Sleep Deprivation

Concerning America's--and Nevada's--poor educational system vs. the rest of the world (notably Finland).  How it could be improved, if tailor-made to advances in child development research: for example, starting high school later, letting teenagers sleep in.  Also discusses standardized testing and the "Social Efficiency Model," the value of play and Creativity equaling problem-solving.

Sleep related problems affect approximately 25-40% of children and adolescents. The acquisition of sleep patterns characterised by later bedtimes, insomnia and excessive daytime sleepiness is related to poorer school performance, daytime drowsiness, physical tiredness and a higher rate of psychiatric illnesses. Many studies have investigated the correlation between sleep and mood in children and adolescents and overall, show a positive association between sleep problems and psychiatric disorders. However, little is known about adolescents' personal perception of their psychological status as it is linked with the occurrence of mood changes and sleep-related problems. The aim of the study is to explore the impact of variables such as age, gender, education and the perception of their own psychological status (evaluated through suitable questionnaires) on the simultaneous presence of sleep disturbances and affective symptoms in a sample of adolescents. A positive correlation betwe...

Insomnia is a prevalent health complaint whose onset is precipitated by a variety of factors. There is an important need to identify and describe these factors to improve our understanding of risk factors and the natural history of insomnia. This article is aimed at identifying and describing the types of precipitating factors related to the onset of insomnia. A total of 345 patients evaluated for insomnia at a sleep-disorders clinic completed a sleep survey and underwent a semistructured clinical interview. As part of the evaluation, the specific precipitating events related to the onset of insomnia were identified. Subsequently, these factors were categorized (work-school, family, physical or psychological health, or indeterminate), and their affective valence (negative, positive, or indeterminate) was coded. The most common precipitating factors of insomnia were related to family, health, and work-school events. Sixty-five percent of precipitating events had a negative valence. These events differed with the age of onset of insomnia but not with the gender of participants. These findings are useful to identify potential risk factors for insomnia and improve our understanding of the natural history of insomnia.

Background: The study aimed to elucidate previously observed associations between morningness-eveningness and depressive symptomatology in university students. Relations between components of depressive symptomatology and morningness-eveningness were analysed.
Methods: Nine hundred and seventy-four university students completed Polish versions of the Centre for Epidemiological Studies – Depression scale (CES-D; Polish translation appended to this paper) and the Composite Scale of Morningness. Principal component analysis (PCA) was used to test the structure of depressive symptoms. Pearson and partial correlations (with age and sex controlled), along with regression analyses with morning affect (MA) and circadian preference as predictors, were used.
Results: PCA revealed three components of depressive symptoms: depressed/somatic affect, positive affect, interpersonal relations. Greater MA was related to less depressive symptoms in three components. Morning circadian preference was related to less depressive symptoms in depressed/somatic and positive affects and unrelated to interpersonal relations. Both morningness-eveningness components exhibited stronger links with depressed/somatic and positive affects than with interpersonal relations. Three CES-D components exhibited stronger links with MA than with circadian preference. In regression analyses only MA was statistically significant for positive affect and better interpersonal relations, whereas more depressed/somatic affect was predicted by lower MA and morning circadian preference (relationship reversed compared to correlations).
Limitations: Self-report assessment.
Conclusions: There are three groups of depressive symptoms in Polish university students. Associations of MA with depressed/somatic and positive affects are primarily responsible for the observed links between morningness-eveningness and depressive symptoms in university students. People with evening circadian preference whose MA is not lowered have less depressed/somatic affect.

The reliability and validity of EEG arousals and other types of arousal are reviewed. Brief arousals during sleep had been observed for many years, but the evolution of sleep medicine in the 1980s directed new attention to these events. Early studies at that time in animals and humans linked brief EEG arousals and associated fragmentation of sleep to daytime sleepiness and degraded performance. Increasing interest in scoring of EEG arousals led the ASDA to publish a scoring manual in 1992. The current review summarizes numerous studies that have examined scoring reliability for these EEG arousals. Validity of EEG arousals was explored by review of studies that empirically varied arousals and found deficits similar to those found after total sleep deprivation depending upon the rate and extent of sleep fragmentation. Additional data from patients with clinical sleep disorders prior to and after effective treatment has also shown a continuing relationship between reduction in patholog...

