Sleep on a high heat capacity mattress increases conductive body heat loss and slow wave sleep

Does body cooling facilitated by bedding compared to control condition improve sleep among adults (18-64 years old)? A systematic review and meta-analysis

INTRODUCTION

The relationship between blood distribution, body temperature, and sleep/wakefulness states is still unclear. The aim of the present study is to systematically review the potential beneficial effects of bedding strategies (e.g., mattress, mattress topper or pillow) on body cooling and night-time sleep.

MATERIAL & METHODS

This systematic review with meta-analysis searched PubMed, ScienceDirect and Web of Science, from inception until March 4, 2024. We included randomized controlled trials aiming to investigate any type of bedding that induced body cooling compared to habitual sleep environment on sleep parameters in healthy adults. Two reviewers independently extracted data, appraised risk of bias by Cochrane tool, and estimated the mean differences between groups with 95% confidence interval. Meta-analyses and proportional meta-analyses were performed depending on the type of variable. The certainty of evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation system.

RESULTS

From 3454 articles screened, 9 studies met the inclusion criteria. Overall, with the certainty of the evidence ranging from very low to low we found no differences between groups on sleep onset latency, sleep efficiency, sleep proportion spent in each sleep stage (i.e. N1, N2, N3 and REM), wake after sleep onset, and total sleep time. Results could be interpreted with caution due to high heterogeneity in the estimated effects.

CONCLUSION

With uncertainty of evidence, that ranged from very low to low, different bedding strategies had no effects on night-time sleep characteristics; however, the studies included into the qualitative synthesis suggested an effect of different bedding strategies on body cooling (i.e., lower core body temperature, p < 0.05) from an acute perspective. Future studies on various forms of bedding interventions susceptible to favour and maintain sleep through a positive body thermal effect are highly warranted.

PROSPERO REGISTRATION

CRD42021275369.

Increased training load promotes sleep propensity and slow-wave sleep in endurance runners: Can a high-heat-capacity mattress topper modulate this effect?

The present study aimed to: (1) investigate sleep architecture in response to an overload training and taper periods among endurance runners; and (2) assess the sleep benefits of a high-heat-capacity mattress topper. Twenty-one trained male endurance runners performed a 2-week usual training regimen (baseline) followed by 2-week overload and taper periods. From overload to the end of the taper period, they were assigned into two groups based on the mattress topper used: high-heat-capacity mattress topper (n = 11) or low-heat-capacity mattress topper (n = 10). Training load was assessed daily using the session rating of perceived exertion. Following each period, sleep was monitored by polysomnography, and nocturnal core body temperature was recorded throughout the night. Irrespective of the group, awakening episodes > 5 min decreased following overload compared with baseline (-0.48, p = 0.05). Independently of mattress topper, each 100 A.U. increase in 7-day training load prior to polysomnographic recording was associated with higher slow-wave sleep proportion (β = +0.13%; p = 0.05), lower sleep-onset latency (β = -0.49 min; p = 0.05), and a reduction in the probability of transition from N1 sleep stage to wakefulness (β = -0.12%; p = 0.05). Sleeping on a high-heat-capacity mattress topper did not affect any sleep variable compared with a low-heat-capacity mattress topper. Increased training loads promote slow-wave sleep and sleep propensity, highlighting the adaptative nature of sleep to diurnal activity and the role of sleep in physiological recovery. Further studies are required on the potential benefits of high-heat-capacity mattress toppers on sleep architecture among athletes.

Promoting healthy sleep among older adults

As people age, their sleep patterns and needs naturally change in response to developmental and health-related factors. However, attaining sufficient restorative sleep remains crucial for overall well-being in older adults. This manuscript provides an overview of common sleep alterations that tend to emerge with advancing age, such as shifts in circadian rhythms, decreases in deeper sleep stages, fragmented sleep architecture and an association between comorbidities and sleep disruption. Practical recommendations that target environmental, behavioral and lifestyle modifications may optimize sleep initiation, maintenance, and duration for the older population. By enhancing understanding of the sleep changes that occur in the aged population, geriatric nurses are better able to provide respectful, patient-centered care to older adults that are experiencing sleep difficulties.

