No first night shift effect observed following a nocturnal main sleep and a prophylactic 1-h afternoon nap

ABSTRACT

Neurobehavioural impairment on the first night shift is often greater than on subsequent night shifts due to extended wakefulness. The aim of the study was to determine whether a 1-h afternoon nap prior to the first night shift is sufficient to produce neurobehavioural performance at levels comparable to the second night shift. Twelve male volunteers (mean age 22.9 years) participated in a laboratory protocol that simulated two 12-h night shifts. A nap preceded the first shift and a 7-h daytime sleep was scheduled between shifts. Neurobehavioural performance and subjective sleepiness measured across each night did not significantly differ between first and second shifts.     

The effects of the preference for music on sleep inertia after a short daytime nap

Sleep and Biological Rhythms - The effects of the preference for excitative music on sleep inertia after a daytime nap were examined. Sixteen young healthy adults took a 20-min nap at 14:00 after...     

Effects of daytime food intake on memory consolidation during sleep or sleep deprivation

Sleep enhances memory consolidation. Bearing in mind that food intake produces many metabolic signals that can influence memory processing in humans (e.g., insulin), the present study addressed the question as to whether the enhancing effect of sleep on memory consolidation is affected by the amount of energy consumed during the preceding daytime. Compared to sleep, nocturnal wakefulness has been shown to impair memory consolidation in humans. Thus, a second question was to examine whether the impaired memory consolidation associated with sleep deprivation (SD) could be compensated by increased daytime energy consumption. To these aims, 14 healthy normal-weight men learned a finger tapping sequence (procedural memory) and a list of semantically associated word pairs (declarative memory). After the learning period, standardized meals were administered, equaling either ～50% or ～150% of the estimated daily energy expenditure. In the morning, after sleep or wakefulness, memory consolidation was tested. Plasma glucose was measured both before learning and retrieval. Polysomnographic sleep recordings were performed by electroencephalography (EEG). Independent of energy intake, subjects recalled significantly more word pairs after sleep than they did after SD. When subjects stayed awake and received an energy oversupply, the number of correctly recalled finger sequences was equal to those seen after sleep. Plasma glucose did not differ among conditions, and sleep time in the sleep conditions was not influenced by the energy intake interventions. These data indicate that the daytime energy intake level affects neither sleep's capacity to boost the consolidation of declarative and procedural memories, nor sleep's quality. However, high energy intake was followed by an improved procedural but not declarative memory consolidation under conditions of SD. This suggests that the formation of procedural memory is not only triggered by sleep but is also sensitive to the fluctuations in the energy state of the body.     

Effect of fasting during Ramadan on sleep architecture,daytime sleepiness and sleep pattern

Sleep and Biological Rhythms - Fasting during Ramadan is distinct from regular voluntary or experimental fasting. This project was conducted to objectively assess the effect of Ramadan fasting on...     

Selective REM sleep deprivation during daytime. II. Muscle atonia in non-REM sleep

One of the hallmarks of rapid eye movement (REM) sleep is muscle atonia. Here we report extended epochs of muscle atonia in non-REM sleep (MAN). Their extent and time course was studied in a protocol that included a baseline night, a daytime sleep episode with or without selective REM sleep deprivation, and a recovery night. The distribution of the latency to the first occurrence of MAN was bimodal with a first mode shortly after sleep onset and a second mode 40 min later. Within a non-REM sleep episode, MAN showed a U-shaped distribution with the highest values before and after REM sleep. Whereas MAN was at a constant level over consecutive 2-h intervals of nighttime sleep, MAN showed high initial values when sleep began in the morning. Selective daytime REM sleep deprivation caused an initial enhancement of MAN during recovery sleep. It is concluded that episodes of MAN may represent an REM sleep equivalent and that it may be a marker of homeostatic and circadian REM sleep regulating processes. MAN episodes may contribute to the compensation of an REM sleep deficit.     

