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Spitschan M. Selecting, implementing and evaluating control and placebo conditions in light therapy and light-based interventions. Ann Med 2024; 56:2298875. [PMID: 38329797 PMCID: PMC10854444 DOI: 10.1080/07853890.2023.2298875] [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] [Received: 09/21/2023] [Accepted: 12/20/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction: Light profoundly influences human physiology, behaviour and cognition by affecting various functions through light-sensitive cells in the retina. Light therapy has proven effective in treating seasonal depression and other disorders. However, designing appropriate control conditions for light-based interventions remains a challenge.Materials and methods: This article presents a novel framework for selecting, implementing and evaluating control conditions in light studies, offering theoretical foundations and practical guidance. It reviews the fundamentals of photoreception and discusses control strategies such as dim light, darkness, different wavelengths, spectral composition and metameric conditions. Special cases like dynamic lighting, simulated dawn and dusk, complex interventions and studies involving blind or visually impaired patients are also considered.Results: The practical guide outlines steps for selection, implementation, evaluation and reporting, emphasizing the importance of α-opic calculations and physiological validation.Conclusion: In conclusion, constructing effective control conditions is crucial for demonstrating the efficacy of light interventions in various research scenarios.
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Affiliation(s)
- Manuel Spitschan
- Max Planck Institute for Biological Cybernetics, Translational Sensory & Circadian Neuroscience, Tübingen, Germany
- Technical University of Munich, TUM School of Medicine and Health, Chronobiology & Health, Munich, Germany
- Technical University of Munich, TUM Institute for Advanced Study (TUM-IAS), Garching, Germany
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He M, Chen H, Li S, Ru T, Chen Q, Zhou G. Evening prolonged relatively low melanopic equivalent daylight illuminance light exposure increases arousal before and during sleep without altering sleep structure. J Sleep Res 2024; 33:e14113. [PMID: 38097530 DOI: 10.1111/jsr.14113] [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: 06/22/2023] [Revised: 11/01/2023] [Accepted: 11/10/2023] [Indexed: 07/17/2024]
Abstract
Light can influence many psychophysiological functions beyond vision, including alertness, circadian rhythm, and sleep, namely the non-image forming (NIF) effects of light. Melanopic equivalent daylight illuminance (mel-EDI) is currently recommended as the predictor of the NIF effects of light. Although light dose is also critical for entraining and regulating circadian cycle, it is still unknown whether relatively low mel-EDI light exposure for prolonged duration in the evening would affect pre-sleep arousal and subsequent sleep. In all, 18 healthy college students (10 females, mean [standard deviation] age 21.67 [2.03] years) underwent 2 experimental nights with a 1 week interval in a simulated bedroom environment. During experimental nights, participants were either exposed to high or low mel-EDI light (73 versus 38 lx mel-EDI, 90 versus 87 photopic lx at eye level, 150 photopic lx at table level) for 3.5 h before regular bedtime, and their sleep was monitored by polysomnography. Subjective sleepiness, mood, and resting-state electroencephalography during light exposure were also investigated. Results showed no significant differences in sleep structure and sleep quality between the two light conditions, whereas 3.5 h of exposure to high versus low mel-EDI light induced marginally higher physiological arousal in terms of a lower delta but higher beta power density before sleep, as well as a lower delta power density during sleep. Moreover, participants felt happier before sleep under exposure to high versus low mel-EDI light. These findings together with the current literature suggest that evening prolonged relatively low mel-EDI light exposure may mildly increase arousal before and during sleep but affected sleep structure less.