Caffeine is the most widely used stimulant to counteract the effects of sleepiness, but it also produces important detrimental effects on subsequent sleep, especially when sleep is initiated at a time when the biological clock sends a strong waking signal such as during daytime. This study compares the effects of caffeine on daytime recovery sleep in young (20-30 y.) and middle-aged subjects (45-60 y.). Subjects participated in both caffeine (200mg) and placebo conditions (double-blind cross-over design), spaced one month apart. For each condition, subjects initially came to the laboratory for a nocturnal sleep episode. Daytime recovery sleep started in the morning after 25h of wakefulness. Subjects were administered either one caffeine (100mg) or placebo capsule three hours before daytime recovery sleep and the remaining dose one hour before daytime recovery sleep. Middle-aged subjects showed greater decrements of sleep duration and sleep efficiency than young subjects during daytime recovery under placebo compared to nocturnal sleep. Caffeine decreased sleep efficiency, sleep duration, slow-wave sleep (SWS) and REM sleep during daytime recovery sleep similarly in both age groups. Caffeine also reduced N-REM sleep EEG synchronization during daytime recovery sleep (reduced delta, theta, and alpha power, and greater beta power). The combined influence of age and caffeine made the sleep of middle-aged subjects particularly vulnerable to the circadian waking signal. We propose that lower brain synchronization due to age and caffeine produces greater difficulty in overriding the circadian waking signal during daytime sleep and leads to fragmented sleep. These results have implications for the high proportion of the population using caffeine to cope with night work and jet lag, particularly the middle-aged.

No statistical data is available on the number of employees working on night shifts in Turkey. Working on shifts is associated with decreased sleep time, decreased daily sleep quality, and decreased alertness during night shifts. Increased incidences of cardiovascular disorders, peptic ulcers, and some types of cancer in shift workers are well known. Exposure to light at nighttime suppresses melatonin production. In non-synchronized circadian rhythm, disturbed melatonin secretion may lead to excessive sleep, hunger for carbohydrates, and weight gain. Melatonin is the hormone that governs sleep. It seems to be the key regulator of the sleep/wake rhythm. Exposure to light at night and disturbance of the circadian rhythm contribute to the health problems of night shift workers by disturbing melatonin production. In this review, the definitions of social jetlag, delayed sleep phase syndrome, and insomnia will be discussed. Sleep disorders in psychiatric diseases will be reviewed. Melatonergic drugs available on the market will be listed, including their contraindications and side effects. The physiopathology of sleep, sleep disorders, depression, and melatonin will be given with an extended discussion. Two recent reviews about the effect of melatonin on sleep patterns will be discussed. Finally, other treatments for sleep disorders will be summarized. In conclusion, in shift workers, sleep problems are a complex subject in which multiple pathophysiological mechanisms play roles. The double-blind randomized controlled studies, systematic reviews, and meta-analyses that have been conducted can provide only weakly positive data about the beneficial effect of melatonin use in shift workers. In the future, multi-centered and multi-participant studies will shed more light on this issue. (Eurasian J Emerg Med 2016; 15: 48-53)

We report an attempted replication of G. T. W. Patrick and J. A. Gilbert’s pioneering sleep deprivation experiment ‘Studies from the psychological laboratory of the University of Iowa. On the effects of loss of sleep’, conducted in 1895/96. Patrick and Gilbert’s study was the first sleep deprivation experiment of its kind, performed by some of the first formally trained psychologists.

Chronic sleep loss and associated sleepiness and daytime impairments in adolescence are a serious threat to the academic success, health, and safety of our nation's youth and an important public health issue. Understanding the extent and potential short- and long-term repercussions of sleep restriction, as well as the unhealthy sleep practices and environmental factors that contribute to sleep loss in adolescents, is key in setting public policies to mitigate these effects and in counseling patients and families in the clinical setting. This report reviews the current literature on sleep patterns in adolescents, factors contributing to chronic sleep loss (ie, electronic media use, caffeine consumption), and health-related consequences, such as depression, increased obesity risk, and higher rates of drowsy driving accidents. The report also discusses the potential role of later school start times as a means of reducing adolescent sleepiness.

Partial or total therapeutic sleep deprivation leads to an immediate and far-reaching release of depressive symptoms in about 60% of patients with depressive disturbances. It is for that reason that this therapeutic option is offered and studied in many psychiatric clinics. Several papers have acclaimed the German psychiatrist Johann Christian August Heinroth (1773-1843) - the first university professor of psychiatry--as a pioneer of this therapeutic approach. However, no reference has been made specifying where in his comprehensive oeuvre he promoted this notion, nor has any analysis of the texts or passages in question been delivered. This study demonstrates that Heinroth indeed understood the existence of numerous close bidirectional relationships between mental disorders and sleep, above all, disorders of the latter. Consequently, he explicitly recommended sleep deprivation as a therapy for "melancholia," the contemporary name for depressive disorders. This finding is ...

