Sleep Deprivation

The collaborative film My place is in between places (2022) explores the experience of being a woman in contemporary Portuguese academia, bringing together researchers from diverse disciplines, career stages, and nationalities, united by a common experience of (past or present) migration. Drawing on multi-sensory feminist research methods and patchwork ethnography, we discovered that our voices resonate in unexpected interstices. Through this collaborative filmmaking process, we engage in collective reflection and made visible the embodied experiences of (migrant) women navigating in-between everyday spaces. This process deepens our understanding of migration, gendering dynamics, and the tension between precariousness and privilege in corporate academia. Collaborative filmmaking as a research method creates new social spaces of resistance and care. Furthermore, the act of writing and filming together generates complementary perspectives that converge into a polyphonic voice which can expand our understanding of subtle social issues. This approach fosters solidarity and support over competition.

In 1981 a study was undertaken to determine intern and resident psychological well-being and identify those house staff who were psychologically impaired. Fourteen percent of house staff were found to be impaired. Single females and house staff who were chronically fatigued or socially isolated were at highest risk for impairment. Impairment arose out of the interaction between sleep and social deprivation and individual vulnerability. Minor tranquillizers, but not alcohol, were used as a coping response to impairment.

According to the laws of physics, electrical signals generate visible pictures if electrical signals are converted to electromagnetic waves (EMW) of the visible range (light photons of wavelengths between 350-700 nm). During dreams our eyes are closed, so the brain is isolated from visible EMWs of the surroundings, yet we can see visible dream pictures. It follows from the foregoing that electrical signals of the brain processes can generate visible pictures of dreams if and only if electrical signals are converted to weak, EMWs of the visible range (biophotons) in the brain. Nobody can explain origin of visible dream pictures if only the laws of physics are being taken into consideration! The homeotherm state and REM phases of sleep are developed simultaneously in evolution. In homeotherm creatures there appear well-regulated body and brain temperatures, restricted neurogenesis, and well-structured neuronal systems, which bear a relationship to the holograph-like operating mechanism of the brain. Exact temperature regulation is important for many holographic systems, because holographic pictures can be deformed if temperature fluctuations are too large. A structured neuron system is also needed to develop explicit memory, because it can guarantee a strong synchronization of different electric and biophoton signals. If dream pictures are generated by biophotons in the brain these processes also have to work during wakefulness. Dream pictures make a connection possible between the explicit and implicit memory systems in the brain. Dynamical series of pictures can carry unambiguous meaning which can be a base of development of words in different languages. The human memory can operate through dynamical pictures, and we link these pictures to each other in the learning process. Neurotransmitters, which play role in neuromolecular processes, also play a role in thermoregulation and in sleep/wake cycles. So, neurotransmitters and synapses are hardly units of information storage. It is proved by in vivo imaging that spontaneous ultra weak biophoton emission from a rat's brain correlated with cerebral energy metabolism (thermoregulation), EEG activity and oxidative stress.

Many women experience sleep problems during pregnancy. This includes difficulty initiating and maintaining sleep due to physiologic changes that occur as pregnancy progresses, as well as increased symptoms of sleepdisordered breathing (SDB). Growing evidence indicates that sleep deficiency alters glucose metabolism and increases risk of diabetes. Poor sleep may exacerbate the progressive increase in insulin resistance that normally occurs during pregnancy, thus contributing to the development of maternal hyperglycemia. Here, we critically review evidence that exposure to short sleep duration or SDB during pregnancy is associated with gestational diabetes mellitus (GDM). Several studies have found that the frequency of GDM is higher in women exposed to short sleep compared with longer sleep durations. Despite mixed evidence regarding whether symptoms of SDB (e.g., frequent snoring) are associated with GDM after adjusting for BMI or obesity, it has been shown that clinically-diagnosed SDB is prospectively associated with GDM. There are multiple mechanisms that may link sleep deprivation and SDB with insulin resistance, including increased levels of oxidative stress, inflammation, sympathetic activity, and cortisol. Despite emerging evidence that sleep deficiency and SDB are associated with increased risk of GDM, it has yet to be demonstrated that improving sleep in pregnant women (e.g., by extending sleep duration or treating SDB) protects against the development of hyperglycemia. If a causal relationship can be established, behavioral therapies for improving sleep can potentially be used to reduce the risk and burden of GDM.

Sleep and wake have global effects on brain physiology, from molecular changes and neuronal activities to synaptic plasticity. Sleep-wake homeostasis is maintained by the generation of a sleep need that accumulates during waking and dissipates during sleep. Here we investigate the molecular basis of sleep need using quantitative phosphoproteomic analysis of the sleep-deprived and Sleepy mouse models of increased sleep need. Sleep deprivation induces cumulative phosphorylation of the brain proteome, which dissipates during sleep. Sleepy mice, owing to a gain-of-function mutation in the Sik3 gene , have a constitutively high sleep need despite increased sleep amount. The brain proteome of these mice exhibits hyperphosphorylation, similar to that seen in the brain of sleep-deprived mice. Comparison of the two models identifies 80 mostly synaptic sleep-need-index phosphoproteins (SNIPPs), in which phosphorylation states closely parallel changes of sleep need. SLEEPY, the mutant SIK3 pro...

and 9(20%), emergencies. Strategies used to stay awake were, 15 (35%) walking around, 13(30%) drinking coffee, 4(10%) browsing the internet. Conclusion: Napping practice has been associated with major health and safety outcomes for the health care givers and patients. Most of the staffs take naps illegally and the managers acknowledged that the night shift hours were too long.

Introduction Sleep is a crucial determinant of maternal and fetal health, significantly impacting the well-being of both the mother and her developing fetus. Poor sleep quality, characterized by difficulties in falling asleep or staying asleep, can cause poor pregnancy outcome. Conversely, studies came with inconsistent result in the prevalence of poor sleep quality in different trimester of pregnancy. Therefore, this systematic review and meta-analysis study aimed to compare the prevalence of poor sleep quality in different trimesters. Method A systematic review and meta-analysis were done on published studies. Electronic data base search was done from PubMed, Hinari, Medline and Google Scholar. Data were extracted with Excel and the analysis were done using STATA version 17. Publication bias was assessed both graphically and statistically. I-square test was used to identify heterogeneity. Result In this meta-analysis, 38 studies that measured poor sleep quality using the Pittsburg Sleep Quality Index (PSQI ≥ 5) were included. The pooled prevalence of poor sleep quality was identified as 37.46% (95% CI: 29.26, 45.67) in the first trimester, 47.62% (95% CI: 42.23, 53.02) in the second trimester, and 60.05% (95% CI: 51.32, 68.78) in the third trimester. Conclusion This study identified a significant discrepancy in the prevalence of poor sleep quality, which increases as gestational age advances. Therefore, this discrepancy should be addressed, and additional support should be provided to pregnant women to help them achieve adequate sleep, especially as gestational age advances.

