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Sauvet F, Beauchamps V, Cabon P. Sleep Inertia in Aviation. Aerosp Med Hum Perform 2024; 95:206-213. [PMID: 38486319 DOI: 10.3357/amhp.6343.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
INTRODUCTION: Sleep inertia is the transition state during which alertness and cognitive performance are temporarily impaired after awakening. Magnitude and time course of sleep inertia are characterized by high individual variability with large differences between the cognitive functions affected. This period of impairment is of concern to pilots, who take sleep or nap periods during on-call work hours or in-flight rest, then need to perform safety-critical tasks soon after waking. This review analyzes literature related to sleep inertia and countermeasures applicable for aviation.METHODS: The large part of scientific literature that focuses on sleep inertia is based on studies in patients with chronic sleep inertia. We analyzed 8 narrative reviews and 64 papers related to acute sleep inertia in healthy subjects.DISCUSSION: Sleep inertia is a multifactorial, complex process, and many different protocols have been conducted, with a low number of subjects, in noncontrolled laboratory designs, with questionnaires or cognitive tests that have not been replicated. Evidence suggests that waking after sleep loss, or from deeper stages of sleep, can exacerbate sleep inertia through complex interactions between awakening and sleep-promoting brain structures. Nevertheless, no meta-analyses are possible and extrapolation to pilots' performances is hypothetical. Studies in real life or simulated operational situations must be conducted to improve the description of the impact of sleep inertia and kinetics on pilots' performances. Taking rest or sleep time remains the main method for pilots to fight against fatigue and related decreases in performance. We propose proactive strategies to mitigate sleep inertia and improve alertness.Sauvet F, Beauchamps V, Cabon P. Sleep inertia in aviation. Aerosp Med Hum Perform. 2024; 95(4):206-213.
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Wingelaar-Jagt YQ, Wingelaar TT, de Vrijer L, Riedel WJ, Ramaekers JG. Daily Caffeine Intake and the Effect of Caffeine on Pilots' Performance After Extended Wakefulness. Aerosp Med Hum Perform 2023; 94:750-760. [PMID: 37726901 DOI: 10.3357/amhp.6253.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
INTRODUCTION: Fatigue is a major contributor to aviation accidents. Sufficient sleep may be difficult to achieve under operational conditions in military aviation. Countermeasures include caffeine, however, studies evaluating its effects often do not represent daily practice with regular caffeine consumption. This study aims to establish the effect of caffeine on psychomotor performance in a realistic scenario (i.e., after a limited period of extended wakefulness).METHODS: This randomized, double-blind, crossover, placebo-controlled trial included 30 aeromedically fit subjects. On trial days, subjects followed their normal routine till 17:00, after which caffeine intake was stopped. At midnight, subjects were given 300 mg of caffeine or placebo and performed the Psychomotor Vigilance Test, Vigilance and Tracking Test, and the Stanford Sleepiness Scale hourly up to 04:00 and again at 06:00 and 08:00. Four blood samples were collected. Statistical analyses included repeated-measures ANOVA or Friedman tests, marginal models, and Wilcoxon Signed Rank tests.RESULTS: Median time awake at midnight was 17 h (IQR 16.5-17.5 h). Performance decreased significantly less during the night in the caffeine condition versus placebo. Neither habitual intake nor daytime caffeine consumption affected this. No statistically significant correlation was identified between blood concentrations of caffeine and performance.DISCUSSION: A single dose of 300 mg of caffeine has beneficial effects on performance during the night in a realistic scenario for military aviation. Daytime caffeine consumption does not affect the effects of caffeine at night. These findings could be relevant for all industries in which optimal performance is required during nighttime after a limited period of extended wakefulness.Wingelaar-Jagt YQ, Wingelaar TT, de Vrijer L, Riedel WJ, Ramaekers JG. Daily caffeine intake and the effect of caffeine on pilots' performance after extended wakefulness. Aerosp Med Hum Perform. 2023; 94(10):750-760.
