Managing neurobehavioral capability when social expediency trumps biological imperatives

Raw scores on subjective sleepiness, fatigue, and vigor metrics consistently define resilience and vulnerability to sleep loss

STUDY OBJECTIVES

Although trait-like individual differences in subjective responses to sleep restriction (SR) and total sleep deprivation (TSD) exist, reliable characterizations remain elusive. We comprehensively compared multiple methods for defining resilience and vulnerability by subjective metrics.

METHODS

41 adults participated in a 13-day experiment:2 baseline, 5 SR, 4 recovery, and one 36h TSD night. The Karolinska Sleepiness Scale (KSS) and the Profile of Mood States Fatigue (POMS-F) and Vigor (POMS-V) were administered every 2h. Three approaches (Raw Score [average SR score], Change from Baseline [average SR minus average baseline score], and Variance [intraindividual SR score variance]), and six thresholds (±1 standard deviation, and the highest/lowest scoring 12.5%, 20%, 25%, 33%, 50%) categorized Resilient/Vulnerable groups. Kendall's tau-b correlations compared the group categorization's concordance within and between KSS, POMS-F, and POMS-V scores. Bias-corrected and accelerated bootstrapped t-tests compared group scores.

RESULTS

There were significant correlations between all approaches at all thresholds for POMS-F, between Raw Score and Change from Baseline approaches for KSS, and between Raw Score and Variance approaches for POMS-V. All Resilient groups defined by the Raw Score approach had significantly better scores throughout the study, notably including during baseline and recovery, whereas the two other approaches differed by measure, threshold, or day. Between-measure correlations varied in strength by measure, approach, or threshold.

CONCLUSION

Only the Raw Score approach consistently distinguished Resilient/Vulnerable groups at baseline, during sleep loss, and during recovery‒‒we recommend this approach as an effective method for subjective resilience/vulnerability categorization. All approaches created comparable categorizations for fatigue, some were comparable for sleepiness, and none were comparable for vigor. Fatigue and vigor captured resilience/vulnerability similarly to sleepiness but not each other.

Considerations for Maximizing the Exercise "Drug" to Combat Insulin Resistance: Role of Nutrition, Sleep, and Alcohol

Insulin resistance is a key etiological factor in promoting not only type 2 diabetes mellitus but also cardiovascular disease (CVD). Exercise is a first-line therapy for combating chronic disease by improving insulin action through, in part, reducing hepatic glucose production and lipolysis as well as increasing skeletal muscle glucose uptake and vasodilation. Just like a pharmaceutical agent, exercise can be viewed as a "drug" such that identifying an optimal prescription requires a determination of mode, intensity, and timing as well as consideration of how much exercise is done relative to sitting for prolonged periods (e.g., desk job at work). Furthermore, proximal nutrition (nutrient timing, carbohydrate intake, etc.), sleep (or lack thereof), as well as alcohol consumption are likely important considerations for enhancing adaptations to exercise. Thus, identifying the maximal exercise "drug" for reducing insulin resistance will require a multi-health behavior approach to optimize type 2 diabetes and CVD care.

Association of 3111T/C Polymorphism of the Clock Gene with Circadian Rhythm of Melatonin in Menopausal Women with Insomnia

We carried out a comparative analysis of circadian rhythms of melatonin secretion in Caucasian menopausal women with and without insomnia depending on the 3111T/C polymorphism of the Clock gene. Melatonin levels was measured in the saliva 4 times a day (06.00-07.00, 12.00-13.00, 18.00-19.00, and 23.00-00.00 h). Carriers of the TT genotype with insomnia demonstrated significantly higher level of melatonin in the early morning hours compared to the carriers of the minor allele C (12.60±7.58 and 8.98±8.62 pg/ml, respectively, p=0.023). In the control group, no statistically significant differences were revealed. The carriers of the TT genotype with sleep disorders have higher morning melatonin level compared to control group women (12.60±7.58 and 5.48±4.74 pg/ml, respectively, p=0.005) and low nocturnal melatonin level (6.42±4.97 and 12.52±10.40 pg/ml, respectively, p=0.039).