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

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

Enhanced conductive body heat loss during sleep increases slow-wave sleep and calms the heart

Substantial evidence suggests that the circadian decline of core body temperature (CBT) triggers the initiation of human sleep, with CBT continuing to decrease during sleep. Although the connection between habitual sleep and CBT patterns is established, the impact of external body cooling on sleep remains poorly understood. The main aim of the present study is to show whether a decline in body temperatures during sleep can be related to an increase in slow wave sleep (N3). This three-center study on 72 individuals of varying age, sex, and BMI used an identical type of a high-heat capacity mattress as a reproducible, non-disturbing way of body cooling, accompanied by measurements of CBT and proximal back skin temperatures, heart rate and sleep (polysomnography). The main findings were an increase in nocturnal sleep stage N3 (7.5 ± 21.6 min/7.5 h, mean ± SD; p = 0.0038) and a decrease in heart rate (- 2.36 ± 1.08 bpm, mean ± SD; p < 0.0001); sleep stage REM did not change (p = 0.3564). Subjects with a greater degree of body cooling exhibited a significant increase in nocturnal N3 and a decrease in REM sleep, mainly in the second part of the night. In addition, these subjects showed a phase advance in the NREM-REM sleep cycle distribution of N3 and REM. Both effects were significantly associated with increased conductive inner heat transfer, indicated by an increased CBT- proximal back skin temperature -gradient, rather than with changes in CBT itself. Our findings reveal a previously far disregarded mechanism in sleep research that has potential therapeutic implications: Conductive body cooling during sleep is a reliable method for promoting N3 and reducing heart rate.

Effect of the pre-taper level of fatigue on the taper-induced changes in performance in elite swimmers

Introduction

In swimming, performance gains after tapering could be influenced by the pre-taper level of fatigue. Moreover, this level of fatigue could be associated with sleep. This study aimed to assess (1) the effect of tapering on performance according to the pre-taper level of fatigue in swimmers and (2) the association between sleep and pre-taper level of fatigue.

Methods

Physiological, psychological and biomechanical profiles were evaluated in 26 elite swimmers on 2 occasions to estimate the pre-taper level of fatigue: at T0 and T1, scheduled respectively 10 and 3 weeks before the main competition. Sleep quantity and quality were also evaluated at T0 and T1. Race time was officially assessed at T0, T1 and during the main competition. The level of significance was set at p ≤ .05.

Results

Fourteen swimmers (17 ± 2 years) were allocated to acute fatigue group (AF) and 12 swimmers (18 ± 2 years) to functional overreaching group (F-OR). From T1 to the main competition, performance was improved in AF (+1.80 ± 1.36%), while it was impaired in F-OR (-0.49 ± 1.58%, p < 0.05 vs. AF). Before taper period, total sleep time was lower in F-OR, as compared to AF. Conversely, the fragmentation index was higher in F-OR (p = .06). From wakefulness to sleep, body core temperature decreased in AF but not in F-OR.

Discussion

Performance gain after tapering was higher in AF swimmers than in overreached. Moreover, pre-taper sleep was poorer in overreached swimmers, which could contribute to their different response to the same training load. This poorer sleep could be linked to a lower regulation of internal temperature.

Higher training loads affect sleep in endurance runners: Can a high-heat-capacity mattress topper mitigate negative effects?

This study investigates the impact of a training program on sleep among endurance runners and the benefits of chronically using a high-heat-capacity mattress topper (HMT). Twenty-one trained male athletes performed a 2-week usual training regimen, sleeping on a Low-heat-capacity Mattress Topper (LMT), followed by 2-week overload and taper periods. From overload, participants were assigned into two groups based on the mattress topper used: HMT (n = 11) or LMT (n = 10). Irrespective of the group, overload increased general stress and stress-reaction symptoms evaluated by questionnaires, with no decline in performance on a graded-exercise treadmill test, the majority of participant being "non-overreached" (n = 14). From a daily perspective, each additional 100 A.U. in training load, assessed using the session rating of perceived exertion, was associated with an impairment in subsequent sleep efficiency (β = -0.2%; p < 0.01), wake after sleep onset (β =  +0.4 min; p < 0.05) and sleep onset latency (β =  +0.5 min; p < 0.05), which was unaffected by HMT use. Practitioners should be aware of sleep needs, especially during excessive training loads, whereas implementing individualised sleep strategies. Further studies should be conducted on potential benefits of HMT among athletes in various sleep conditions.