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Affiliation(s)
- Meiheng He
- Lab of Lighting and Physio-psychological Health, School of Psychology, South China Normal University, Guangzhou, China
- National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, China
| | - Hanyu Chen
- Lab of Lighting and Physio-psychological Health, School of Psychology, South China Normal University, Guangzhou, China
| | - Siyu Li
- Lab of Lighting and Physio-psychological Health, School of Psychology, South China Normal University, Guangzhou, China
| | - Taotao Ru
- National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Optical Information Materials and Technology, Institute of Electronic Paper Displays, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou, China
| | - Qingwei Chen
- National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, China
| | - Guofu Zhou
- National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Optical Information Materials and Technology, Institute of Electronic Paper Displays, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou, China
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Sauvet F, Beauchamps V, Cabon P. Sleep Inertia in Aviation. Aerosp Med Hum Perform 2024; 95:206-213. [PMID: 38486319 DOI: 10.3357/amhp.6343.2024] [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: 03/17/2024]
Abstract
INTRODUCTION: Sleep inertia is the transition state during which alertness and cognitive performance are temporarily impaired after awakening. Magnitude and time course of sleep inertia are characterized by high individual variability with large differences between the cognitive functions affected. This period of impairment is of concern to pilots, who take sleep or nap periods during on-call work hours or in-flight rest, then need to perform safety-critical tasks soon after waking. This review analyzes literature related to sleep inertia and countermeasures applicable for aviation.METHODS: The large part of scientific literature that focuses on sleep inertia is based on studies in patients with chronic sleep inertia. We analyzed 8 narrative reviews and 64 papers related to acute sleep inertia in healthy subjects.DISCUSSION: Sleep inertia is a multifactorial, complex process, and many different protocols have been conducted, with a low number of subjects, in noncontrolled laboratory designs, with questionnaires or cognitive tests that have not been replicated. Evidence suggests that waking after sleep loss, or from deeper stages of sleep, can exacerbate sleep inertia through complex interactions between awakening and sleep-promoting brain structures. Nevertheless, no meta-analyses are possible and extrapolation to pilots' performances is hypothetical. Studies in real life or simulated operational situations must be conducted to improve the description of the impact of sleep inertia and kinetics on pilots' performances. Taking rest or sleep time remains the main method for pilots to fight against fatigue and related decreases in performance. We propose proactive strategies to mitigate sleep inertia and improve alertness.Sauvet F, Beauchamps V, Cabon P. Sleep inertia in aviation. Aerosp Med Hum Perform. 2024; 95(4):206-213.
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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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5
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Beute F, Aries MB. The importance of residential dusk and dawn light exposure for sleep quality, health, and well-being. Sleep Med Rev 2023; 72:101865. [PMID: 37864914 DOI: 10.1016/j.smrv.2023.101865] [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: 12/28/2022] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/23/2023]
Abstract
Light exposure during twilight plays a critical role in the entrainment of the human circadian system. People are most often at home during dusk and dawn, and light exposure at home - either natural or from electric light - may therefore contribute substantially to sleep and well-being. However, very little research has focused on the effects of home lighting on sleep and well-being, and even less research has investigated the effects of light exposure during twilight. Therefore, a literature study was performed to collect studies on light exposure at home during dusk and dawn. Studies looking at light exposure during dusk and dawn have focused on either electric light intervention (i.e., dusk and dawn simulation) at home or in the laboratory or daylight exposure in the bedroom (i.e., the presence and type of curtains in the bedroom). Most research has focused on dawn simulation during the darker months of the year, often using sunrise alarms. In general, study results pointed to the importance of twilight light exposure at home for sleep and well-being. These results may depend on the characteristics of the user, such as age or chronotype.
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Affiliation(s)
| | - Myriam Bc Aries
- Jönköping University, School of Engineering, Jönköping, Sweden.
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Effects of dynamic bedroom lighting on measures of sleep and circadian rest-activity rhythm in inpatients with major depressive disorder. Sci Rep 2022; 12:6137. [PMID: 35414714 PMCID: PMC9005730 DOI: 10.1038/s41598-022-10161-8] [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: 10/04/2021] [Accepted: 04/01/2022] [Indexed: 11/08/2022] Open
Abstract
Bright light therapy is an effective treatment option for seasonal and non-seasonal affective disorders. However up to now, no study has investigated effects of dynamic bedroom lighting in hospitalized patients with major depression. A bedroom lighting system, which automatically delivered artificial dawn and dusk and blue-depleted nighttime lighting (DD-N lighting) was installed in a psychiatric ward. Patients with moderate to severe depression were randomly assigned to stay in bedrooms with the new lighting or standard lighting system. Patients wore wrist actimeters during the first two treatment weeks. Additionally, hospitalization duration and daily psychotropic medication were retrieved from patients' medical charts. Data from thirty patients, recorded over a period of two weeks, were analyzed. Patients under DD-N lighting generally woke up earlier (+ 20 min), slept longer (week 1: + 11 min; week 2: + 27 min) and showed higher sleep efficiency (+ 2.4%) and shorter periods of nighttime awakenings (- 15 min). In the second treatment week, patients started sleep and the most active 10-h period earlier (- 33 min and - 64 min, respectively). This pilot study gives first evidence that depressed patients' sleep and circadian rest/activity system may benefit from bedroom lighting when starting inpatient treatment.