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Drogou C, Sauvet F, Erblang M, Leger D, Thomas C, Chennaoui M, Gomez-Merino D. Effects of Acute Caffeine Intake on Insulin-Like Growth Factor-1 Responses to Total Sleep Deprivation: Interactions with COMT Polymorphism - A Randomized, Crossover Study. Lifestyle Genom 2023; 16:113-123. [PMID: 37279709 DOI: 10.1159/000529897] [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: 11/18/2022] [Accepted: 02/23/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION Genes encoding catechol-O-methyl-transferase (COMT) and adenosine A2A receptor (ADORA2A) have been shown to influence cognitive performances and responses to caffeine intake during prolonged wakefulness. The rs4680 single-nucleotide polymorphism (SNP) of COMT differentiates on memory score and circulating levels of the neurotrophic factor IGF-1. This study aimed to determine the kinetics of IGF-1, testosterone, and cortisol concentrations during prolonged wakefulness under caffeine or placebo intake in 37 healthy participants, and to analyze whether the responses are dependent on COMT rs4680 or ADORA2A rs5751876 SNPs. METHODS In caffeine (2.5 mg/kg, twice over 24 h) or placebo-controlled condition, blood sampling was performed at 1 h (08:00, baseline), 11 h, 13 h, 25 h (08:00 next day), 35 h, and 37 h of prolonged wakefulness, and at 08:00 after one night of recovery sleep, to assess hormonal concentrations. Genotyping was performed on blood cells. RESULTS Results indicated a significant increase in IGF-1 levels after 25, 35, and 37 h of prolonged wakefulness in the placebo condition, in subjects carrying the homozygous COMT A/A genotype only (expressed in absolute values [±SEM]: 118 ± 8, 121 ± 10, and 121 ± 10 vs. 105 ± 7 ng/mL for A/A, 127 ± 11, 128 ± 12, and 129 ± 13 vs. 120 ± 11 ng/mL for G/G, and 106 ± 9, 110 ± 10, and 106 ± 10 vs. 101 ± 8 ng/mL for G/A, after 25, 35, and 37 h of wakefulness versus 1 h; p < 0.05, condition X time X SNP). Acute caffeine intake exerted a COMT genotype-dependent reducing effect on IGF-1 kinetic response (104 ± 26, 107 ± 27, and 106 ± 26 vs. 100 ± 25 ng/mL for A/A genotype, at 25, 35, and 37 h of wakefulness vs. 1 h; p < 0.05 condition X time X SNP), plus on resting levels after overnight recovery (102 ± 5 vs. 113 ± 6 ng/mL) (p < 0.05, condition X SNP). Testosterone and cortisol concentrations decreased during wakefulness, and caffeine alleviated the testosterone reduction, unrelated to the COMT polymorphism. No significant main effect of the ADORA2A SNP was shown regardless of hormonal responses. CONCLUSION Our results indicated that the COMT polymorphism interaction is important in determining the IGF-1 neurotrophic response to sleep deprivation with caffeine intake (NCT03859882).
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Affiliation(s)
- Catherine Drogou
- Département Environnements Opérationnels, Institut de recherche biomédicale des armées (IRBA), Brétigny sur Orge, France
- VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, Paris, France
| | - Fabien Sauvet
- Département Environnements Opérationnels, Institut de recherche biomédicale des armées (IRBA), Brétigny sur Orge, France
- VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, Paris, France
| | - Mégane Erblang
- Département Environnements Opérationnels, Institut de recherche biomédicale des armées (IRBA), Brétigny sur Orge, France
- VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, Paris, France
- ED 566 Sciences du sport, de la motricité et du mouvement humain, Université Paris-Saclay, Orsay, France
| | - Damien Leger
- VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, Paris, France
- APHP, Hôtel-Dieu, Centre du sommeil et de la Vigilance, Paris, France
| | - Claire Thomas
- LBEPS, Univ Evry, IRBA, Université Paris-Saclay, Evry, France
| | - Mounir Chennaoui
- Département Environnements Opérationnels, Institut de recherche biomédicale des armées (IRBA), Brétigny sur Orge, France
- VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, Paris, France
| | - Danielle Gomez-Merino
- Département Environnements Opérationnels, Institut de recherche biomédicale des armées (IRBA), Brétigny sur Orge, France
- VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, Paris, France