Core body temperature changes before sleep are associated with nocturnal heart rate variability

Core body temperature (CBT) reductions occur before and during the sleep period, with the extent of presleep reductions corresponding to sleep onset and quality. Presleep reductions in CBT coincide with increased cardiac parasympathetic activity measured via heart rate variability (HRV), and while this appears to persist into the sleep period, individual differences in presleep CBT decline and nocturnal HRV remain unexplored. The purpose of the current study was to assess the relationship between individual differences in presleep CBT reductions and nocturnal heart rate (HR) and HRV in a population of 15 objectively poor sleeping adults [10 males, 5 females; age, 33 ± 4 yr; body mass index (BMI) 27 ± 1 kg/m2] with the hypothesis that blunted CBT rate of decline would be associated with elevated HR and reduced nocturnal HRV. Following an adaptation night, all participants underwent an overnight, in-laboratory sleep study with simultaneous recording of polysomnographic sleep including electrocardiography (ECG) and CBT recording. Correlations between CBT rate of change before sleep and nocturnal HRV were assessed. Blunted rate of CBT decline was significantly associated with increased heart rate (HR) in stage 2 (N2; R = 0.754, P = 0.001), stage 3 (N3; R = 0.748, P = 0.001), and rapid-eye movement (REM; R = 0.735, P = 0.002). Similarly, blunted rate of CBT decline before sleep was associated with reduced HRV across sleep stages. These findings indicate a relationship between individual differences in presleep thermoregulatory processes and nocturnal cardiac autonomic function in poor sleeping adults.NEW & NOTEWORTHY Core body temperature (CBT) reductions before sleep onset coincide with increases in heart rate variability (HRV) that persist throughout the sleep period. However, the relationship between individual differences in the efficiency of presleep core temperature regulation and nocturnal heart rate variability remains equivocal. The present study reports an association between the magnitude of presleep core body temperature changes and nocturnal parasympathetic activity, highlighting overlap between thermoregulatory processes before sleep and nocturnal cardiac autonomic function.

Impact of Body Composition on Sleep and Its Relationship with Sleep Disorders: Current Insights

Sleep is involved in many physiological processes and is essential for both physical and mental health. Obesity and sleep deprivation due to sleep disorders are major public health issues. Their incidence is increasing, and they have a wide range of adverse health-related consequences, including life-threatening cardiovascular disease. The impact of sleep on obesity and body composition is well-known, and many studies have shown an association between insufficient or excessive sleep duration and obesity, body fat percentage, and weight gain. However, there is growing evidence of the effects of body composition on sleep and sleep disorders (particularly sleep disordered breathing) through anatomical and physiological mechanisms (nocturnal fluid shift, core body temperature, or diet). Although some research has been conducted on the bidirectional effects of sleep-disordered breathing and body composition, the specific effects of obesity and body composition on sleep and the underlying mechanisms that explain these effects remain unclear. Therefore, this review summarizes the findings on the effects of body composition on sleep and draws conclusions and proposals for future research in this field.

How to deal with sleep problems during heatwaves: practical recommendations from the European Insomnia Network

Heatwaves are occurring more frequently and are known to affect particularly night-time temperatures. We review here literature on how night-time ambient temperature changes affect body temperature and sleep quality. We then discuss how these temperature effects impact particularly vulnerable populations such as older adults, children, pregnant women, and those with psychiatric conditions. Several ways of dealing with sleep problems in the context of heatwaves are then suggested, adapted from elements of cognitive behavioural therapy for insomnia, with more specific advice for vulnerable populations. By better dealing with sleep problems during heatwaves, general health effects of heatwaves may be more limited. However, given the sparse literature, many links addressed in this review on sleep problems affected by temperature changes should be the focus of future research.