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7
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Spitschan M. Time-Varying Light Exposure in Chronobiology and Sleep Research Experiments. Front Neurol 2021; 12:654158. [PMID: 34335437 PMCID: PMC8319561 DOI: 10.3389/fneur.2021.654158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/06/2021] [Indexed: 12/17/2022] Open
Abstract
Light exposure profoundly affects human physiology and behavior through circadian and neuroendocrine photoreception primarily through the melanopsin-containing intrinsically photosensitive retinal ganglion cells. Recent research has explored the possibility of using temporally patterned stimuli to manipulate circadian and neuroendocrine responses to light. This mini-review, geared to chronobiologists, sleep researchers, and scientists in adjacent disciplines, has two objectives: (1) introduce basic concepts in time-varying stimuli and (2) provide a checklist-based set of recommendations for documenting time-varying light exposures based on current best practices and standards.
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Affiliation(s)
- Manuel Spitschan
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom.,Centre for Chronobiology, Psychiatric Hospital of the University of Basel (UPK), Basel, Switzerland.,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
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8
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Trait Interindividual Differences in the Magnitude of Subjective Sleepiness from Sleep Inertia. Clocks Sleep 2021; 3:298-311. [PMID: 34204864 PMCID: PMC8293243 DOI: 10.3390/clockssleep3020019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 01/06/2023] Open
Abstract
In shift work settings and on-call operations, workers may be at risk of sleep inertia when called to action immediately after awakening from sleep. However, individuals may differ substantially in their susceptibility to sleep inertia. We investigated this using data from a laboratory study in which 20 healthy young adults were each exposed to 36 h of total sleep deprivation, preceded by a baseline sleep period and followed by a recovery sleep period, on three separate occasions. In the week prior to each laboratory session and on the corresponding baseline night in the laboratory, participants either extended their sleep period to 12 h/day or restricted it to 6 h/day. During periods of wakefulness in the laboratory, starting right after scheduled awakening, participants completed neurobehavioral tests every 2 h. Testing included the Karolinska Sleepiness Scale to measure subjective sleepiness, for which the data were analyzed with nonlinear mixed-effects regression to quantify sleep inertia. This revealed considerable interindividual differences in the magnitude of sleep inertia, which were highly stable within individuals after both baseline and recovery sleep periods, regardless of study condition. Our results demonstrate that interindividual differences in subjective sleepiness due to sleep inertia are substantial and constitute a trait.
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Mattingly SM, Grover T, Martinez GJ, Aledavood T, Robles-Granda P, Nies K, Striegel A, Mark G. The effects of seasons and weather on sleep patterns measured through longitudinal multimodal sensing. NPJ Digit Med 2021; 4:76. [PMID: 33911176 PMCID: PMC8080821 DOI: 10.1038/s41746-021-00435-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 02/25/2021] [Indexed: 11/16/2022] Open
Abstract
Previous studies of seasonal effects on sleep have yielded unclear results, likely due to methodological differences and limitations in data size and/or quality. We measured the sleep habits of 216 individuals across the U.S. over four seasons for slightly over a year using objective, continuous, and unobtrusive measures of sleep and local weather. In addition, we controlled for demographics and trait-like constructs previously identified to correlate with sleep behavior. We investigated seasonal and weather effects of sleep duration, bedtime, and wake time. We found several small but statistically significant effects of seasonal and weather effects on sleep patterns. We observe the strongest seasonal effects for wake time and sleep duration, especially during the spring season: wake times are earlier, and sleep duration decreases (compared to the reference season winter). Sleep duration also modestly decreases when day lengths get longer (between the winter and summer solstice). Bedtimes and wake times tend to be slightly later as outdoor temperature increases.
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Affiliation(s)
- Stephen M Mattingly
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, USA.
| | - Ted Grover
- Department of Informatics, University of California, Irvine, CA, USA
| | - Gonzalo J Martinez
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, USA
| | | | - Pablo Robles-Granda
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, USA
| | - Kari Nies
- Department of Informatics, University of California, Irvine, CA, USA
| | - Aaron Striegel
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, USA
| | - Gloria Mark
- Department of Informatics, University of California, Irvine, CA, USA
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Walsh NP, Halson SL, Sargent C, Roach GD, Nédélec M, Gupta L, Leeder J, Fullagar HH, Coutts AJ, Edwards BJ, Pullinger SA, Robertson CM, Burniston JG, Lastella M, Le Meur Y, Hausswirth C, Bender AM, Grandner MA, Samuels CH. Sleep and the athlete: narrative review and 2021 expert consensus recommendations. Br J Sports Med 2020; 55:bjsports-2020-102025. [PMID: 33144349 DOI: 10.1136/bjsports-2020-102025] [Citation(s) in RCA: 173] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 12/22/2022]
Abstract
Elite athletes are particularly susceptible to sleep inadequacies, characterised by habitual short sleep (<7 hours/night) and poor sleep quality (eg, sleep fragmentation). Athletic performance is reduced by a night or more without sleep, but the influence on performance of partial sleep restriction over 1-3 nights, a more real-world scenario, remains unclear. Studies investigating sleep in athletes often suffer from inadequate experimental control, a lack of females and questions concerning the validity of the chosen sleep assessment tools. Research only scratches the surface on how sleep influences athlete health. Studies in the wider population show that habitually sleeping <7 hours/night increases susceptibility to respiratory infection. Fortunately, much is known about the salient risk factors for sleep inadequacy in athletes, enabling targeted interventions. For example, athlete sleep is influenced by sport-specific factors (relating to training, travel and competition) and non-sport factors (eg, female gender, stress and anxiety). This expert consensus culminates with a sleep toolbox for practitioners (eg, covering sleep education and screening) to mitigate these risk factors and optimise athlete sleep. A one-size-fits-all approach to athlete sleep recommendations (eg, 7-9 hours/night) is unlikely ideal for health and performance. We recommend an individualised approach that should consider the athlete's perceived sleep needs. Research is needed into the benefits of napping and sleep extension (eg, banking sleep).
