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Steghaus S, Poth CH. Feeling tired versus feeling relaxed: Two faces of low physiological arousal. PLoS One 2024; 19:e0310034. [PMID: 39250459 PMCID: PMC11383234 DOI: 10.1371/journal.pone.0310034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 08/23/2024] [Indexed: 09/11/2024] Open
Abstract
Human well-being and functioning depend on two fundamental mental states: Relaxation and sleepiness. Relaxation and sleepiness are both assumed to be states of low physiological arousal and negatively correlated. However, it is still unclear how consistent this negative relationship is across different settings and whether it changes before and after an intervention. Here we investigated this intricate relationship between subjective momentary sleepiness and relaxation states by meta-analytically analyzing several data sets from studies using the Relaxation State Questionnaire. We discovered that subjective sleepiness and relaxation were in fact anti-correlated pre-intervention. This anti-correlation provides a quantitative dissociation between sleepiness and relaxation. Thus, even though sleepiness and relaxation both implicate a low arousal level, the two mental states are subjectively experienced in a qualitatively different fashion, and thus reflect distinct underlying constructs. For the post-intervention relationship, this negative correlation could not be consistently found. This indicates that there are aspects of the experimental setting or intervention that introduce changes in the dynamics of the relationship of the two constructs.
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Affiliation(s)
- Sarah Steghaus
- Neuro-cognitive Psychology and Center of Cognitive Interaction Technology (CITEC), Bielefeld University, Bielefeld, Germany
| | - Christian H. Poth
- Neuro-cognitive Psychology and Center of Cognitive Interaction Technology (CITEC), Bielefeld University, Bielefeld, Germany
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2
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Shin S, Lee S, Choi SJ, Joo EY, Suh S. Validation of the Karolinska Sleepiness Scale in Korean. J Clin Neurol 2024; 20:501-508. [PMID: 39227333 PMCID: PMC11372212 DOI: 10.3988/jcn.2024.0042] [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: 01/19/2024] [Revised: 03/13/2024] [Accepted: 04/12/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND AND PURPOSE The Karolinska Sleepiness Scale (KSS) is widely used for assessing current level of sleepiness, but it has not been validated in South Korea. This study aimed to validate the KSS using the Stanford Sleepiness Scale (SSS), polysomnography (PSG), and electroencephalography (EEG). METHODS The sample consisted of 27 adult participants in this study aged 40.5±7.7 years (mean±standard deviation) and included 22 males. They completed questionnaires and underwent EEG recording and overnight PSG. The KSS was completed from 18:00 to 24:00 every 2 hours and following PSG (at 07:00). KSS scores changed over time and in particular increased with the time since waking, with the score peaking at 24:00. RESULTS Convergent validity of the KSS was verified by performing a Spearman correlation analysis between the KSS and SSS (r=0.742, p<0.01). Concurrent validity of the KSS was verified by performing a Spearman correlation analysis between the KSS administered before sleep and the sleep onset latency measured using PSG (r=-0.456, p<0.05). Alpha waves were measured 5 minutes before administering the KSS, and the KSS scores were compared with these alpha waves. There were no significant correlations observed between the KSS scores and alpha waves measured in the left occipital area (O1), left frontal area (F3), or left central area (C3). In addition, Spearman correlation analyses of the difference between KSS scores and alpha waves measured at O1, F3, and C3 produced no significant results. CONCLUSIONS This study verified the convergent validity and concurrent validity of the KSS, and confirmed the capabilities of this scale in assessing sleepiness changes over time.
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Affiliation(s)
- Sungkyoung Shin
- Department of Psychology, Sungshin Women's University, Seoul, Korea
| | - Sujin Lee
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Su Jung Choi
- Graduate School of Clinical Nursing Science, Sungkyunkwan University, Seoul, Korea
| | - Eun Yeon Joo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Sooyeon Suh
- Department of Psychology, Sungshin Women's University, Seoul, Korea.
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3
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Cipriano A, Kapil RP, Zhou M, Shet MS, Harris SC, Apseloff G, Whiteside GT. Evaluation of sunobinop for next-day residual effects in healthy participants. Front Pharmacol 2024; 15:1432902. [PMID: 39224779 PMCID: PMC11366868 DOI: 10.3389/fphar.2024.1432902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
Sunobinop is a novel, potent, selective partial agonist at nociceptin/orphanin FQ peptide (NOP) receptors. The primary objective of this randomized, double-blind, placebo-controlled study was to assess the next-day residual effects of an evening dose of sunobinop in healthy participants. Participants were randomized into 1 of 5 treatment sequences. Treatment consisted of 1 dose each of sunobinop 0.2, 0.6, 2, and 6 mg suspension and placebo suspension. Key pharmacodynamic (PD) measures included the digit symbol substitution test (DSST), Karolinska sleepiness scale (KSS), and body sway. The randomized safety population consisted of 25 participants. The DSST, KSS, and body sway showed dose-dependent effects following the administration of sunobinop, with no significant differences versus placebo at sunobinop doses <2 mg. At sunobinop 2 mg, PD effects were relatively small in magnitude and inconsistent. The last timepoint where significant differences between sunobinop 2 mg and placebo on the DSST, KSS, and body sway were observed was at 12 h, 16.5 h, and 13.5 h postdose, respectively. Sunobinop 6 mg resulted in larger and consistent PD effects, with significant differences from placebo at all timepoints up to 16.5-18 h postdose. Somnolence was the most frequently reported adverse event (AE), and all AEs were mild-to-moderate. No deaths occurred during the study or discontinuations due to an AE. Overall, a nighttime oral dose of sunobinop up to 2 mg was safe and generally well tolerated in healthy participants with limited next-day residual effects that were consistent with other sedative/hypnotic drugs.
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Affiliation(s)
| | - Ram P. Kapil
- Imbrium Therapeutics, Stamford, CT, United States
| | - Mingyan Zhou
- Imbrium Therapeutics, Stamford, CT, United States
| | | | | | - Glen Apseloff
- Ohio Clinical Trials, Inc., Columbus, OH, United States
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4
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Grant LK, Gonsalvez I, Cohn AY, Nathan MD, Harder JA, Klerman EB, Scheer FAJL, Kaiser UB, Crawford S, Luo T, Wiley A, Rahman SA, Joffe H. The effect of experimentally induced sleep fragmentation and estradiol suppression on neurobehavioral performance and subjective sleepiness in premenopausal women. Sleep 2024; 47:zsae130. [PMID: 38874415 PMCID: PMC11321839 DOI: 10.1093/sleep/zsae130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/02/2024] [Indexed: 06/15/2024] Open
Abstract
STUDY OBJECTIVES Menopause is associated with nighttime sleep fragmentation, declining estradiol, and impaired cognition. In a model of pharmacologically induced estradiol suppression mimicking menopause, we examined the impact of menopause-pattern sleep fragmentation on daytime neurobehavioral performance and sleepiness in premenopausal women. METHODS Twenty premenopausal women completed two five-night inpatient studies in the mid-to-late follicular phase (estrogenized) and after pharmacological estradiol suppression (hypo-estrogenized). During each study, participants had an uninterrupted 8-hour sleep opportunity for two nights, followed by three nights where sleep was experimentally fragmented to mimic menopause-pattern sleep disturbance, and during which the sleep opportunity was extended to prevent shortening of the sleep duration. Neurobehavioral performance and subjective sleepiness were measured using the Psychomotor Vigilance Task and Karolinska Sleepiness Scale (KSS). RESULTS Compared to unfragmented sleep, sleep fragmentation increased attentional lapses (+ 0.6 lapses, p < .05), slowed reaction time (+ 9.4 milliseconds, p < .01), and increased daytime sleepiness (+ 0.5 KSS score, p < .001). Estradiol suppression increased attentional lapses (+ 0.8; p < .001) and reaction time (+ 12.3, p < .01) but did not significantly affect daytime sleepiness. The effect of sleep fragmentation on neurobehavioral performance differed by estradiol state, such that the adverse effects of sleep fragmentation on attentional lapses (+ 0.9, trend p = .06) and reaction time (+ 15, p < .05) were observed only when estrogenized. CONCLUSIONS Menopause-pattern sleep fragmentation and estradiol suppression worsened neurobehavioral performance and daytime sleepiness, even while sleep duration was not reduced. The adverse effects of sleep fragmentation in the context of an adequate sleep duration highlight the importance of sleep continuity as a vital aspect of good sleep health.
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Affiliation(s)
- Leilah K Grant
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Irene Gonsalvez
- Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Aviva Y Cohn
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Margo D Nathan
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Jessica A Harder
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Frank A J L Scheer
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Ursula B Kaiser
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Sybil Crawford
- University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Tianyu Luo
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Aleta Wiley
- Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Shadab A Rahman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Hadine Joffe
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
- Women’s Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Holmelid Ø, Harris A, Pallesen S, Bjorvatn B, Vedaa Ø, Waage S, Nielsen MB, Djupedal ILR, Sunde E. Acute effects of a simulated quick return on subjective sleepiness, mood, and cognitive performance: A laboratory crossover controlled trial. Chronobiol Int 2024; 41:1116-1127. [PMID: 39037118 DOI: 10.1080/07420528.2024.2380736] [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: 03/18/2024] [Revised: 06/11/2024] [Accepted: 07/11/2024] [Indexed: 07/23/2024]
Abstract
Sleep loss due to short time off between shifts has been proposed as a mechanism contributing to impaired functioning in occupational settings. This laboratory crossover trial (ClinicalTrials.gov identifier: NCT05162105, N = 66) compared subjective sleepiness, mood, and cognitive performance on a day shift after an evening shift with only 8 h off between shifts (quick return, QR) to a day shift after another day shift with 16 h off between shifts (control). Results indicated higher subjective sleepiness (Karolinska Sleepiness Scale) during the QR condition compared to the control condition (p < 0.001). No significant differences were found on mood (Positive and Negative Affect Schedule) and cognitive performance (Psychomotor Vigilance- and Digit Symbol Substitution Test) between the conditions. Findings of increased subjective sleepiness corroborate previous field studies. This trial is to our knowledge the first to compare mood and cognitive performance after a QR to a longer shift transition using an experimental design. Future research should explore the effects of accumulated sleep loss associated with QRs (e.g. having several QRs within a short time period) on behavioral outcomes.