The aim of the study was to conduct in-depth analyses of the lived experiences of the caregivers of dementia and their maladaptive thinking patterns and how their physical health was influenced and compromised. The main method used was interpretative phenomenological analysis and involved in-depth analysis of eight participants screened through homogenous purposive sampling. After taking written consent from the participants, semi-structured interviews were conducted to gather the data that were transcribed later on to carry out free textual analysis. The themes were generated from the transcripts through the funneling approach in order to arrive at the themes that were common, frequent, and reflected the experiences shared by the participants. The verification was done through peer review and rich thick description. The most significant themes regarding maladaptive cognitions were catastrophizing, overgeneralizing, and blaming, whereas fatigue and sleep disturbances were the most significant themes regarding physical health. The emergent themes point towards a need to devise indigenous therapeutic intervention for the caregivers of dementia in the Pakistani sociocultural context as the literature available on caregiving is quite scanty in our culture.

Introduction: A person spends one third life in sleep, so the quality and quantity of sleep is of utmost importance. Health Care Professionals (HCPs) are more prone to inconsistency in sleep both in quality and quantity, which leads to deflection from health and well-being of themselves and care of others. This study aims to assess the various factors influencing sleep quality and daytime sleepiness among medical and nursing healthcare professionals. Methodology: A cross sectional study was conducted using a structured questionnaire to collect socio-demographic and work-related information, co-morbidity and quality of Sleep using ESS (Epworth Sleepiness Scale) and PSQI (Pittsburgh Sleep Quality Index) scale. Results: Among the 150 HCPs, 64.7% were medical and 35.3% were nursing professionals. 53.6% of medical and 66% of nursing professionals reported poor sleep quality. Increased coffee consumption influences sleep quality and it was found to be statistically significant. Nursing pr...

Background Sleep plays a crucial role in the health and well-being of adolescents; however, inadequate sleep is frequently reported in numerous countries. This current paper aimed to describe sleep duration, factors impacting sleep, consequences of insufficient sleep and satisfaction with life in Norwegian adolescents, stratified by sex and by adherence to the 8-hour sleep recommendation, and to examine potential associations between adherence to the 8-hours sleep recommendation and satisfaction with life. Methods This is a cross-sectional study using data from the Norwegian Ungdata Survey, collected in 2021. Adolescents from five Norwegian counties were included, comprising a total of 32,161 upper secondary school students. Study variables were collected through an electronic questionnaire administered during school hours and all data are anonymous. Descriptive data of sleep patterns are presented, and linear regressions were conducted adjusting for SES, perceived stress, physical activity level, over-the-counter analgesics use, grade level and screen time. Results 73% of adolescents did not adhere to the 8-hours of sleep recommendation per night, with similar results for girls and boys. 64% reported tiredness at school (minimum 1-2 days weekly) and 62% reported that screen time negatively affected their ability to sleep. 23% reported that gaming affected their sleep, with a higher prevalence in boys than girls. Satisfaction with life score was 7.0 ± 1.9 points (out of 10) for the total sample, with higher scores for boys (7.3 ± 1.8 points) than girls (6.9 ± 1.9 points). Regressions revealed a positive association with satisfaction with life (B = 0.31, 95% [0.15 to 0.48]) in adolescents adhering to sleep recommendation of 8h compared to the ones not adhering to the sleep recommendation. Conclusions Most Norwegian adolescents fail to adhere to the 8-hours of sleep recommendation and the majority feel tired at school or during activities. More than half of adolescents reported that screen time negatively affected their ability to sleep. Adhering to the sleep recommendation was associated with higher life satisfaction. Our findings highlight the importance of sufficient sleep in adolescents, while future research is needed to examine other sleep related measures on adolescents´ satisfaction with life.

Acutely restricting sleep worsens insulin sensitivity in healthy individuals whose usual sleep is normal in duration and pattern. The effect of recovery or weekend 'catch-up' sleep on insulin sensitivity and metabolically active hormones in individuals with chronic sleep restriction who regularly 'catch-up' on sleep at weekends is as yet unstudied. 19 men (mean±SEM age 28.6±2.0years, BMI 26.0±0.8kg/m(2) ) with at least 6 months' history (5.1±0.9years) of lifestyle driven, restricted sleep during the working week (373±6.6 min/night) with regular weekend 'catch up' sleep (weekend sleep extension 37.4±2.3%) completed an in-laboratory, randomised, cross-over study comprising 2 of 3 conditions, stratified by age. Conditions were 3 weekend nights of 10 hours, 6 hours or 10 hours time-in-bed with slow wave sleep suppression using targeted acoustic stimuli. Insulin sensitivity was measured in the morning following the 3(rd) intervention night by minimal modelling...

The aim of this study was to determine the role of obesity on the association between sleep and on-duty injury among male career firefighters. Methods: Data on 1419 male career firefighters for this cross-sectional study came from two firefighter cohorts from 2008 to 2013. On-duty injury within the past 6 to 12 months was the dependent variable and getting enough sleep was the independent variable. A multivariable, mixed effect logistic regression model stratified by body mass index (BMI) categories was created to examine the presence of effect measure modification. Results: Only obese firefighters who did not get enough sleep were twice as likely to have an on-duty injury than those who got enough sleep. This association was not significant among normal or overweight firefighters. Conclusions: Future studies into on-duty injury and sleep should examine body composition as an effect modifier among career firefighters.