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Affiliation(s)
- Neil P Walsh
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Shona L Halson
- School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
| | - Charli Sargent
- Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, Queensland, Australia
| | - Gregory D Roach
- Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, Queensland, Australia
| | - Mathieu Nédélec
- Laboratory Sport, Expertise and Performance (EA 7370), French National Institute of Sport (INSEP), Paris, France
| | - Luke Gupta
- English Institute of Sport, Bisham Abbey National High Performance Centre, Marlow, UK
| | | | - Hugh H Fullagar
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Aaron J Coutts
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Ben J Edwards
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Samuel A Pullinger
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
- Sports Science Department, Aspire Academy, Doha, Qatar
| | - Colin M Robertson
- School for Sport and Exercise Sciences, University of Bolton, Bolton, UK
| | - Jatin G Burniston
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Michele Lastella
- Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, Queensland, Australia
| | - Yann Le Meur
- Laboratory Sport, Expertise and Performance (EA 7370), French National Institute of Sport (INSEP), Paris, France
| | | | - Amy M Bender
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Michael A Grandner
- Sleep and Health Research Program, University of Arizona, Tucson, Arizona, USA
| | - Charles H Samuels
- Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Brubaker JR, Swan A, Beverly EA. A brief intervention to reduce burnout and improve sleep quality in medical students. BMC MEDICAL EDUCATION 2020; 20:345. [PMID: 33023594 PMCID: PMC7539390 DOI: 10.1186/s12909-020-02263-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Perceived stress, burnout, and poor sleep quality are high among medical students. Interventions designed to target these issues are necessary to promote the health and well-being of medical students. The purpose of this study was twofold: 1) to assess the feasibility of implementing a sunrise alarm clock intervention with medical students and 2) to evaluate the impact of the intervention on perceived stress, burnout scores, and sleep quality. METHODS We conducted a feasibility study to evaluate the efficacy of a two-week, sunrise alarm clock intervention in combination with electronic device removal at bedtime. We assessed first- and second-year medical students' perceived stress, burnout scores, including Emotional Exhaustion, Depersonalization, and Low Sense of Personal Achievement, and sleep quality before and after the intervention. In addition, we measured smartphone addiction prior to the intervention. RESULTS A total of 57 students consented to participate, of which 55 completed both the pre- and post-assessments (3.5% attrition). The mean age of the participants was 24.8 ± 1.9 years, 50.9% (n = 29) identified as women, and 68.4% (n = 39) identified as white. Pre-intervention, 42.1% (n = 24) of students met criteria for smartphone addiction and 77.2% (n = 44) met criteria for poor sleep quality. In addition, 22.8% (n = 13) of participants had high emotional exhaustion, 64.9% (n = 31) high depersonalization, and 42.1% (n = 24) low sense of personal accomplishment prior to the intervention. Following the two-week intervention, participants showed improvements in emotional exhaustion (p = 0.001, Cohen's d = 0.353), depersonalization (p = 0.001, Cohen's d = 0.411) low sense of personal accomplishment (p = 0.023, Cohen's d = 0.275), perceived stress (p < .001, Cohen's d = .334), and sleep quality (p < 0.001, Cohen's d = 0.925). The number of participants who reported poor sleep quality decreased to 41.8% (n = 23), demonstrating a significant decline (p = 0.026). Participants also improved subjective sleep quality (p < 0.001, Cohen's d = 1.033), sleep duration (p = 0.001, Cohen's d = 0.431), sleep latency (p < 0.001, Cohen's d = 0.433), and sleep efficiency (p = 0.021, Cohen's d = 0.673). CONCLUSIONS These findings suggest that the two-week sunrise alarm clock protocol with electronic device removal was effective in improving sleep quality and reducing burnout scores, and perceived stress. However, additional research comparing this intervention to a proper control group is needed to draw meaningful conclusions about the effectiveness of this intervention.
