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Thieux M, Guyon A, Seugnet L, Franco P. Salivary α-amylase as a marker of sleep disorders: A theoretical review. Sleep Med Rev 2024; 74:101894. [PMID: 38157687 DOI: 10.1016/j.smrv.2023.101894] [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: 07/27/2023] [Revised: 12/04/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
Sleep disorders are commonplace in our modern societies. Specialized hospital departments are generally overloaded, and sleep assessment is an expensive process in terms of equipment, human resources, and time. Biomarkers would usefully complement current measures in the screening and follow-up of sleep disorders and their daytime repercussions. Among salivary markers, a growing body of literature suggests that salivary α-amylase (sAA) may be a cross-species marker of sleep debt. However, there is no consensus as to the direction of variation in sAA with sleep disorders. Herein, after describing the mechanisms of sAA secretion and its relationship with stress, studies assessing the relationship between sAA and sleep parameters are reviewed. Finally, the influence of confounding factors is discussed, along with methodological considerations, to better understand the fluctuations in sAA and facilitate future studies in the field.
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Affiliation(s)
- Marine Thieux
- Centre de Recherche en Neurosciences de Lyon (CRNL), INSERM, Lyon, France.
| | - Aurore Guyon
- Pediatric Sleep Unit and CRMR Narcolepsie-Hypersomnies Rares, Department of Pediatric Clinical Epileptology, Sleep Disorders and Functional Neurology, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France
| | - Laurent Seugnet
- Centre de Recherche en Neurosciences de Lyon (CRNL), INSERM, Lyon, France
| | - Patricia Franco
- Centre de Recherche en Neurosciences de Lyon (CRNL), INSERM, Lyon, France; Pediatric Sleep Unit and CRMR Narcolepsie-Hypersomnies Rares, Department of Pediatric Clinical Epileptology, Sleep Disorders and Functional Neurology, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France
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Fabries P, Gomez-Merino D, Sauvet F, Malgoyre A, Koulmann N, Chennaoui M. Sleep loss effects on physiological and cognitive responses to systemic environmental hypoxia. Front Physiol 2022; 13:1046166. [PMID: 36579023 PMCID: PMC9792101 DOI: 10.3389/fphys.2022.1046166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
In the course of their missions or training, alpinists, but also mountain combat forces and mountain security services, professional miners, aircrew, aircraft and glider pilots and helicopter crews are regularly exposed to altitude without oxygen supplementation. At altitude, humans are exposed to systemic environmental hypoxia induced by the decrease in barometric pressure (<1,013 hPa) which decreases the inspired partial pressure of oxygen (PIO2), while the oxygen fraction is constant (equal to approximately 20.9%). Effects of altitude on humans occur gradually and depend on the duration of exposure and the altitude level. From 1,500 m altitude (response threshold), several adaptive responses offset the effects of hypoxia, involving the respiratory and the cardiovascular systems, and the oxygen transport capacity of the blood. Fatigue and cognitive and sensory disorders are usually observed from 2,500 m (threshold of prolonged hypoxia). Above 3,500 m (the threshold for disorders), the effects are not completely compensated and maladaptive responses occur and individuals develop altitude headache or acute altitude illness [Acute Mountain Sickness (AMS)]. The magnitude of effects varies considerably between different physiological systems and exhibits significant inter-individual variability. In addition to comorbidities, the factors of vulnerability are still little known. They can be constitutive (genetic) or circumstantial (sleep deprivation, fatigue, speed of ascent.). In particular, sleep loss, a condition that is often encountered in real-life settings, could have an impact on the physiological and cognitive responses to hypoxia. In this review, we report the current state of knowledge on the impact of sleep loss on responses to environmental hypoxia in humans, with the aim of identifying possible consequences for AMS risk and cognition, as well as the value of behavioral and non-pharmacological countermeasures.