Sleep deprivation interferes with cognitive performance but the mechanisms are poorly understood. We recently reported that one night of sleep deprivation increased dopamine in striatum (measured with [ 11 C] raclopride, a PET radiotracer that competes with endogenous dopamine for binding to D2 receptors) and that these increases were associated with impaired performance in a visual attention task. To better understand this association here we evaluate the relationship between changes in striatal dopamine (measured as changes in D2 receptor availability using PET and [ 11 C]raclopride) and changes in brain activation to a visual attention task (measured with BOLD and fMRI) when performed during sleep deprivation versus during rested wakefulness. We find that sleep induced changes in striatal dopamine were associated with changes in cortical brain regions modulated by dopamine (attenuated deactivation of anterior cingulate gyrus and insula) but also in regions that are not recognized targets of dopaminergic modulation (attenuated activation of inferior occipital cortex and cerebellum). Moreover, the increases in striatal dopamine as well as its associated regional activation and deactivation patterns correlated negatively with performance accuracy. These findings therefore suggest that hyperstimulation of D2 receptors in striatum may contribute to the impairment in visual attention during sleep deprivation. Thus, while dopamine increases in prefrontal regions (including stimulation of D1 receptors) may facilitate attention our findings suggest that hyperstimulation of D2 receptors in striatum may impair it. Alternatively, these associations may reflect a compensatory striatal dopamine response (to maintain arousal) that is superimposed on a larger response to sleep deprivation.

Objectives: Discrimination between narcolepsy, idiopathic hypersomnia, and behavior-induced inadequate sleep syndrome (BIISS) is based on clinical features and on specific nocturnal polysomnography (NPSG) and multiple sleep latency test (MSLT) results. However, previous studies have cast doubt on the specificity and sensitivity of these diagnostic tools. Methods: Eleven variables of the NPSG were analyzed in 101 patients who were retrospectively diagnosed with narcolepsy with cataplexy (N + C) (n = 24), narcolepsy without cataplexy (NÀC) (n = 38), idiopathic hypersomnia with long sleep period (IHL) (n = 21), and BIISS (n = 18). Results: Fifteen out of 24 N + C and 8 out of 38 NÀC entered the first rapid eye movement (REM) sleep period (FREMP) from sleep stage 1 (N1) or wake (W), though this sleep-stage sequence did not arise in the other patient groups. FREMP stage sequence was a function of REM sleep latency (REML) for both N + C and NÀC groups. FREMP stage sequence was not associated with mean sleep latency (MSL) in N + C but was associated in NÀC, which implies heterogeneity within the NÀC group. REML also was a useful discriminator. Depending on the cutoff period, REML had a sensitivity and specificity of up to 85.5% and 97.4%, respectively. Conclusions: The FREMP stage sequence may be a useful tool in the diagnosis of narcolepsy, particularly in conjunction with sleep-stage sequence analysis of sleep-onset REM periods (SOREMPs) in the MSLT; it also may provide a helpful intermediate phenotype in the clarification of heterogeneity in the NÀC diagnostic group. However, larger prospective studies are necessary to confirm these findings.

Animals maximize fitness by modulating sleep and foraging strategies in response to changes in nutrient availability. Wild populations of the fruit fly, Drosophila melanogaster, display highly variable levels of starvation and desiccation resistance that differ in accordance with geographic location, nutrient availability, and evolutionary history. Further, flies potently modulate sleep in response to changes in food availability, and selection for starvation resistance enhances sleep, revealing strong genetic relationships between sleep and nutrient availability. To determine the genetic and evolutionary relationship between sleep and nutrient deprivation, we assessed sleep in flies selected for desiccation or starvation resistance. While starvation resistant flies have higher levels of triglycerides, desiccation resistant flies have enhanced glycogen stores, indicative of distinct physiological adaptations to food or water scarcity. Strikingly, selection for starvation resistance, but not desiccation resistance, leads to increased sleep, indicating that enhanced sleep is not a generalized consequence of higher energy stores. Thermotolerance is not altered in starvation or desiccation resistant flies, providing further evidence for context-specific adaptation to environmental stressors. F 2 hybrid flies were generated by crossing starvation selected flies with desiccation selected flies, and the relationship between nutrient deprivation and sleep was examined. Hybrids exhibit a positive correlation between starvation resistance and sleep, while no interaction was detected between desiccation resistance and sleep, revealing that prolonged sleep provides an adaptive response to starvation stress. Therefore, these findings demonstrate context-specific evolution of enhanced sleep in response to chronic food deprivation, and provide a model for understanding the evolutionary relationship between sleep and nutrient availability.

Dysregulation of sleep is associated with metabolic diseases, and metabolic rate is acutely regulated by sleep-wake behavior. In humans and rodent models, sleep loss is associated with obesity, reduced metabolic rate, and negative energy balance, yet little is known about the neural mechanisms governing interactions between sleep and metabolism. We have developed a system to simultaneously measure sleep and metabolic rate in individual Drosophila, allowing for interrogation of neural systems governing interactions between sleep and metabolic rate. Like mammals, metabolic rate in flies is reduced during sleep and increased during sleep deprivation suggesting sleepdependent regulation of metabolic rate is conserved across phyla. The reduction of metabolic rate during sleep is not simply a consequence of inactivity because metabolic rate is reduced ~30 minutes following the onset of sleep, raising the possibility that CO 2 production provides a metric to distinguish different sleep states in the fruit fly. To examine the relationship between sleep and metabolism, we determined basal and sleep-dependent changes in metabolic rate is reduced in starved flies, suggesting that starvation inhibits normal sleep-associated effects on metabolic rate. Further, translin mutant flies that fail to suppress sleep during starvation demonstrate a lower basal metabolic rate, but this rate was further reduced in response to starvation, revealing that regulation of starvation-induced changes in metabolic rate and sleep duration are genetically distinct. Therefore, this system provides the unique ability to simultaneously measure sleep and oxidative metabolism, providing novel insight into the physiological changes associated with sleep and wakefulness in the fruit fly.

Dysregulation of sleep is associated with metabolic diseases, and metabolic rate is acutely regulated by sleep-wake behavior. In humans and rodent models, sleep loss is associated with obesity, reduced metabolic rate, and negative energy balance, yet little is known about the neural mechanisms governing interactions between sleep and metabolism. We have developed a system to simultaneously measure sleep and metabolic rate in individual Drosophila, allowing for interrogation of neural systems governing interactions between sleep and metabolic rate. Like mammals, metabolic rate in flies is reduced during sleep and increased during sleep deprivation suggesting sleep-dependent regulation of metabolic rate is conserved across phyla. The reduction of metabolic rate during sleep is not simply a consequence of inactivity because metabolic rate is reduced ∼30 minutes following the onset of sleep, raising the possibility that CO2 production provides a metric to distinguish different sleep sta...