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Affiliation(s)
- Øystein Holmelid
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Bjørn Bjorvatn
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Øystein Vedaa
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Siri Waage
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | | | - Ingebjørg Louise Rockwell Djupedal
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Erlend Sunde
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
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Sharman R, Kyle SD, Espie CA, Tamm S. Associations between self-reported sleep, overnight memory consolidation, and emotion perception: A large-scale online study in the general population. J Sleep Res 2024; 33:e14094. [PMID: 38009410 DOI: 10.1111/jsr.14094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/08/2023] [Accepted: 10/24/2023] [Indexed: 11/28/2023]
Abstract
Experimental studies suggest that short or disrupted sleep impairs memory consolidation, mood, and perception of emotional stimuli. However, studies have chiefly relied on laboratory-based study designs and small sample sizes. The aim of this fully online and pre-registered study was to investigate the association between sleep and overnight memory consolidation, emotion perception, and affect in a large, self-selected UK sample. A total of 1646 participants (473 completed) took part in an online study, where they completed a declarative (word-pairs) memory task, emotion perception task (valence ratings of images), and rated their affect within 2 h of bed-time. The following morning, participants reported on their state affect, sleep for the previous night, completed a cued recall task for the previously presented word-pairs, rated the valence of previously viewed images, and completed a surprise recognition task. Demographic data and habitual sleep quality and duration (sleep traits) were also recorded. Habitual sleep traits were associated with immediate recall for the word-pairs task, while self-reported sleep parameters for the specific night were not associated with overnight memory consolidation. Neither habitual sleep traits, nor nightly sleep parameters were associated with unpleasantness ratings to negative stimuli or overnight habituation. Habitual poor sleep was associated with less positive and more negative affect, and morning affect was predicted by the specific night's sleep. This study suggests that overnight emotional processing and declarative memory may not be associated with self-reported sleep across individuals. More work is needed to understand how findings from laboratory-based studies extrapolate to real-world samples and contexts.
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Affiliation(s)
- Rachel Sharman
- Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Simon D Kyle
- Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Colin A Espie
- Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Sandra Tamm
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm, Sweden
- Department of Psychiatry, University of Oxford, Oxford, UK
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7
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Liu Y, Barnet JH, Hagen EW, Peppard PE, Mignot E, Reither EN. Objectively measured daytime sleepiness predicts weight change among adults: Findings from the Wisconsin Sleep Cohort Study. Sleep Health 2024; 10:327-334. [PMID: 38688810 DOI: 10.1016/j.sleh.2024.03.002] [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: 05/30/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Body mass index (BMI) trajectories are associated with night-time sleep, but it is not clear how they relate to daytime sleepiness in population data. This study aimed to examine longitudinal associations between levels and changes in daytime sleepiness and BMI trajectories among men and women. METHODS We estimated growth curve models among 827 participants in the Wisconsin Sleep Cohort Study (mean [sd] age = 55.2 [8.0] years at baseline). The outcome variable was BMI (kg/m2) and the key predictor was daytime sleepiness measured by Multiple Sleep Latency Test (MSLT) scores. Covariates included demographics, health behaviors, retirement status, stimulant use, and depressive symptoms. In sensitivity analyses, we evaluated the potential effects of cardiovascular disease, shift work status, and sleep apnea on the robustness of sleepiness and BMI associations. RESULTS At the between-person level, men who were sleepier had higher BMI levels. At the within-person level, age moderated the positive association between sleepiness and BMI among women. Specifically, young women who became sleepier over time gained more BMI than older women with comparable increases in sleepiness. Furthermore, while BMI tended to increase with age among women, BMI trajectories were steeper among sleepy women than among well-rested women, who experienced less increase in BMI over time. CONCLUSION The study suggested that levels and changes in daytime sleepiness as objectively measured by MSLT scores are associated with body mass among adults.
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Affiliation(s)
- Yin Liu
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, USA
| | - Jodi H Barnet
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Erika W Hagen
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Paul E Peppard
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Emmanuel Mignot
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Eric N Reither
- Department of Sociology and Anthropology, Utah State University, Logan, Utah, USA.
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8
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Fernandes GL, da Silva Vallim JR, D'Almeida V, Tufik S, Andersen ML. The effects of social jetlag and sleep variability on sleepiness in a population-based study: The mediating role of sleep debt. J Sleep Res 2024; 33:e14043. [PMID: 37691450 DOI: 10.1111/jsr.14043] [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: 04/18/2023] [Revised: 07/25/2023] [Accepted: 08/25/2023] [Indexed: 09/12/2023]
Abstract
Sleepiness is a multicausal condition, and previous research has highlighted associations between this symptom and the circadian timing system, specifically concerning social jetlag and sleep variability. Recent inquiries have shown that the effects of social jetlag on sleepiness can be confounded with the consequences of sleep debt. In light of the current evidence, we aimed to assess the effects of social jetlag and sleep variability on sleepiness and the potential mediating role of sleep debt. We used data from the EPISONO study, a cross-sectional population-based study with a sample size of 1042 participants, representative of the city of Sao Paulo, Brazil. Participants completed the UNIFESP Sleep Questionnaire (self-reported bedtime and get-up time) and the Epworth Sleepiness Scale (subjective daytime sleepiness). Subsequently, sleep-corrected mid-sleep time (chronotype), total sleep time, social jetlag (absolute difference between the mid-sleep time on workdays and mid-sleep time on free days), sleep variability (standard deviation of mid-sleep time), and sleep debt (difference between total sleep time on workdays and free days) were calculated. Generalised linear models were used to test whether social jetlag and sleep variability affected sleepiness. Mediation models were used to determine if any observed significant effects were mediated by sleep debt. The prevalence of social jetlag was 23% for >1 h and 12% for >2 h. The mean sleep variability was 41 ± 30 min. Social jetlag had a significant effect on the Epworth Sleepiness Scale scores. This association was no longer statistically significant after controlling for age, sex, body mass index, work schedule, and chronotype. A significant indirect effect of social jetlag on sleep debt and subsequently on the Epworth Sleepiness Scale scores was found. No effect of sleep variability on sleepiness could be identified. In conclusion, the association between social jetlag and sleepiness was mediated by sleep debt but was not independent of demographic, work, and chronotype variables. This study provides new evidence on the importance of circadian misalignment and sleep debt for sleep health on a population level.
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Affiliation(s)
| | | | - Vânia D'Almeida
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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9
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Martin VP, Gauld C, Taillard J, Peter-Derex L, Lopez R, Micoulaud-Franchi JA. Sleepiness should be reinvestigated through the lens of clinical neurophysiology: A mixed expertal and big-data Natural Language Processing approach. Neurophysiol Clin 2024; 54:102937. [PMID: 38401240 DOI: 10.1016/j.neucli.2023.102937] [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: 10/21/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 02/26/2024] Open
Abstract
Historically, the field of sleep medicine has revolved around electrophysiological tools. However, the use of these tools as a neurophysiological method of investigation seems to be underrepresented today, from both international recommendations and sleep centers, in contrast to behavioral and psychometric tools. The aim of this article is to combine a data-driven approach and neurophysiological and sleep medicine expertise to confirm or refute the hypothesis that neurophysiology has declined in favor of behavioral or self-reported dimensions in sleep medicine for the investigation of sleepiness, despite the use of electrophysiological tools. Using Natural Language Processing methods, we analyzed the abstracts of the 18,370 articles indexed by PubMed containing the terms 'sleepiness' or 'sleepy' in the title, abstract, or keywords. For this purpose, we examined these abstracts using two methods: a lexical network, enabling the identification of concepts (neurophysiological or clinical) related to sleepiness in these articles and their interconnections; furthermore, we analyzed the temporal evolution of these concepts to extract historical trends. These results confirm the hypothesis that neurophysiology has declined in favor of behavioral or self-reported dimensions in sleep medicine for the investigation of sleepiness. In order to bring sleepiness measurements closer to brain functioning and to reintroduce neurophysiology into sleep medicine, we discuss two strategies: the first is reanalyzing electrophysiological signals collected during the standard sleep electrophysiological test; the second takes advantage of the current trend towards dimensional models of sleepiness to situate clinical neurophysiology at the heart of the redefinition of sleepiness.
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Affiliation(s)
- Vincent P Martin
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, L-1445 Strassen, Luxembourg; Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, F-33400 Talence, France; Univ. Bordeaux, CNRS, SANPSY, UMR 6033, F-33000 Bordeaux, France
| | - Christophe Gauld
- Service Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, France; Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, France
| | - Jacques Taillard
- Univ. Bordeaux, CNRS, SANPSY, UMR 6033, F-33000 Bordeaux, France
| | - Laure Peter-Derex
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR 5292, Lyon, France; Centre for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France
| | - Régis Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy-Rare hypersomnias, Sleep Unit, Department of Neurology, CHU de Montpellier, University of Montpellier, Montpellier, France; Institute for Neurosciences of Montpellier (INM), University of Montpellier, Inserm, Montpellier, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, CNRS, SANPSY, UMR 6033, F-33000 Bordeaux, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076 Bordeaux, France.
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10
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Mahoney HL, Schmidt TM. The cognitive impact of light: illuminating ipRGC circuit mechanisms. Nat Rev Neurosci 2024; 25:159-175. [PMID: 38279030 DOI: 10.1038/s41583-023-00788-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 01/28/2024]
Abstract
Ever-present in our environments, light entrains circadian rhythms over long timescales, influencing daily activity patterns, health and performance. Increasing evidence indicates that light also acts independently of the circadian system to directly impact physiology and behaviour, including cognition. Exposure to light stimulates brain areas involved in cognition and appears to improve a broad range of cognitive functions. However, the extent of these effects and their mechanisms are unknown. Intrinsically photosensitive retinal ganglion cells (ipRGCs) have emerged as the primary conduit through which light impacts non-image-forming behaviours and are a prime candidate for mediating the direct effects of light on cognition. Here, we review the current state of understanding of these effects in humans and mice, and the tools available to uncover circuit-level and photoreceptor-specific mechanisms. We also address current barriers to progress in this area. Current and future efforts to unravel the circuits through which light influences cognitive functions may inform the tailoring of lighting landscapes to optimize health and cognitive function.
