-subjects design comparing postlearning retention periods of nighttime sleep versus daytime wakefulness. At postretention testing, we found that sleep supports consolidation of both stimulus-action and stimulus-classification associations, as indicated by increased reaction times in "switch conditions"; that is, when, at test, the acutely instructed classification task and/or correct motor response for a given stimulus differed from that during original learning. Polysomnographic recordings revealed that both kinds of associations were correlated with non-REM spindle activity. Our results do not support the view of differential roles for non-REM and REM sleep in the consolidation of stimulus-classification and stimulus-action associations, respectively.
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Affiliation(s)
- Xiu Miao
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard-Karls-Universität, Tübingen 72076, Germany
| | - Carolin Müller
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard-Karls-Universität, Tübingen 72076, Germany
| | - Nicolas D Lutz
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard-Karls-Universität, Tübingen 72076, Germany
- Institute of Medical Psychology, Ludwig-Maximilians-Universität, Munich 80336, Germany
| | - Qing Yang
- Université Paris Cité, Integrative Neuroscience and Cognition Center, UMR 8002, Centre National de la Recherche Scientifique, Paris 75006, France
| | - Florian Waszak
- Université Paris Cité, Integrative Neuroscience and Cognition Center, UMR 8002, Centre National de la Recherche Scientifique, Paris 75006, France
| | - Jan Born
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard-Karls-Universität, Tübingen 72076, Germany
- Center for Integrative Neuroscience, Eberhard-Karls-Universität, Tübingen 72076, Germany
| | - Karsten Rauss
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard-Karls-Universität, Tübingen 72076, Germany
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24
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LaGoy AD, Kubala AG, Deering S, Germain A, Markwald RR. Dawn of a New Dawn: Advances in Sleep Health to Optimize Performance. Sleep Med Clin 2023; 18:361-371. [PMID: 37532375 DOI: 10.1016/j.jsmc.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
Optimal sleep health is a critical component to high-level performance. In populations such as the military, public service (eg, firefighters), and health care, achieving optimal sleep health is difficult and subsequently deficiencies in sleep health may lead to performance decrements. However, advances in sleep monitoring technologies and mitigation strategies for poor sleep health show promise for further ecological scientific investigation within these populations. The current review briefly outlines the relationship between sleep health and performance as well as current advances in behavioral and technological approaches to improving sleep health for performance.
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Affiliation(s)
- Alice D LaGoy
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA; Leidos, Inc., San Diego, CA, USA
| | - Andrew G Kubala
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA; Leidos, Inc., San Diego, CA, USA
| | - Sean Deering
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA; Leidos, Inc., San Diego, CA, USA
| | | | - Rachel R Markwald
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA.
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25
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Hsu AL, Li MK, Kung YC, Wang ZJ, Lee HC, Li CW, Huang CWC, Wu CW. Temporal consistency of neurovascular components on awakening: preliminary evidence from electroencephalography, cerebrovascular reactivity, and functional magnetic resonance imaging. Front Psychiatry 2023; 14:1058721. [PMID: 37215667 PMCID: PMC10196490 DOI: 10.3389/fpsyt.2023.1058721] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 04/18/2023] [Indexed: 05/24/2023] Open
Abstract
Sleep inertia (SI) is a time period during the transition from sleep to wakefulness wherein individuals perceive low vigilance with cognitive impairments; SI is generally identified by longer reaction times (RTs) in attention tasks immediately after awakening followed by a gradual RT reduction along with waking time. The sluggish recovery of vigilance in SI involves a dynamic process of brain functions, as evidenced in recent functional magnetic resonance imaging (fMRI) studies in within-network and between-network connectivity. However, these fMRI findings were generally based on the presumption of unchanged neurovascular coupling (NVC) before and after sleep, which remains an uncertain factor to be investigated. Therefore, we recruited 12 young participants to perform a psychomotor vigilance task (PVT) and a breath-hold task of cerebrovascular reactivity (CVR) before sleep and thrice after awakening (A1, A2, and A3, with 20 min intervals in between) using simultaneous electroencephalography (EEG)-fMRI recordings. If the NVC were to hold in SI, we hypothesized that time-varying consistencies could be found between the fMRI response and EEG beta power, but not in neuron-irrelevant CVR. Results showed that the reduced accuracy and increased RT in the PVT upon awakening was consistent with the temporal patterns of the PVT-induced fMRI responses (thalamus, insula, and primary motor cortex) and the EEG beta power (Pz and CP1). The neuron-irrelevant CVR did not show the same time-varying pattern among the brain regions associated with PVT. Our findings imply that the temporal dynamics of fMRI indices upon awakening are dominated by neural activities. This is the first study to explore the temporal consistencies of neurovascular components on awakening, and the discovery provides a neurophysiological basis for further neuroimaging studies regarding SI.
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Affiliation(s)
- Ai-Ling Hsu
- Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ming-Kang Li
- Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Chia Kung
- Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan
| | - Zhitong John Wang
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chia-Wei Li
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | | | - Changwei W. Wu
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
- Brain and Consciousness Research Center, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
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26
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Carciofo R. Morning affect or sleep inertia? Comparing the constructs and their measurement. Chronobiol Int 2023:1-15. [PMID: 36912023 DOI: 10.1080/07420528.2023.2187211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
The construct of Morning Affect (MA; alertness upon awakening/time required to feel fully awake) emerged from exploratory factor analysis of morningness-eveningness questionnaires, and while it has been equated with morningness-eveningness preference it has much conceptual overlap with sleep inertia (SI; the transitional state between sleep and being fully awake). The current study compared questionnaire measures of these constructs to help clarify their inter-relationships. A volunteer sample of 453 students at an English-medium university in China completed an online survey including the Sleep Inertia Questionnaire (SIQ), the Morningness-Eveningness-Stability-Scale-improved (MESSi), with subscales for MA, Eveningness, and Distinctness (amplitude of diurnal variation), and the reduced Morningness-Eveningness Questionnaire (rMEQ). Measures of depression, sleep quality, mindfulness, and personality were also included. Exploratory factor analysis of the SIQ, MESSi, and rMEQ items revealed seven factors: Cognitive, Emotional, and Physiological SI, Responses to SI (including one MA item), and Duration of SI (one SIQ item, 3/5 MA items, and one rMEQ item); Morningness-Eveningness (MESSi Eveningness items, plus 3/5 rMEQ items); Distinctness (3/5 MESSi items). These results suggest that Morning Affect may be better characterised as a general measure of sleep inertia, and may contribute to ongoing development/refinement of questionnaire measures of circadian functioning.