Objectives: The primary objective was to assess the level of stress-related to work and quality of sleep among intern nursing students. The secondary objective is to determine the level of work-related stress& its association with the demographic variables. Methods: This was a descriptive study conducted among 160 internship students. The subjects were selected conveniently and interviewed through a self-structured demographic Performa.PSQI sleep assessment scale and perceived stress scale were administered to assess the sleep quality and level of stress related to work respectively. Results: As per the survey results, with regards to work-related stress majority 64.4% of the subjects were having a moderate level of stress and a very few i.e 3.8% of the sample were having severe stress. In the case of sleep quality among interns, more of the samples (83.3%) were having the average quality of sleep and only 6.2% of samples were having good sleep quality. There is an extremely statist...

Background Current evidence supports associations between circadian, sleep, and mood disturbances. However, it is still debated to what extent different chronobiological and mood variables act independently or in synergy to impact health. This study assesses how these variables interact to affect depressive symptoms and sleep quality in 26 Uruguayan dancers (age=22.27±2.43) training in the morning (n=9) or in the night shift (n=17). Participants completed the Munich Chronotype Questionnaire, the Pittsburgh Sleep Quality Index, and the Beck Depression Inventory-II. Participants reported high social jetlag (1.58±1.45h), late chronotypes (05:43±01:35), and poor sleep quality (6.77±2.67), while adequate sleep duration (7.10±1.31h) and minimal depression (7.15±3.62), without differences across shifts. Depressive symptoms increased as sleep quality worsened (F(1,21)=20.66, p<0.001, η 2 =0.50). In addition, we found a marginal interaction between sleep duration and the shift to explain depressive mood (F(1,21)=4.06, p=0.057, η 2 =0.16), with participants in the morning shift showing higher depressive symptoms with decreased sleep duration. Furthermore, sleep quality deteriorated as social jetlag increased (F(1,20)=14.82, p=0.001, η 2 =0.43), particularly in more depressed individuals (F(1,20)=24.09, p<0.001, η 2 =0.55). Our findings indicate that social, circadian, sleep, and mood variables are inextricably linked in this population of dancers.

The perifornical-lateral hypothalamic area (PF-LHA) is a major wake-promoting structure. It predominantly contains neurons that are active during behavioral and cortical activation. PF-LHA stimulation produces arousal and PF-LHA lesions produce somnolence. Nitric oxide (NO) is a gaseous neurotransmitter that has been implicated in the regulation of multiple pathological and physiological processes including the regulation of sleep. NO levels are higher in the cortex and in the basal forebrain (BF) during arousal. In this study we determined whether NO levels increase in the PF-LHA during prolonged arousal and whether increased NO modulates the discharge activity of PF-LHA neurons. Experiments were conducted during lights-on phase between 8.00 -20.00h (lights-on at 8.00h). First, we quantified levels of NO metabolites, NO 2 -and NO 3 -(collectively called NOx -) in the microdialysis dialysates collected from the PF-LHA during baseline (undisturbed rats), 6h of sleep deprivation (SD), and recovery after SD. We further determined the effects of a NO donor, NOC-18, on the discharge activity of PF-LHA neurons in urethane-anesthetized rats.

Machines do not sleep, and so they do not dream. Humans must sleep, and in this fragility lies survival and vision. Sleep is not only a biological necessity but also a threshold into altered states of consciousness. At its boundary lies hypnagogia, the fleeting, liminal state that has inspired figures such as Nikola Tesla and Salvador Dalí, fuelling creativity while also risking instability. This essay explores the fine line between adaptive hypnagogia and pathological sleep loss, drawing on neuropsychological research, historical examples, and practices from meditation to micro-napping. It examines how sleep sustains memory, emotion, and social cognition, while deprivation corrodes them. It also explores artificial intelligence, machines may calculate without rest, but without dreams they cannot know what it means to be conscious. Sleep, with all its fragility and vision, remains the rhythm that defines humanity.

Smartphones are now in very widespread use, and concerns have arisen about potential detrimental effects, even with acute use. These adverse consequences are often linked to the emergence of mental fatigue. While the cognitive implications of fatigue are well-documented, knowledge about the specific influence of acute smartphone use on cognitive performance remains scarce. The aim of this study was therefore to investigate the impact of acute smartphone use on cognitive performance. It included two experiments: one designed to assess the impact of smartphone use on vigilance, and the other focusing on evaluating inhibition capacities. In Experiment 1, two groups of 40 participants completed a Psychomotor Vigilance Task (PVT) before and after using a smartphone for 45 min (experimental group), or before and after watching a documentary (control group). In Experiment 2, two groups of 40 participants were subjected to a similar experimental design but had to perform a Go/NoGo task instead of a PVT. Mental fatigue and drowsiness were evaluated with visual analog scales before and after smartphone use and watching a documentary. Results suggested that both watching a documentary and using a smartphone for 45 min increased subjective mental fatigue and drowsiness. Watching the documentary did not impair cognitive performance. Reaction times on the PVT and number of errors on NoGo trials in the Go/NoGo task were higher among the participants in the smartphone condition. These results indicate reduced vigilance and impaired inhibition capacities only after smartphone use. We conclude that acute smartphone use induces mental fatigue and decreases cognitive performance. Further research is needed to understand the mechanisms underlying this decline in cognitive performance.

Drivers should be aware of possible impairing effects of alcohol, medicinal substance, or fatigue on driving performance. Such effects are assessed in clinical trials, including a driving task or related psychomotor tasks. However, a choice between predicting tasks must be made. Here, we compare driving performance with on-the-road driving, simulator driving, and psychomotor tasks using the effect of sleep deprivation. This two-way cross over study included 24 healthy men with a minimum driving experience of 3000km per year. Psychomotor tasks, simulated driving, and on-the-road driving were assessed in the morning and the afternoon after a well-rested night and in the morning after a sleep-deprived night. Driving behaviour was examined by calculating the Standard Deviation of Lateral Position (SDLP). SDLP increased after sleep deprivation for simulated (10cm, 95%CI:6.7-13.3) and onthe-road driving (2.8cm, 95%CI:1.9-3.7). The psychomotor test battery detected effects of sleep deprivation in almost all tasks. Correlation between on-the-road tests and simulator SDLP after a well-rested night (0.63, p < .001) was not present after a night of sleep deprivation (0.31, p = .18). Regarding the effect of sleep deprivation on the psychomotor test battery, only adaptive tracking correlated with the SDLP of the driving simulator (-0.50, p = .02). Other significant correlations were related to subjective VAS scores.