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Affiliation(s)
- Heather L Mahoney
- Department of Neurobiology, Northwestern University, Evanston, IL, USA.
| | - Tiffany M Schmidt
- Department of Neurobiology, Northwestern University, Evanston, IL, USA.
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11
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Bjorvatn B, Waage S, Pallesen S, Buysse DJ, Saxvig IW. The association between different sleep health dimensions and sex, age, education, circadian preference, and chronic insomnia: a representative population-based study. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 4:zpad041. [PMID: 37954092 PMCID: PMC10635412 DOI: 10.1093/sleepadvances/zpad041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/12/2023] [Indexed: 11/14/2023]
Abstract
Objectives The aims were to explore multidimensional sleep health and the different dimensions of sleep health in the adult Norwegian population in relation to sex, age, education, circadian preference, and chronic insomnia. Methods A representative sample of 1028 Norwegians, aged 18 + years completed a cross-sectional web-based survey. Sleep health was measured with the multidimensional RU_SATED scale, which assesses the dimensions of regularity, satisfaction, alertness, timing, efficiency, and duration. Insomnia was assessed with the Bergen Insomnia Scale. Data were analyzed with chi-square tests, t-tests, one-way ANOVAs, and regression analyses, as appropriate. Response rate was 33.5%. Results Sleep health was better in males, with increasing age, and with higher educational level, and was poorer in participants with evening preference and chronic insomnia, compared to their respective counterparts. When investigating the different sleep health dimensions, males scored better than females on satisfaction (adjusted odds ratio [aOR] = 0.69, 95% CI = 0.51 to 0.93), timing (aOR = 0.66, 95% CI = 0.49 to 0.88), and efficiency (aOR = 0.68, 95% CI = 0.52 to 0.89). Older age was associated with better scores on regularity and satisfaction, whereas young age was associated with better scores on alertness and duration. High educational level was associated with better scores on alertness, timing, and duration. Evening types scored worse than morning types on regularity (aOR = 0.27, 95% CI = 0.18 to 0.41), satisfaction (aOR = 0.37, 95% CI = 0.26 to 0.53), and timing (aOR = 0.36, 95% CI = 0.26 to 0.51). Participants with chronic insomnia scored worse than participants without insomnia on all six sleep health dimensions. Conclusions Sleep health differed significantly in relation to sex, age, education, circadian preference, and chronic insomnia. However, specific group differences were not equally evident in all sleep health dimensions.
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Affiliation(s)
- Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Siri Waage
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Ingvild W Saxvig
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
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12
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Hao C, Xie T, Peng Y, Li M, Luo W, Ma N. Effect of homeostatic pressure on daytime vigilance performance: Evidence from behaviour and resting-state EEG. J Sleep Res 2023; 32:e13890. [PMID: 36948509 DOI: 10.1111/jsr.13890] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/25/2023] [Accepted: 03/06/2023] [Indexed: 03/24/2023]
Abstract
Vigilance is highly sensitive to the time-of-day effect and goes through the daytime trough during the period of the post-noon dip. A midday nap could maintain individuals' vigilance at an optimal level. Thus, homeostatic sleep pressure is one of the main reasons for the post-noon dip in daytime vigilance. The current study focussed on the role of homeostatic sleep pressure in the diurnal variation of vigilance performance with normal circadian rhythms and the corresponding neural basis. With 34 healthy adults, we recorded the resting-state electroencephalogram activities and the following vigilance performance measured by psychomotor vigilance test in the morning, the no-nap mid afternoon, and the nap mid afternoon. The circadian process was controlled by measuring vigilance and resting-state electroencephalogram activities at the same time point in the nap and no-nap conditions. Homeostatic sleep pressure accumulated from morning to mid afternoon induced the declined vigilance performance and a global increase in resting-state delta, theta, alpha, and beta1 bands power, and a local increase in beta2 band power in the central region. Furthermore, the more the spontaneous beta2 power increased, the less vigilance declined from morning to mid afternoon. The current findings suggest that homeostatic sleep pressure increased cortical excitability but decreased cortical communication efficiency from morning to mid afternoon. In addition, the activity of the high beta waves probably reflected the compensatory effort to counteract the negative impact of the low arousal state on the following vigilance task by performing more action preparation in the no-nap afternoon.
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Affiliation(s)
- Chao Hao
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, Ministry of Education, South China Normal University, 510631, Guangzhou, China
- Center for Sleep Research, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, 510631, Guangzhou, China
| | - Tian Xie
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, Ministry of Education, South China Normal University, 510631, Guangzhou, China
- Center for Sleep Research, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, 510631, Guangzhou, China
| | - Yudi Peng
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, Ministry of Education, South China Normal University, 510631, Guangzhou, China
- Center for Sleep Research, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, 510631, Guangzhou, China
| | - Mingzhu Li
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, Ministry of Education, South China Normal University, 510631, Guangzhou, China
- Center for Sleep Research, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, 510631, Guangzhou, China
| | - Wei Luo
- School of Architecture and Urban Planning, Shenzhen University, 518060, Shenzhen, China
| | - Ning Ma
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, Ministry of Education, South China Normal University, 510631, Guangzhou, China
- Center for Sleep Research, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, 510631, Guangzhou, China
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13
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Jung FU, Luppa M, Riedel-Heller SG. [Physician working hours and effects on health, satisfaction and healthcare]. ZENTRALBLATT FUR ARBEITSMEDIZIN, ARBEITSSCHUTZ UND ERGONOMIE 2023; 73:1-7. [PMID: 37361962 PMCID: PMC10141868 DOI: 10.1007/s40664-023-00503-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 06/28/2023]
Abstract
Changes in the working environment with respect to innovative working time models are also increasingly affecting patient care. The number of physicians working part-time, for example, is continuously rising. At the same time, a general increase in chronic diseases and multimorbid conditions as well as the growing shortage of medical staff, leads to more workload and dissatisfaction among this profession. This short overview summarizes the current study situation and associated consequences regarding working hours of physicians and gives a first explorative overview of possible solutions.
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Affiliation(s)
- F. U. Jung
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Ph.-Rosenthal-Str. 55, 04103 Leipzig, Deutschland
| | - M. Luppa
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Ph.-Rosenthal-Str. 55, 04103 Leipzig, Deutschland
| | - S. G. Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Ph.-Rosenthal-Str. 55, 04103 Leipzig, Deutschland
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14
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Shoaib Z, Akbar A, Kim ES, Kamran MA, Kim JH, Jeong MY. Utilizing EEG and fNIRS for the detection of sleep-deprivation-induced fatigue and its inhibition using colored light stimulation. Sci Rep 2023; 13:6465. [PMID: 37081056 PMCID: PMC10119294 DOI: 10.1038/s41598-023-33426-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 04/12/2023] [Indexed: 04/22/2023] Open
Abstract
Drowsy driving is a common, but underestimated phenomenon in terms of associated risks as it often results in crashes causing fatalities and serious injuries. It is a challenging task to alert or reduce the driver's drowsy state using non-invasive techniques. In this study, a drowsiness reduction strategy has been developed and analyzed using exposure to different light colors and recording the corresponding electrical and biological brain activities. 31 subjects were examined by dividing them into 2 classes, a control group, and a healthy group. Fourteen EEG and 42 fNIRS channels were used to gather neurological data from two brain regions (prefrontal and visual cortices). Experiments shining 3 different colored lights have been carried out on them at certain times when there is a high probability to get drowsy. The results of this study show that there is a significant increase in HbO of a sleep-deprived participant when he is exposed to blue light. Similarly, the beta band of EEG also showed an increased response. However, the study found that there is no considerable increase in HbO and beta band power in the case of red and green light exposures. In addition to that, values of other physiological signals acquired such as heart rate, eye blinking, and self-reported Karolinska Sleepiness Scale scores validated the findings predicted by the electrical and biological signals. The statistical significance of the signals achieved has been tested using repeated measures ANOVA and t-tests. Correlation scores were also calculated to find the association between the changes in the data signals with the corresponding changes in the alertness level.
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Affiliation(s)
- Zeshan Shoaib
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busandaehak-ro 63 beon-gil 2, Geumjeong-gu, Busan, 46241, Korea
| | - Arbab Akbar
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busandaehak-ro 63 beon-gil 2, Geumjeong-gu, Busan, 46241, Korea
| | - Eung Soo Kim
- Department of Electronic and Robot Engineering, Busan University of Foreign Studies, 65, KeumSaem-Ro 485 beongil, KeumJeong-Gu, Busan, 46234, Korea
| | - Muhammad Ahmad Kamran
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busandaehak-ro 63 beon-gil 2, Geumjeong-gu, Busan, 46241, Korea
| | - Jun Hyun Kim
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busandaehak-ro 63 beon-gil 2, Geumjeong-gu, Busan, 46241, Korea
| | - Myung Yung Jeong
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busandaehak-ro 63 beon-gil 2, Geumjeong-gu, Busan, 46241, Korea.
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15
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Jensen MA, Nielsen HB, Sallinen M, Kristiansen J, Hansen ÅM, Garde AH. Self-Reported Sleepiness after 2, 4, and 7 Consecutive Night Shifts and Recovery Days in Danish Police Officers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10527. [PMID: 36078243 PMCID: PMC9518407 DOI: 10.3390/ijerph191710527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/10/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Night shift work often implies shorter sleep duration and this can lead to sleepiness, which has been associated with an increased risk of accidents and injuries. The aim is to study how the number of consecutive night shifts affects self-reported sleepiness. PARTICIPANTS AND METHODS The study was a quasi-experimental, within-subject crossover study with 73 police officers. Three work schedules of two, four, and seven consecutive night shifts followed by the same number of recovery days, i.e., days worked or days off, was performed by all participants. Sleepiness was self-reported using the Karolinska sleepiness scale (KSS) every fourth hour on the last night shift and the last recovery day in each sequence. RESULTS We observed differences in the level of sleepiness between recovery days and night shift days but no differences in the pattern of sleepiness levels on night shift days in the different work schedules. The highest levels of KSS were observed before bedtime (at 07:00 after a night shift and 23:00 on a recovery day). CONCLUSION The number of consecutive night shifts did not affect the self-reported levels of self-reported sleepiness among Danish police officers.