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Affiliation(s)
- Richard Carciofo
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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27
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Hilditch CJ, Bansal K, Chachad R, Wong LR, Bathurst NG, Feick NH, Santamaria A, Shattuck NL, Garcia JO, Flynn-Evans EE. Reconfigurations in brain networks upon awakening from slow wave sleep: Interventions and implications in neural communication. Netw Neurosci 2023; 7:102-121. [PMID: 37334002 PMCID: PMC10270716 DOI: 10.1162/netn_a_00272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/05/2022] [Indexed: 04/04/2024] Open
Abstract
Sleep inertia is the brief period of impaired alertness and performance experienced immediately after waking. Little is known about the neural mechanisms underlying this phenomenon. A better understanding of the neural processes during sleep inertia may offer insight into the awakening process. We observed brain activity every 15 min for 1 hr following abrupt awakening from slow wave sleep during the biological night. Using 32-channel electroencephalography, a network science approach, and a within-subject design, we evaluated power, clustering coefficient, and path length across frequency bands under both a control and a polychromatic short-wavelength-enriched light intervention condition. We found that under control conditions, the awakening brain is typified by an immediate reduction in global theta, alpha, and beta power. Simultaneously, we observed a decrease in the clustering coefficient and an increase in path length within the delta band. Exposure to light immediately after awakening ameliorated changes in clustering. Our results suggest that long-range network communication within the brain is crucial to the awakening process and that the brain may prioritize these long-range connections during this transitional state. Our study highlights a novel neurophysiological signature of the awakening brain and provides a potential mechanism by which light improves performance after waking.
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Affiliation(s)
- Cassie J. Hilditch
- Fatigue Countermeasures Laboratory, Department of Psychology, San José State University, San José, CA, USA
| | - Kanika Bansal
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
- US DEVCOM Army Research Laboratory, Humans in Complex Systems Division, Aberdeen Proving Ground, MD, USA
| | - Ravi Chachad
- Fatigue Countermeasures Laboratory, Department of Psychology, San José State University, San José, CA, USA
| | - Lily R. Wong
- Fatigue Countermeasures Laboratory, Department of Psychology, San José State University, San José, CA, USA
| | - Nicholas G. Bathurst
- Fatigue Countermeasures Laboratory, Human Systems Integration Division, NASA Ames Research Center, Moffett Field, CA, USA
| | - Nathan H. Feick
- Fatigue Countermeasures Laboratory, Department of Psychology, San José State University, San José, CA, USA
| | - Amanda Santamaria
- Cognitive and Systems Neuroscience Research Hub, University of South Australia, Adelaide, SA, Australia
| | - Nita L. Shattuck
- Operations Research Department, Naval Postgraduate School, Monterey, CA, USA
| | - Javier O. Garcia
- US DEVCOM Army Research Laboratory, Humans in Complex Systems Division, Aberdeen Proving Ground, MD, USA
| | - Erin E. Flynn-Evans
- Fatigue Countermeasures Laboratory, Human Systems Integration Division, NASA Ames Research Center, Moffett Field, CA, USA
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28
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Ogawa K, Kaizuma-Ueyama E, Hayashi M. Effects of using a snooze alarm on sleep inertia after morning awakening. J Physiol Anthropol 2022; 41:43. [PMID: 36587230 PMCID: PMC9804954 DOI: 10.1186/s40101-022-00317-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/09/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Many people use the snooze function of digital alarm clocks for morning awakening, but the effects of a snooze alarm on waking are unclear. We examined the effects of a snooze alarm on sleep inertia, which is a transitional state characterized by reduced arousal and impaired cognitive and behavioral performance immediately upon awakening. METHODS In study 1, healthy Japanese university students responded to a sleep survey during a psychology class (study 1), and we collected 293 valid responses. In study 2, we compared a separate sample of university students (n = 10) for the effects of using or not using a snooze alarm on sleep inertia immediately after awakening from normal nocturnal sleep in a sleep laboratory. RESULTS Of 293 valid respondents in study 1, 251 often used a tool to wake up in the morning (85.7%). Moreover, 70.5% reported often using the snooze function of their mobile phones, mainly to reduce anxiety about oversleeping. Study 2 indicated no differences in the sleep quality or quantity before awakening with or without the snooze alarm, except in the last 20 min. However, during the last 20 min of sleep with snooze alarm, the snooze alarm prolonged waking and stage N1 sleep. Stage N1 sleep is non-rapid eye movement sleep that is primarily defined as a drowsy state. Furthermore, Global Vigor values were enhanced after awakening compared to pre-sleep in the no-snooze condition. CONCLUSIONS Using a snooze alarm prolongs sleep inertia compared to a single alarm, possibly because snooze alarms induce repeated forced awakenings.
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Affiliation(s)
- Keiko Ogawa
- grid.257022.00000 0000 8711 3200Integrated Arts and Human Sciences Program, Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan
| | - Emi Kaizuma-Ueyama
- grid.257022.00000 0000 8711 3200School of Integrated Arts and Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan
| | - Mitsuo Hayashi
- grid.257022.00000 0000 8711 3200Integrated Arts and Human Sciences Program, Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan
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29
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Vallat R, Berry SE, Tsereteli N, Capdevila J, Khatib HA, Valdes AM, Delahanty LM, Drew DA, Chan AT, Wolf J, Franks PW, Spector TD, Walker MP. How people wake up is associated with previous night's sleep together with physical activity and food intake. Nat Commun 2022; 13:7116. [PMID: 36402781 PMCID: PMC9675783 DOI: 10.1038/s41467-022-34503-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/27/2022] [Indexed: 11/21/2022] Open
Abstract
How people wake up and regain alertness in the hours after sleep is related to how they are sleeping, eating, and exercising. Here, in a prospective longitudinal study of 833 twins and genetically unrelated adults, we demonstrate that how effectively an individual awakens in the hours following sleep is not associated with their genetics, but instead, four independent factors: sleep quantity/quality the night before, physical activity the day prior, a breakfast rich in carbohydrate, and a lower blood glucose response following breakfast. Furthermore, an individual's set-point of daily alertness is related to the quality of their sleep, their positive emotional state, and their age. Together, these findings reveal a set of non-genetic (i.e., not fixed) factors associated with daily alertness that are modifiable.
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Affiliation(s)
- Raphael Vallat
- Center for Human Sleep Science, Department of Psychology, University of California, Berkeley, CA, USA.
| | - Sarah E Berry
- Department of Nutritional Sciences, King's College London, London, UK
| | - Neli Tsereteli
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - Haya Al Khatib
- Department of Nutritional Sciences, King's College London, London, UK
- Zoe Ltd, London, UK
| | - Ana M Valdes
- School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham NIHR Biomedical Research Centre, Nottingham, UK
| | - Linda M Delahanty
- Diabetes Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - David A Drew
- Clinical & Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrew T Chan
- Clinical & Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Paul W Franks
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
- Department of Nutrition, Harvard Chan School of Public Health, Boston, MA, USA
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Matthew P Walker
- Center for Human Sleep Science, Department of Psychology, University of California, Berkeley, CA, USA.
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30
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Oh KT, Ko J, Shin J, Ko M. Using Wake-Up Tasks for Morning Behavior Change: Development and Usability Study. JMIR Form Res 2022; 6:e39497. [PMID: 36129742 PMCID: PMC9529170 DOI: 10.2196/39497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/11/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Early morning behaviors between waking up and beginning daily work can develop into productive habits. However, sleep inertia limits the level of human ability immediately after waking, lowering a person’s motivation and available time for productive morning behavior.