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

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

What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature

Energy spent during daily activities is recuperated by humans through sleep, ensuring optimal performance on the following day. Sleep disturbances are common: a meta-analysis on sleep quality showed that 15–30% of adults report sleep disorders, such as sleep onset latency (SOL), insufficient duration of sleep and frequently waking up at night. Low back pain (LBP) has been identified as one of the main causes of poor sleep quality. Literature findings are discordant on the type of mattress that might prevent onset of back pain, resulting in an improved quality of sleep. We conducted a systematic literature review of articles published until 2019, investigating the association of different mattresses with sleep quality and low back pain. Based on examined studies, mattresses were classified according to the European Committee for Standardization (2000) as: soft, medium-firm, extra-firm or mattresses customized for patients affected by supine decubitus. A total of 39 qualified articles have been included in the current systematic review. Results of this systematic review show that a medium-firm mattress promotes comfort, sleep quality and rachis alignment.

The Circadian Rhythm of Thermoregulation Modulates both the Sleep/Wake Cycle and 24 h Pattern of Arterial Blood Pressure

Borbély proposed an interacting two-component model of sleep regulation comprising a homeostatic Process S and a circadian Process C. The model has provided understanding of the association between core body temperature (CBT) as a key element of Process C that is deterministic of sleep onset and offset. However, it additionally provides a new perspective of the importance of the thermoregulatory mechanisms of Process C in modulating the circadian rhythm of arterial blood pressure (ABP). Herein, we examine the circadian physiology of thermoregulation, including at the end of the activity span the profound redistribution of cardiac output from the systemic circulation to the arteriovenous anastomoses of the glabrous skin that markedly enhances convective transfer of heat from the body to the environment to cause (i) decrease of the CBT as a pathway to sleep onset and (ii) attenuation of the asleep ABP mean and augmentation of the ABP decline (dipping) from the wake-time mean, in combination the strongest predictors of the risk for blood vessel and organ pathology and morbid and mortal cardiovascular disease events. We additionally review the means by which blood perfusion to the glabrous skin can be manipulated on demand by selective thermal stimulation, that is, mild warming, on the skin of the cervical spinal cord to intensify Process C as a way to facilitate sleep induction and promote healthy asleep ABP. © 2021 American Physiological Society. Compr Physiol 11:1-14, 2021.

Eucaloric Balanced Diet Improved Objective Sleep in Adolescents with Obesity

Background: A better understanding of the influence of energy balance on sleep in adolescents, particularly those with obesity, could help develop strategies to optimize sleep in these populations. The purpose of this study was to investigate sleep under ad libitum-vs-controlled diets adjusted to energy requirement (eucaloric) among adolescents with obesity and their normal weight controls. Methods: Twenty-eight male adolescents aged between 12 and 15 years, n = 14 adolescents with obesity (OB: BMI ≥ 90th centile) and n = 14 normal weight age matched controls (NW), completed an experimental protocol comprising ad libitum or eucaloric meals for three days, in random order. During the third night of each condition, they underwent in home polysomnography (PSG). Results: An interaction effect of energy intake (EI) was detected (p < 0.001). EI was higher during ad libitum compared to the eucaloric condition (p < 0.001) and in OB compared to NW (p < 0.001) in the absence of any substantial modification to macronutrient proportions. Analyses of energy intake distribution throughout the day showed a significant interaction with both a condition and group effect during lunch and dinner. Sleep improvements were noted in OB group during the eucaloric condition compared to ad libitum with reduced sleep onset latency and N1 stage. Sleep improvements were correlated to reduced EI, especially during the evening meal. Conclusion: Simply adjusting dietary intake to energy requirement and reducing the energy proportion of the evening meal could have therapeutic effects on sleep in adolescents with obesity. However, positive energy balance alone cannot justify worsened sleep among adolescents with obesity compared to normal weight counterparts.

The relationship between body composition and sleep architecture in athletes

Sleep is essential for athletes to recover physical fitness. It has been suggested that sleep is affected by muscle volume. Compared to female athletes, male athletes with greater muscle volume may have inferior objective sleep quality. This study aimed to assess the relationship between body composition and objective sleep parameters in male and female athletes. The body composition of 17 male and 19 female collegiate athletes were measured, and they underwent overnight home sleep monitoring. Compared with female athletes, male athletes had more muscle mass and less fat mass. Moreover, male athletes had lower sleep efficiency, longer sleep onset latency, higher arousal index, less rapid eye movement (REM) sleep, and lower percentage of slow-wave (N3) sleep in the initial non-REM sleep. Furthermore, the percentage of muscle mass was inversely related, whereas fat mass or percentage of fat mass was directly related to the percentage of N3 sleep in the initial non-REM sleep. Overall, there were no significant association between sex and sleep parameters. However, a significant correlation was found within both subgroups. Objective sleep quality was suggested to be worse in male athletes than in female athletes, implying that sleep architecture may be related to the muscle volume.