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Affiliation(s)
- Marie Aarrebo Jensen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
| | - Helena Breth Nielsen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
| | - Mikael Sallinen
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland
| | - Jesper Kristiansen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
| | - Åse Marie Hansen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, 1353 Copenhagen, Denmark
| | - Anne Helene Garde
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, 1353 Copenhagen, Denmark
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16
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Lok R, Woelders T, van Koningsveld MJ, Oberman K, Fuhler SG, Beersma DGM, Hut RA. Bright Light Increases Alertness and Not Cortisol in Healthy Men: A Forced Desynchrony Study Under Dim and Bright Light (I). J Biol Rhythms 2022; 37:403-416. [PMID: 35686534 PMCID: PMC9326799 DOI: 10.1177/07487304221096945] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Light-induced improvements in alertness are more prominent during nighttime than during the day, suggesting that alerting effects of light may depend on internal clock time or wake duration. Relative contributions of both factors can be quantified using a forced desynchrony (FD) designs. FD designs have only been conducted under dim light conditions (<10 lux) since light above this amount can induce non-uniform phase progression of the circadian pacemaker (also called relative coordination). This complicates the mathematical separation of circadian clock phase from homeostatic sleep pressure effects. Here we investigate alerting effects of light in a novel 4 × 18 h FD protocol (5 h sleep, 13 h wake) under dim (6 lux) and bright light (1300 lux) conditions. Hourly saliva samples (melatonin and cortisol assessment) and 2-hourly test sessions were used to assess effects of bright light on subjective and objective alertness (electroencephalography and performance). Results reveal (1) stable free-running cortisol rhythms with uniform phase progression under both light conditions, suggesting that FD designs can be conducted under bright light conditions (1300 lux), (2) subjective alerting effects of light depend on elapsed time awake but not circadian clock phase, while (3) light consistently improves objective alertness independent of time awake or circadian clock phase. Reconstructing the daily time course by combining circadian clock phase and wake duration effects indicates that performance is improved during daytime, while subjective alertness remains unchanged. This suggests that high-intensity indoor lighting during the regular day might be beneficial for mental performance, even though this may not be perceived as such.
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Affiliation(s)
- R. Lok
- Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
- Current address: Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California, USA
- University of Groningen, Leeuwarden, the Netherlands
| | - T. Woelders
- Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
| | - M. J. van Koningsveld
- Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
| | - K. Oberman
- Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
| | - S. G. Fuhler
- Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
| | - D. G. M. Beersma
- Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
| | - R. A. Hut
- Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
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17
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An Ultra-Short Measure of Excessive Daytime Sleepiness Is Related to Circadian Biological Rhythms: The French Psychometric Validation of the Barcelona Sleepiness Index. J Clin Med 2022; 11:jcm11133892. [PMID: 35807176 PMCID: PMC9267909 DOI: 10.3390/jcm11133892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 11/24/2022] Open
Abstract
The Barcelona Sleepiness Index (BSI) is an ultra-short instrument with several advantages for assessing excessive daytime sleepiness (EDS). The present study was performed to analyze the validity of the French version of the BSI in screening for EDS. We conducted a cross-sectional study on a population of students using an online questionnaire. The French version of the BSI was developed by a rigorous forward-backward translation process. We computed the discrimination properties of the BSI to predict EDS assessed by the Epworth Sleepiness Scale (ESS), as well as correlations with other sleep measures. In total, 662 students were enrolled in the study (mean age: 20.9 years, 76.0% women). The BSI score (mean = 1.5 ± 1.0) showed a strong correlation with the ESS score (r = 0.47, p < 10−4) and acceptable discrimination of EDS assessed by ESS score ≥ 11 (AUC = 0.742) with an optimal cutoff point of 2, as in the original study. The BSI score was significantly associated with sleep deprivation and social jetlag. Therefore, the French version of the BSI is a valid ultra-short instrument for EDS screening in individuals. In addition, the BSI score may be associated with both homeostatic and circadian processes. Further studies are needed to confirm these findings in general populations and in patients with sleep disorders.
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18
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Lok R, Joyce DS, Zeitzer JM. Impact of daytime spectral tuning on cognitive function. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2022; 230:112439. [PMID: 35398657 DOI: 10.1016/j.jphotobiol.2022.112439] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/22/2022] [Accepted: 03/25/2022] [Indexed: 06/14/2023]
Abstract
Light at night can improve alertness and cognition. Exposure to daytime light, however, has yielded less conclusive results. In addition to direct effects, daytime light may also mitigate the impact of nocturnal light exposure on alertness. To examine the impact of daytime lighting on daytime cognitive performance, and evening alertness, we studied nine healthy individuals using a within subject crossover design. On four visits, participants were exposed to one of four lighting conditions for 10 h (dim fluorescent, room fluorescent, broad-spectrum LED, standard white LED; the latter three conditions were matched for 100 lx) followed by an exposure to bright evening light. Cognitive performance, subjective and objective measures of alertness were regularly obtained. While daytime alertness was not impacted by light exposure, the broad-spectrum LED light improved several aspects of daytime cognition. The impact of evening light on alertness was not mitigated by the pre-exposure to different daytime lighting conditions. Results suggest that daytime exposure to white light with high melanopic efficacy has the potential to improve daytime cognitive function and that such improvements are likely to be direct rather than a consequence of light-induced changes in alertness.
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Affiliation(s)
- Renske Lok
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, United States of America
| | - Daniel S Joyce
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, United States of America; Department of Psychology, University of Nevada, Reno, Reno, NV 89557, United States of America
| | - Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, United States of America; Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA 94304, United States of America.
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19
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Impact of Long-Haul Travel to International Competition on Sleep and Recovery in Elite Male and Female Soccer Athletes. Int J Sports Physiol Perform 2022; 17:1361-1370. [PMID: 35172276 DOI: 10.1123/ijspp.2021-0165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/19/2021] [Accepted: 09/21/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE To investigate the impact of eastward travel across 7 time zones on sleep, jet lag, and recovery in elite soccer athletes. METHODS Twenty-one male and 20 female athletes (21.5 [1.7] y) traveled from Ireland to Taiwan to represent their national team at the World University Games 2017. Daily monitoring via actigraphy and subjective sleep and well-being measures were obtained for 1 week in Ireland (baseline), and for the duration of an international soccer tournament (days 1-5 [precompetition] and days 6-18 [competition]). RESULTS Sleep duration (P = .028) and time in bed (P = .006) were significantly lower at precompetition compared with baseline. Sleep quality (P < .001) was significantly decreased in precompetition compared with baseline and competition. Subjective jet lag symptoms continued for up to 13 days posttravel. Athletes reported significantly greater fatigue during precompetition compared with competition (P = .005); however, there were no significant differences for recovery (P = .35) and readiness to train (P = .35). Sleep hygiene changed significantly during precompetition and competition compared with baseline in relation to reduced electronic device use (P = .005) and reduced caffeine intake (P < .001). Females reported significantly greater presleep tension-anxiety compared with males at all timepoints (P = .02). CONCLUSION Long-haul eastward travel across 7 time zones has a significant impact on sleep duration and quality, likely related to changes in sleep patterns and jet lag. Athletes report changes in sleep hygiene posttravel; however, sleep remained negatively impacted for up to 5 days. Despite significant sleep disturbance and jet lag symptoms, young healthy athletes appear to recover well from long-haul travel; however, it is unknown if this interferes with training and competition performance.
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20
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An on-road examination of daytime and evening driving on rural roads: physiological, subjective, eye gaze, and driving performance outcomes. Atten Percept Psychophys 2022; 84:418-426. [PMID: 34984650 DOI: 10.3758/s13414-021-02424-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 11/08/2022]
Abstract
Experiencing sleepiness when driving is associated with increased crash risk. An increasing number of studies have examined on-road driver sleepiness; however, these studies typically assess the effect of sleepiness during the late night or early morning hours when sleep pressure is approaching its greatest. An on-road driving study was performed to assess how a range of physiological and sleepiness measures are impacted when driving during the daytime and evening when moderate sleepiness is experienced. In total, 27 participants (14 women and 13 men) completed a driving session in a rural town lasting approximately 60 minutes, while physiological sleepiness (heart rate variability), subjective sleepiness, eye tracking data, vehicle kinematic data and GPS speed data were recorded. Daytime driving sessions began at 12:00 or 14:00, with the evening sessions beginning at 19:30 or 20:30; only a subset of participants (n = 11) completing the evening sessions (daytime and evening order counterbalanced). The results suggest reductions in the horizontal and vertical scanning ranges occurred during the initial 40 minutes of driving for both daytime and evening sessions, but with evening sessions reductions in scanning ranges occurred across the entire driving session. Moreover, during evening driving there was an increase in physiological and subjective sleepiness levels. The results demonstrate meaningful increases in sleepiness and reductions in eye scanning when driving during both the daytime and particularly in the evening. Thus, drivers need to remain vigilant when driving during the daytime and the evening.
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21
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Luo X, Ru T, Chen Q, Hsiao FC, Hung CS, Yang CM, Zhou G. Temporal Dynamics of Subjective and Objective Alertness During Exposure to Bright Light in the Afternoon for 5 h. Front Physiol 2021; 12:771605. [PMID: 34950050 PMCID: PMC8691749 DOI: 10.3389/fphys.2021.771605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/08/2021] [Indexed: 11/22/2022] Open
Abstract
Light can induce an alertness response in humans. The effects of exposure to bright light vs. dim light on the levels of alertness during the day, especially in the afternoon, as reported in the literature, are inconsistent. This study employed a multiple measurement strategy to explore the temporal variations in the effects of exposure to bright light vs. regular office light (1,200 lx vs. 200 lx at eye level, 6,500 K) on the alertness of participants for 5 h in the afternoon. In this study, 20 healthy adults (11 female; mean age 23.25 ± 2.3 years) underwent the Karolinska sleepiness scale (KSS), the auditory psychomotor vigilance test (PVT), and the waking electroencephalogram (EEG) test for two levels of light intervention. The results yielded a relatively lower relative delta power and a relatively higher beta power for the 1,200 lx condition in comparison with the 200 lx condition. However, the light conditions elicited no statistically significant differences in the KSS scores and performance with respect to the PVT. The results suggested that exposure to bright light for 5 h in the afternoon could enhance physiological arousal while exerting insignificant effects on subjective feelings and performance abilities relating to the alertness of the participants.