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Quiquempoix M, Drogou C, Erblang M, Van Beers P, Guillard M, Tardo-Dino PE, Rabat A, Léger D, Chennaoui M, Gomez-Merino D, Sauvet F. Relationship between Habitual Caffeine Consumption, Attentional Performance, and Individual Alpha Frequency during Total Sleep Deprivation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4971. [PMID: 36981883 PMCID: PMC10049386 DOI: 10.3390/ijerph20064971] [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: 02/06/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Caffeine is a psychostimulant that is well known to mitigate the deleterious effects of sleep debt. Our aim was to assess the effects of acute caffeine intake on cognitive vulnerability and brain activity during total sleep deprivation (TSD), taking into account habitual caffeine consumption. (2) Methods: Thirty-seven subjects were evaluated in a double-blind, crossover, total sleep deprivation protocol with caffeine or placebo treatment. Vigilant attention was evaluated every six hours during TSD using the psychomotor vigilance test (PVT) with EEG recordings. The influence of habitual caffeine consumption was analyzed by categorizing subjects into low, moderate, and high consumers. (3) Results: The PVT reaction time (RT) increased during TSD and was lower in the caffeine condition vs. the placebo condition. The RT was shorter in the low-caffeine consumers compared to moderate and high consumers, regardless of conditions and treatments. The TSD-related increase in EEG power was attenuated by acute caffeine intake independently of habitual caffeine consumption, and the individual alpha frequency (IAF) was lower in the high-consumption group. The IAF was negatively correlated with daytime sleepiness. Moreover, a correlation analysis showed that the higher the daily caffeine consumption, the higher the RT and the lower the IAF. (4) Conclusions: A high level of habitual caffeine consumption decreases attentional performance and alpha frequencies, decreasing tolerance to sleep deprivation.
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Affiliation(s)
- Michael Quiquempoix
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Catherine Drogou
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Mégane Erblang
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
- Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (UMR LBEPS), Université d’Evry, 91025 Evry-Courcouronnes, France
| | - Pascal Van Beers
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Mathias Guillard
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Pierre-Emmanuel Tardo-Dino
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
- Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (UMR LBEPS), Université d’Evry, 91025 Evry-Courcouronnes, France
| | - Arnaud Rabat
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Damien Léger
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
- APHP, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, 75004 Paris, France
| | - Mounir Chennaoui
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Danielle Gomez-Merino
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Fabien Sauvet
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
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van den Berg NH, Michaud X, Pattyn N, Simonelli G. How Sleep Research in Extreme Environments Can Inform the Military: Advocating for a Transactional Model of Sleep Adaptation. Curr Psychiatry Rep 2023; 25:73-91. [PMID: 36790725 DOI: 10.1007/s11920-022-01407-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 02/16/2023]
Abstract
PURPOSE OF REVIEW We review the literature on sleep in extreme environments. Accordingly, we present a model that identifies the need for mitigating interventions to preserve sleep quality for military deployments. RECENT FINDINGS Situational factors that affect sleep in extreme environments include cold temperatures, isolated and confined areas, fluctuating seasonality, photoperiodicity, and extreme latitudes and altitudes. Results vary across studies, but general effects include decreased total sleep time, poor sleep efficiency, and non-specific phase delays or phase advances in sleep onset and sleep architecture. Considering habitability measures (e.g., light or temperature control) and individual differences such as variable stress responses or sleep need can mitigate these effects to improve mood, cognition, and operational performance. Although the situational demands during military missions inevitably reduce total sleep time and sleep efficiency, mitigating factors can attenuate sleep-related impairments, hence allowing for optimal mission success and personnel safety.