Drivers should be aware of possible impairing effects of alcohol, medicinal substance, or fatigue on driving performance. Such effects are assessed in clinical trials, including a driving task or related psychomotor tasks. However, a choice between predicting tasks must be made. Here, we compare driving performance with on-the-road driving, simulator driving, and psychomotor tasks using the effect of sleep deprivation. This two-way cross over study included 24 healthy men with a minimum driving experience of 3000km per year. Psychomotor tasks, simulated driving, and on-the-road driving were assessed in the morning and the afternoon after a well-rested night and in the morning after a sleep-deprived night. Driving behaviour was examined by calculating the Standard Deviation of Lateral Position (SDLP). SDLP increased after sleep deprivation for simulated (10cm, 95%CI:6.7-13.3) and onthe-road driving (2.8cm, 95%CI:1.9-3.7). The psychomotor test battery detected effects of sleep deprivation in almost all tasks. Correlation between on-the-road tests and simulator SDLP after a well-rested night (0.63, p < .001) was not present after a night of sleep deprivation (0.31, p = .18). Regarding the effect of sleep deprivation on the psychomotor test battery, only adaptive tracking correlated with the SDLP of the driving simulator (-0.50, p = .02). Other significant correlations were related to subjective VAS scores.

Drivers should be aware of possible impairing effects of alcohol, medicinal substance, or fatigue on driving performance. Such effects are assessed in clinical trials, including a driving task or related psychomotor tasks. However, a choice between predicting tasks must be made. Here, we compare driving performance with on-the-road driving, simulator driving, and psychomotor tasks using the effect of sleep deprivation. This two-way cross over study included 24 healthy men with a minimum driving experience of 3000km per year. Psychomotor tasks, simulated driving, and on-the-road driving were assessed in the morning and the afternoon after a well-rested night and in the morning after a sleep-deprived night. Driving behaviour was examined by calculating the Standard Deviation of Lateral Position (SDLP). SDLP increased after sleep deprivation for simulated (10cm, 95%CI:6.7-13.3) and onthe-road driving (2.8cm, 95%CI:1.9-3.7). The psychomotor test battery detected effects of sleep deprivation in almost all tasks. Correlation between on-the-road tests and simulator SDLP after a well-rested night (0.63, p < .001) was not present after a night of sleep deprivation (0.31, p = .18). Regarding the effect of sleep deprivation on the psychomotor test battery, only adaptive tracking correlated with the SDLP of the driving simulator (-0.50, p = .02). Other significant correlations were related to subjective VAS scores.

Introduction: The role of sleep in supporting psychological, mental, and physical health is well documented. Sleep hygiene practices are effective modifiable behaviours that can be beneficial to improve sleep quality among medical students who are in short supply of sleep due to a demanding course. Aim and Objective: To estimate the magnitude and beliefs about of poor sleep hygiene among medical students. To identify specific changes to needed to Sleep Hygiene Index (SHI). Methods: A cross-sectional study involving 293 undergraduate medical students using a pre-designed, selfadministered questionnaire was conducted. Validated instruments the SHI and Pittsburgh Sleep Quality Index were used. Results: Poor sleep hygiene practices (47.4%) and poor sleep quality (69.3%) were prevalent among substantial number of medical students. Bedtime technology use, sleep latency (AOR=2.276), sleep disturbance (AOR=2.459), use of sleeping medication (AOR=6.559) and daytime dysfunction (AOR=2.128) had a significant association with poor sleep hygiene practices (p<0.05). The area under the ROC curve for SHI as a tool for predicting good sleep quality was 0.663. Conclusions: Regularization of sleep schedules by conducting time-management workshops among students and addition of items in SHI, on bedtime technology use along with dietary changes and daytime exposure to sunlight to improve sleep quality is recommended.

Narcolepsy is a chronic, disabling neurological disorder of rapid eye movement (REM) sleep regulation characterized by excessive daytime sleepiness (EDS), recurrent sleep attacks, nocturnal sleep fragmentation, and in many patients, the presence of cataplexy, hypnagogic hallucinations, and sleep paralysis. Classically divided into narcolepsy type 1 (NT1, formerly with cataplexy, associated with hypocretin deficiency) and narcolepsy type 2 (NT2, formerly without cataplexy, often with preserved hypocretin levels), the condition represents a prototypical disorder of unstable transitions between sleep and wakefulness. Despite increasing recognition, narcolepsy remains underdiagnosed, with average diagnostic delays of 5–10 years, contributing substantially to academic, occupational, and psychosocial morbidity.
Etiological studies strongly implicate autoimmune-mediated destruction of hypothalamic orexin-producing neurons, particularly in NT1, supported by robust associations with HLA-DQB1*0602 and environmental triggers such as influenza infection or vaccination. The prevalence of NT1 is estimated at 14 per 100,000 and NT2 at 65 per 100,000, with onset typically in adolescence or early adulthood and a modest female predominance. Pathophysiologically, disruption of orexin signaling destabilizes the balance between the reticular activating system and sleep-promoting regions such as the ventrolateral preoptic area, allowing inappropriate intrusion of REM phenomena into wakefulness.
Clinically, narcolepsy manifests through EDS, cataplexy (in NT1), recurrent episodes of sleep paralysis, hypnagogic/hypnopompic hallucinations, and disturbed nocturnal sleep, often misdiagnosed as epilepsy, psychiatric illness, or behavioral disturbance in children. Diagnostic confirmation relies on polysomnography and multiple sleep latency testing (MSLT), demonstrating rapid sleep-onset REM episodes, alongside cerebrospinal fluid (CSF) hypocretin assays where available.
Therapeutic approaches are multidisciplinary, combining pharmacologic strategies—stimulants (modafinil, methylphenidate), sodium oxybate, antidepressants for cataplexy—with lifestyle modifications, behavioral counseling, and academic/workplace accommodations. Recent advances include orexin receptor agonists currently in clinical development, representing potential disease-modifying therapies.
This review synthesizes contemporary understanding of narcolepsy, emphasizing its pathobiology, clinical evaluation, and evolving treatment paradigms, while underscoring the critical role of interprofessional collaboration in optimizing patient outcomes.