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Affiliation(s)
- Xue Luo
- School of Psychology, South China Normal University, Guangzhou, China
| | - Taotao Ru
- Lab of Light and Physiopsychological Health, National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Optical Information Materials and Technology and Institute of Electronic Paper Displays, South China Normal University, South China Academy of Advanced Optoelectronics, Guangzhou, China
| | - Qingwei Chen
- Lab of Light and Physiopsychological Health, National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Optical Information Materials and Technology and Institute of Electronic Paper Displays, South China Normal University, South China Academy of Advanced Optoelectronics, Guangzhou, China
| | - Fan-Chi Hsiao
- Department of Counseling and Industrial/Organizational Psychology, Ming Chuan University, Taoyuan, Taiwan
| | - Ching-Sui Hung
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Chien-Ming Yang
- Department of Psychology, National Chengchi University, Taipei, Taiwan.,The Research Center for Mind, Brain, and Learning, National Chengchi University, Taipei, Taiwan
| | - Guofu Zhou
- Lab of Light and Physiopsychological Health, National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Optical Information Materials and Technology and Institute of Electronic Paper Displays, South China Normal University, South China Academy of Advanced Optoelectronics, Guangzhou, China
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22
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Ropponen A, Koskinen A, Puttonen S, Ervasti J, Kivimäki M, Oksanen T, Härmä M, Karhula K. Association of working hour characteristics and on-call work with risk of short sickness absence among hospital physicians: A longitudinal cohort study. Chronobiol Int 2021; 39:233-240. [PMID: 34724854 DOI: 10.1080/07420528.2021.1993238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Physicians often work long hours and on-call shifts, which may expose them to circadian misalignment and negative health outcomes. However, few studies have examined whether these working hour characteristics, ascertained using objective working hour records, are associated with the physicians' risk of sickness absence. We investigated the associations of 14 characteristics of payroll-based working hours and on-call work with the risk of short sickness absence among hospital physicians. In this cohort study, 2845 physicians from six Finnish hospital districts were linked to electronic payroll-based records of daily working hours, on-call duty and short (1-3 days) sickness absence between 2005 and 2019. A case-crossover design was applied using conditional logistic regression with the 28 day case and control windows to estimate odds ratios (ORs) and 95% confidence intervals (CI) for short sickness absence. After controlling for weekly working hours and the number of normal (≤12 h) shifts, a higher number of long (>12 h) shifts (ORs for ≥5 versus none: 2.54, 95% CI 1.68-3.84), very long (>24 h) shifts (ORs for ≥5 versus none: 2.62, 95%CI 1.61-4.27), and on-call shifts (OR for ≥5 versus none: 2.15, 95% CI 1.44-3.21) and a higher number of short (<11 h) shift intervals (OR for ≥5 versus none: 12.61, 95% CI 8.88-17.90) were all associated with the increased risk of short sickness absence. These associations did not differ between male and female physicians or between age groups. To conclude, the findings from objective working hour records show that long work shifts, on-call shifts and short shift intervals are related to the risk of short (1-3 days) sickness absence among hospital physicians.
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Affiliation(s)
- Annina Ropponen
- Finnish Institute of Occupational Health, Helsinki, Finland.,Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland.,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Tuula Oksanen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Kati Karhula
- Finnish Institute of Occupational Health, Helsinki, Finland
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Martyn J, Grabias K, Chmiel Z. Do Polish Nurses Have a Problem with Sleepiness during the Epidemiological Threat of the SARS-CoV-2 Virus? INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021; 58:469580211022909. [PMID: 34176343 PMCID: PMC8236762 DOI: 10.1177/00469580211022909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Nurses may experience cumulative sleep deprivation in the current epidemiological situation, which is the COVID-19 disease. Lack of rest leads to decreased concentration. The research topic is important for improving patient safety in hospitals. Assessment and analysis of the level of sleepiness of nurses after 3 consecutive night shifts and its impact on functioning in social life. The study adopted the diagnostic survey method, which was conducted using a survey technique. The questionnaire consisted of 3 parts: personal particulars, the survey and the Karolinska Sleepiness Scale (KSS) version A. After the research, 164 correctly completed questionnaires were obtained. The level of somnolence in individual measurements after a night shift significantly increased among the nurses examined (P < .0001). Respondents who felt a higher level of drowsiness after a night shift thought that their work definitely influenced contact with their friends or family and had difficulty in performing household duties. There is no statistically significant relationship between the level of sleepiness and sociodemographic factors. After each night shift, the level of drowsiness in nurses increases. This may result in reduced alertness and attention levels on subsequent working days. Shift work has negative consequences in the form of depleted personal life. Further research into the effects of insufficient sleep among nurses should be conducted. This may be necessary for patient safety in healthcare centers. The awareness on the subject of healthy sleep among shift nurses should be raised. It is advisable to conduct research in order to assess the effectiveness of various therapies in dealing with sleep disorders among shift nurses. The interventions taken should be adapted to the current epidemiological situation, which is the COVID-19 disease.
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Affiliation(s)
- Julia Martyn
- Medical College of Rzeszów University, Rzeszów, Poland
| | - Kamil Grabias
- Chopin Clinical Provincial Hospital No. 1 in Rzeszów, Rzeszów, Poland
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24
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Bougard C, VanBeers P, Sauvet F, Drogou C, Guillard M, Dorey R, Gomez-Merino D, Dauguet J, Takillah S, Espié S, Chennaoui M, Léger D. Motorcycling performance and sleepiness during an extended ride on a dynamic simulator: relationship with stress biomarkers. Physiol Meas 2020; 41:104004. [PMID: 33164915 DOI: 10.1088/1361-6579/abb75e] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Powered two-wheelers (PTW) make up a large proportion of fatal accidents. The aim of this study was to investigate the effects of time-of-day and total sleep deprivation (SD) on simulated motorcycling performance during extended riding sessions (60 min), while evaluating stress mechanisms. APPROACH A total of 16 healthy males participated in four simulated motorcycling sessions at 07:00, 11:00, 15:00 and 19:00, including city (8 min), country (2 min) and highway pathways (40 min), after a normal night of sleep and after total SD (30 h), in a randomized counterbalanced order. The recorded motorcycle parameters included: variation of lateral position, number of inappropriate line crossings (ILC), falls, riding errors, speed and speed limit violations. Subject parameters included the number of microsleeps in each pathway, the number of lapses during the 3-min psychomotor vigilance task (PVT-Brief version), and the Karolinska sleepiness scale (KSS) score. Saliva samples were used to assess cortisol (sC), α-amylase (sAA), and chromogranin-A (sCgA). ANOVAs and Pearson's correlation analysis were performed between these variables. MAIN RESULTS Most parameters were influenced by an interaction effect between 'Motorcycling pathways' × 'SD' (speed (p < 0.05), legal speed violations (p < 0.01), variation of lateral position (p < 0.001), falls (p < 0.001), EEG-microsleeps (p < 005)). An interaction effect between 'SD' × 'Time-of-day' influenced the number of ILCs (p < 0.01), sC (p < 0.05) and sCgA (p < 0.05) levels. SD affected KSS scores (p < 0.001) and PVT lapses (p < 0.05). The highest disturbances were associated with highway motorcycling simulation. SIGNIFICANCE Sleepiness due to circadian or SD and fatigue effects significantly affect riding and increase the risks involved with PTWs. The activation of both stress systems seems not sufficient to alleviate these deleterious effects.
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Affiliation(s)
- C Bougard
- French Armed Forces Biomedical Research Institute (IRBA), Fatigue and Vigilance Unit, Brétigny sur Orge, France. Université de Paris, VIFASOM EA 7330, Vigilance Fatigue Sommeil et Santé Publique, Paris, France. GroupePSA, Centre technique de Vélizy, Vélizy-Villacoublay, Cedex, France
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25
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Sleepiness, sleep duration, and human social activity: An investigation into bidirectionality using longitudinal time-use data. Proc Natl Acad Sci U S A 2020; 117:21209-21217. [PMID: 32817530 DOI: 10.1073/pnas.2004535117] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Daytime sleepiness impairs cognitive ability, but recent evidence suggests it is also an important driver of human motivation and behavior. We aimed to investigate the relationship between sleepiness and a behavior strongly associated with better health: social activity. We additionally aimed to investigate whether a key driver of sleepiness, sleep duration, had a similar relationship with social activity. For these questions, we considered bidirectionality, time of day, and differences between workdays and days off. Over 3 wk, 641 working adults logged their behavior every 30 min, completed a sleepiness scale every 3 h, and filled a sleep diary every morning (rendering >292,000 activity and >70,000 sleepiness datapoints). Using generalized additive mixed-effect models, we analyzed potential nonlinear relationships between sleepiness/sleep duration and social activity. Greater sleepiness predicted a substantial decrease in the probability of social activity (odds ratio 95% CI = 0.34 to 0.35 for days off), as well as a decreased duration of such activity when it did occur. These associations appear especially robust on days off and in the evenings. Social duration moderated the typical time-of-day pattern of sleepiness, with, for example, extended evening socializing associated with lower sleepiness. Sleep duration did not robustly predict next-day social activity. However, extensive social activity (>5 h) predicted up to 30 min shorter subsequent sleep duration. These results indicate that sleepiness is a strong predictor of voluntary decreases in social contact. It is possible that bouts of sleepiness lead to social withdrawal and loneliness, both risk factors for mental and physical ill health.