Objective
This study explores a design for morning behavior change using a wake-up task, a simple assignment the user needs to finish before alarm dismissal. Specifically, we set two research objectives: (1) exploring key factors that relate to morning behavior performance, including the use of wake-up tasks in an alarm app and (2) understanding the general practice of affecting morning behavior change by implementing wake-up tasks.
Methods
We designed and implemented an apparatus that provides wake-up task alarms and facilities for squat exercises. We recruited 36 participants to perform squat exercises in the early morning using the wake-up tasks for 2 weeks. First, we conducted a generalized estimating equation (GEE) analysis for the first research objective. Next, we conducted a thematic analysis of the postsurvey answers to identify key themes about morning behavior change with the wake-up tasks for the second objective.
Results
The use of wake-up tasks was significantly associated with both the completion of the target behavior (math task: P=.005; picture task: P<.001) and the elapsed time (picture task: P=.08); the time to alarm dismissal was significantly related to the elapsed time to completion (P<.001). Moreover, the theory of planned behavior (TPB) variables, common factors for behavior change, were significant, but their magnitudes and directions differed slightly from the other domains. Furthermore, the survey results reveal how the participants used the wake-up tasks and why they were effective for morning behavior performance.
Conclusions
The results reveal the effectiveness of wake-up tasks in accomplishing the target morning behavior and address key factors for morning behavior change, such as (1) waking up on time, (2) escaping from sleep inertia, and (3) quickly starting the desired target behavior.
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Affiliation(s)
- Kyue Taek Oh
- Department of Human-Computer Interaction, Hanyang University, Ansan, Republic of Korea
| | - Jisu Ko
- Department of Applied Artificial Intelligence, Hanyang University, Ansan, Republic of Korea
| | | | - Minsam Ko
- Department of Human-Computer Interaction, Hanyang University, Ansan, Republic of Korea
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31
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Aime M, Adamantidis AR. Sleep to Survive Predators. Neurosci Bull 2022; 38:1114-1116. [PMID: 35570232 PMCID: PMC9468192 DOI: 10.1007/s12264-022-00875-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/10/2022] [Indexed: 10/18/2022] Open
Affiliation(s)
- Mattia Aime
- Department of Neurology, Zentrum für Experimentelle Neurologie, Inselspital University Hospital Bern, 3010, Bern, Switzerland
- Department of Biomedical Research, University of Bern, 3010, Bern, Switzerland
| | - Antoine R Adamantidis
- Department of Neurology, Zentrum für Experimentelle Neurologie, Inselspital University Hospital Bern, 3010, Bern, Switzerland.
- Department of Biomedical Research, University of Bern, 3010, Bern, Switzerland.
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32
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Adaptive Solutions to the Problem of Vulnerability During Sleep. EVOLUTIONARY PSYCHOLOGICAL SCIENCE 2022. [DOI: 10.1007/s40806-022-00330-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
AbstractSleep is a behavioral state whose quantity and quality represent a trade-off between the costs and benefits this state provides versus the costs and benefits of wakefulness. Like many species, we humans are particularly vulnerable during sleep because of our reduced ability to monitor the external environment for nighttime predators and other environmental dangers. A number of variations in sleep characteristics may have evolved over the course of human history to reduce this vulnerability, at both the individual and group level. The goals of this interdisciplinary review paper are (1) to explore a number of biological/instinctual features of sleep that may have adaptive utility in terms of enhancing the detection of external threats, and (2) to consider relatively recent cultural developments that improve vigilance and reduce vulnerability during sleep and the nighttime. This paper will also discuss possible benefits of the proposed adaptations beyond vigilance, as well as the potential costs associated with each of these proposed adaptations. Finally, testable hypotheses will be presented to evaluate the validity of these proposed adaptations.
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Effects of 90 Min Napping on Fatigue and Associated Environmental Factors among Nurses Working Long Night Shifts: A Longitudinal Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159429. [PMID: 35954787 PMCID: PMC9367999 DOI: 10.3390/ijerph19159429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 02/01/2023]
Abstract
For nurses working long night shifts, it is imperative that they have the ability to take naps to reduce fatigue, and that an appropriate environment is prepared where such naps can be taken. We verified the effects of 90 min napping on fatigue and the associated factors among nurses working 16-h night shifts. We investigated 196-night shifts among 49 nurses for one month. Wearable devices, data logging devices, and questionnaires were used to assess nap parameters, fatigue, and environmental factors such as the napping environment, ways of spending breaks, and working environment. Nurses who nap at least 90 min on most night shifts had more nursing experience. Multivariable logistic regression analysis showed that the environmental factors significantly associated with total nap duration (TND) ≥ 90 min were noise, time spent on electronic devices such as cellphones and tablets during breaks, and nap break duration. The night shifts with TND ≥ 90 min showed lower drowsiness after nap breaks and less fatigue at the end of night shift compared to those with TND < 90 min. Nurses and nursing managers should recognize the importance of napping and make adjustments to nap for at least 90 min during long night shifts.
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Abstract
The conventional wisdom that sleep is a global state, affecting the whole brain uniformly and simultaneously, was overturned by the discovery of local sleep, where individual neuronal populations were found to be asleep and the rest of the brain awake. However, due to the difficulty of monitoring local neuronal states in humans, our understanding of local sleep remains limited. Using simultaneous functional MRI (fMRI) and electroencephalography, we find that the oscillations of brain hemodynamic activity provide signatures of sleep at a local neuronal population level. We show that the fMRI signatures of sleep can be employed to monitor local neuronal states and investigate which brain regions are the first to fall asleep or wake up at wake–sleep transitions. Sleep can be distinguished from wake by changes in brain electrical activity, typically assessed using electroencephalography (EEG). The hallmark of nonrapid-eye-movement (NREM) sleep is the shift from high-frequency, low-amplitude wake EEG to low-frequency, high-amplitude sleep EEG dominated by spindles and slow waves. Here we identified signatures of sleep in brain hemodynamic activity, using simultaneous functional MRI (fMRI) and EEG. We found that, at the transition from wake to sleep, fMRI blood oxygen level–dependent (BOLD) activity evolved from a mixed-frequency pattern to one dominated by two distinct oscillations: a low-frequency (<0.1 Hz) oscillation prominent in light sleep and correlated with the occurrence of spindles, and a high-frequency oscillation (>0.1 Hz) prominent in deep sleep and correlated with the occurrence of slow waves. The two oscillations were both detectable across the brain but exhibited distinct spatiotemporal patterns. During the falling-asleep process, the low-frequency oscillation first appeared in the thalamus, then the posterior cortex, and lastly the frontal cortex, while the high-frequency oscillation first appeared in the midbrain, then the frontal cortex, and lastly the posterior cortex. During the waking-up process, both oscillations disappeared first from the thalamus, then the frontal cortex, and lastly the posterior cortex. The BOLD oscillations provide local signatures of spindle and slow wave activity. They may be employed to monitor the regional occurrence of sleep or wakefulness, track which regions are the first to fall asleep or wake up at the wake–sleep transitions, and investigate local homeostatic sleep processes.