The aim of this study was to investigate the effects of sleep deprivation induced anxiety on anaerobic performance. Thirteen volunteer male physical education students completed the Turkish version of State Anxiety Inventory and performed Wingate anaerobic test for three times: (1) following a full-night of habitual sleep (baseline measurements), (2) following 30 hours of sleep deprivation, and (3) following partial-night sleep deprivation. Baseline measurements were performed the day before total sleep deprivation. Measurements following partial sleep deprivation were made 2 weeks later than total sleep deprivation measurements. State anxiety was measured prior to each Wingate test. The mean state anxiety following total sleep deprivation was higher than the baseline measurement (44.9 ± 12.9 vs. 27.6 ± 4.2, respectively, p = 0.02) whereas anaerobic performance parameters remained unchanged. Neither anaerobic parameters nor state anxiety levels were affected by one night partial sle...

Background: Published evidence suggests an inverse association between sleep duration and body weight status. Objective: We examined the association of sleep duration with eating behaviors reported by adult Americans to understand the relation between sleep duration and body weight status. Design: This cross-sectional study used sleep duration and dietary data from the continuous NHANES conducted from 2005 to 2010 (n = 15,199, age $20 y). Eating behaviors examined included the following: reporting of and energy from main meals (breakfast, lunch, and dinner) and snacks (before breakfast, after dinner, and after 2000 h), intermeal intervals, time of day of main meal reporting, and intakes of macronutrients and beverages. Multiple regression methods were used to examine the independent association of hours of sleep duration grouped as short (#6 h), average (7-8 h), and long ($9 h) with eating behavior outcomes. Results: Relative to average-duration sleepers, a smaller percentage of short-duration sleepers mentioned breakfast, lunch (women only), and dinner in the recall (P # 0.04). They also reported a lower mean percentage of energy from main meals but higher energy from all snacks (P # 0.0004) and after 2000 h (P = 0.03). Short-duration sleepers reported the earliest eating time of the first episode and the latest time of the last eating episode. Absolute amounts of sugar and caffeine and percentage of energy from beverages (women only) were higher in short-duration sleepers. However, the total number of eating episodes and energy intake were not related with sleep duration. Conclusions: Short-duration sleepers began eating earlier and ended their eating later in the day, but despite the longer eating period, they did not report more eating events. Profiles of the relative contribution of main meals and snacks, at or after 2000 h eating, and beverages in shortduration sleepers were suggestive of eating behaviors that may increase energy intake, but 24-h energy intake did not differ among categories of sleep duration.

points of the day (ie, night), perhaps in combination with metabolically equally challenging mistimed sleep. Given that eating at the ''wrong'' time from a circadian perspective may increase the risk of weight gain, even under neutral energy balance conditions, an important next step would be to examine to what extent specifically misaligned sleep or rotating sleep schedules-habits typically seen in those who ''work on shifts''-favor energy surplus and metabolic consequences in cohorts such as NHANES.

Morning" and "evening" persons, defined according to a modified version of the Home and Ostberg questionnaire, performed the 7/13 min sleep-waking schedule under attempting sleep condition after sleeping for one night in the laboratory, and under the resisting sleep condition after one night of sleep deprivation. Morning types slept significantly more under the attempting sleep condition and showed an earlier rise in nocturnal sleepiness. After sleep deprivation, morning types had a more distinct sleep propensity pattern with well-defined midafternoon and nocturnal sleep gates. In this condition there was a significant interaction between type and time of day with respect to amount of sleep: morning types slept more during the night, and evening types slept more during the day. Based on their amounts of sleep, subjects were also divided into "sleepy" and "alert" types, which were independent from the chronotypology.

Study Objectives Sleep disruption is common in attention deficit hyperactivity disorder (ADHD). Likewise, deficits in attention are a hallmark of sleep deprivation in healthy individuals. Whether ADHD and sleep deprivation modulate common, or disparate, neural systems is unknown. No study has yet utilized functional magnetic resonance imaging (fMRI) to investigate sleep loss in ADHD. We address this gap by performing a novel meta-analysis to compare patterns of fMRI activation during sleep deprivation and ADHD. Methods We performed a coordinate-based activation likelihood estimate (ALE) meta-analysis using the GingerALE software. A systematic review of task-based fMRI studies of sleep deprivation vs. rested and also ADHD vs. healthy controls (HC) yielded 134 articles. fMRI coordinates were extracted for each contrast (i.e. “ADHD vs. HC,” “TSD vs. Rested”) and normalized to the Talairach-atlas. Separate ALE analyses were performed for ADHD and sleep deprivation. We directly compared ...

Objective: Caregivers to persons with dementia (PWD) consistently report lower sleep quality than non-caregiving controls. Low sleep quality, in addition to being unhealthy for the caregiver, may also impact the quality of care provided to the PWD. One factor that may contribute to poor sleep among caregivers is neurobehavioral symptoms (NBS) of the PWD. NBS, such as mood changes, lack of motivation, and disinhibition, are consistently rated as some of the most distressing symptoms by caregivers. Furthermore, they can include some symptoms related to sleep, such as nighttime wandering and REM sleep behaviors. Prior correlational research indicates a very strong association between NBS of the PWD and sleep quality of the caregiver. However, there are third variables, particularly demographics of the caregiver, which may better explain this relationship. When these variables are controlled in research, findings on the association between PWD NBS and caregiver sleep quality are mixed. Thus, we sought to investigate the relation between PWD NBS and caregiver sleep quality while controlling for caregiver demographics. Participants and Methods: Fifty caregivers to PWD completed a survey containing the Mild Behavioral Impairment Checklist as a measure of PWD NBS, the Pittsburgh Sleep Quality Index as a measure of caregiver sleep quality, and caregiver demographics. The relationship between PWD NBS and caregiver sleep quality was assessed using hierarchical linear Categories: Sleep and Sleep Disorders Keyword 1: caregiver burden Keyword 2: sleep