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Ropponen A, Koskinen A, Puttonen S, Härmä M. A case‐crossover study of age group differences in objective working‐hour characteristics and short sickness absence. J Nurs Manag 2020; 28:787-796. [DOI: 10.1111/jonm.12992] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/27/2020] [Accepted: 03/01/2020] [Indexed: 01/08/2023]
Affiliation(s)
| | - Aki Koskinen
- Finnish Institute of Occupational Health Helsinki Finland
| | | | - Mikko Härmä
- Finnish Institute of Occupational Health Helsinki Finland
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27
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Prospective relationships of mentally passive sedentary behaviors with depression: Mediation by sleep problems. J Affect Disord 2020; 265:538-544. [PMID: 31784118 DOI: 10.1016/j.jad.2019.11.088] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 09/13/2019] [Accepted: 11/12/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND As distinct from mentally-active sedentary behaviors (e.g. reading), passive sedentary behaviors (e.g. TV-viewing) have been linked to a higher risk of depression, but the underlying mechanisms are unclear. We examined the potential mediating role of sleep problems in prospective relationships of passive sedentary behaviors with major depressive disorder (MDD). METHOD In 1997, 43 863 adults were surveyed and responses linked to clinician diagnoses of MDD until 2010. The questionnaire included items on sedentary behavior and sleep problems (Karolinska Sleep Questionnaire). Cox proportional hazard models and the 'counterfactual approach' were used to identify potential mediating effects of sleep problems in the association of passive sedentary behavior and MDD. RESULTS Of the total sample, 3,065 (7.6%) were excluded for having indications of depression at baseline. Of 33,116 participants with complete data (mean age = 51.3 years, SD = 15.7, 64% female); 472 (1.4%) incident cases of MDD were identified during the 13-year follow-up. In Cox regression analyses, higher durations of passive sedentary behavior (≥3 h/day versus <3 h/day) were associated with greater hazards of developing MDD (HR = 1.27; 95% CI = 1.01, 1.58). This relationship remained after adjusting for confounders (HR = 1.29; 95% CI = 1.03, 1.63). Adding sleep problems into the analysis significantly attenuated these relationships (HR = 1.25; 95% CI = 0.99, 1.57). The excess MDD relative risk of passive sedentary behaviors due to sleep problems was statistically significant. LIMITATIONS Measures of sedentary behavior, physical activity and sleep were self-reported. CONCLUSION Sleep problems appear to mediate detrimental associations of passive sedentary behavior with depression. Findings require further confirmation using objective measures.
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28
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Åkerstedt T, Lekander M, Nilsonne G, Tamm S, d'Onofrio P, Kecklund G, Fischer H, Schwarz J, Petrovic P, Månsson KNT. Gray Matter Volume Correlates of Sleepiness: A Voxel-Based Morphometry Study in Younger and Older Adults. Nat Sci Sleep 2020; 12:289-298. [PMID: 32547279 PMCID: PMC7247733 DOI: 10.2147/nss.s240493] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 04/14/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Subjectively experienced sleepiness is a problem in society, possibly linked with gray matter (GM) volume. Given a different sleep pattern, aging may affect such associations, possibly due to shrinking brain volume. PURPOSE The purpose of the present study was to investigate the association between subjectively rated sleepiness and GM volume in thalamus, insula, hippocampus, and orbitofrontal cortex of young and older adults, after a normal night's sleep. METHODS Eighty-four healthy individuals participated (46 aged 20-30 years, and 38 aged 65-75 years). Morphological brain data were collected in a 3T magnetic resonance imaging (MRI) scanner. Sleepiness was rated multiple times during the imaging sessions. RESULTS In older, relative to younger, adults, clusters within bilateral mid-anterior insular cortex and right thalamus were negatively associated with sleepiness. Adjustment for the immediately preceding total sleep time eliminated the significant associations. CONCLUSION Self-rated momentary sleepiness in a monotonous situation appears to be negatively associated with GM volume in clusters within both thalamus and insula in older individuals, and total sleep time seems to play a role in this association. Possibly, this suggests that larger GM volume in these clusters may be protective against sleepiness in older individuals. This notion needs confirmation in further studies.
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Affiliation(s)
- Torbjörn Åkerstedt
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Mats Lekander
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gustav Nilsonne
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Sandra Tamm
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Paolo d'Onofrio
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Göran Kecklund
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Håkan Fischer
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Johanna Schwarz
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Predrag Petrovic
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kristoffer N T Månsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany.,Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany
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29
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De Nobrega AK, Luz KV, Lyons LC. Resetting the Aging Clock: Implications for Managing Age-Related Diseases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1260:193-265. [PMID: 32304036 DOI: 10.1007/978-3-030-42667-5_9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Worldwide, individuals are living longer due to medical and scientific advances, increased availability of medical care and changes in public health policies. Consequently, increasing attention has been focused on managing chronic conditions and age-related diseases to ensure healthy aging. The endogenous circadian system regulates molecular, physiological and behavioral rhythms orchestrating functional coordination and processes across tissues and organs. Circadian disruption or desynchronization of circadian oscillators increases disease risk and appears to accelerate aging. Reciprocally, aging weakens circadian function aggravating age-related diseases and pathologies. In this review, we summarize the molecular composition and structural organization of the circadian system in mammals and humans, and evaluate the technological and societal factors contributing to the increasing incidence of circadian disorders. Furthermore, we discuss the adverse effects of circadian dysfunction on aging and longevity and the bidirectional interactions through which aging affects circadian function using examples from mammalian research models and humans. Additionally, we review promising methods for managing healthy aging through behavioral and pharmacological reinforcement of the circadian system. Understanding age-related changes in the circadian clock and minimizing circadian dysfunction may be crucial components to promote healthy aging.
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Affiliation(s)
- Aliza K De Nobrega
- Department of Biological Science, Program in Neuroscience, Florida State University, Tallahassee, FL, USA
| | - Kristine V Luz
- Department of Biological Science, Program in Neuroscience, Florida State University, Tallahassee, FL, USA
| | - Lisa C Lyons
- Department of Biological Science, Program in Neuroscience, Florida State University, Tallahassee, FL, USA.
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30
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Block VJ, Meyer AH, Miché M, Mikoteit T, Hoyer J, Imboden C, Bader K, Hatzinger M, Lieb R, Gloster AT. The effect of anticipatory stress and openness and engagement on subsequently perceived sleep quality-An Experience Sampling Method study. J Sleep Res 2019; 29:e12957. [PMID: 31850590 DOI: 10.1111/jsr.12957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/30/2019] [Accepted: 11/11/2019] [Indexed: 11/29/2022]
Abstract
High stress levels can influence sleep quality negatively. If this also applies to anticipatory stress is poorly documented, however. Across insomnia severity levels, this study examined participants' evening levels of (a) anticipatory stress and (b) their skills hypothesized to downregulate the impact of stress, namely openness to internal experiences and continuous engagement in meaningful activities (openness and engagement) and their association with the quality of the subsequent night's sleep. The moderating role of insomnia severity was also tested. We used a quasi-experimental longitudinal design with Experience Sampling Method using smartphones over the course of 1 week (3,976 assessments; 93.2% of prompted queries). Participants recorded their sleep quality, anticipatory stress, and openness and engagement within their daily context. Participants included in the study were diagnosed with major depressive disorder (n = 118), social phobia (n = 47) or belonged to the control group (n = 119). Both anticipatory stress and openness and engagement predicted subsequent sleep quality. Diagnostic group was associated with overall sleep quality, but did not interact with the predictors. These findings were invariant across levels of self-reported insomnia severity. Furthermore, openness and engagement and anticipatory stress did not interact in their effect on sleep quality. The results suggest that both stress reduction and increased openness and engagement are associated with improved subjective sleep quality on a day to day basis, regardless of insomnia severity. Targeting these variables may help improve sleep quality. Future research should disentangle the effects of openness and engagement on anticipatory stress.
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Affiliation(s)
- Victoria J Block
- Division of Clinical Psychology and Intervention Science, Department of Psychology, University of Basel, Basel, Switzerland
| | - Andrea H Meyer
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Marcel Miché
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Thorsten Mikoteit
- Center for Affective, Stress and Sleep Disorders, University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Jürgen Hoyer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Christian Imboden
- Psychiatric Services Solothurn, Solothurn Hospital Group, Solothurn, Switzerland.,Privatklinik Wyss, Münchenbuchsee, Switzerland
| | - Klaus Bader
- Center for Specialized Psychotherapy, University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Martin Hatzinger
- Psychiatric Services Solothurn, Solothurn Hospital Group, Solothurn, Switzerland.,University Psychiatric Clinics (UPK), Psychiatric Services, University of Basel, Basel, Switzerland
| | - Roselind Lieb
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Andrew T Gloster
- Division of Clinical Psychology and Intervention Science, Department of Psychology, University of Basel, Basel, Switzerland
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31
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Daytime sleepiness in relation to gender and premenstrual symptoms in a sample of Japanese college students. Sleep Biol Rhythms 2019. [DOI: 10.1007/s41105-019-00236-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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32
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Lok R, van Koningsveld MJ, Gordijn MCM, Beersma DGM, Hut RA. Daytime melatonin and light independently affect human alertness and body temperature. J Pineal Res 2019; 67:e12583. [PMID: 31033013 PMCID: PMC6767594 DOI: 10.1111/jpi.12583] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 04/17/2019] [Accepted: 04/19/2019] [Indexed: 12/01/2022]
Abstract
Light significantly improves alertness during the night (Cajochen, Sleep Med Rev, 11, 2007 and 453; Ruger et al., AJP Regul Integr Comp Physiol, 290, 2005 and R1413), but results are less conclusive at daytime (Lok et al., J Biol Rhythms, 33, 2018 and 589). Melatonin and core body temperature levels at those times of day may contribute to differences in alerting effects of light. In this experiment, the combined effect of daytime exogenous melatonin administration and light intensity on alertness, body temperature, and skin temperature was studied. The goal was to assess whether (a) alerting effects of light are melatonin dependent, (b) soporific effects of melatonin are mediated via the thermoregulatory system, and (c) light can improve alertness after melatonin-induced sleepiness during daytime. 10 subjects (5 females, 5 males) received melatonin (5 mg) in dim (10 lux) and, on a separate occasion, in bright polychromatic white light (2000 lux). In addition, they received placebo both under dim and bright light conditions. Subjects participated in all four conditions in a balanced order, yielding a balanced within-subject design, lasting from noon to 04:00 pm. Alertness and performance were assessed half hourly, while body temperature and skin temperature were measured continuously. Saliva samples to detect melatonin concentrations were collected half hourly. Melatonin administration increased melatonin concentrations in all subjects. Subjective sleepiness and distal skin temperature increased after melatonin ingestion. Bright light exposure after melatonin administration did not change subjective alertness scores, but body temperature and proximal skin temperature increased, while distal skin temperature decreased. Light exposure did not significantly affect these parameters in the placebo condition. These results indicate that (a) exogenous melatonin administration during daytime increases subjective sleepiness, confirming a role for melatonin in sleepiness regulation, (b) bright light exposure after melatonin ingestion significantly affected thermoregulatory parameters without altering subjective sleepiness, therefore temperature changes seem nonessential for melatonin-induced sleepiness, (c) subjective sleepiness was increased by melatonin ingestion, but bright light administration was not able to improve melatonin-induced sleepiness feelings nor performance. Other (physiological) factors may therefore contribute to differences in alerting effects of light during daytime and nighttime.
