Dissociation of Subjective and Objective Alertness During Prolonged Wakefulness

Sleep and Ultramarathon: Exploring Patterns, Strategies, and Repercussions of 1,154 Mountain Ultramarathons Finishers

BACKGROUND

Sleep and physical performance are strongly related and mutually influence each other. Athletes, particularly in disciplines like offshore sailing and ultra-endurance sports, often suffer from sleep deprivation due to factors like irregular training times, travel, and the extended duration of events like 100-mile mountain races. Despite growing interest in sleep's role in sports science, few studies have specifically investigated the sleep patterns of ultramarathon runners. This study aimed to investigate sleep patterns and sleep management strategies in ultramarathons, and the repercussions of sleep deprivation during and after races.

METHODS

This cross-sectional study using e-survey was conducted on 1154 runners from two ultramarathons (a 165 km race with 9,576 m positive elevation; 2018 finish time [23:18:48-66:04:00], and a 111 km race with 6,433 m elevation; [15:34:56 - 41:54:16]).

RESULTS

The results revealed that 58% of the runners reported implementing sleep management strategies before or during the race. Most runners began the race with some level of sleep debt (-50 min a week before the race). During the races, 77% of runners slept, with the cumulative sleep duration varying based on race duration and the number of nights spent on the race (76 min at 165 km and 27 min at 111 km). Short naps lasting less than 30 min were the most popular strategy. The prevalence of symptoms attributed to sleep deprivation during the race was high (80%), with reported falls and hallucinations. After the race, runners reported recovering a normal state of wakefulness relatively quickly (within two days); 22% believed that sleep deprivation during the race increased the risk of accidents in everyday life.

CONCLUSION

This study provides valuable insights into sleep patterns and strategies in ultramarathon running and emphasizes the importance of adequate sleep management for performance and post-race recovery.

Association Between EEG Microarousal During Nocturnal Sleep and Next-Day Selective Attention in Mild Sleep-Restricted Healthy Undergraduates

Purpose

To explore whether sleep electroencephalogram (EEG) microarousals of different standard durations predict daytime mood and attention performance in healthy individuals after mild sleep restriction.

Participants and Methods

Sixteen (nine female) healthy college students were recruited to examine the correlations between nocturnal EEG microarousals of different standard durations (≥3 s, ≥5 s, ≥7 s, ≥9 s) under mild sleep restriction (1.5 h) and the following morning's subjective alertness, mood, sustained attention, and selective attention task performance.

Results

Results revealed that mild sleep restriction significantly reduced subjective alertness and positive mood, while having no significant effect on negative mood, sustained attention and selective attention performance. The number of microarousals (≥5 s) was negatively associated with positive mood at 6:30. The number of microarousals was significantly and positively correlated with the response time difference value of disengagement component of the selective attention task at around 7:30 (≥5 s and ≥7 s) and 9:00 (≥5 s). The number of microarousals (≥7 s) was significantly and positively correlated with the inaccuracy difference value of orientation component of the selective attention task at around 9:00.

Conclusion

The number of EEG microarousals during sleep in healthy adults with mild sleep restriction was significantly and negatively related to their daytime positive affect while positively associated with the deterioration of disengagement and orientation of selective attention performance, but this link is dependent on the standard duration of microarousals, test time and the type of task.

A sleepless night disrupts the resolution of emotional conflicts: Behavioural and neural evidence

The present study aims to investigate the influence of 24-hr sleep deprivation on implicit emotion regulation using the emotional conflict task. Twenty-five healthy young adults completed a repeated-measures study protocol involving a night of at-home normal sleep control and a night of in-laboratory sleep deprivation. Prior to the experimental session, all participants wore an actigraph watch and completed the sleep diary. Following each condition, participants performed an emotional conflict task with electroencephalographic recordings. Emotional faces (fearful or happy) overlaid with words ("fear" or "happy") were used as stimuli creating congruent or incongruent trials, and participants were instructed to indicate whether the facial expression was happy or fearful. We measured the accuracy and reaction time on the emotional conflict task, as well as the mean amplitude of the P300 component of the event-related potential at CPz. At the behavioural level, sleep-deprived participants showed reduced alertness with overall longer reaction times and higher error rates. In addition, participants in the sleep deprivation condition made more errors when the current trial followed congruent trials compared with when it followed incongruent trials. At the neural level, P300 amplitude evoked under the sleep-deprived condition was significantly more positive compared with the normal sleep condition, and this effect interacted with previous-trial and current-trial congruency conditions, suggesting that participants used more attentional resources to resolve emotional conflicts when sleep deprived. Our study provided pioneering data demonstrating that sleep deprivation may impair the regulation of emotional processing in the absence of explicit instruction among emerging adults.