Athletes and coaches believe that adequate sleep is essential for peak performance. There is ample scientific evidence which support the conclusion that sleep loss seems to stress many physiological functions in humans. The aim of this study was to determine the effect of one night's sleep deprivation on intermittent exercise performance in the evening of the following day. Ten male Taekwondo players performed the Yo-Yo intermittent recovery test (YYIRT) in three sleep conditions (reference sleep night [RN], partial sleep deprivation at the beginning of night [PSDBN], partial sleep deprivation at the end of night [PSDEN]) in a counterbalanced order, allowing a recovery period ≥ 36 hr in between them. Heart rate peak (HRpeak), plasma lactate concentrations (Lac) and rating of perceived exertion (RPE) were measured during the test. A significant effect of sleep restriction was observed on the total distance covered in YYIRT (P< 0.0005) and Lac (P< 0.01) in comparison with the RN. In addition, performance more decreased after PSDEN (P< 0.0005) than PSDBN (P< 0.05). Also, Lac decreased significantly only after PS-DEN (P< 0.05) compared with RN. However, there were no significant changes in HRpeak and RPE after the two types of partial sleep deprivation compared to RN. The present study indicates that short-term sleep restriction affect the intermittent performance, as well as the Lac levels of the Taekwondo players in the evening of the following day, without alteration of HRpeak and RPE.

INTRODUCCI‹ N: aunque está demostrado que el tratamiento mejora la mortalidad, morbilidad y calidad de vida de los pacientes con síndrome de apnea/hipopnea obstructiva del sueño, la mayoría de los pacientes no es diagnosticado y por tanto no se les ofrece terapéutica alguna. OBJETIVO: describir el impacto en la demora del proceso clínico-administrativo que siguen los pacientes hasta obtener el diagnóstico de síndrome de apnea/hipopnea obstructiva del sueño, determinar su duración y estimar su costo. METODOS: se realizó un estudio descriptivo multicéntrico en tres instituciones de salud colombianas a través de una encuesta que indagó aspectos demográficos, clínica y proceso para el diagnóstico. RESULTADOS: Se encuestaron 149 pacientes. Se encontró que los pacientes requerían en promedio 5,3 años de consultas y práctica de exámenes paraclínicos para obtener el diagnóstico. Los costos totales de los estudios paraclínicos realizados fueron en promedio $841.677 por paciente (2,2 salarios mínimos legales vigentes). CONCLUSIONES: se evidenció que el síndrome de apnea/hipopnea obstructiva del sueño es un problema frecuente, mal diagnosticado y por lo tanto mal tratado. Se debe capacitar tanto a los médicos generales como a los especialistas para que reconozcan oportunamente los signos y síntomas que llevan al diagnóstico (Acta Neurol Colomb 2006;22:12-24). PALABRAS CLAVE: síndromes de la apnea del sueño, ronquido, diagnóstico, terapéutica, costos de la atención en salud. eventhough it is demonstrated that the treatment of sleep apnea syndrome improves mortality, morbility and quality of life of those patients, most of them are not diagnosed leading to a delayed therapeutic management. OBJECTIVE: to measure the impact of the delay in the diagnosis of patients with obstructive sleep apnea syndrome on time and healthcare expenditures (medical visits and complementary tests). METHODS: a multicenter descriptive study was conducted, at three Colombian health institutions. A survey asking about demographic, clinical and paraclinical aspects for the process of diagnosis was held. RESULTS: total of 149 adult patients were followed. Patients had an average of 5,3 years of medical visits and complementary studies to obtain the diagnosis. The total cost in complementary tests was $841.677 per patient (2,2 monthly legal minimum salaries). CONCLUSIONS: this results provide fairly clear medical and economic arguments in favour of early management of patients with obstructive sleep apnea syndrome, it is a frequent and poorly diagnosed and treated disease. General doctors and specialists must be trained to identify signs and symptoms to make the diagnosis (Acta Neurol Colomb 2006;22:12-24).

Sleep hygiene is essential for maintaining both health and academic performance, poor sleep has become a public c health concern. This study evaluated awareness, perception of sleep hygiene and sleep hygiene behaviours among medical students in the studied institution. The study is a descriptive cross-sectional design; multi-stage sampling was used to determine sample size of 273, (200 to 400) levels students. Self-structured questionnaire was used to collect data, reliability of the instrument was established through test-retest method. Pearson Correlation Coefficient was used to determine the reliability coefficient of 0.85, same was adjudged adequate for the instrument. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 23 and results presented as percentage and frequency distributions. Findings revealed that majority of students 139 (55%), had limited awareness of sleep hygiene. Students' perceptions on essentiality of good sleep hygiene for physical and mental health showed poor perception as only 55 (21.7%), strongly agreed with this opinion, many believed sleep hygiene was mainly beneficial for individuals with sleep disorders. Majority 113 (44.6%) demonstrated moderate adherence to maintaining a consistent sleep schedule by consistently going to bed and waking up at same time daily. In conclusion, there is low level of awareness, poor perception of sleep hygiene and low level of sleep hygiene behaviours among respondents. Recommendations included, integrating sleep hygiene education in medical curriculum; students should learn about sleep hygiene and its impact on their overall health to effectively address existing knowledge gaps and promote better sleep hygiene.

IntroductionThe rapid eye movement sleep deprivation (REMSD) of rats relates with increased inflammations, acute phase response, oxidative damage, neuronal cell loss, and neurodegenerative diseases. Whereas, its role outside brain are not well studied. This study tried to explore the causal effect of REM sleep loss on hepatocytes.MethodsWe deprived the rats of REM sleep using standard flower pot method. We focused on liver to see the REMSD affects which controls most of the metabolic processes of the body.ResultsWe report here that flower pot induced REMSD causes apoptotic cell death of hepatocytes (~10% by Annexin Assay & ~20% by TUNEL assay). This were further got alleviated up to extent after sleep recovery of 5 days (recovered approximately 8.0% by Annexin Assay & 14% by TUNEL assay). The gene expression and protein level profiling revealed the up-regulation of p53, Bax, Cytochrome c, Caspase 3, and Caspase 9. While, Bcl2 which is an anti-apoptotic protein were down-regulated in...