Association of the melatonin circadian rhythms with clock 3111T/C gene polymorphism in Caucasian and Asian menopausal women with insomnia

A comparative analysis of melatonin circadian rhythms in Caucasian (incoming population) and Asian (indigenous population) menopausal women with/without sleep disorders depending on the genotype of Clock 3111T/C gene polymorphism was realized.The melatonin level in the saliva was determined four times a day (6:00-7:00, 12:00-13:00, 18:00-19:00, 23:00-00:00 h). The Caucasian women-carriers of the TT-genotype with insomnia as compared to control group-had a higher morning melatonin level and a lower night melatonin level. The Asian women with TT-genotype and insomnia had a lower levels of melatonin as compared to control at daytime, evening and night. A significantly higher melatonin level in the early morning hours was detected in the Caucasian women-carriers of the TT-genotype with insomnia as compared to group womencarriers of the minor 3111C-allele. There were no statistically significant differences in the circadian rhythms of melatonin in the Asian women depending on the genotype of the Clock 3111T/C polymorphism. An assumption with respect to the protective role of the minor allele 3111C in the development of insomnia associated with the displacement of melatonin circadian rhythms in the representatives of the incoming population was made.

Sleep and need for recovery in shift workers: do chronotype and age matter?

This study examined associations of chronotype and age with shift-specific assessments of main sleep duration, sleep quality and need for recovery in a cross-sectional study among N = 261 industrial shift workers (96.6% male). Logistic regression analyses were used, adjusted for gender, lifestyle, health, nap behaviour, season of assessment and shift schedule. Shift workers with latest versus earliest chronotype reported a shorter sleep duration (OR 11.68, 95% CI 3.31-41.17) and more awakenings complaints (OR 4.84, 95% CI 4.45-11.92) during morning shift periods. No associations were found between chronotype, sleep and need for recovery during evening and night shift periods. For age, no associations were found with any of the shift-specific outcome measures. The results stress the importance of including the concept of chronotype in shift work research and scheduling beyond the concept of age. Longitudinal research using shift-specific assessments of sleep and need for recovery are needed to confirm these results.

PRACTITIONER SUMMARY

Chronotype seems to better explain individual differences in sleep than age. In view of ageing societies, it might therefore be worthwhile to further examine the application of chronotype for individualised shift work schedules to facilitate healthy and sustainable employment.

Intense illumination in the morning hours improved mood and alertness but not mental performance

Cognitive performance and alertness are two determinants for work efficiency, varying throughout the day and depending on bright light. We conducted a prospective crossover study evaluating the impacts of exposure to an intense, early morning illumination on sustained attention, alertness, mood, and serum melatonin levels in 33 healthy individuals. Compared with a dim illumination, the intense illumination negatively impacted performance requiring sustained attention; however, it positively impacted subjective alertness and mood and had no impact on serum melatonin levels. These results suggest that brief exposure to bright light in the morning hours can improve subjective measures of mood and alertness, but can also have detrimental effects on mental performance as a result of visual distraction. Therefore, it is important that adequate lighting should correspond to both non-visual and visual demands.

Social and environmental contexts modulate sleep deprivation-induced c-Fos activation in rats

People often sleep deprive themselves voluntarily for social and lifestyle reasons. Animals also appear to stay awake longer as a result of their natural curiosity to explore novel environments and interact socially with conspecifics. Although multiple arousal systems in the brain are known to act jointly to promote and maintain wakefulness, it remains unclear whether these systems are similarly engaged during voluntary vs. forced wakefulness. Using c-Fos immunohistochemistry, we compared neuronal responses in rats deprived of sleep for 2 h by gentle sensory stimulation, exploration under social isolation, or exploration with social interaction, and rats under undisturbed control conditions. In many arousal, limbic, and autonomic nuclei examined (e.g., anterior cingulate cortex and locus coeruleus), the two sleep deprivation procedures involving exploration were similarly effective, and both were more effective than sleep deprivation with sensory stimulation, in increasing the number of c-Fos immunoreactive neurons. However, some nuclei (e.g., paraventricular hypothalamic nucleus and select amygdala nuclei) were more responsive to exploration with social interaction, while others (e.g., histaminergic tuberomammillary nucleus) responded more strongly to exploration in social isolation. In the rostral basal forebrain, cholinergic and GABAergic neurons responded preferentially to exploration with social interaction, whereas resident neurons in general responded most strongly to exploration without social interaction. These results indicate that voluntary exploration with/without social interaction is more effective than forced sleep deprivation with gentle sensory stimulation for inducing c-Fos in arousal and limbic/autonomic brain regions, and suggest that these nuclei participate in different aspects of arousal during sustained voluntary wakefulness.