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Affiliation(s)
- N H van den Berg
- Centre d'études avancées en médecine du sommeil, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord de l'Île-de-Montréal, Montreal, Quebec, Canada.,School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - X Michaud
- Centre d'études avancées en médecine du sommeil, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord de l'Île-de-Montréal, Montreal, Quebec, Canada.,Department of Psychology, Faculty of Arts and Science, Université de Montréal, Montreal, Quebec, Canada
| | - N Pattyn
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Human Physiology Department (MFYS), Vrije Universiteit Brussel, Brussels, Belgium.,VIPER Research Unit, Royal Military Academy, Brussels, Belgium
| | - G Simonelli
- Centre d'études avancées en médecine du sommeil, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord de l'Île-de-Montréal, Montreal, Quebec, Canada. .,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. .,Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
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Drogou C, Erblang M, Metlaine A, Berot S, Derbois C, Olaso R, Boland A, Deleuze JF, Thomas C, Léger D, Chennaoui M, Sauvet F, Gomez-Merino D. Relationship between genetic polymorphisms of cytokines and self-reported sleep complaints and habitual caffeine consumption. Sleep Med 2023; 101:66-76. [PMID: 36335893 DOI: 10.1016/j.sleep.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 10/10/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022]
Abstract
Pro-inflammatory cytokines are involved in sleep-wake regulation and are associated with caffeine consumption. This is a cross-sectional study in 1023 active French workers investigating associations between self-reported sleep complaints (>3months) and total sleep time (TST) with nine single-nucleotide-polymorphisms (SNPs) including pro-inflammatory cytokines, according to caffeine consumption. Participants were characterized as low, moderate and high (0-50, 51-300, and >300 mg/day) caffeine consumers. After adjusting the odd ratios (OR) for age, gender, and smoking, the risk of sleep complaints was higher in subjects with genetic mutations in tumor necrosis factor alpha (TNF-α, rs 1800629) (ORa [95%CI] = 1.43 [1.07-1.92] for both G/A and A/A aggregate genotypes) or interleukin-1 beta (IL-1β, rs1143627) (ORa = 1.61 [1.08-2.44] for homozygous A/A genotype), and the risk was higher when subjects carry the mutations in TNF-α plus IL-1β regardless of caffeine consumption. When stratified with caffeine consumption, the risk of sleep complaints was higher in TNF-α A allele carriers in high caffeine consumers, and in homozygous A/A genotype of IL-1β in moderate and high consumers. None of the nine SNPs influence TST, with the exception of the mutation on CYP1A2 and only when stratified with caffeine consumption. Our results also indicated more caffeine side-effects when carrying mutation on IL1β. This study showed that polymorphisms in TNF-α and/or IL-1β influenced sleep complaints but did not influence total sleep time. This suggests that management of sleep complaints, which can be addressed by clinical interventions, should consider the influence of the genetic profile of pro-inflammatory cytokines.
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Affiliation(s)
- Catherine Drogou
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223, Brétigny-sur Orge, France; Université Paris Cité, VIFASOM, (UPR 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Paris, France
| | - Mégane Erblang
- Laboratoire de Biologie de l'Exercice pour la Performance et la Santé (UMR LBEPS), Université d'Evry, Paris, Saclay, 91025, Evry-Courcouronnes, France
| | - Arnaud Metlaine
- APHP, APHP-Centre Université de Paris, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, 75004, Paris, France; Service de santé au travail, Tour First, 92400, Courbevoie, France
| | - Stéphanie Berot
- Service de santé au travail, Tour First, 92400, Courbevoie, France
| | - Céline Derbois
- CEA, Centre National de Recherche en Génomique Humaine, 91057, Evry, France
| | - Robert Olaso
- CEA, Centre National de Recherche en Génomique Humaine, 91057, Evry, France
| | - Anne Boland
- CEA, Centre National de Recherche en Génomique Humaine, 91057, Evry, France
| | | | - Claire Thomas
- Laboratoire de Biologie de l'Exercice pour la Performance et la Santé (UMR LBEPS), Université d'Evry, Paris, Saclay, 91025, Evry-Courcouronnes, France
| | - Damien Léger
- Université Paris Cité, VIFASOM, (UPR 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Paris, France; APHP, APHP-Centre Université de Paris, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, 75004, Paris, France
| | - Mounir Chennaoui
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223, Brétigny-sur Orge, France; Université Paris Cité, VIFASOM, (UPR 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Paris, France
| | - Fabien Sauvet
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223, Brétigny-sur Orge, France; Université Paris Cité, VIFASOM, (UPR 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Paris, France.