Effects of manipulating body temperature on sleep in postmenopausal women

STUDY OBJECTIVES

A decline in sleep quality, slow wave sleep (SWS) and slow wave activity (SWA) are common in older adults. Prior studies have shown that manipulating body temperature during sleep can increase SWS/SWA. The aim of this study was to determine the effects of manipulation of body temperatures during sleep, using a high heat capacity mattress, on SWS/SWA and heart rate in post-menopausal women.

METHODS

Twenty-four healthy postmenopausal women between 40 and 75 years of age (mean age 62.4 ± 8.2 years, mean BMI 25.4 ± 3.5 kg/m²) were randomized in a single-blind, counterbalanced, cross-over manner to sleep on either a high heat capacity mattress (HHCM) or a low heat capacity mattress (LHCM) a week apart. Sleep was recorded using polysomnography during an 8-h sleep opportunity. Core and peripheral temperature were recorded using an ingestible capsule and thermochron respectively.

RESULTS

In comparison to the LHCM, sleep on HHCM exhibited a selective increase in SWS (average increase in Stage N3 of 9.6 min (2.1%), p = 0.04) and in slow oscillatory (SO) activity (0.5-1 Hz) in the first NREM/REM cycle (p = 0.04). In addition, the HHCM induced a greater reduction in core body temperature (p = 0.002). The reduction in core body temperature (first 180 min after lights out) from LHCM to HHCM was associated (r = 0.5, p = 0.012) with the increase in SO activity (SO cycle 1 and 2/cycle 3 and 4). Average heart rate was 1.6 beats/minute lower across the night on the HHCM compared to the LHCM (p = 0.001).

CONCLUSIONS

The results of this study indicate that manipulation of body temperature during sleep may be a useful approach to enhance SWS sleep in postmenopausal women.

Shaping the slow waves of sleep: A systematic and integrative review of sleep slow wave modulation in humans using non-invasive brain stimulation

The experimental study of electroencephalographic slow wave sleep (SWS) stretches over more than half a century and has corroborated its importance for basic physiological processes, such as brain plasticity, metabolism and immune system functioning. Alterations of SWS in aging or pathological conditions suggest that modulating SWS might constitute a window for clinically relevant interventions. This work provides a systematic and integrative review of SWS modulation through non-invasive brain stimulation in humans. A literature search using PubMed, conducted in May 2020, identified 3220 studies, of which 82 fulfilled inclusion criteria. Three approaches have been adopted to modulate the macro- and microstructure of SWS, namely auditory, transcranial electrical and transcranial magnetic stimulation. Our current knowledge about the modulatory mechanisms, the space of stimulation parameters and the physiological and behavioral effects are reported and evaluated. The integration of findings suggests that sleep slow wave modulation bears the potential to promote our understanding of the functions of SWS and to develop new treatments for conditions of disrupted SWS.

Periocular skin warming promotes body heat loss and sleep onset: a randomized placebo-controlled study

Periocular skin warming was reported to have favorable effects on subjective and objective sleep quality. We hypothesized that enhancing body heat loss by periocular skin warming would reduce sleep onset and improve sleep quality. Eighteen healthy volunteers were asked to maintain wakefulness with their eyes closed for 60 min after applying either a warming or sham eye mask, followed by a 60-min sleep period. Compared to the sham, periocular warming increased the distal skin temperature and distal-proximal skin temperature gradient only during the 30-min thermal manipulation period. In the subsequent sleep period, periocular warming facilitated sleep onset, increased stage 2 sleep and electroencephalographic delta activity during the first half of the sleep period relative to the sham. These results suggest that periocular skin warming may accelerate and deepen sleep by enhancing physiological heat loss via the distal skin, mimicking physiological conditions preceding habitual sleep.

Differential effects of heat in the phases of the light-dark cycle in the activity-based anorexia model

BACKGROUND

This research builds on the studies on ambient temperature as a key influence in the recovery of rodents exposed to the activity-based anorexia (ABA) model. The ABA model is an experimental paradigm in which rodents under a restricted feeding schedule and with free access to an activity wheel show signs that parallel those of anorexia nervosa in humans.