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Affiliation(s)
- Renske Lok
- Chronobiology Unit, Groningen Institute for Evolutionary Life SciencesUniversity of GroningenGroningenThe Netherlands
| | - Minke J. van Koningsveld
- Chronobiology Unit, Groningen Institute for Evolutionary Life SciencesUniversity of GroningenGroningenThe Netherlands
| | - Marijke C. M. Gordijn
- Chronobiology Unit, Groningen Institute for Evolutionary Life SciencesUniversity of GroningenGroningenThe Netherlands
- Chrono@WorkGroningenThe Netherlands
| | - Domien G. M. Beersma
- Chronobiology Unit, Groningen Institute for Evolutionary Life SciencesUniversity of GroningenGroningenThe Netherlands
| | - Roelof A. Hut
- Chronobiology Unit, Groningen Institute for Evolutionary Life SciencesUniversity of GroningenGroningenThe Netherlands
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33
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Matsuoka E, Saji M, Kanemoto K. Daytime sleepiness in epilepsy patients with special attention to traffic accidents. Seizure 2019; 69:279-282. [DOI: 10.1016/j.seizure.2019.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/19/2019] [Accepted: 04/08/2019] [Indexed: 01/24/2023] Open
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34
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Riethmeister V, Matthews RW, Dawson D, de Boer MR, Brouwer S, Bültmann U. Time-of-day and days-on-shift predict increased fatigue over two-week offshore day-shifts. APPLIED ERGONOMICS 2019; 78:157-163. [PMID: 31046947 DOI: 10.1016/j.apergo.2019.02.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 02/07/2019] [Accepted: 02/27/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the accumulation of fatigue over a two-week offshore period. In particular, the effects of (1) time-of-day and days-on-shift as well as (2) acute and chronic sleep loss on the rate at which fatigue accumulates were investigated. METHODS 42 day-shift offshore workers were examined. Fatigue was measured using pre- and post-shift scores on the Karolinska Sleepiness Scale (KSS). Total sleep time was measured using actigraphy (Motionwatch8, Camntech). Data was analyzed using a linear mixed model analyses. RESULTS Average sleep loss per night was 92 min (95%CI: 89.6-94.0; p < .001). Mean cumulative sleep loss across the study was 21:20hrs (SD = 08:10hrs) over the 14 days. Chronic sleep loss was significantly related to a modest increase in sleepiness (KSS) across the shift (95%CI: 0.01-0.17; p = .020) and in post-shift scores (95%CI:.07-0.19; p < .001). Time-of-day (95%CI: 0.63 to -0.01; p = .042) and days-on-shift (95%CI: 0.03-0.08; p < .001) as well as their interaction (95%CI: 0.08 to -0.00; p = .027) influenced the rate at which fatigue accumulated over a two-week offshore period. CONCLUSIONS Pre- and post-shift fatigue accumulate in different ways over the two-week offshore period. The accumulation of post-shift fatigue scores was positively related to successive days-on-shift and chronic sleep loss. Our results suggest that prolonging offshore periods will likely result in elevated fatigue risk. Accumulating fatigue and sleep loss over two-week offshore periods should be considered in fatigue risk management plans and systems.
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Affiliation(s)
- V Riethmeister
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands.
| | - R W Matthews
- Karolinska Institute, Department of Clinical Neuroscience, Nobels väg 9, 171 77, Stockholm, Sweden; Stress Research Institute, Stockholm University, Frescati Hagväg 16 A, SE-106 91, Stockholm, Sweden; Appleton Institute for Behavioural Science, Central Queensland University Australia, Adelaide Campus, 44 Greenhill Road, Wayville, SA, 5034, Australia.
| | - D Dawson
- Appleton Institute for Behavioural Science, Central Queensland University Australia, Adelaide Campus, 44 Greenhill Road, Wayville, SA, 5034, Australia.
| | - M R de Boer
- Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, Department of Health Sciences, Faculty of Earth and Life Sciences, Amsterdam, the Netherlands.
| | - S Brouwer
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands.
| | - U Bültmann
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands.
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35
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Wang F, Boros S. The effect of physical activity on sleep quality: a systematic review. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2019.1623314] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Feifei Wang
- Institute of Health Promotion & Sport Sciences, Faculty of Education & Psychology, Eötvös Loránd University (ELTE), Budapest, Hungary
| | - Szilvia Boros
- Institute of Health Promotion & Sport Sciences, Faculty of Education & Psychology, Eötvös Loránd University (ELTE), Budapest, Hungary
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Basner M, Asch DA, Shea JA, Bellini LM, Carlin M, Ecker AJ, Malone SK, Desai SV, Sternberg AL, Tonascia J, Shade DM, Katz JT, Bates DW, Even-Shoshan O, Silber JH, Small DS, Volpp KG, Mott CG, Coats S, Mollicone DJ, Dinges DF. Sleep and Alertness in a Duty-Hour Flexibility Trial in Internal Medicine. N Engl J Med 2019; 380:915-923. [PMID: 30855741 PMCID: PMC6457111 DOI: 10.1056/nejmoa1810641] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND A purpose of duty-hour regulations is to reduce sleep deprivation in medical trainees, but their effects on sleep, sleepiness, and alertness are largely unknown. METHODS We randomly assigned 63 internal-medicine residency programs in the United States to follow either standard 2011 duty-hour policies or flexible policies that maintained an 80-hour workweek without limits on shift length or mandatory time off between shifts. Sleep duration and morning sleepiness and alertness were compared between the two groups by means of a noninferiority design, with outcome measures including sleep duration measured with actigraphy, the Karolinska Sleepiness Scale (with scores ranging from 1 [extremely alert] to 9 [extremely sleepy, fighting sleep]), and a brief computerized Psychomotor Vigilance Test (PVT-B), with long response times (lapses) indicating reduced alertness. RESULTS Data were obtained over a period of 14 days for 205 interns at six flexible programs and 193 interns at six standard programs. The average sleep time per 24 hours was 6.85 hours (95% confidence interval [CI], 6.61 to 7.10) among those in flexible programs and 7.03 hours (95% CI, 6.78 to 7.27) among those in standard programs. Sleep duration in flexible programs was noninferior to that in standard programs (between-group difference, -0.17 hours per 24 hours; one-sided lower limit of the 95% confidence interval, -0.45 hours; noninferiority margin, -0.5 hours; P = 0.02 for noninferiority), as was the score on the Karolinska Sleepiness Scale (between-group difference, 0.12 points; one-sided upper limit of the 95% confidence interval, 0.31 points; noninferiority margin, 1 point; P<0.001). Noninferiority was not established for alertness according to the PVT-B (between-group difference, -0.3 lapses; one-sided upper limit of the 95% confidence interval, 1.6 lapses; noninferiority margin, 1 lapse; P = 0.10). CONCLUSIONS This noninferiority trial showed no more chronic sleep loss or sleepiness across trial days among interns in flexible programs than among those in standard programs. Noninferiority of the flexible group for alertness was not established. (Funded by the National Heart, Lung, and Blood Institute and American Council for Graduate Medical Education; ClinicalTrials.gov number, NCT02274818.).
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Affiliation(s)
- Mathias Basner
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - David A Asch
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Judy A Shea
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Lisa M Bellini
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Michele Carlin
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Adrian J Ecker
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Susan K Malone
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Sanjay V Desai
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Alice L Sternberg
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - James Tonascia
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - David M Shade
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Joel T Katz
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - David W Bates
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Orit Even-Shoshan
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Jeffrey H Silber
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Dylan S Small
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Kevin G Volpp
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Christopher G Mott
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Sara Coats
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - Daniel J Mollicone
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
| | - David F Dinges
- From the University of Pennsylvania (M.B., D.A.A., J.A.S., L.M.B., M.C., A.J.E., S.K.M., D.S.S., K.G.V., D.F.D.), Corporal Michael J. Crescenz Veterans Affairs Medical Center (D.A.A., K.G.V.), Children's Hospital of Philadelphia (O.E.-S., J.H.S.), and Pulsar Informatics (C.G.M., S.C., D.J.M.) - all in Philadelphia; Johns Hopkins University, Baltimore (S.V.D., A.L.S., J.T., D.M.S.); and Brigham and Women's Hospital, Boston (J.T.K., D.W.B.)
