Sleep deprivation: A clinical perspective

Effects of sleep deprivation on perceived and performance fatigability in females: An exploratory study

Sleep deprivation (SD) is prevalent and impairs motor function; however, little is known about its effect on perceived and performance fatigability, especially in females. To examine the effects of 24 h of SD on these attributes of fatigue, nine females completed a 20-min isometric, sustained elbow flexion contraction, followed by 10 min of recovery. The superimposed twitch (SIT) elicited via transcranial magnetic stimulation (TMS) assessed supraspinal drive. Biceps brachii electromyographic data indicated neural excitability in response to stimulation over the motor cortex (motor evoked potential; MEP), corticospinal tract (cervicomedullary motor evoked potential; CMEP), and brachial plexus (maximal M-wave; Mmax). MEPs and CMEPs were recorded during a TMS-induced silent period. At baseline, ratings of perceived effort (RPE; 2.9 vs. 1.6) and fatigue (RPF; 6.9 vs. 2.9), were higher for SD than control. Across the 20-min contraction, RPE increased from 2.2 to 7.6, SIT and MEP/CMEP increased by 284 and 474%, respectively, whereas maximal voluntary isometric contraction (MVC) torque and CMEP/Mmax decreased by 26 and 57%, respectively. No differences were found across conditions for MVC, SIT, Mmax, CMEP/Mmax, or MEP/CMEP prior to, during, and after the fatiguing task. During recovery, RPE (4.9 vs. 3.4), RPF (7.6 vs. 2.8), and perception of task difficulty (5.5 vs. 4.5) were greater for SD than control. Acute SD does not appear to alter performance fatigability development and subsequent recovery; however, it increases perceptions of fatigue, effort, and task difficulty. Thus, the disconnect between perceived and actual neuromuscular capacity following a sustained, submaximal isometric task is exacerbated by SD.HighlightsSleep deprivation did not alter supraspinal drive or neural excitability during and after a 20-min submaximal elbow flexion contractionSleep deprivation increased perceived fatigue and perception of task difficultyThe disconnect between perceived and performance fatigability is exacerbated in a sleep-deprived state.

Methylmercury plus Ethanol Exposure: How Much Does This Combination Affect Emotionality?

Mercury is a heavy metal found in organic and inorganic forms that represents an important toxicant with impact on human health. Mercury can be released in the environment by natural phenoms (i.e., volcanic eruptions), industrial products, waste, or anthropogenic actions (i.e., mining activity). Evidence has pointed to mercury exposure inducing neurological damages related to emotional disturbance, such as anxiety, depression, and insomnia. The mechanisms that underlie these emotional disorders remain poorly understood, although an important role of glutamatergic pathways, alterations in HPA axis, and disturbance in activity of monoamines have been suggested. Ethanol (EtOH) is a psychoactive substance consumed worldwide that induces emotional alterations that have been strongly investigated, and shares common pathophysiological mechanisms with mercury. Concomitant mercury and EtOH intoxication occur in several regions of the world, specially by communities that consume seafood and fish as the principal product of nutrition (i.e., Amazon region). Such affront appears to be more deleterious in critical periods of life, such as the prenatal and adolescence period. Thus, this review aimed to discuss the cellular and behavioral changes displayed by the mercury plus EtOH exposure during adolescence, focused on emotional disorders, to answer the question of whether mercury plus EtOH exposure intensifies depression, anxiety, and insomnia observed by the toxicants in isolation.

Urban bus drivers' sleep problems and crash accidents

Sleep problems and their direct consequence, sleepiness, results in critical effects on psychomotor skills, memory, decision making, concentration and learning; all of which may play roles in accidents and errors. Despite the importance of quality of sleep among drivers there are only few researches that deal with them. Therefore, we designed this research to better understand possible relationships. This cross-sectional study was performed between 2006 and 2007 among 175 bus drivers of a transportation company in Tehran, the capital of Iran. Participants filled out a questionnaire concerning their demographic and personal history, associated disease, the insomnia index, the Epworth sleepiness scale (ESS), and the apnea index. Then they elaborated their history of crashes. Data was analyzed with the SPSS software through χ(2), Oneway ANOVAs, and Pearson correlation tests. The mean age, and body mass index (BMI) were 43.47 ± 6.85 years and 26.35 ± 3.87 kg/m(2). The mean duration of sleep among these drivers was 6.37 ± 1.62 h per day. The mean accident rate was 2.31 ± 1.83 per year. There was a significant correlation between the insomnia index and BMI (P = 0.014), age (0.00), marital status (0.00), associated disease (0.005), and drug history (0.028). There was a significant relationship between marital status and the ESS, and also between age and accident rate in the past years. Sleep problems were a frequent finding among the studied group and had a significant relationship with their crash history. These results can be an alarming sign to choose bus drivers more carefully and pay more attention to treating their sleep disorders.

Scopoli's work in the field of mercurialism in light of today's knowledge: past and present perspectives

The Idrija Mercury Mine (1490-1994) appointed its first physician, Joannes Antonius Scopoli, in 1754. Most of his descriptions of mercurialism are still relevant today. This study highlights Scopoli's observations on the interaction between elemental mercury (Hg degrees ) and alcohol, on the appearance of lung impairment, insomnia, and depressive mood in mercurialism. This presentation is based on Scopoli's experiences presented in his book, De Hydrargyro Idriensi Tentamina (1761), current knowledge, and our own experience acquired through health monitoring of occupational Hg degrees exposure. Some studies have confirmed Scopoli's observation that alcohol enhances mercurialism and his hypothesis that exposure to high Hg degrees concentrations causes serious lung impairment. Neurobiological studies have highlighted the influence of Hg degrees on sleep disorder and depressive mood observed by Scopoli. Although today's knowledge provides new perspectives of Scopoli's work on mercurialism, his work is still very important and can be considered a part of occupational medicine heritage.