| | - Danielle Gomez-Merino
- Unité Fatigue et Vigilance, Institut de Recherche Biomédicale des Armées (IRBA), 91223, Brétigny-sur Orge, France; Université Paris Cité, VIFASOM, (UPR 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Paris, 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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Reichert CF, Deboer T, Landolt HP. Adenosine, caffeine, and sleep-wake regulation: state of the science and perspectives. J Sleep Res 2022; 31:e13597. [PMID: 35575450 PMCID: PMC9541543 DOI: 10.1111/jsr.13597] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 01/11/2023]
Abstract
For hundreds of years, mankind has been influencing its sleep and waking state through the adenosinergic system. For ~100 years now, systematic research has been performed, first started by testing the effects of different dosages of caffeine on sleep and waking behaviour. About 70 years ago, adenosine itself entered the picture as a possible ligand of the receptors where caffeine hooks on as an antagonist to reduce sleepiness. Since the scientific demonstration that this is indeed the case, progress has been fast. Today, adenosine is widely accepted as an endogenous sleep‐regulatory substance. In this review, we discuss the current state of the science in model organisms and humans on the working mechanisms of adenosine and caffeine on sleep. We critically investigate the evidence for a direct involvement in sleep homeostatic mechanisms and whether the effects of caffeine on sleep differ between acute intake and chronic consumption. In addition, we review the more recent evidence that adenosine levels may also influence the functioning of the circadian clock and address the question of whether sleep homeostasis and the circadian clock may interact through adenosinergic signalling. In the final section, we discuss the perspectives of possible clinical applications of the accumulated knowledge over the last century that may improve sleep‐related disorders. We conclude our review by highlighting some open questions that need to be answered, to better understand how adenosine and caffeine exactly regulate and influence sleep.
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Affiliation(s)
- Carolin Franziska Reichert
- Centre for Chronobiology, University Psychiatric Clinics Basel, Basel, Switzerland.,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.,Center for Affective, Stress, and Sleep Disorders, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Tom Deboer
- Laboratory for Neurophysiology, Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Hans-Peter Landolt
- Institute of Pharmacology and Toxicology, University of Zürich, Zürich, Switzerland.,Sleep & Health Zürich, University Center of Competence, University of Zürich, Zürich, Switzerland
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Quiquempoix M, Sauvet F, Erblang M, Van Beers P, Guillard M, Drogou C, Trignol A, Vergez A, Léger D, Chennaoui M, Gomez-Merino D, Rabat A. Effects of Caffeine Intake on Cognitive Performance Related to Total Sleep Deprivation and Time on Task: A Randomized Cross-Over Double-Blind Study. Nat Sci Sleep 2022; 14:457-473. [PMID: 35321359 PMCID: PMC8935086 DOI: 10.2147/nss.s342922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/07/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION It is widely admitted that both total sleep deprivation (TSD) and extended task engagement (Time-On-Task, TOT) induce a cognitive fatigue state in healthy subjects. Even if EEG theta activity and adenosine both increase with cognitive fatigue, it remains unclear if these modifications are common mechanisms for both sustained attention and executive processes. METHODS We performed a double-blind counter-balanced (placebo (PCBO) and caffeine (CAF) - 2×2.5 mg/kg/24 h)) study on 24 healthy subjects (33.7 ± 5.9 y). Subjects participated in an experimental protocol including an habituation/training day followed by a baseline day (D0 and D1) and a total sleep deprivation (TSD) day beginning on D1 at 23:00 until D2 at 21:00. Subjects performed the psychomotor vigilance test (PVT) assessing sustained attention, followed by the executive Go-NoGo inhibition task and the 2-NBack working memory task at 09:15 on D1 and D2. RESULTS We showed differential contributions of TSD and TOT on deficits in sustained attention and both executive processes. An alleviating effect of caffeine intake is only observed on sustained attention deficits related to TSD and not at all on TOT effect. The caffeine dose slows down the triggering of sustained attention deficits related to TOT effect. DISCUSSION These results suggest that sustained attention deficits induced by TSD rely on the adenosinergic mechanism whereas TOT effect observed for both sustained attention and executive would not.