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35
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Charlot K, Millet J, Pasquier F, Oustric P, Finlayson G, Van Beers P, Monin J, Sauvet F, Tardo-Dino PE, Malgoyre A. The impact of 16-h heat exposure on appetite and food reward in adults. Appetite 2022; 177:106144. [PMID: 35753442 DOI: 10.1016/j.appet.2022.106144] [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: 05/02/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/02/2022]
Abstract
Heat exposure is thought to reduce energy intake (EI) but studies are sparse and results not always concordant. The aim of this study was to examine whether a 16-h exposure to 32 °C leads to reduced EI compared to a control session (22 °C) and whether modifications in appetite sensations or food reward are implied. Sixteen healthy, lean, and active participants (9 women and 7 men, 25 ± 5 yo, body mass index: 22.0 ± 2.4 kg.m-2) were passively exposed to two different thermal temperatures from 4:00 pm to 8:00 am under controlled conditions. Hunger and thirst scores were regularly assessed using visual analogue scales. A fixed dinner meal (3670 ± 255 kJ) was consumed at 7:30 pm and an ad libitum breakfast buffet (20 foods/drinks varying in temperature, fat, and carbohydrate content) at 7:30 am. Components of reward (explicit liking [EL] and implicit wanting [EI]) for fat and sweet properties of food were assessed before each meal using the Leeds Food Preference Questionnaire (LFPQ). Ad libitum EI at breakfast did not differ between sessions (2319 ± 1108 vs 2329 ± 1141 kJ, in 22 and 32 °C sessions, respectively; p = 0.955). While thirst scores were higher in the 32 than the 22 °C session (p < 0.001), hunger scores did not differ (p = 0.580). EL and IW for high fat foods relative to low fat foods were decreased in 32 compared to 22 °C before dinner and breakfast (p < 0.001 for all). Although EI and hunger were not affected by a 16-h exposure to heat, modifications in food reward suggested a reduction in the preference of high-fat foods. Future research should investigate whether reduced EI in response to heat exposure is due to spontaneous selection of low-fat foods rather than altered appetite sensations.
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Affiliation(s)
- Keyne Charlot
- Unité de Physiologie des Exercices et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, 1 place Général Valérie André, 91223, Brétigny Cedex, France; LBEPS, Univ Evry, IRBA, Université Paris Saclay, 91025, Evry, France.
| | - Juliette Millet
- Unité de Physiologie des Exercices et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, 1 place Général Valérie André, 91223, Brétigny Cedex, France; LBEPS, Univ Evry, IRBA, Université Paris Saclay, 91025, Evry, France
| | - Florane Pasquier
- French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance, EA, 7370, Paris, France
| | - Pauline Oustric
- Appetite Control Energy Balance Research Group, School of Psychology, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Graham Finlayson
- Appetite Control Energy Balance Research Group, School of Psychology, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Pascal Van Beers
- Unité Fatigue et Vigilance, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, 1 place Général Valérie André, 91223, Brétigny Cedex, France; EA 7330 VIFASOM, Université de Paris, 75004, Paris, France
| | - Jonathan Monin
- Centre d'expertise principal du personnel naviguant, Hôpital d'instruction des armées Percy, 94140, Clamart, France
| | - Fabien Sauvet
- Unité Fatigue et Vigilance, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, 1 place Général Valérie André, 91223, Brétigny Cedex, France; EA 7330 VIFASOM, Université de Paris, 75004, Paris, France
| | - Pierre-Emmanuel Tardo-Dino
- Unité de Physiologie des Exercices et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, 1 place Général Valérie André, 91223, Brétigny Cedex, France; LBEPS, Univ Evry, IRBA, Université Paris Saclay, 91025, Evry, France
| | - Alexandra Malgoyre
- Unité de Physiologie des Exercices et Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, 1 place Général Valérie André, 91223, Brétigny Cedex, France; LBEPS, Univ Evry, IRBA, Université Paris Saclay, 91025, Evry, France
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Trotti LM, Saini P, Bremer E, Mariano C, Moron D, Rye DB, Bliwise DL. The Psychomotor Vigilance Test as a measure of alertness and sleep inertia in people with central disorders of hypersomnolence. J Clin Sleep Med 2022; 18:1395-1403. [PMID: 35040431 PMCID: PMC9059588 DOI: 10.5664/jcsm.9884] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 01/12/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The central disorders of hypersomnolence (CDH) manifest with daytime sleepiness, often accompanied by cognitive symptoms. Objective tests characterizing cognitive dysfunction may have diagnostic utility. Further, because some people with CDH report worsening cognition upon awakening, cognitive testing before and after napping may provide additional diagnostic information. METHODS Patients with CDH with idiopathic hypersomnia (n = 76), narcolepsy type 1 (n = 19), narcolepsy type 2 (n = 22), and self-reported excessive daytime sleepiness not meeting current diagnostic criteria (n = 76) and nonsleepy controls (n = 33) underwent testing with the Psychomotor Vigilance Test (PVT), a 10-minute reaction-time test. A subset of participants underwent repeat testing during a Multiple Sleep Latency Test, before and immediately after naps 2 and 4. RESULTS Most PVT metrics were significantly better in controls than in patients with CDH. Minimal group differences in PVT performance were observed by CDH diagnosis. PVT performance was weakly correlated to Epworth Sleepiness Scale and Multiple Sleep Latency Test mean sleep latency in the CDH group. Before and after naps, PVT metrics were minimally different for controls, while PVT performance generally worsened following naps in the CDH group, with significant worsening compared with controls for nap 2 mean, median, lapses, and fastest 10% of responses and nap 4 lapses and slowest 10% of responses. Change in performance did not differ based on CDH diagnostic group for any metric on either nap. CONCLUSIONS The PVT, at baseline and following a short nap, may provide adjunctive diagnostic utility in separating individuals with CDH from controls. CITATION Trotti LM, Saini P, Bremer E, et al. The Psychomotor Vigilance Test as a measure of alertness and sleep inertia in people with central disorders of hypersomnolence. J Clin Sleep Med. 2022;18(5):1395-1403.