OBJECTIVE

The present study focuses on the effects of applying heat during the different phases of the dark-light cycle in the activity levels, body weight, food intake, body temperature, and recovery rates of 30 male rats submitted to ABA.

METHOD

After reaching a 20% weight loss criterion, animals were randomly assigned to three experimental conditions: (a) continuous warming, (b) warming exclusively during the light phase, or (c) warming exclusively during the dark phase.

RESULTS

Differential effects were found depending on the modalities of warming: in comparison with either light or dark warming, continuous warming significatively decreased activity, facilitated weight gain, and maintained body temperature. Transient effects of warming were found both in the groups warmed either during light or dark periods exclusively.

DISCUSSION

The results suggest that both light and dark warming did not promote recovery in animals exposed to ABA. Evidence about the beneficial effects of continuous warming are in line with previous research and reinforces adding external heat as a useful tool in the treatment of anorexia nervosa.

Skin Temperatures of Back or Neck Are Better Than Abdomen for Indication of Average Proximal Skin Temperature During Sleep of School-Aged Children

PURPOSE

The tight association between sleep, body temperature regulation, and patterns of skin temperature change highlights the necessity for accurate and valid assessment of skin temperatures during sleep. With increased interest in this functional relationship in infants and children, it is important to identify where to best measure proximal skin temperature and whether it is possible to reduce the number of sites of measures, in order to limit the experimental effects in natural settings. Thus, the aim of this study was to determine the most suitable single skin temperature sites for representation of average proximal skin temperature during sleep of school aged children.

METHODS

Statistical analyses were applied to skin temperature data of 22 children, aged 6 to 12 years, measured over four consecutive school nights in their home settings, to compare single site measures of abdomen, back, neck, forehead and subclavicular skin temperatures (local temperatures) with average proximal skin temperatures.

RESULTS

Abdomen and forehead skin temperatures were significantly different (respectively higher and lower) to the other local proximal temperatures and to average proximal skin temperatures. Moreover, the time pattern of forehead temperature was very different from that of the other local temperatures.

CONCLUSIONS

Local forehead and abdomen skin temperatures are least suitable as single site representations of average proximal skin temperatures in school aged children when considering both the level and the time course pattern of the temperature across the night. Conversely, back and neck temperatures provide most fitting representation of average proximal skin temperatures.

Evaluations of effects of sleep surfaces on athletic performance in youth

We recently demonstrated that sleeping on high rebound [HR] mattress toppers induced a continuous and more rapid decline in core body temperature compared to low rebound [LR] mattress toppers during the initial phase of nocturnal sleep in young healthy volunteers. HR toppers are characterized by their supportive feel and high breathability whereas LR toppers are pressure-absorbing. In the current study, we evaluated effects of HR mattress toppers on objectively-(actigraphy) and subjectively-(questionnaires) evaluated sleep, vigilance (psychomotor vigilance test), and athletic performance (40-m sprint time, long jump distance, and star drill time) in youth male athletes age 10–19, in two sessions: fifty-one subjects in 2013 (study I) and 23 subjects in 2014 (study II). Sleeping on HR mattress toppers for four to six weeks improved some athletic performance measures compared to sleeping on LR or sleeping directly on spring mattresses without a topper. Statistically significant improvements in 40-m sprint time in study I (compared to LR) and in star drill time in study II (no topper) were observed. No changes in sleep and psychomotor vigilance were observed. These results suggest selecting optimal sleep surfaces may contribute to the maximization of athletic performances, and further studies are warranted.

Effect of an Innovative Mattress and Cryotherapy on Sleep after an Elite Rugby Match

INTRODUCTION

This study aimed to explore the relationship between elite rugby union match and postmatch sleep architecture and to investigate the effects of a high-heat capacity mattress (MAT) and a whole-body cryotherapy (WBC) session on postmatch sleep architecture.

METHODS

Nineteen elite male U23 rugby union players performed in three official matches, followed by three experimental conditions, in a randomized order: MAT, WBC, and no intervention (CONT). Match load was evaluated using GPS trackers and video analyses. Sleep architecture was assessed by polysomnography (PSG). Core body temperature (CBT) and mattress surface temperature were monitored during sleep. Linear mixed-effects models were conducted to assess the effects of each experimental condition on sleep, with match load variables as covariates.