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Affiliation(s)
- Jennifer R Brubaker
- Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, 45701, USA
| | - Aili Swan
- Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, 45701, USA
| | - Elizabeth A Beverly
- Department of Primary Care, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, 45701, USA.
- The Diabetes Institute, Ohio University, Athens, OH, 45701, USA.
- Heritage Faculty Endowed Fellowship in Behavioral DiabetesOHF Ralph S. Licklider, D.O., Research Endowment, Athens, USA.
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12
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Figueiro MG, Sahin L, Roohan C, Kalsher M, Plitnick B, Rea MS. Effects of red light on sleep inertia. Nat Sci Sleep 2019; 11:45-57. [PMID: 31118850 PMCID: PMC6506010 DOI: 10.2147/nss.s195563] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 03/08/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction: Sleep inertia, broadly defined as decrements in performance and lowering of alertness following waking, lasts for durations ranging between 1 min and 3 hrs. This study investigated whether, compared to a dim light condition (the control), exposure to long-wavelength (red) light delivered to closed eyelids during sleep (red light mask) and to eyes open upon waking (red light goggles) reduced sleep inertia. Methods: Thirty participants (18 females, 12 males; mean age=30.4 years [SD 13.7]) completed this crossover, within-subjects, counterbalanced design study. Self-reported measures of sleepiness and objective measures of auditory performance and cortisol levels were collected on 3 Friday nights over the course of 3 consecutive weeks. Results: Performance improved significantly during the 30-min data collection period in all experimental conditions. Subjective sleepiness also decreased significantly with time awake in all experimental conditions. As hypothesized, performance of some tasks was significantly better in the red light mask condition than in the dim light condition. Performance scores in the red light goggles condition improved significantly after a few minutes of wearing the light goggles. Discussion: The results show that saturated red light delivered through closed eyelids at levels that do not suppress melatonin can be used to mitigate sleep inertia upon waking.
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Affiliation(s)
- Mariana G Figueiro
- Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY 12180, USA
| | - Levent Sahin
- Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY 12180, USA
| | - Charles Roohan
- Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY 12180, USA
| | - Michael Kalsher
- Department of Cognitive Sciences, Rensselaer Polytechnic Institute, Troy, NY 12180, USA
| | - Barbara Plitnick
- Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY 12180, USA
| | - Mark S Rea
- Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY 12180, USA
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Dautovich ND, Schreiber DR, Imel JL, Tighe CA, Shoji KD, Cyrus J, Bryant N, Lisech A, O'Brien C, Dzierzewski JM. A systematic review of the amount and timing of light in association with objective and subjective sleep outcomes in community-dwelling adults. Sleep Health 2018; 5:31-48. [PMID: 30670164 DOI: 10.1016/j.sleh.2018.09.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 09/12/2018] [Accepted: 09/17/2018] [Indexed: 12/01/2022]
Abstract
Light is considered the dominant environmental cue, or zeitgeber, influencing the sleep-wake cycle. Despite recognizing the importance of light for our well-being, less is known about the specific conditions under which light is optimally associated with better sleep. Therefore, a systematic review was conducted to examine the association between the amount and timing of light exposure in relation to sleep outcomes in healthy, community-dwelling adults. A systematic search was conducted of four databases from database inception to June 2016. In total, 45 studies met the review eligibility criteria with generally high study quality excepting for the specification of eligibility criteria and the justification of sample size. The majority of studies involved experimental manipulation of light (n = 32) vs observational designs (n = 13). Broad trends emerged suggesting that (1) bright light (>1000 lux) has positive implications for objectively assessed sleep outcomes compared to dim (<100 lux) and moderate light (100-1000 lux) and (2) bright light (>1000 lux) has positive implications for subjectively assessed sleep outcomes compared to moderate light (100-1000 lux). Effects due to the amount of light are moderated by the timing of light exposure such that, for objectively assessed sleep outcomes, brighter morning and evening light exposure are consistent with a shift in the timing of the sleep period to earlier and later in the day, respectively. For subjectively assessed sleep outcomes, brighter light delivered in the morning was associated with self-reported sleep improvements and brighter evening light exposure was associated with worse self-reported sleep.