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Affiliation(s)
- Lynn Marie Trotti
- Emory Sleep Center, Emory University School of Medicine, Atlanta, Georgia
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Prabhjyot Saini
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Erin Bremer
- Nell Hobson Woodruff School of Nursing, Emory University, Atlanta, Georgia
- Atlanta Veterans Affairs Medical Center, Atlanta, Georgia
| | - Christianna Mariano
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Danielle Moron
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - David B. Rye
- Emory Sleep Center, Emory University School of Medicine, Atlanta, Georgia
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Donald L. Bliwise
- Emory Sleep Center, Emory University School of Medicine, Atlanta, Georgia
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
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Hejazi NS, Farmer CA, Oppenheimer M, Falodun TB, Park LT, Duncan WC, Zarate CA. The relationship between the HDRS insomnia items and polysomnographic (PSG) measures in individuals with treatment-resistant depression. J Psychiatr Res 2022; 148:27-33. [PMID: 35092868 PMCID: PMC8957609 DOI: 10.1016/j.jpsychires.2022.01.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/04/2022] [Accepted: 01/09/2022] [Indexed: 10/19/2022]
Abstract
The Hamilton Depression Rating Scale (HDRS), which includes several insomnia-related items, is potentially valuable in evaluating both depressive and sleep symptoms. However, the HDRS insomnia items have not been fully assessed by objective measures. This study compared the three HDRS insomnia items (Early, Middle, and Late) with the corresponding objective polysomnography (PSG) measures of Sleep Latency (SL), middle wakefulness, and late wakefulness. The study used HDRS and PSG data from 130 baseline nights, drawn from 80 participants enrolled in clinical trials for treatment-resistant depression (TRD). Mixed models evaluated the relationship between the HDRS and PSG, and primary analyses examined the Early, Middle, and Late Insomnia HDRS items and the PSG variables SL and Waking After Sleep Onset (WASO). To approximate the Middle and Late HDRS Insomnia items more closely, WASO was divided into WASO before 4:00 a.m. (waking between Sleep Onset and 0400 h) and WASO after 4:00 a.m. (waking between 0400 h and 0700 h). Secondary analyses included summed HDRS Global Insomnia score. HDRS Early and Late Insomnia items predicted objective PSG measures of early and late wakefulness. For Early Insomnia, each additional point in severity was associated with 61% [95%CI: 35%, 93%] longer SL. For Late Insomnia, each additional point was associated with a 35% [95% CI: 13%, 63%] increase in WASO after 4:00 a.m. Middle Insomnia was marginally related to WASO before 4:00 a.m. HDRS Early and Late Insomnia items may thus provide an index of wakefulness in TRD and help monitor treatment response when objective measures such as PSG are not feasible. CLINICAL TRIALS IDENTIFIER: www.clinicaltrials.gov (NCT01204918, NCT00054704, NCT00088699).
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Affiliation(s)
- Nadia S Hejazi
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
| | - Cristan A Farmer
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Mark Oppenheimer
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Tolulope B Falodun
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Lawrence T Park
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Wallace C Duncan
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Carlos A Zarate
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
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C Gupta C, Dominiak M, Kovac K, C Reynolds A, A Ferguson S, J Hilditch C, Sprajcer M, E Vincent G. On-call work and sleep: the importance of switching on during a callout and switching off after a call. INDUSTRIAL HEALTH 2022; 60:91-96. [PMID: 34690251 PMCID: PMC8980688 DOI: 10.2486/indhealth.2021-0124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/23/2021] [Indexed: 06/13/2023]
Abstract
Due to the unpredictable nature of working time arrangements, on-call workers experience regular disruption to sleep, particularly if woken by calls. Sleep disruption can impact long term physical and mental health, next day performance, and importantly, performance immediately after waking. To reduce the impact of performance impairments upon waking (i.e., reducing sleep inertia), research has investigated strategies to promote alertness (e.g., bright light, caffeine, and exercise). This review puts forth on-call workers who are likely to return to sleep after a call, it is also important to consider the impact of these sleep inertia countermeasures on subsequent sleep. Future research should build on the preliminary evidence base for sleep inertia countermeasures by examining the impact on subsequent sleep. This research is key for both supporting alertness and performance during a call ("switching on") and for allowing the on-call worker to return to sleep after a call ("switching off").
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Affiliation(s)
- Charlotte C Gupta
- Central Queensland University, Appleton Institute for Behavioural Science, Australia
| | - Michelle Dominiak
- Central Queensland University, Appleton Institute for Behavioural Science, Australia
| | - Katya Kovac
- Central Queensland University, Appleton Institute for Behavioural Science, Australia
| | - Amy C Reynolds
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Australia
| | - Sally A Ferguson
- Central Queensland University, Appleton Institute for Behavioural Science, Australia
| | - Cassie J Hilditch
- San José State University, Fatigue Countermeasures Laboratory, Department of Psychology, USA
| | - Madeline Sprajcer
- Central Queensland University, Appleton Institute for Behavioural Science, Australia
| | - Grace E Vincent
- Central Queensland University, Appleton Institute for Behavioural Science, Australia
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Time Course of Motor Sleep Inertia Dissipation According to Age. Brain Sci 2022; 12:brainsci12040424. [PMID: 35447956 PMCID: PMC9028565 DOI: 10.3390/brainsci12040424] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023] Open
Abstract
Sleep inertia (SI) refers to a complex psychophysiological phenomenon observed after morning awakening that can be described as the gradual recovery of waking-like status after a night of sleep. The time course of SI dissipation in an everyday life condition is little studied. The present study aims to investigate the SI dissipation in motor activity, as a function of age, upon spontaneous morning awakening after a usual night-time sleep. To this end, we performed a retrospective study in a naturalistic setting in a wide life span sample: 382 healthy participants (219 females) from middle childhood (9 years old) to late adulthood (70 years old). Participants were required to wear the actigraph on the non-dominant wrist for at least seven consecutive nights. Results show that SI of motor activity is dissipated in 70 min. Mean motor activity in such a time window was significantly modulated by age: lower age corresponded to higher motor activity.
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Ma Z, Chen XY, Wang D, Zhu Z, Niu H, Huang S, Zhou X, Yang Z, Fan F. Who is the hardest to wake up from sleep? An investigation of self-reported sleep inertia using a latent profile analysis. J Sleep Res 2022; 31:e13552. [PMID: 35112414 DOI: 10.1111/jsr.13552] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/02/2022] [Accepted: 01/03/2022] [Indexed: 11/30/2022]
Abstract
Few studies have assessed the overall nature and profiles of subjective sleep inertia (SI) within the general population. This study was designed to identify subjective SI profiles and examine the associations between profiles of subjective SI with sociodemographic and sleep-related characteristics. A total of 11 colleges and universities were surveyed from May 30 to June 17, 2021, by convenience sampling. A total of 1,240 participants provided usable data regarding sociodemographic information, Sleep Inertia Questionnaire, and sleep-related characteristics via an online platform. Latent profile analysis was utilised to identify profiles of SI. Multinomial logistic regression was further performed to examine the predisposing factors of profiles of SI. Four profiles of SI were identified: (1) "Low SI", 20%; (2) "Mild SI", 31%; (3) "Moderate SI", 33%; and (4) "Severe SI", 16%. Compared to a Low SI profile, younger, individuals with an evening chronotype, and individuals who had <6 h sleep/night, experienced poor sleep quality, and moderate-to-severe sleep disturbance were at increased risk of experiencing severe SI. Individuals with more languid types tended to show more severe SI, while individuals reporting greater flexibility experienced less SI. This study is the first effort to examine the profiles of subjective SI using latent profile analysis and identified four profiles of SI in the general population. This effort may contribute to a greater understanding of SI, including the development of a screening tool and interventions to reduce SI.