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Affiliation(s)
- Michael Quiquempoix
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Fabien Sauvet
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Mégane Erblang
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France.,LBEPS, Univ Evry, IRBA, University of Paris-Saclay, Paris, France
| | - Pascal Van Beers
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Mathias Guillard
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Catherine Drogou
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Aurélie Trignol
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Anita Vergez
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Damien Léger
- VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France.,Centre du sommeil et de la vigilance, Hôpital Hôtel Dieu AP-HP, Paris, 75004, France
| | - Mounir Chennaoui
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Danielle Gomez-Merino
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Arnaud Rabat
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
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10
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Grèzes J, Erblang M, Vilarem E, Quiquempoix M, Van Beers P, Guillard M, Sauvet F, Mennella R, Rabat A. Impact of total sleep deprivation and related mood changes on approach-avoidance decisions to threat-related facial displays. Sleep 2021; 44:zsab186. [PMID: 34313789 PMCID: PMC8664577 DOI: 10.1093/sleep/zsab186] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/14/2021] [Indexed: 11/26/2022] Open
Abstract
STUDY OBJECTIVES Total sleep deprivation is known to have significant detrimental effects on cognitive and socio-emotional functioning. Nonetheless, the mechanisms by which total sleep loss disturbs decision-making in social contexts are poorly understood. Here, we investigated the impact of total sleep deprivation on approach/avoidance decisions when faced with threatening individuals, as well as the potential moderating role of sleep-related mood changes. METHODS Participants (n = 34) made spontaneous approach/avoidance decisions in the presence of task-irrelevant angry or fearful individuals, while rested or totally sleep deprived (27 h of continuous wakefulness). Sleep-related changes in mood and sustained attention were assessed using the Positive and Negative Affective Scale and the psychomotor vigilance task, respectively. RESULTS Rested participants avoided both fearful and angry individuals, with stronger avoidance for angry individuals, in line with previous results. On the contrary, totally sleep deprived participants favored neither approach nor avoidance of fearful individuals, while they still comparably avoided angry individuals. Drift-diffusion models showed that this effect was accounted for by the fact that total sleep deprivation reduced value-based evidence accumulation toward avoidance during decision making. Finally, the reduction of positive mood after total sleep deprivation positively correlated with the reduction of fearful display avoidance. Importantly, this correlation was not mediated by a sleep-related reduction in sustained attention. CONCLUSIONS All together, these findings support the underestimated role of positive mood-state alterations caused by total sleep loss on approach/avoidance decisions when facing ambiguous socio-emotional displays, such as fear.
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Affiliation(s)
- Julie Grèzes
- Cognitive and Computational Neuroscience Laboratory (LNC Inserm U960), Department of Cognitive Studies, École Normale Supérieure, PSL University, Paris, France
| | - Mégane Erblang
- Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (LBEPS), Université d’Evry, IRBA, Université de Paris Saclay, Evry-Courcouronnes, France
| | - Emma Vilarem
- Cognitive and Computational Neuroscience Laboratory (LNC Inserm U960), Department of Cognitive Studies, École Normale Supérieure, PSL University, Paris, France
| | - Michael Quiquempoix
- Unité Fatigue et Vigilance, Département Environnements Opérationnels, Institut de recherche biomédicale des armées (IRBA), Brétigny sur Orge cedex, France
- Equipe d’accueil VIgilance FAtigue SOMmeil (VIFASOM), EA 7330, Hôtel Dieu, Université de Paris, France
| | - Pascal Van Beers
- Unité Fatigue et Vigilance, Département Environnements Opérationnels, Institut de recherche biomédicale des armées (IRBA), Brétigny sur Orge cedex, France
- Equipe d’accueil VIgilance FAtigue SOMmeil (VIFASOM), EA 7330, Hôtel Dieu, Université de Paris, France
| | - Mathias Guillard
- Unité Fatigue et Vigilance, Département Environnements Opérationnels, Institut de recherche biomédicale des armées (IRBA), Brétigny sur Orge cedex, France
- Equipe d’accueil VIgilance FAtigue SOMmeil (VIFASOM), EA 7330, Hôtel Dieu, Université de Paris, France
| | - Fabien Sauvet