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Affiliation(s)
- Natalie D Dautovich
- Psychology Department, Virginia Commonwealth University, 800 W Franklin St, Room 203, PO Box 842018, Richmond, VA 23284-2018.
| | - Dana R Schreiber
- Psychology Department, Virginia Commonwealth University, 806 W Franklin St, PO Box 842018, Richmond, VA 23284-2018
| | - Janna L Imel
- Psychology Department, Virginia Commonwealth University, 806 W Franklin St, PO Box 842018, Richmond, VA 23284-2018
| | - Caitlan A Tighe
- Department of Psychology, University of Alabama, Box 870348, The University of Alabama, Tuscaloosa, AL 35487-0348
| | - Kristy D Shoji
- South Texas Veterans Healthcare System, 7400 Merton Minter, San Antonio, TX 78229
| | - John Cyrus
- Tompkins-McCaw Library, Virginia Commonwealth University, 509 N 12th St, Box 980582, Richmond, VA 23298-0582
| | - Nita Bryant
- James Branch Cabell Library, Virginia Commonwealth University, 901 Park Ave, Box 842033,Richmond, VA 23284-2033
| | - Andrew Lisech
- Psychology Department, Virginia Commonwealth University, 806 W Franklin St, PO Box 842018, Richmond, VA 23284-2018
| | - Chris O'Brien
- Psychology Department, Chatham University, Woodland Rd, Pittsburgh, PA 15232
| | - Joseph M Dzierzewski
- Psychology Department, Virginia Commonwealth University, 806 W Franklin St, PO Box 842018, Richmond, VA 23284-2018
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Robertson CM, Pullinger SA, Robinson WR, Smith ME, Burniston JG, Waterhouse JM, Edwards BJ. Is the diurnal variation in muscle force output detected/detectable when multi-joint movements are analysed using the musclelab force-velocity encoder? Chronobiol Int 2018; 35:1391-1401. [PMID: 29944449 DOI: 10.1080/07420528.2018.1485685] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We have investigated the magnitude of diurnal variation in back squat and bench press performance using the MuscleLab force velocity transducer. Thirty resistance-trained males (mean ± SD: age 21.7 ± 1.4 years; body mass 80.5 ± 4.5 kg; height 1.79 ± 0.06 m) underwent two sessions at different times of day: morning (M, 07:30 h) and evening (E, 17:30 h). Each session included a period when rectal temperature (Trec) was measured at rest, a 5-min standardized 150 W warm-up on a cycle ergometer, then defined programme of bench press (at 20, 40 and 60 kg) and back squat (at 30, 50 and 70 kg) exercises. A linear encoder was attached to an Olympic bar used for the exercises and average force (AF), peak velocity (PV) and time-to-peak velocity (tPV) were measured (MuscleLab software; MuscleLab Technology, Langesund, Norway) during the concentric phase of the movements. Values for Trec at rest were higher in the evening compared to morning values (0.48°C, P < 0.0005). Daily variations were apparent for both bench press and back squat performance for AF (1.9 and 2.5%), PV (8.3 and 12.7%) and tPV (-16.6 and -9.8%; where a negative number indicates a decrease in the variable from morning to evening). There was a main effect for load where AF and tPV increased and PV decreased from the lightest load to the heaviest for both bench press and back squat (47.1 and 80.2%; 31.7 and 57.7%; -42.1 and -73.9%; P < 0.0005 where a negative number indicates a decrease in the variable with increasing load). An interaction was found only for tPV, such that the tPV occurs earlier in the evening than the morning at the highest loads (60 and 70 kg) for both bench press and back squat, respectively (mean difference of 0.32 and 0.62 s). In summary, diurnal variation in back squat and bench press was shown; and the tPV in complex multi-joint movements occurs earlier during the concentric phase of exercise when back squat or bench press is performed in the evening compared to the morning. This difference can be detected using a low cost, portable and widely available commercial instrument and enables translation of past laboratory/tightly controlled experimental research in to main-stream coaching practice.