Prioritizing sleep for healthy work schedules

ABSTRACT: Good sleep is advantageous to the quality of life. Sleep-related benefits are particularly helpful for the working class, since poor or inadequate amounts of sleep degrade work productivity and overall health. This review paper explores the essential role of sleep in healthy work schedules and primarily focuses on the timing of sleep in relation to the work period (that is, before, during and after work). Data from laboratory, field and modeling studies indicate that consistent amounts of sleep prior to work are fundamental to improved performance and alertness in the workplace. In addition, planned naps taken during work maintain appropriate levels of waking function for both daytime and night-time work. Clearly, sufficient sleep after work is vital in promoting recovery from fatigue. Recent data also suggest that the time interval between shifts should be adjusted according to the biological timing of sleep. Although sleep is more likely to be replaced by job and other activities in the real life, research shows that it is worthwhile to revise the work schedules in order to optimize sleep before, sometime during and after the work period. Therefore, we suggest establishing work-sleep balance, similar to work-life balance, as a principle for designing and improving work schedules.     

The effects of extended nap periods on cognitive,physiological and subjective responses under simulated night shift conditions

Extended nap opportunities have been effective in maintaining alertness in the context of extended night shifts (+12?h). However, there is limited evidence of their efficacy during 8-h shifts. Thus, this study explored the effects of extended naps on cognitive, physiological and perceptual responses during four simulated, 8-h night shifts. In a laboratory setting, 32 participants were allocated to one of three conditions. All participants completed four consecutive, 8-h night shifts, with the arrangements differing by condition. The fixed night condition worked from 22h00 to 06h00, while the nap early group worked from 20h00 to 08h00 and napped between 00h00 and 03h20. The nap late group worked from 00h00 to 12h00 and napped between 04h00 and 07h20. Nap length was limited to 3 hours and 20 minutes. Participants performed a simple beading task during each shift, while also completing six to eight test batteries roughly every 2?h. During each shift, six test batteries were completed, in which the following measures were taken. Performance indicators included beading output, eye accommodation time, choice reaction time, visual vigilance, simple reaction time, processing speed and object recognition, working memory, motor response time and tracking performance. Physiological measures included heart rate and tympanic temperature, whereas subjective sleepiness and reported sleep length and quality while outside the laboratory constituted the self reported measures. Both naps reduced subjective sleepiness but did not alter the circadian and homeostatic-related changes in cognitive and physiological measures, relative to the fixed night condition. Additionally, there was evidence of sleep inertia following each nap, which resulted in transient reductions in certain perceptual cognitive performance measures. The present study suggested that there were some benefits associated with including an extended nap during 8-h night shifts. However, the effects of sleep inertia need to be effectively managed to ensure that post-nap alertness and performance is maintained.     

The levels of urinary epinephrine during daytime REM sleep deprivation.

Urinary excretion of epinephrine during REM sleep deprivation in the daytime was examined in an attempt to determine whether epinephrine excretion during sleep is related to the structure of disturbed sleep. Six healthy males were subjected to two experimental conditions: 1) day sleep without interruption, as a control condition, and 2) day sleep with REM sleep deprivation. Under both conditions, epinephrine excretion levels of five of the subjects were found to be distributed along a basal regression line, expressing the relationship of epinephrine excretion and percent of waking time, as calculated in a previous study. The epinephrine levels of the one remaining subject exceeded the values predicted by the regression line. His sleep structure was not only distorted under REM deprivation conditions but also under control conditions as well. These results suggest that the basal regression line is useful for observing the existence of sleep disturbance; indeed, a subject with epinephrine excretion levels much higher than those predicted by the regression line was found to have spontaneously disturbed sleep. More study is needed to clarify the relationship between high epinephrine levels and disturbed sleep.     