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Affiliation(s)
- Zijuan Ma
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
| | - Xiao-Yan Chen
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
| | - Zhiyi Zhu
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
| | - Haiquan Niu
- School of Psychology, Nanjing Normal University, Nanjing, China
| | - Shuiqing Huang
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
| | - Xiuzhu Zhou
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
| | - Zheng Yang
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
| | - Fang Fan
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
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Ma Z, Tao Y, Chen H, Zhang Y, Pan Y, Meng D, Fan F. An Exploration of Self-Reported Sleep Inertia Symptoms Using Network Analysis. Nat Sci Sleep 2022; 14:661-674. [PMID: 35450224 PMCID: PMC9018210 DOI: 10.2147/nss.s347419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/30/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Sleep inertia (SI) is the transitional state accompanied by compromised cognitive and physical performance and sleepiness. Network analysis offers a potential new framework to conceptualize a complex network of symptom-symptom interactions, and the network structure is analyzed to reveal the core characteristics. However, no previous study examined the network structure of SI symptoms. Thus, this study aimed to elucidate characteristics and compare sex differences of SI symptom networks in the general population. MATERIALS AND METHODS A total of 1491 participants from China were recruited from 30 May to 17 June, 2021. SI symptoms were assessed by using the Sleep Inertia Questionnaire (SIQ). The network structures were estimated and compared using network analytic methods in the R version 4.1.1. RESULTS Centrality properties analysis of the expected influence suggested that symptoms of "Feel sleepy", "Groggy, fuzzy or hazy mind", and "Dread starting your day" exerted greatest influences. The weighted adjacency matrix revealed that the "Dread starting your day" and "Anxious about the upcoming day" edge showed the strongest connection (edge weight value = 0.70). The network comparison test found no significant difference in network global strength (p=0.928), distribution of edge weights (p=0.194) and individual edge weights (all p values >0.05 after Holm-Bonferroni corrections) between males and females. CONCLUSION Symptoms of "Feel sleepy", "Groggy, fuzzy or hazy mind", and "Dread starting your day" were central in the SI symptom network. Intervention, such as the artificial dawn and change in body temperature, for symptoms of "Feel sleepy", "Groggy, fuzzy or hazy mind", and "Dread starting your day" might be crucial to hasten the dissipation of SI in the general population who may need to perform tasks upon waking.
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Affiliation(s)
- Zijuan Ma
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People's Republic of China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, People's Republic of China
| | - Yanqiang Tao
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, People's Republic of China
| | - Huilin Chen
- Department of Psychology, University of Bath, Bath, UK
| | - Yifan Zhang
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People's Republic of China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, People's Republic of China
| | - Ye Pan
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People's Republic of China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, People's Republic of China
| | - Dongjing Meng
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People's Republic of China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, People's Republic of China
| | - Fang Fan
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People's Republic of China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, People's Republic of China
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Gurubhagavatula I, Barger LK, Barnes CM, Basner M, Boivin DB, Dawson D, Drake CL, Flynn-Evans EE, Mysliwiec V, Patterson PD, Reid KJ, Samuels C, Shattuck NL, Kazmi U, Carandang G, Heald JL, Van Dongen HP. Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society. J Clin Sleep Med 2021; 17:2283-2306. [PMID: 34666885 PMCID: PMC8636361 DOI: 10.5664/jcsm.9512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022]
Abstract
CITATION Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: (1) a recognition of the factors contributing to fatigue and fatigue-related risks; (2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and (3) an informed approach to selecting workplace-specific strategies for managing work hours. We propose a series of guiding principles to assist stakeholders with designing a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.
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Affiliation(s)
- Indira Gurubhagavatula
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Laura K. Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Christopher M. Barnes
- Department of Management and Organization, Foster School of Business, University of Washington, Seattle, WA, USA
| | - Mathias Basner
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Diane B. Boivin
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Drew Dawson
- Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | | | - Erin E. Flynn-Evans
- Fatigue Countermeasures Laboratory, NASA Ames Research Center, Moffett Field, CA, USA
| | - Vincent Mysliwiec
- STRONG STAR ORU, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, TX, USA
| | - P. Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathryn J. Reid
- Center for Circadian and Sleep Medicine, Department of Neurology, Division of Sleep Medicine, Northwestern University, Chicago, IL, USA
| | - Charles Samuels
- Centre for Sleep and Human Performance, Calgary, Alberta, Canada
| | - Nita Lewis Shattuck
- Operations Research Department, Naval Postgraduate School, Monterey, CA, USA
| | - Uzma Kazmi
- American Academy of Sleep Medicine, Darien, IL, USA
| | | | | | - Hans P.A. Van Dongen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
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43
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Kohler M, Sandiford C, Schilds L, Payne JD. Memory for emotional images across sleep versus wake in school-aged children. J Exp Child Psychol 2021; 214:105308. [PMID: 34715399 DOI: 10.1016/j.jecp.2021.105308] [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: 06/18/2020] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 10/20/2022]
Abstract
Sleep is important for emotional well-being, memory, and development in children. Regarding memory, sleep has been shown to advantage accuracy for declarative tasks but not procedural tasks. There is some evidence to suggest that sleep provides a relatively greater benefit for memory of negative emotional versus neutral images. However, the extent to which sleep benefits emotionally positive memories in children is not clear. This study assessed memory after nocturnal sleep versus daytime wake in a within-person design involving a sample of 40 children aged 7 to 14 years (M = 10.6 ± 1.9 years; 18 boys and 22 girls) for images of negative, neutral, and positive valences. Results show that after accounting for response time, memory accuracy overall was greater after sleep compared with equivalent time of wake and memory accuracy was greatest for positive images compared with both negative and neutral images. However, there was no difference between memory for negative images and that for neutral images in children, and there was no condition by valence interaction. Sleep characteristics as recorded using actigraphy, diary, and parent report were not predictive of memory performance after sleep when correcting for multiple comparisons. Overall, the results suggest that sleep may benefit memory in otherwise healthy children but that despite a bias toward memory for positive items over both negative and neutral items, there is not a relatively greater benefit for emotional versus neutral memory consolidation across sleep periods compared with wake periods.