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Affiliation(s)
- Pierre Fabries
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (LBEPS), UMR, Université Paris-Saclay, IRBA, Evry-Courcouronnes, France,French Military Health Academy—Ecole du Val-de-Grâce, Place Alphonse Laveran, Paris, France,*Correspondence: Pierre Fabries,
| | - Danielle Gomez-Merino
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Vigilance Fatigue Sommeil et Santé Publique (VIFASOM) URP 7330, Université de Paris Cité, Paris, France
| | - Fabien Sauvet
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,French Military Health Academy—Ecole du Val-de-Grâce, Place Alphonse Laveran, Paris, France,Vigilance Fatigue Sommeil et Santé Publique (VIFASOM) URP 7330, Université de Paris Cité, Paris, France
| | - Alexandra Malgoyre
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (LBEPS), UMR, Université Paris-Saclay, IRBA, Evry-Courcouronnes, France
| | - Nathalie Koulmann
- Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (LBEPS), UMR, Université Paris-Saclay, IRBA, Evry-Courcouronnes, France,French Military Health Academy—Ecole du Val-de-Grâce, Place Alphonse Laveran, Paris, France
| | - Mounir Chennaoui
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Vigilance Fatigue Sommeil et Santé Publique (VIFASOM) URP 7330, Université de Paris Cité, Paris, France
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Thieux M, Guyon A, Herbillon V, Merle L, Lachaux JP, Plancoulaine S, Seugnet L, Franco P. Interest of the BLAST paradigm and salivary markers for the evaluation of sleepiness in drivers. Front Neurosci 2022; 16:991528. [PMID: 36161153 PMCID: PMC9490274 DOI: 10.3389/fnins.2022.991528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives Sleepiness is associated with decreased cognitive abilities and remains one of the main causes of fatal road accidents. The tools currently available to assess sleepiness, such as questionnaires, are subject to intra- and inter-individual variability, while multiple sleep latency tests are only feasible in few sleep laboratories. The main objective of this study was to explore new potential markers (neurocognitive, biological) to objectively assess sleepiness in drivers. Methods A total of 186 drivers (median age 44 years, range 20–74 years, 73% men, 14% obese) were included during a break at a highway service area, in the morning, while on the road for vacation. Questionnaires on sleepiness and sleep characteristics (habitual and on the night before travel), the Bron-Lyon Attention Stability Test (BLAST), and two salivary samples (α-amylase and oxalate) were collected. Associations between measures of sleepiness [Epworth Sleepiness Scale (ESS), and Stanford Sleepiness Scale (SSS)], sleep characteristics, neurocognitive, and biological markers were tested using regression models adjusted for confounding factors. Results The night before travel, 83% of the drivers reduced their sleep time and 30% slept 5 h or less. The higher the number of miles to be traveled, the higher the decrease, and the shorter the sleep time. The night before travel, 18 and 24% of the drivers complained of poor sleep quality and difficulty falling asleep. The sleep characteristics on the night before travel were associated with the habitual sleep characteristics. At the time of the test, 47% of the drivers scored pathologically on the SSS. Poor sleep quality and difficulty falling asleep the night before travel were associated with increased sleepiness as assessed by the SSS and decreased attentional ability as assessed by the BLAST. No association between salivary markers and acute sleepiness was observed. Conclusions The sleep characteristics of the night before travel were associated with sleepiness and attentional performance. The SSS and the BLAST could be used by individual drivers in a self-evaluation context. Biological markers showed a high variability and limited association with sleep parameters across subjects, emphasizing the need for within-subject designs to assess their usefulness.
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Affiliation(s)
- Marine Thieux
- Centre de Recherche en Neurosciences de Lyon (CRNL), Institut National de la Santé et de la Recherche Médicale (INSERM), Lyon, France
- Centre de Référence Maladies Rares (CRMR) Narcolepsie-Hypersomnies Rares, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon (HCL), Lyon, France
| | - Aurore Guyon
- Centre de Référence Maladies Rares (CRMR) Narcolepsie-Hypersomnies Rares, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon (HCL), Lyon, France
| | - Vania Herbillon
- Centre de Recherche en Neurosciences de Lyon (CRNL), Institut National de la Santé et de la Recherche Médicale (INSERM), Lyon, France
- Centre de Référence Maladies Rares (CRMR) Narcolepsie-Hypersomnies Rares, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon (HCL), Lyon, France
| | - Lydie Merle
- Centre de Recherche en Neurosciences de Lyon (CRNL), Institut National de la Santé et de la Recherche Médicale (INSERM), Lyon, France
| | - Jean-Philippe Lachaux
- Centre de Recherche en Neurosciences de Lyon (CRNL), Institut National de la Santé et de la Recherche Médicale (INSERM), Lyon, France
| | | | - Laurent Seugnet
- Centre de Recherche en Neurosciences de Lyon (CRNL), Institut National de la Santé et de la Recherche Médicale (INSERM), Lyon, France
| | - Patricia Franco
- Centre de Recherche en Neurosciences de Lyon (CRNL), Institut National de la Santé et de la Recherche Médicale (INSERM), Lyon, France
- Centre de Référence Maladies Rares (CRMR) Narcolepsie-Hypersomnies Rares, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon (HCL), Lyon, France