- Unité Fatigue et Vigilance, Département Environnements Opérationnels, Institut de recherche biomédicale des armées (IRBA), Brétigny sur Orge cedex, France
- Equipe d’accueil VIgilance FAtigue SOMmeil (VIFASOM), EA 7330, Hôtel Dieu, Université de Paris, France
| | - Rocco Mennella
- Cognitive and Computational Neuroscience Laboratory (LNC Inserm U960), Department of Cognitive Studies, École Normale Supérieure, PSL University, Paris, France
- Laboratory on the Interactions between Cognition, Action, and Emotion (LICAE) – Paris Nanterre University, Nanterre, France
| | - Arnaud Rabat
- Unité Fatigue et Vigilance, Département Environnements Opérationnels, Institut de recherche biomédicale des armées (IRBA), Brétigny sur Orge cedex, France
- Equipe d’accueil VIgilance FAtigue SOMmeil (VIFASOM), EA 7330, Hôtel Dieu, Université de Paris, France
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Genetics and Cognitive Vulnerability to Sleep Deprivation in Healthy Subjects: Interaction of ADORA2A, TNF-α and COMT Polymorphisms. Life (Basel) 2021; 11:life11101110. [PMID: 34685481 PMCID: PMC8540997 DOI: 10.3390/life11101110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/02/2021] [Accepted: 10/13/2021] [Indexed: 11/17/2022] Open
Abstract
Several genetic polymorphisms differentiate between healthy individuals who are more cognitively vulnerable or resistant during total sleep deprivation (TSD). Common metrics of cognitive functioning for classifying vulnerable and resilient individuals include the Psychomotor Vigilance Test (PVT), Go/noGo executive inhibition task, and subjective daytime sleepiness. We evaluated the influence of 14 single-nucleotide polymorphisms (SNPs) on cognitive responses during total sleep deprivation (continuous wakefulness for 38 h) in 47 healthy subjects (age 37.0 ± 1.1 years). SNPs selected after a literature review included SNPs of the adenosine-A2A receptor gene (including the most studied rs5751876), pro-inflammatory cytokines (TNF-α, IL1-β, IL-6), catechol-O-methyl-transferase (COMT), and PER3. Subjects performed a psychomotor vigilance test (PVT) and a Go/noGo-inhibition task, and completed the Karolinska Sleepiness Scale (KSS) every 6 h during TSD. For PVT lapses (reaction time >500 ms), an interaction between SNP and SDT (p < 0.05) was observed for ADORA2A (rs5751862 and rs2236624) and TNF-α (rs1800629). During TSD, carriers of the A allele for ADORA2A (rs5751862) and TNF-α were significantly more impaired for cognitive responses than their respective ancestral G/G genotypes. Carriers of the ancestral G/G genotype of ADORA2A rs5751862 were found to be very similar to the most resilient subjects for PVT lapses and Go/noGo commission errors. Carriers of the ancestral G/G genotype of COMT were close to the most vulnerable subjects. ADORA2A (rs5751862) was significantly associated with COMT (rs4680) (p = 0.001). In conclusion, we show that genetic polymorphisms in ADORA2A (rs5751862), TNF-α (rs1800629), and COMT (rs4680) are involved in creating profiles of high vulnerability or high resilience to sleep deprivation. (NCT03859882).
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Casale CE, Goel N. Genetic Markers of Differential Vulnerability to Sleep Loss in Adults. Genes (Basel) 2021; 12:1317. [PMID: 34573301 PMCID: PMC8464868 DOI: 10.3390/genes12091317] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 12/15/2022] Open
Abstract
In this review, we discuss reports of genotype-dependent interindividual differences in phenotypic neurobehavioral responses to total sleep deprivation or sleep restriction. We highlight the importance of using the candidate gene approach to further elucidate differential resilience and vulnerability to sleep deprivation in humans, although we acknowledge that other omics techniques and genome-wide association studies can also offer insights into biomarkers of such vulnerability. Specifically, we discuss polymorphisms in adenosinergic genes (ADA and ADORA2A), core circadian clock genes (BHLHE41/DEC2 and PER3), genes related to cognitive development and functioning (BDNF and COMT), dopaminergic genes (DRD2 and DAT), and immune and clearance genes (AQP4, DQB1*0602, and TNFα) as potential genetic indicators of differential vulnerability to deficits induced by sleep loss. Additionally, we review the efficacy of several countermeasures for the neurobehavioral impairments induced by sleep loss, including banking sleep, recovery sleep, caffeine, and naps. The discovery of reliable, novel genetic markers of differential vulnerability to sleep loss has critical implications for future research involving predictors, countermeasures, and treatments in the field of sleep and circadian science.
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Affiliation(s)
| | - Namni Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 425, Chicago, IL 60612, USA;
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