Selective REM sleep deprivation during daytime I. Time course of interventions and recovery sleep

Although repeated selective rapid eye movement (REM) sleep deprivation by awakenings during nighttime has shown that the number of sleep interruptions required to prevent REM sleep increases within and across consecutive nights, the underlying regulatory processes remained unspecified. To assess the role of circadian and homeostatic factors in REM sleep regulation, REM sleep was selectively deprived in healthy young adult males during a daytime sleep episode (7-15 h) after a night without sleep. Circadian REM sleep propensity is known to be high in the early morning. The number of interventions required to prevent REM sleep increased from the first to the third 2-h interval by a factor of two and then leveled off. Only a minor REM sleep rebound (11.6%) occurred in the following undisturbed recovery night. It is concluded that the limited rise of interventions during selective daytime REM sleep deprivation may be due to the declining circadian REM sleep propensity, which may partly offset the homeostatic drive and the sleep-dependent disinhibition of REM sleep.     

Correlations between sleep patterns and cardiovascular diseases in a Chinese middle-aged population

Epidemiological and animal studies have suggested an association between habitual sleep patterns and cardiovascular (CV) disease, but the results are still controversial. Therefore, the aims of this study are to investigate the relationships between habitual sleep patterns and CV disease based on Prospective Urban Rural Epidemiology (PURE) China study. PURE China study recruited 46 285 participants, aged 35–70, from 12 provinces and 115 communities in China. Habitual sleep patterns and CV disease were self-reported. Multilevel logistic regression was used in our analysis. In this study, 39 515 participants were eligible in our analysis, including 23 345 (59.1%) women and 16 170 (40.9%) men. Sleeping ≥9 h per day was associated with increased odds of CV disease (OR = 1.16, 95% CI: 1.01–1.32, p = 0.033) compared with sleeping 7–8 h per day. Taking daytime naps was also associated with an increased odds of CV disease, and the CV odds increased with increasing napping duration (p for trend < 0.001). For the sleeping < 6 h per day, we only found an association with coronary artery disease (CAD) (OR = 1.58, 95% CI: 1.01–2.48, p = 0.046). Participants with only 7–8 h sleep per night had lowest prevalence of CV disease (OR = 0.77, 95% CI: 0.65–0.90, p = 0.001) compared with other sleep patterns. Napping, long and short duration of habitual sleep may increase the odds of CV disease. Only participants sleeping 7–8 hours at night are recommended in this study, and large longitudinal studies are needed to confirm these results.     

Train drivers' sleep quality and quantity during extended relay operations

Relay operations are an important mode of freight transportation within Australia. Relay work requires multiple crews to drive the train continuously from one specified destination to another and return. Importantly, the nature of relay work requires train drivers to sleep on-board during designated resting shifts. The main aim of the present study was to investigate the quality and quantity of sleep obtained in on-board rest facilities (relay vans) during extended (four-day) relay operations. Drivers (n=9) working the Port Augusta to Darwin relay operation volunteered to participate. The first leg of the trip typically took 40 h followed by an overnight stay in Darwin (between 8-12 h) prior to return. Two crews, each consisting of two drivers, changed every 8 h, giving the crew an 8 h rest in the relay van prior to each 8 h working shift. Using polysomnography, home sleep data were collected prior to and following each trip using a standard five-channel EEG montage. All sleep periods during the relay trip (including Darwin) were also recorded. Additionally, subjective sleep quality ratings were recorded following each sleep period. Analyses revealed that the quantity of sleep obtained in the relay vans (3.3 h) was significantly reduced compared to home (6.8 h). In general, the total sleep time was increased at night and reduced during the day. In terms of quality, sleep onset latency, sleep efficiency, and amount of slow wave and rapid eye movement sleep did not differ significantly between home and the relay vans. The results of the study highlight sleep quantity as the main concern during extended relay operations. Future research should focus on investigating the subjective and objective impact of this sleep reduction on waking functions.     