Occupation-Induced Fatigue and Impacts on Emergency First Responders: A Systematic Review

Fatigue in emergency first responders (EFRs) is known to affect performance abilities and safety outcomes for both patients and EFRs. The primary aim of this review was to determine the main contributors to occupation-induced fatigue in EFRs and its subsequent impacts. Following the PRIMSA checklist, academic databases (Medline, Embase, CINAHL, and SPORTDiscus) were searched using key terms with results subjected to inclusion and exclusion criteria. Populations of interest were firefighters, paramedics, or emergency call centre personnel. Of the 5633 records identified, 43 studies, which reported on 186 unique measures from a total population of 6373 participants, informed the review. Synthesis revealed fatigue was caused by lack of sleep during the shift and consistent poor sleep quality which negatively impacted cognitive function, alertness, and physical and mental health while increasing safety-compromising behaviours and injuries. Both subjective and objective assessments of fatigue are necessary for effective risk management in EFRs. EFRs that are consistently fatigued are at a greater risk of poor physical and mental health, reduced cognitive function, and increased injuries. No studies reported on fatigue in emergency call centre personnel, highlighting a literature gap. Funding was provided by the Australian Capital Territory Emergency Services Agency. Preregistration was filed in OSF: osf.io/26f3s.

Dissociable brainstem functional connectivity changes correlate with objective and subjective vigilance decline after total sleep deprivation in healthy male subjects

The maintenance of vigilance relies on the activation of the cerebral cortex by the arousal system centered on the brainstem. Previous studies have suggested that both objective and subjective vigilance are susceptible to sleep deprivation. This study aims to explore the alterations in brainstem arousal system functional connectivity (FC) and its involvement in these two types of vigilance decline following total sleep deprivation (TSD). Thirty-seven healthy male subjects underwent two counterbalanced resting-state fMRI scans, once in rested wakefulness (RW) and once after 36 h of TSD. The pontine tegmental area and caudal midbrain (PTA-cMidbrain), the core regions of the brainstem arousal system, were chosen as the seeds for FC analysis. The difference in PTA-cMidbrain FC between RW and TSD conditions was then investigated, as well as its associations with objective vigilance measured by psychomotor vigilance task (PVT) and subjective vigilance measured by Stanford Sleepiness Scale. The sleep-deprived subjects showed increased PTA-cMidbrain FC with the thalamus and cerebellum and decreased PTA-cMidbrain FC with the occipital, parietal, and sensorimotor regions. TSD-induced increases in PVT reaction time were negatively correlated with altered PTA-cMidbrain FC in the dorsolateral prefrontal cortex, extrastriate visual cortex, and precuneus. TSD-induced increases in subjective sleepiness were positively correlated with altered PTA-cMidbrain FC in default mode regions including the medial prefrontal cortex and precuneus. Our results suggest that different brainstem FC patterns underlie the objective and subjective vigilance declines induced by TSD.

Comprehensive detrimental effects of a simulated frequently shifting schedule on diurnal rhythms and vigilance

Accumulating data have demonstrated that shift work causes a disturbance in circadian rhythms, which is detrimental to physiology and performance. However, the detailed effects of shift work and especially the underlying mechanisms remain to be further investigated. Frequently shifting schedules are widely used in industries, e.g., maritime tasks, oil mining, and aviation. In this work, we investigated the physiological changes and vigilance of 12 subjects who lived on a 30-day frequent shift working schedule in a confined environment, which mimics the common maritime schedules. Elevated and decreased cortisol levels were observed at different stages during the shift, suggesting the occurrence of stress and fatigue. The results of the Karolinska Sleepiness Scale (KSS) indicate increased sleepiness and a changed pattern of the rhythmicity of sleepiness during the shift. The tests of the Psychomotor Vigilance Task (PVT) reveal that the shift led to a continuously decreasing alertness as the shift working schedule progressed, which is prevalently due to the increasingly slower reaction speed. The PVT time-out errors were significantly increased in the early period but decreased in the late period. In addition, we found recoupling of the correlations between multiple physiological and cognitive variables. For instance, heartbeat rate (HR) and breath rate (BR) showed moderate correlations in the control and early periods but little in the late period. Together, these results reveal substantial alterations in diurnal rhythms, affected vigilance and changed coupling of the correlations of diurnal rhythms, physiology and cognition caused by a shift schedule. Our findings may help in the recognition of the detrimental effects of such working schedules and provide clues for the development of potential mitigations.

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

STUDY OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSION

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