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Affiliation(s)
- Colin M Robertson
- a School for Sport and Biological Sciences , University of Bolton , Bolton , UK
| | - Samuel A Pullinger
- b Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK.,c Sports Science Department , Aspire Academy , Doha , Qatar
| | - William R Robinson
- b Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Mathew E Smith
- b Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Jatin G Burniston
- b Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - James M Waterhouse
- b Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Ben J Edwards
- b Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
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15
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Pullinger SA, Oksa J, Clark LF, Guyatt JWF, Newlove A, Burniston JG, Doran DA, Waterhouse JM, Edwards BJ. Diurnal variation in repeated sprint performance cannot be offset when rectal and muscle temperatures are at optimal levels (38.5°C). Chronobiol Int 2018; 35:1054-1065. [PMID: 29566344 DOI: 10.1080/07420528.2018.1454938] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The present study investigated whether increasing morning rectal temperatures (Trec) to evening levels, or increasing morning and evening Trec to an "optimal" level (38.5°C), resulting in increased muscle temperatures (Tm), would offset diurnal variation in repeated sprint (RS) performance in a causal manner. Twelve trained males underwent five sessions [age (mean ± SD) 21.0 ± 2.3 years, maximal oxygen consumption (V̇O2max) 60.0 ± 4.4 mL.kg-1 min-1, height 1.79 ± 0.06 m, body mass 78.2 ± 11.8 kg]. These included control morning (M, 07:30 h) and evening (E, 17:30 h) sessions (5-min warm-up), and three further sessions consisting of a warm-up morning trial (ME, in 39-40°C water) until Trec reached evening levels; two "optimal" trials in the morning and evening (M38.5 and E38.5, in 39-40°C water) respectively, until Trec reached 38.5°C. All sessions included 3 × 3-s task-specific warm-up sprints, thereafter 10 × 3-s RS with 30-s recoveries were performed a non-motorised treadmill. Trec and Tm measurements were taken at the start of the protocol and following the warm-up periods. Values for Trec and Tm at rest were higher in the evening compared to morning values (0.48°C and 0.69°C, p < 0.0005). RS performance was lower (7.8-8.3%) in the M for distance covered (DC; p = 0.002), average power (AP; p = 0.029) and average velocity (AV; p = 0.002). Increasing Trec in the morning to evening values or optimal values (38.5°C) did not increase RS performance to evening levels (p = 1.000). However, increasing Trec in the evening to "optimal" level through a passive warm-up significantly reduced DC (p = 0.008), AP (p < 0.0005) and AV (p = 0.007) to values found in the M condition (6.0-6.9%). Diurnal variation in Trec and Tm is not wholly accountable for time-of-day oscillations in RS performance on a non-motorised treadmill; the exact mechanism(s) for a causal link between central temperature and human performance are still unclear and require more research.
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Affiliation(s)
- Samuel A Pullinger
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK.,b Sports Science Department , Aspire Academy , Doha , Qatar
| | - Juha Oksa
- c Research Department , Finnish Institute of Occupational Health , Oulu , Finland
| | - Liam F Clark
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Joe W F Guyatt
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Antonia Newlove
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Jatin G Burniston
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Dominic A Doran
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - James M Waterhouse
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Ben J Edwards
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
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Pullinger SA, Oksa J, Brocklehurst EL, Iveson RP, Newlove A, Burniston JG, Doran DA, Waterhouse JM, Edwards BJ. Controlling rectal and muscle temperatures: Can we offset diurnal variation in repeated sprint performance? Chronobiol Int 2018; 35:959-968. [DOI: 10.1080/07420528.2018.1444626] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Samuel A. Pullinger
- Sport and Exercise Sciences Department, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Sports Science Department, Aspire Academy, Doha, Qatar
| | - Juha Oksa
- Research Department, Finnish Institute of Occupational Health, Oulu, Finland
| | - Emma L. Brocklehurst
- Sport and Exercise Sciences Department, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Reece P. Iveson
- Sport and Exercise Sciences Department, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Antonia Newlove
- Sport and Exercise Sciences Department, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Jatin G. Burniston
- Sport and Exercise Sciences Department, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Dominic A. Doran
- Sport and Exercise Sciences Department, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - James M. Waterhouse
- Sport and Exercise Sciences Department, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Ben J. Edwards
- Sport and Exercise Sciences Department, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Trotti LM. Waking up is the hardest thing I do all day: Sleep inertia and sleep drunkenness. Sleep Med Rev 2017; 35:76-84. [PMID: 27692973 PMCID: PMC5337178 DOI: 10.1016/j.smrv.2016.08.005] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/28/2016] [Accepted: 08/23/2016] [Indexed: 11/24/2022]
Abstract
The transition from sleep to wake is marked by sleep inertia, a distinct state that is measurably different from wakefulness and manifests as performance impairments and sleepiness. Although the precise substrate of sleep inertia is unknown, electroencephalographic, evoked potential, and neuroimaging studies suggest the persistence of some features of sleep beyond the point of awakening. Forced desynchrony studies have demonstrated that sleep inertia impacts cognition differently than do homeostatic and circadian drives and that sleep inertia is most intense during awakenings from the biological night. Recovery sleep after sleep deprivation also amplifies sleep inertia, although the effects of deep sleep vary based on task and timing. In patients with hypersomnolence disorders, especially but not exclusively idiopathic hypersomnia, a more pronounced period of confusion and sleepiness upon awakening, known as "sleep drunkenness", is common and problematic. Optimal treatment of sleep drunkenness is unknown, although several medications have been used with benefit in small case series. Difficulty with awakening is also commonly endorsed by individuals with mood disorders, disproportionately to the general population. This may represent an important treatment target, but evidence-based treatment guidance is not yet available.