Influence of bright light during daytime on sleep parameters in hospitalized elderly patients

Nurses frequently care for sleepless elderly patients on bed rest in a hospital environment. Our previous study with young adults showed that bright light exposure during the daytime affected the induction of nocturnal deep sleep. The purpose of this study is aimed at finding whether similar research could be observed with hospitalized elderly patients. Seven patients (mean age 67; range 57-77 yrs, males 3: females 4) served as participants and their informed written consent was obtained. A fluorescent lamp fixed in the bed frame near the head of the patient was turned on at 10:00 h and off at 15:00 h each day for 1 week (BL). Moreover, each patient was required to stay near this light during this period. The patients lived in a room facing north, where the ambient light intensities ranged from 50 to 300 lx during the daytime. Their activities were continuously measured using an Actiwatch (model-AWL, Mini-Mitter, USA). Salivary samples were collected at midnight for the measurement of melatonin. The findings were compared between 2 days before BL exposure (baseline) and the last 2 days during BL exposure, respectively. The bright light exposure during the daytime prolonged "Time in Bed" (p < 0.05), increased "Immobile Minutes" (p < 0.05), and delayed "Get up Time" (p < 0.01). The average melatonin secretion at midnight in four patients increased from 7.5 +/- 2.6 pg/ml to 13.3 +/- 9.2 pg/ml. These findings suggest that diurnal bright light exposure for hospitalized elderly patients lying in bed under dark condition during the daytime may favor clinically the induction of nocturnal deep sleep. Attention should be given to the illumination conditions for elderly patients in hospitals to improve their impaired sleep.     

Flat-out napping: The quantity and quality of sleep obtained in a seat during the daytime increase as the angle of recline of the seat increases

ABSTRACT

Some shiftwokers in the long-haul transportation industries (i.e. road, rail, sea, air) have the opportunity to sleep in on-board rest facilities during duty periods. These rest facilities are typically fitted with a seat with a maximum back angle to the vertical of 20°, 40°, or 90°. The aim of this study was to examine the impact of “back angle” on the quantity and quality of sleep obtained in a seat during a daytime nap. Six healthy adults (3 females aged 27.0 years and 3 males aged 22.7 years) each participated in three conditions. For each condition, participants had a 4-h sleep opportunity in a bed (02:00–06:00 h) followed by a 4-h sleep opportunity in a seat (13:00–17:00 h). The only difference between conditions was in the back angle of the seat to the vertical during the seat-based sleep periods: 20° (upright), 40° (reclined), and 90° (flat). Polysomnographic data were collected during all sleep episodes. For the seat-based sleep episodes, there was a significant effect of back angle on three of four measures of sleep quantity, i.e. total sleep time, slow-wave sleep, and rapid eye movement (REM) sleep, and three of four measures of sleep quality, i.e. latency to REM sleep, arousals, and stage shifts. In general, the quantity and quality of sleep obtained in the reclined and flat seats were better than those obtained in the upright seat. In particular, compared to the flat seat, the reclined seat resulted in similar amounts of total sleep and slow-wave sleep, but 37% less REM sleep; and the upright seat resulted in 29% less total sleep, 30% less slow-wave sleep, and 79% less REM sleep. There are two main mechanisms that may explain the results. First, it is difficult to maintain the head in a comfortable position for sleep when sitting upright, and this is likely exacerbated during REM sleep, when muscle tone is very low. Second, an upright posture increases sympathetic activity and decreases parasympathetic activity, resulting in a heightened level of physiological arousal.     

Delayed sleep/wake rhythm and excessive daytime sleepiness correlate with decreased daytime brain activity during cognitive task in university students

Insufficient sleep and irregular sleep/wake rhythm are common problems among university students. We investigated the effect of sleep/wake rhythm and excessive daytime sleepiness (EDS) on the cortical oxygenation as measured by near-infrared spectroscopy (NIRS) and cognitive performance in university students. Peak- and integral values by a word fluency task were measured with NIRS. EDS was evaluated by the Epworth sleepiness scale (ESS), and performance function was evaluated using N-back task. Peak cerebral oxygenation was significantly correlated with ESS, bedtime, wake-up time, and median time of sleep. Accuracy on 2-back task was significantly correlated with integral value. Peak- and integral values were significantly lower, and bedtime and median time of sleep were significantly delayed in the EDS group than in the non-EDS group. EDS accompanied by delayed sleep/wake rhythm and short sleep duration may play an important role in decreasing daytime brain activity and cognitive performance.     