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Affiliation(s)
- Mark Kohler
- School of Psychology, University of Adelaide, Adelaide, South Australia 5005, Australia.
| | - Carol Sandiford
- School of Psychological Sciences, Monash University, Melbourne, Victoria 3800, Australia
| | - Lauren Schilds
- School of Psychology, University of Adelaide, Adelaide, South Australia 5005, Australia
| | - Jessica D Payne
- Sleep, Stress, and Memory Laboratory, Department of Psychology, University of Notre Dame, Notre Dame, IN 46556, USA
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Stephan AM, Lecci S, Cataldi J, Siclari F. Conscious experiences and high-density EEG patterns predicting subjective sleep depth. Curr Biol 2021; 31:5487-5500.e3. [PMID: 34710350 DOI: 10.1016/j.cub.2021.10.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 07/06/2021] [Accepted: 10/06/2021] [Indexed: 10/20/2022]
Abstract
What accounts for feeling deeply asleep? Standard sleep recordings only incompletely reflect subjective aspects of sleep and some individuals with so-called sleep misperception frequently feel awake although sleep recordings indicate clear-cut sleep. To identify the determinants of sleep perception, we performed 787 awakenings in 20 good sleepers and 10 individuals with sleep misperception and interviewed them about their subjective sleep depth while they underwent high-density EEG sleep recordings. Surprisingly, in good sleepers, sleep was subjectively lightest in the first 2 h of non-rapid eye movement (NREM) sleep, generally considered the deepest sleep, and deepest in rapid eye movement (REM) sleep. Compared to good sleepers, sleep misperceptors felt more frequently awake during sleep and reported lighter REM sleep. At the EEG level, spatially widespread high-frequency power was inversely related to subjective sleep depth in NREM sleep in both groups and in REM sleep in misperceptors. Subjective sleep depth positively correlated with dream-like qualities of reports of mental activity. These findings challenge the widely held notion that slow wave sleep best accounts for feeling deeply asleep. Instead, they indicate that subjective sleep depth is inversely related to a neurophysiological process that predominates in early NREM sleep, becomes quiescent in REM sleep, and is reflected in high-frequency EEG activity. In sleep misperceptors, this process is more frequently active, more spatially widespread, and abnormally persists into REM sleep. These findings help identify the neuromodulatory systems involved in subjective sleep depth and are relevant for studies aiming to improve subjective sleep quality.
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Affiliation(s)
- Aurélie M Stephan
- Center for Investigation and Research on Sleep, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1010 Lausanne, Switzerland
| | - Sandro Lecci
- Center for Investigation and Research on Sleep, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1010 Lausanne, Switzerland
| | - Jacinthe Cataldi
- Center for Investigation and Research on Sleep, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1010 Lausanne, Switzerland
| | - Francesca Siclari
- Center for Investigation and Research on Sleep, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1010 Lausanne, Switzerland; Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1010 Lausanne, Switzerland.
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45
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A novel bedtime pulsatile-release caffeine formula ameliorates sleep inertia symptoms immediately upon awakening. Sci Rep 2021; 11:19734. [PMID: 34611208 PMCID: PMC8492773 DOI: 10.1038/s41598-021-98376-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/30/2021] [Indexed: 02/08/2023] Open
Abstract
Sleep inertia is a disabling state of grogginess and impaired vigilance immediately upon awakening. The adenosine receptor antagonist, caffeine, is widely used to reduce sleep inertia symptoms, yet the initial, most severe impairments are hardly alleviated by post-awakening caffeine intake. To ameliorate this disabling state more potently, we developed an innovative, delayed, pulsatile-release caffeine formulation targeting an efficacious dose briefly before planned awakening. We comprehensively tested this formulation in two separate studies. First, we established the in vivo caffeine release profile in 10 young men. Subsequently, we investigated in placebo-controlled, double-blind, cross-over fashion the formulation's ability to improve sleep inertia in 22 sleep-restricted volunteers. Following oral administration of 160 mg caffeine at 22:30, we kept volunteers awake until 03:00, to increase sleep inertia symptoms upon scheduled awakening at 07:00. Immediately upon awakening, we quantified subjective state, psychomotor vigilance, cognitive performance, and followed the evolution of the cortisol awakening response. We also recorded standard polysomnography during nocturnal sleep and a 1-h nap opportunity at 08:00. Compared to placebo, the engineered caffeine formula accelerated the reaction time on the psychomotor vigilance task, increased positive and reduced negative affect scores, improved sleep inertia ratings, prolonged the cortisol awakening response, and delayed nap sleep latency one hour after scheduled awakening. Based on these findings, we conclude that this novel, pulsatile-release caffeine formulation facilitates the sleep-to-wake transition in sleep-restricted healthy adults. We propose that individuals suffering from disabling sleep inertia may benefit from this innovative approach.Trials registration: NCT04975360.
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46
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Wingelaar-Jagt YQ, Wingelaar TT, Riedel WJ, Ramaekers JG. Fatigue in Aviation: Safety Risks, Preventive Strategies and Pharmacological Interventions. Front Physiol 2021; 12:712628. [PMID: 34552504 PMCID: PMC8451537 DOI: 10.3389/fphys.2021.712628] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/06/2021] [Indexed: 01/22/2023] Open
Abstract
Fatigue poses an important safety risk to civil and military aviation. In addition to decreasing performance in-flight (chronic) fatigue has negative long-term health effects. Possible causes of fatigue include sleep loss, extended time awake, circadian phase irregularities and work load. Despite regulations limiting flight time and enabling optimal rostering, fatigue cannot be prevented completely. Especially in military operations, where limits may be extended due to operational necessities, it is impossible to rely solely on regulations to prevent fatigue. Fatigue management, consisting of preventive strategies and operational countermeasures, such as pre-flight naps and pharmaceuticals that either promote adequate sleep (hypnotics or chronobiotics) or enhance performance (stimulants), may be required to mitigate fatigue in challenging (military) aviation operations. This review describes the pathophysiology, epidemiology and effects of fatigue and its impact on aviation, as well as several aspects of fatigue management and recommendations for future research in this field.
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Affiliation(s)
- Yara Q Wingelaar-Jagt
- Center for Man in Aviation, Royal Netherlands Air Force, Soesterberg, Netherlands.,Department of of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Thijs T Wingelaar
- Diving Medical Center, Royal Netherlands Navy, Den Helder, Netherlands
| | - Wim J Riedel
- Department of of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Johannes G Ramaekers
- Department of of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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47
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Evangelista E, Rassu AL, Lopez R, Biagioli N, Chenini S, Barateau L, Jaussent I, Dauvilliers Y. Sleep inertia measurement with the psychomotor vigilance task in idiopathic hypersomnia. Sleep 2021; 45:6358036. [PMID: 34436617 DOI: 10.1093/sleep/zsab220] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/29/2021] [Indexed: 12/31/2022] Open
Abstract
STUDY OBJECTIVES Sleep inertia is a frequent and disabling symptom in idiopathic hypersomnia (IH), but poorly defined and without objective measures. The study objective was to determine whether the psychomotor vigilance task (PVT) can reliably measure sleep inertia in patients with IH or other sleep disorders (non-IH). METHODS Sixty-two (51 women, mean age: 27.7±9.2) patients with IH and 140 (71 women, age: 33.3±12.1) with non-IH (narcolepsy=29, non-specified hypersomnolence NSH=47, obstructive sleep apnea=39, insomnia=25) were included. Sleep inertia and sleep drunkenness in the last month (M-sleep inertia) and on PVT day (D-sleep inertia) were assessed with three items of the Idiopathic Hypersomnia Severity Scale (IHSS), in drug-free conditions. The PVT was performed four times (7:00 PM, and 7:00, 7:30 and 11:00 AM) and three metrics were used: lapses, mean 1/Reaction Time (RT), slowest 10% 1/RT. RESULTS Sleep inertia was more frequent in patients with IH than non-IH (56.5% and 43.6% with severe sleep inertia in the past month, including 24% and 12% with sleep drunkenness). Lapse number increase and slowest 10% 1/RT decrease, particularly at 7:00 and 7:30AM, were proportional with M-sleep inertia severity, but regardless of sleep drunkenness and sleep disorders. Similar results were obtained when PVT results were compared in patients with/without D-sleep inertia, with the largest increase of the lapse number at 7:00 and 7:30AM associated with severe sleep inertia and sleep drunkenness. CONCLUSION PVT is a reliable and objective measure of sleep inertia that might be useful for its characterization, management and follow-up in patients with IH.