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Affiliation(s)
- Lynn M Trotti
- Emory Sleep Center and Department of Neurology, Emory University School of Medicine, 12 Executive Park Dr NE, Atlanta, GA 30329, USA.
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Caddick ZA, Gregory K, Flynn-Evans EE. Sleep Environment Recommendations for Future Spaceflight Vehicles. ADVANCES IN INTELLIGENT SYSTEMS AND COMPUTING 2017. [DOI: 10.1007/978-3-319-41682-3_76] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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HILDITCH CJ, DORRIAN J, BANKS S. Time to wake up: reactive countermeasures to sleep inertia. INDUSTRIAL HEALTH 2016; 54:528-541. [PMID: 27193071 PMCID: PMC5136610 DOI: 10.2486/indhealth.2015-0236] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 05/11/2016] [Indexed: 06/05/2023]
Abstract
Sleep inertia is the period of impaired performance and grogginess experienced after waking. This period of impairment is of concern to workers who are on-call, or nap during work hours, and need to perform safety-critical tasks soon after waking. While several studies have investigated the best sleep timing and length to minimise sleep inertia effects, few have focused on countermeasures -especially those that can be implemented after waking (i.e. reactive countermeasures). This structured review summarises current literature on reactive countermeasures to sleep inertia such as caffeine, light, and temperature and discusses evidence for the effectiveness and operational viability of each approach. Current literature does not provide a convincing evidence-base for a reactive countermeasure. Caffeine is perhaps the best option, although it is most effective when administered prior to sleep and is therefore not strictly reactive. Investigations into light and temperature have found promising results for improving subjective alertness; further research is needed to determine whether these countermeasures can also attenuate performance impairment. Future research in this area would benefit from study design features highlighted in this review. In the meantime, it is recommended that proactive sleep inertia countermeasures are used, and that safety-critical tasks are avoided immediately after waking.
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Affiliation(s)
| | - Jillian DORRIAN
- Centre for Sleep Research, University of South Australia, Australia
| | - Siobhan BANKS
- Centre for Sleep Research, University of South Australia, Australia
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Abstract
In elite soccer, players are frequently exposed to various situations and conditions that can interfere with sleep, potentially leading to sleep deprivation. This article provides a comprehensive and critical review of the current available literature regarding the potential acute and chronic stressors (i.e., psychological, sociological and physiological stressors) placed on elite soccer players that may result in compromised sleep quantity and/or quality. Sleep is an essential part of the recovery process as it provides a number of important psychological and physiological functions. The effects of sleep disturbance on post-soccer match fatigue mechanisms and recovery time course are also described. Physiological and cognitive changes that occur when competing at night are often not conducive to sleep induction. Although the influence of high-intensity exercise performed during the night on subsequent sleep is still debated, environmental conditions (e.g., bright light in the stadium, light emanated from the screens) and behaviours related to evening soccer matches (e.g., napping, caffeine consumption, alcohol consumption) as well as engagement and arousal induced by the match may all potentially affect subsequent sleep. Apart from night soccer matches, soccer players are subjected to inconsistency in match schedules, unique team schedules and travel fatigue that may also contribute to the sleep debt. Sleep deprivation may be detrimental to the outcome of the recovery process after a match, resulting in impaired muscle glycogen repletion, impaired muscle damage repair, alterations in cognitive function and an increase in mental fatigue. The role of sleep in recovery is a complex issue, reinforcing the need for future research to estimate the quantitative and qualitative importance of sleep and to identify influencing factors. Efficient and individualised solutions are likely needed.
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Muginshtein-Simkovitch E, Dagan Y, Cohen-Zion M, Waissengrin B, Ketko I, Heled Y. Heat tolerance after total and partial acute sleep deprivation. Chronobiol Int 2015; 32:717-24. [DOI: 10.3109/07420528.2015.1030409] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tonetti L, Fabbri M, Erbacci A, Filardi M, Martoni M, Natale V. Effects of dawn simulation on attentional performance in adolescents. Eur J Appl Physiol 2014; 115:579-87. [DOI: 10.1007/s00421-014-3033-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 10/15/2014] [Indexed: 01/25/2023]
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