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Dijk DJ, Landolt HP. Sleep Physiology, Circadian Rhythms, Waking Performance and the Development of Sleep-Wake Therapeutics. Handb Exp Pharmacol 2019; 253:441-481. [PMID: 31254050 DOI: 10.1007/164_2019_243] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Disturbances of the sleep-wake cycle are highly prevalent and diverse. The aetiology of some sleep disorders, such as circadian rhythm sleep-wake disorders, is understood at the conceptual level of the circadian and homeostatic regulation of sleep and in part at a mechanistic level. Other disorders such as insomnia are more difficult to relate to sleep regulatory mechanisms or sleep physiology. To further our understanding of sleep-wake disorders and the potential of novel therapeutics, we discuss recent findings on the neurobiology of sleep regulation and circadian rhythmicity and its relation with the subjective experience of sleep and the quality of wakefulness. Sleep continuity and to some extent REM sleep emerge as determinants of subjective sleep quality and waking performance. The effects of insufficient sleep primarily concern subjective and objective sleepiness as well as vigilant attention, whereas performance on higher cognitive functions appears to be better preserved albeit at the cost of increased effort. We discuss age-related, sex and other trait-like differences in sleep physiology and sleep need and compare the effects of existing pharmacological and non-pharmacological sleep- and wake-promoting treatments. Successful non-pharmacological approaches such as sleep restriction for insomnia and light and melatonin treatment for circadian rhythm sleep disorders target processes such as sleep homeostasis or circadian rhythmicity. Most pharmacological treatments of sleep disorders target specific signalling pathways with no well-established role in either sleep homeostasis or circadian rhythmicity. Pharmacological sleep therapeutics induce changes in sleep structure and the sleep EEG which are specific to the mechanism of action of the drug. Sleep- and wake-promoting therapeutics often induce residual effects on waking performance and sleep, respectively. The need for novel therapeutic approaches continues not at least because of the societal demand to sleep and be awake out of synchrony with the natural light-dark cycle, the high prevalence of sleep-wake disturbances in mental health disorders and in neurodegeneration. Novel approaches, which will provide a more comprehensive description of sleep and allow for large-scale sleep and circadian physiology studies in the home environment, hold promise for continued improvement of therapeutics for disturbances of sleep, circadian rhythms and waking performance.
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Affiliation(s)
- Derk-Jan Dijk
- Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
| | - Hans-Peter Landolt
- Institute of Pharmacology and Toxicology, Sleep and Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland
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Ropponen A, Koskinen A, Puttonen S, Härmä M. Exposure to working-hour characteristics and short sickness absence in hospital workers: A case-crossover study using objective data. Int J Nurs Stud 2018; 91:14-21. [PMID: 30665013 DOI: 10.1016/j.ijnurstu.2018.11.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 11/26/2018] [Accepted: 11/26/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Shift work characteristics, such as the number of night shifts or quick returns, are linked to disturbed sleep and greater work-life conflict, but little is known about their association with short sickness absences. Studies utilizing objective working-hour characteristic data can provide knowledge on specific shift work characteristics that may associate with sick leave. We investigated the association between working-hour characteristics in shift work and the incidence of short (1-3 days) sickness absences. PARTICIPANTS AND METHODS The individual-level data were collected from the employers' electronic working time records of the Finnish Public Sector study. The final analytical sample was restricted to the first incidence of short sickness absence (1-3 days) from January 1, 2008 to the end of 2015. We studied employees with shift work contracts (n = 12 156) and day work contracts (n = 6225). Of these, 89% were female workers, with a mean age of 37.1 years, and 12% worked part-time. We calculated type of shift (morning, day, evening, and night), quick returns (< 11 h between two work shifts), length of work shift and weekly working time. We utilized case-crossover study design to compare the working-hour characteristics of the 28 days preceding sickness absence (exposure window) and those of the 28 days before the exposure window (control window), using conditional logistic regression models for odds ratios with 95% Confidence Intervals (95%CI). RESULTS Exposure to ≥ 2, and especially ≥ 4 consecutive night shifts associated with an increased likelihood of short sickness absence (OR 1.24, 95%CI 1.12-1.38 and OR 1.54, 95%CI 1.10-2.15, respectively) among shift workers, whereas a high number (> 25%) of evening shifts and having ≥ 2 consecutive evening shifts associated with lower odds of sickness absence. Over 40-hour weeks (OR 1.29, 95%CI 1.20-1.39), over 48-hour weeks (OR 1.24, 95%CI 1.01-1.54) and quick returns (OR 1.02, 95%CI 1.01-1.02) increased the likelihood of sickness absence. Having only a few (0-1 or 2-3) quick returns over 28 days decreased the likelihood of sickness absence (ORs 0.46 and 0.67), whereas having ≥ 5 quick returns over 28 days increased it (OR 1.88, 95%CI 1.76-1.99). These associations were similar among both shift and day workers. CONCLUSIONS Long working hours, several consecutive night shifts and quick returns increase the risk of short sickness absence. These working-hour characteristics should be avoided in shift scheduling to minimize sickness absence and increased costs for the employer.
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Affiliation(s)
- Annina Ropponen
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki, Finland
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Lok R, Smolders KCHJ, Beersma DGM, de Kort YAW. Light, Alertness, and Alerting Effects of White Light: A Literature Overview. J Biol Rhythms 2018; 33:589-601. [PMID: 30191746 PMCID: PMC6236641 DOI: 10.1177/0748730418796443] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Light is known to elicit non-image-forming responses, such as effects on alertness. This has been reported especially during light exposure at night. Nighttime results might not be translatable to the day. This article aims to provide an overview of (1) neural mechanisms regulating alertness, (2) ways of measuring and quantifying alertness, and (3) the current literature specifically regarding effects of different intensities of white light on various measures and correlates of alertness during the daytime. In general, the present literature provides inconclusive results on alerting effects of the intensity of white light during daytime, particularly for objective measures and correlates of alertness. However, the various research paradigms employed in earlier studies differed substantially, and most studies tested only a limited set of lighting conditions. Therefore, the alerting potential of exposure to more intense white light should be investigated in a systematic, dose-dependent manner with multiple correlates of alertness and within one experimental paradigm over the course of day.
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Affiliation(s)
- Renske Lok
- Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
| | - Karin C H J Smolders
- Human-Technology Interaction, School of Innovation Sciences, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Domien G M Beersma
- Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
| | - Yvonne A W de Kort
- Human-Technology Interaction, School of Innovation Sciences, Eindhoven University of Technology, Eindhoven, the Netherlands
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Lok R, Woelders T, Gordijn MCM, Hut RA, Beersma DGM. White Light During Daytime Does Not Improve Alertness in Well-rested Individuals. J Biol Rhythms 2018; 33:637-648. [PMID: 30191761 PMCID: PMC6236585 DOI: 10.1177/0748730418796036] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Broad-spectrum light applied during the night has been shown to affect alertness in a
dose-dependent manner. The goal of this experiment was to investigate whether a similar
relationship could be established for light exposure during daytime. Fifty healthy
participants were subjected to a paradigm (0730-1730 h) in which they were intermittently
exposed to 1.5 h of dim light (<10 lux) and 1 h of experimental light (24-2000 lux).
The same intensity of experimental light was used throughout the day, resulting in groups
of 10 subjects per intensity. Alertness was assessed with subjective and multiple
objective measures. A significant effect of time of day was found in all parameters of
alertness (p < 0.05). Significant dose-response relationships between
light intensity and alertness during the day could be determined in a few of the
parameters of alertness at some times of the day; however, none survived correction for
multiple testing. We conclude that artificial light applied during daytime at intensities
up to 2000 lux does not elicit significant improvements in alertness in non-sleep-deprived
subjects.
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Affiliation(s)
- Renske Lok
- University of Groningen, Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, Groningen, the Netherlands
| | - Tom Woelders
- University of Groningen, Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, Groningen, the Netherlands
| | - Marijke C M Gordijn
- University of Groningen, Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, Groningen, the Netherlands.,Chrono@Work, Groningen, the Netherlands
| | - Roelof A Hut
- University of Groningen, Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, Groningen, the Netherlands
| | - Domien G M Beersma
- University of Groningen, Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, Groningen, the Netherlands
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Della Monica C, Johnsen S, Atzori G, Groeger JA, Dijk DJ. Rapid Eye Movement Sleep, Sleep Continuity and Slow Wave Sleep as Predictors of Cognition, Mood, and Subjective Sleep Quality in Healthy Men and Women, Aged 20-84 Years. Front Psychiatry 2018; 9:255. [PMID: 29988413 PMCID: PMC6024010 DOI: 10.3389/fpsyt.2018.00255] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/24/2018] [Indexed: 12/16/2022] Open
Abstract
Sleep and its sub-states are assumed to be important for brain function across the lifespan but which aspects of sleep associate with various aspects of cognition, mood and self-reported sleep quality has not yet been established in detail. Sleep was quantified by polysomnography, quantitative Electroencephalogram (EEG) analysis and self-report in 206 healthy men and women, aged 20-84 years, without sleep complaints. Waking brain function was quantified by five assessments scheduled across the day covering objectively assessed performance across cognitive domains including sustained attention and arousal, decision and response time, motor and sequence control, working memory, and executive function as well as self-reports of alertness, mood and affect. Controlled for age and sex, self-reported sleep quality was negatively associated with number of awakenings and positively associated with the duration of Rapid Eye Movement (REM) sleep, but no significant associations with Slow Wave Sleep (SWS) measures were observed. Controlling only for age showed that associations between objective and subjective sleep quality were much stronger in women than in men. Analysis of 51 performance measures demonstrated that, after controlling for age and sex, fewer awakenings and more REM sleep were associated significantly with better performance on the Goal Neglect task, which is a test of executive function. Factor analysis of the individual performance measures identified four latent variables labeled Mood/Arousal, Response Time, Accuracy, and Visual Perceptual Sensitivity. Whereas Mood/Arousal improved with age, Response Times became slower, while Accuracy and Visual perceptual sensitivity showed little change with age. After controlling for sex and age, nominally significant association between sleep and factor scores were observed such that Response Times were faster with more SWS, and Accuracy was reduced where individuals woke more often or had less REM sleep. These data identify a positive contribution of SWS to processing speed and in particular highlight the importance of sleep continuity and REM sleep for subjective sleep quality and performance accuracy across the adult lifespan. These findings warrant further investigation of the contribution of sleep continuity and REM sleep to brain function.
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Affiliation(s)
- Ciro Della Monica
- Surrey Clinical Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Sigurd Johnsen
- Surrey Clinical Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Giuseppe Atzori
- Surrey Clinical Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - John A Groeger
- Division of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Derk-Jan Dijk
- Surrey Clinical Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom.,Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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