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Danilenko KV, Kobelev E, Zhanaeva SY, Aftanas LI. Winter-summer difference in post-awakening salivary α-amylase and sleepiness depending on sleep and melatonin. Physiol Behav 2021; 240:113549. [PMID: 34371023 DOI: 10.1016/j.physbeh.2021.113549] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/27/2021] [Accepted: 08/03/2021] [Indexed: 11/16/2022]
Abstract
Winter and summer seasons are contrasted by light/dark conditions at temperate latitudes, and the negative influence of this contrast on circadian health is yet to be quantified. This field study (performed in Novosibirsk, 55°N, no daylight saving time transitions) aimed to compare post-awakening arousal state in summer and winter in subjects (N=45) on a fixed 5-workday schedule (waken up by alarm at either ∼6 am or ∼7 am). Their circadian status (by 24-h melatonin profiles) and sleep (by log data) have been previously reported. Salivary α-amylase levels (a biomarker of the sympathetic nervous system activity, or stress) and subjective sleepiness were measured immediately after awakening on Friday, at minute 0 (supine), 10, 20, and 30 (not supine). α-Amylase levels were found to be higher in winter, along with a blunted α-amylase awakening response (AAR; a decline from minute 0 to minute 10 value). Both effects were attributable mainly to the 7am group. Sleepiness levels also increased in winter, mainly due to the seasonally dependent subjects, and predictably associated with shorter, later sleep, and later melatonin circadian phase. The sleepiness and α-amylase changes did not correlate. The seasonal change in α-amylase was positively associated with the change in the amount of melatonin secreted, probably reflecting the parallelism in the noradrenergic neural control of both α-amylase and melatonin secretion. Together, higher post-awakening salivary α-amylase levels (indicating stress) and subjective sleepiness levels (indicating greater sleep need) in winter compared to summer point to a less healthy state in winter.
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Affiliation(s)
| | - Evgenii Kobelev
- Institute of Neurosciences and Medicine, Timakova 4, Novosibirsk 630117, Russia
| | - Svetlana Y Zhanaeva
- Institute of Neurosciences and Medicine, Timakova 4, Novosibirsk 630117, Russia
| | - Lyubomir I Aftanas
- Institute of Neurosciences and Medicine, Timakova 4, Novosibirsk 630117, Russia; V. Zelman Institute for Medicine and Psychology, Novosibirsk State University, Novosibirsk, Russia
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Zhou Y, Chen Q, Luo X, Li L, Ru T, Zhou G. Does Bright Light Counteract the Post-lunch Dip in Subjective States and Cognitive Performance Among Undergraduate Students? Front Public Health 2021; 9:652849. [PMID: 34164367 PMCID: PMC8215386 DOI: 10.3389/fpubh.2021.652849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/19/2021] [Indexed: 11/24/2022] Open
Abstract
The post-lunch dip in alertness and performance was widely experienced during the early afternoon. Taking a short nap was documented as a practical strategy for habitual nappers to counteract the decline of alertness and performance. Yet, it remains unknown whether bright light exposure in the early afternoon working hours could alleviate the performance deficits caused by a post-lunch nap loss for habitual nappers. Seventeen undergraduate students who had a long-term habit of taking a post-lunch nap were assigned to three interventions: (1) a short nap + normal indoor light (100 lx, 4,000 K at eye level); (2) no nap + normal indoor light, and (3) no nap + blue-enriched bright light (1,000 lx, 6,500 K at eye level), in which subjective alertness (Karolinska Sleepiness Scale, KSS), mood (Positive and Negative Affect Schedule, PANAS), and task performance in sustained attention (psychomotor vigilance test, PVT), response inhibition (go/no-go task), and working memory (paced visual serial addition test, PVSAT) were measured. Results showed that a post-lunch nap deprivation significantly increased subjective sleepiness and negative mood and impaired performance in PVT and PVSAT, while exposure to bright blue-enriched white light vs. normal indoor light in the early afternoon significantly relieved such negative effects on mood, sleepiness, and performance in PVSAT; subjective positive mood and performance in PVT and go/no-go task remained unaffected with light intervention. These findings suggested that bright blue-enriched white light exposure could be a potential strategy for those who are suffering from drowsiness and low working memory following a habitual midday nap loss.
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Affiliation(s)
- Ying Zhou
- Lab of Lighting and Physio-Psychological 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 & Institute of Electronic Paper Displays, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou, China
| | - Qingwei Chen
- Lab of Lighting and Physio-Psychological 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 & Institute of Electronic Paper Displays, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou, China
| | - Xue Luo
- School of Psychology, South China Normal University, Guangzhou, China
| | - Le Li
- Lab of Lighting and Physio-Psychological 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 & Institute of Electronic Paper Displays, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou, China
| | - Taotao Ru
- Lab of Lighting and Physio-Psychological 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 & Institute of Electronic Paper Displays, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou, China
| | - Guofu Zhou
- Lab of Lighting and Physio-Psychological 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 & Institute of Electronic Paper Displays, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou, China
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