RESULTS

A lower wake after sleep onset (β = -10.5 min, P < 0.01) and higher rapid eye movement sleep proportion (β = +2.8%, P < 0.05) were reported for MAT compared with CONT. Moreover, lower mean CBT (β = -0.135°C, P < 0.001) and mean mattress surface temperature (β = -2.736°C, P < 0.001) during sleep were observed for MAT compared CONT. WBC did not affect nocturnal CBT nor interfere with sleep architecture. For every 100-m increase in high-speed running distance, a higher slow wave sleep (β = +1.1%, P = 0.05) and lower light sleep proportion (β = -1.2%, P < 0.05) proportion were observed. Conversely, for every 10 supplementary collisions, lower slow wave sleep (β = -1.9, P = 0.09) and higher light sleep (β = +2.9%, P < 0.001) proportion were observed.

CONCLUSION

MAT use had a positive effect on sleep architecture after an elite rugby union match, potentially through a more efficient nocturnal heat transfer.

Effects of sleep on a high-heat capacity mattress on sleep stages, EEG power spectra, cardiac interbeat intervals and body temperatures in healthy middle-aged men‡

Study Objectives

This study deals with the question whether a slow (non-disturbing) reduction of core body temperature (CBT) during sleep increases sleep stage N3 and EEG slow wave energy (SWE) and leads to a slowing of heart rate in humans.

Participants

Thirty-two healthy male subjects with a mean ± SD age 46 ± 4 years and body mass index 25.2 ± 1.8 kg/m2.

Methods

A high-heat capacity mattress (HM) was used to lower body temperatures in sleep and was compared to a conventional low-heat capacity mattress (LM) in a double-blinded fashion. Polysomnography was performed accompanied by measurements of skin-, core body- and mattress surface-temperatures, and heart rate. EEG power spectral analyses were carried out using Fast Fourier Transform. Interbeat intervals were derived from the electrocardiogram.

Results

The HM led to a larger decline in CBT, mediated through higher heat conduction from the core via the proximal back skin onto the mattress together with reduced heart rate. These effects occurred together with a significant increase in sleep stage N3 and standardized slow wave energy (sSWE, 0.791–4.297 Hz) accumulated in NREM sleep. In the 2nd half of the night sSWE increase was significantly correlated with body temperature changes, for example with CBT decline in the same phase.

Conclusions

A HM subtly decreases CBT, leading to an increased amount of sleep stage N3 and of sSWE, as well as a slowing of heart rate.

Assessment of Circadian Rhythms

Circadian rhythms are observed in most physiologic functions across a variety of species and are controlled by a master pacemaker in the brain called the suprachiasmatic nucleus. The complex nature of the circadian system and the impact of circadian disruption on sleep, health, and well-being support the need to assess internal circadian timing in the clinical setting. The ability to assess circadian rhythms and the degree of circadian disruption can help in categorizing subtypes or even new circadian rhythm disorders and aid in the clinical management of the these disorders.

Sleep quality prediction in caregivers using physiological signals

Most caregivers of people with dementia (CPWD) experience a high degree of stress due to the demands of providing care, especially when addressing unpredictable behavioral and psychological symptoms of dementia. Such challenging responsibilities make caregivers susceptible to poor sleep quality with detrimental effects on their overall health. Hence, monitoring caregivers' sleep quality can provide important CPWD stress assessment. Most current sleep studies are based on polysomnography, which is expensive and potentially disrupts the caregiving routine. To address these issues, we propose a clinical decision support system to predict sleep quality based on trends of physiological signals in the deep sleep stage. This system utilizes four raw physiological signals using a wearable device (E4 wristband): heart rate variability, electrodermal activity, body movement, and skin temperature. To evaluate the performance of the proposed method, analyses were conducted on a two-week period of sleep monitored on eight CPWD. The best performance is achieved using the random forest classifier with an accuracy of 75% for sleep quality, and 73% for restfulness, respectively. We found that the most important features to detect these measures are sleep efficiency (ratio of amount of time asleep to the amount of time in bed) and skin temperature. The results from our sleep analysis system demonstrate the capability of using wearable sensors to measure sleep quality and restfulness in CPWD.