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Affiliation(s)
- Elisa Evangelista
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France.,Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Anna Laura Rassu
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Régis Lopez
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France.,Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Niccolò Biagioli
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Sofiène Chenini
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Lucie Barateau
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France.,Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Isabelle Jaussent
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Yves Dauvilliers
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France.,Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
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48
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Casale CE, Goel N. Genetic Markers of Differential Vulnerability to Sleep Loss in Adults. Genes (Basel) 2021; 12:1317. [PMID: 34573301 PMCID: PMC8464868 DOI: 10.3390/genes12091317] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 12/15/2022] Open
Abstract
In this review, we discuss reports of genotype-dependent interindividual differences in phenotypic neurobehavioral responses to total sleep deprivation or sleep restriction. We highlight the importance of using the candidate gene approach to further elucidate differential resilience and vulnerability to sleep deprivation in humans, although we acknowledge that other omics techniques and genome-wide association studies can also offer insights into biomarkers of such vulnerability. Specifically, we discuss polymorphisms in adenosinergic genes (ADA and ADORA2A), core circadian clock genes (BHLHE41/DEC2 and PER3), genes related to cognitive development and functioning (BDNF and COMT), dopaminergic genes (DRD2 and DAT), and immune and clearance genes (AQP4, DQB1*0602, and TNFα) as potential genetic indicators of differential vulnerability to deficits induced by sleep loss. Additionally, we review the efficacy of several countermeasures for the neurobehavioral impairments induced by sleep loss, including banking sleep, recovery sleep, caffeine, and naps. The discovery of reliable, novel genetic markers of differential vulnerability to sleep loss has critical implications for future research involving predictors, countermeasures, and treatments in the field of sleep and circadian science.
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Affiliation(s)
| | - Namni Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 425, Chicago, IL 60612, USA;
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49
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Isaacs RA, Balendran J, Tran L, Dobbie ML, Templeton DJ. Sleep, waking and sleep inertia in sexual assault: A retrospective descriptive study. J Forensic Leg Med 2021; 82:102222. [PMID: 34358925 DOI: 10.1016/j.jflm.2021.102222] [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: 02/23/2021] [Revised: 06/28/2021] [Accepted: 07/21/2021] [Indexed: 11/20/2022]
Abstract
Women who wake from sleep during sexual assault commonly report confusion and disorientation. Confusion and disorientation, with impaired decision making after waking, are symptoms of 'sleep inertia', and part of the normal transition from sleep to full wakefulness which is maximal in the minutes after wakening and can be prolonged. In this study of 305 adult females (median age 26, range 18-68), who presented for a sexual assault forensic medical examination, 38 (12%) (median age 27, range 18-51) woke to find sexual acts already in progress. For 25 of these women (25/38 for 66%), an act of penile-vaginal penetration was already occurring when the woman woke. Of the 38 women (12%) who woke during the sexual assault, several had factors known to enhance the impairment of sleep inertia including forced arousal (38/38, 100%) and age under 25 (15/38, 39%). 17 (17/38 for 45%) of these women who woke had consumed varying amounts of alcohol prior to sleep and these 17 woke fully during the assault and then stayed awake. A further 16 women, (16/38 for 42%) woke during the sexual assault but returned to sleep during or after the assault, and all these 16 gave a history of intoxication by drugs or alcohol prior to sleep. Importantly 5, (5/38 for 13%) of the women who woke during the assault had consumed no intoxicating substances. A further 68 (23%) of the 305 women, (median age 26, range 18-58) had no memory on waking of the alleged sexual assault despite having other reasons to believe that a sexual assault had occurred. Forensic medical examiners can assist both the justice process, and patient care, by considering the possibility of sleep inertia among victims who report disorientation and slow or confused decision making on waking during a sexual assault.
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Affiliation(s)
- Rosemary Alison Isaacs
- RPAH Sexual Assault Medical Service, Sydney Local Health District, School of Medicine: Western Sydney University, NSW, 2050, Australia.
| | - Jananie Balendran
- Department of Obstetrics and Gynaecology, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW, 2050, Australia.
| | - Lauren Tran
- Royal Prince Alfred Hospital Sexual Assault Medical Service, Sydney Local Health District, Camperdown, NSW, 2050, Australia.
| | - Mary Louise Dobbie
- Royal Prince Alfred Hospital Sexual Assault Medical Service, Sydney Local Health District, Camperdown, NSW, 2050, Australia.
| | - David James Templeton
- Department of Sexual Health and Sexual Assault Forensic Medicine, Sydney Local Health District, Camperdown: Central Clinical School, The University of Sydney, Sydney, NSW, 2050, Australia.
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50
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Gurubhagavatula I, Barger LK, Barnes CM, Basner M, Boivin DB, Dawson D, Drake CL, Flynn-Evans EE, Mysliwiec V, Patterson PD, Reid KJ, Samuels C, Shattuck NL, Kazmi U, Carandang G, Heald JL, Van Dongen HPA. Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society. Sleep 2021; 44:6312566. [PMID: 34373924 DOI: 10.1093/sleep/zsab161] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/17/2021] [Indexed: 11/12/2022] Open
Abstract
Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: (1) a recognition of the factors contributing to fatigue and fatigue-related risks; (2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and (3) an informed approach to selecting workplace-specific strategies for managing work hours. We propose a series of guiding principles to assist stakeholders with designing a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.
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Affiliation(s)
- Indira Gurubhagavatula
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Laura K Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Christopher M Barnes
- Department of Management and Organization, Foster School of Business, University of Washington, Seattle, WA, USA
| | - Mathias Basner
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Diane B Boivin
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Drew Dawson
- Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | | | - Erin E Flynn-Evans
- Fatigue Countermeasures Laboratory, NASA Ames Research Center, Moffett Field, CA, USA
| | - Vincent Mysliwiec
- STRONG STAR ORU, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, TX, USA
| | - P Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathryn J Reid
- Center for Circadian and Sleep Medicine, Department of Neurology, Division of Sleep Medicine, Northwestern University, Chicago, IL, USA
| | - Charles Samuels
- Centre for Sleep and Human Performance, Calgary, Alberta, Canada
| | - Nita Lewis Shattuck
- Operations Research Department, Naval Postgraduate School, Monterey, CA, USA
| | - Uzma Kazmi
- American Academy of Sleep Medicine, Darien, IL, USA
| | | | | | - Hans P A Van Dongen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
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