The effects of a 30-min nap during night shift following a prophylactic sleep in the afternoon

Sleep and Biological Rhythms - The purpose of this study was to investigate the effects of a 30-min nap, during a simulated night shift environment, when a prophylactic daytime sleep was...     

EEG power density during nap sleep: reflection of an hourglass measuring the duration of prior wakefulness

The relation between the duration of prior wakefulness and EEG power density during sleep in humans was assessed by means of a study of naps. The duration of prior wakefulness was varied from 2 to 20 hr by scheduling naps at 1000 hr, 1200 hr, 1400 hr, 1600 hr, 1800 hr, 2000 hr, and 0400 hr. In contrast to sleep latencies, which exhibited a minimum in the afternoon, EEG power densities in the delta and theta frequencies were a monotonic function of the duration of prior wakefulness. The data support the hypothesis that EEG power density during non-rapid eye movement sleep is only determined by the prior history of sleep and wakefulness and is not determined by clock-like mechanisms.     

The effect of a daytime 60-min nap opportunity on postural control in highly active individuals

Although napping is commonly used as a strategy to improve numerous physical and cognitive performances, the efficacy of this strategy for improving postural balance has not yet been elucidated. Thus, the aim of this study was to conduct a comprehensive examination of the effect of a 60 min nap opportunity (N60) on different components of postural control. Ten highly active individuals (age = 27 ± 3.5 y, height = 1.75 ± 0.52 m, weight = 66.02 ± 8.63 kg) performed, in a randomized order, two afternoon test sessions following no nap (NN) and N60. Postural balance was assessed using the sensory organisation test (SOT), the unilateral stance test (UST), and the limits of Stability Test performed on NeuroCom^® Smart Balance Master. The subjective rating of sleepiness before and after the nap conditions was also assessed. Compared to NN, N60 improved the composite balance score (p < 0.05, ES = 0.75, Δ = 5.3%) and the average and maximum percentage balance in the most challenging postural conditions of the SOT (p < 0.05 for SOT-4 and 5 and p < 0.0005 for SOT-6; ES range between 0.58 and 1.1). This enhanced postural balance in N60 was accompanied with improved visual (p < 0.05; ES = 0.93; Δ = 8.9%) and vestibular (p < 0.05; ES = 0.81; Δ = 10.5%) ratios and a reduced level of sleepiness perception (p < 0.001, ES = 0.87). However, no significant differences were found in any of the UST and LOS components’ scores (p > 0.05). Overall, a 60 min post lunch nap opportunity may be viable for improving static balance, although further work, involving larger samples and more complex motor activities, is warranted.     

Neurophysiologic measurement of continuity in the sleep of fetuses during the last week of pregnancy and in newborns

Our aim was to measure the correlation between fetal electrocardiographic (FECG) recordings of low-risk pregnancies and polysomnographic (PSG) study parameters in low-risk infants born at term as a measurement of perinatal sleep-development continuity.We designed a short, prospective, observational follow-up of physiologic parameters between fetuses and newborns. We studied 10 fetuses from low-risk pregnant female out-patients and the same subjects as low-risk newborns delivered at term. Fetal state (FS) was defined in FECG recordings reassembling the following: fetal state I (quiet sleep or QS); fetal state II (active sleep or AS); fetal state III (quiet waking), and fetal state IV (active waking). Percentages of AS, QS, and wakefulness in PSG studies of newborns were also determined.Comparisons of FS I with QS showed a significant reduction in QS, while comparison of FS II with AS showed significant reduction in AS. Negative correlations were found between FS I with QS, and FS II with AS. Number of cycles in FECG recordings and PSG sleep cycles also demonstrated significant correlation.In conclusion our data showed partial but significant sleep function continuity from fetal to neonatal period.