Background: Rapid Eye Movement sleep deprivation (REMSD) of rats causes inflammation of the liver and apoptotic cell death of neurons and hepatocytes. Studies also suggest that REMSD are involved with muscle injury, cardiac injury and neurodegerative diseases. Objective and methods: The aim of this research was to determine whether REMSD of rats would generate reactive oxygen species (ROS) and create oxidative stress in the hepatocytes. We selectively deprived the rats from REM sleep using the standard flower pot method. Results: We observed that when rats were subjected to REMSD, the levels of ROS in the hepatocytes increased with the increase in the number of days of REMSD by ~265%, but it returned towards normal levels after recovery sleep for 5 days (~36%) compared to controls. Nitric oxide synthase (iNOS) gene and protein was found elevated in hepatocytes in response to REM sleep loss as confirmed by real time PCR and western blot analysis compared to controls. The level of nit...

Sleep is essential for the survival of most living beings. Numerous researchers have identified a series of genes that are thought to regulate “sleep-state” or the “deprived state”. As sleep has significant effect on physiology, we believe that lack of sleep or particularly REM sleep for a prolonged period would have a profound impact on various body tissues. Therefore, using microarray method, we sought to determine which genes and processes are affected in the brain and liver of rats following 9 days of REM sleep deprivation. Our findings showed that REM sleep deprivation affected a total of 652 genes in the brain and 426 genes in the liver. Only 23 genes were affected commonly, 10 oppositely and 13 similarly across brain and liver tissue. Our results suggest that 9-day REM sleep deprivation differentially affects genes and processes in the brain and liver of rats.Highlights of the study➢Gene expression profile of brain and liver tissues of rats was analyzed using microarray techn...

Investigations of the neuro-physiological correlates of mental loads, or states, have attracted significant attention recently, as it is particularly important to evaluate mental fatigue in drivers operating a motor vehicle. In this research, we collected multimodal EEG/ECG/EOG and fNIRS data simultaneously to develop algorithms to explore neuro-physiological correlates of drivers&#39; mental states. Each subject performed simulated driving under two different conditions (well-rested and sleep-deprived) on different days. During the experiment, we used 68 electrodes for EEG/ECG/EOG and 8 channels for fNIRS recordings. We extracted the prominent features of each modality to distinguish between the well-rested and sleep-deprived conditions, and all multimodal features, except EOG, were combined to quantify mental fatigue during driving. Finally, a novel driving condition level (DCL) was proposed that distinguished clearly between the features of well-rested and sleep-deprived conditio...

Objective: To distinguish aging from menopause effects on sleep architecture, we studied an episode of disturbed hospital sleep in asymptomatic midlife women during the follicular phase of an ovulatory cycle and three control groups differing by age or menopause status. Methods: Fifty-one studies were conducted in four groups of volunteers: young cycling (YC, 20-30 years, n 5 14), older cycling (OC, 40-50 years, n 5 15), ovariectomized receiving estrogen therapy (OVX, 40-50 years, n 5 12), and spontaneously postmenopausal (PM, 40-50 years, n 5 10). Subjects were admitted to the University Hospital General Clinical Research Center (GCRC) for a first-night sleep study conducted during a 24-hour, frequent blood sampling protocol. Results: Despite similar estrogen concentrations in the YC (28 6 4 pg/ml) and OC (34 6 6 pg/ml) groups, OC women had reduced sleep efficiency (79% 6 2%) vs. YC (87% 6 3%; p 5 0.009). In the OVX and PM groups where estrogen concentrations were markedly different, sleep efficiency was also reduced vs. the YC group (OVX vs. YC, 79% 6 3% vs. 87% 6 3%, p 5 0.05; PM vs. YC, 75% 6 3% vs. 87% 6 3%, p 5 0.007). Wake time was longer in the three older groups (103 6 10 minutes, 101 6 12 minutes, 123 6 12 minutes for OC, OVX, PM, respectively) vs. YC (63 6 13 minutes, p , 0.05). The number of stage shifts was positively associated with advancing age (rho 5 0.3, p , 0.03) but not with estrogen concentration. Conclusions: Aging-related sleep deficits in response to an experimental stressor occur in midlife women prior to menopause.

Sleep deprivation reduces vigilance or arousal levels, affecting the efficiency of certain cognitive functions such as learning and memory. Here we assessed whether the differential outcomes procedure (DOP), a learning procedure that has proved useful to ameliorate episodic memory deficits, can also improve memory performance in sleep-deprived participants. Photographs were presented as sample faces. A probe face was then presented for recognition after either short or long delays. In the differential outcomes condition a unique reinforcer followed correct responses. In the non-differential outcomes condition reinforcers were provided in a random manner. The results indicated that the DOP prevented the recognition memory to decrement during the long delay in the control group, replicating previous findings. The sleep-deprived group showed DOP benefits mainly with the short delay, when working memory could be affected by low arousal. These findings confirm that the DOP can overcome impaired recognition memory due to sleep deprivation conditions.

The aim is to analyze the sleep architecture using polysomnography (PSG)in patients with Juvenile Myoclonic Epilepsy (JME):(newly diagnosed and those on valproate drug) attending epilepsy clinic at Alexandria University Hospitals. Methods: This study involved 20 patients with JME on valproate (age: 22.40 ± 5.80 years; M: F = 6:14), 20 newly diagnosed patients (age:18.55 ± 6.0 years; M: F = 6:14), and 20 matched healthy controls (age: 22.10 ± 5.0 years; M: F = 6:14). Clinical assessment, electroencephalogram (EEG), evaluation with comprehensive sleep questionnaire, and PSG were done for all patients. Results: PSG showed significant alterations in sleep architecture in the total JME group in the form of reduced mean sleep efficiency (p = 0.001 * ), increased mean Rapid eye movement (REM) onset latency (p = 0.046 * ), decrease mean REM percentage (p = 0.011 * ), increased mean wakefulness after sleep onset (p = 0.018 * ), increase the index of total arousal (p = 0.005 * ), increased mean periodic limb movement index (P =0.001 * ), and reduced apnea hypopnea index (P = <0.001) in comparison to control group. Valproate treated group showed increased sleep efficiency (p =0.040 * ), decreased REM arousal index (P = 0.012), longer stage 3 (P = 0.038),and prolonged stage 2 (P = 0.049 * ) than the newly diagnosed group. Conclusions: Sleep architecture was significantly disturbed in JME, with improvement in sleep efficiency in valproate treated patients.