There is disagreement in the literature about the importance of sleep disruption from intensive care unit (ICU) environmental noise. Previous reports have assumed that sleep disruption is produced by high-peak noise. This study aimed to determine whether peak noise or the change in noise level from baseline is more important in inducing sleep disruption. We hypothesized that white noise added to the environment would reduce arousals by reducing the magnitude of changing noise levels.Four subjects underwent polysomnography under three conditions: (1) baseline, (2) exposure to recorded ICU noise and (3) exposure to ICU noise and mixed-frequency white noise, while one additional subject completed the first two conditions. Baseline and peak noise levels were recorded for each arousal from sleep.A total of 1178 arousals were recorded during these studies. Compared to the baseline night (13.3±1.8 arousals/h) the arousal index increased during the noise (48.4±7.6) but not the white noise/ICU noise night (15.7±4.5) (P<0.004). The change in sound from baseline to peak, rather than the peak sound level, determined whether an arousal occurred and was the same for the ICU noise and white noise/ICU noise condition (17.7±0.4 versus 17.5±0.3 DB, P=0.65).Peak noise was not the main determinant of sleep disruption from ICU noise. Mixed frequency white noise increases arousal thresholds in normal individuals exposed to recorded ICU noise by reducing the difference between background noise and peak noise.

To quantify the relationships between age, sex and country of residence and sleep time (time in bed) in young people aged 9-18 years. Thirty studies of sleep patterns in healthy adolescents from the last 30 years in 20 countries were reviewed. Monte Carlo simulation generated pseudo-data where only summary statistics were available. Raw and pseudo-data were combined, generating a total of 92,977 data points. A mixed model, clustering on countries, analysed data for school and non-school days separately. Sleep time varied with sex, age and geographical region. School day sleep differed slightly between boys and girls, girls sleeping 11 min/night more than boys (p = 0.003). On non-school days, girls slept 29 min more each day (p = 0.003). Sleep time declined with age, - 14 min/day per year of age (school days), and seven min/night per year of age (non-school days). Large differences between countries, showed adolescents from Asian countries sleeping 40-60 min less each night than Americans, and 60-120 min less than Europeans. Sex, age, geographical region and day type interact and predict sleep patterns in adolescents. One consistent trend is the increasing gap between sleep on school days and non-school days as adolescents get older.

This study examined the effect of 30 h of sleep deprivation and intermittent physical exercise, on both cognitive and psychomotor function as well subjective ratings of mood. Six subjects with the following physical characteristics participated in the study (Mean ± S.D.): age 22 ± 0.3 years, height 180 ± 5 cm, body mass: 77 ± 5 kg, VO2peak 44 ± 5 ml kg− 1 min− 1. Three subjects engaged in normal sedentary activities while three others cycled on a cycle ergometer at 50% VO2peak for 20 min out of every 2 h during 30 h of sleep deprivation. One week later sleep deprivation was repeated with a cross over of subjects. Every 4 h, subjects completed simple and two-choice reaction time tasks at both rest and during exercise, a computerized tracking task, a number cancellation task, and an assessment of subjective mood state as measured by the POMS questionnaire. A 3 × 4 repeated measures ANOVA revealed that resting but not exercising reaction times were significantly slower with sleep deprivation. Sleep deprivation was also associated with significantly greater negative disturbances to subjective vigour, fatigue and depression assessed by the Profile of Mood States questionnaire. Compared to those who have been deprived of sleep alone, individuals that performed 5 h of intermittent moderate exercise during 30 h of sleep deprivation appeared to be more vulnerable to negative mood disturbances and impairment in reaction times. This could result in greater risk of accident due to a reduced capacity to respond quickly.

Translational biomarkers, such as prepulse inhibition (PPI) of the acoustic startle response, are playing an increasingly important role in the development of antipsychotic drugs for schizophrenia and related conditions. However, attempts to reliably induce a PPI deficit by psychotomimetic drugs have not been successful, leaving an unmet need for a cross-species psychosis model sensitive to this widely studied surrogate treatment target. Sleep deprivation (SD) might be such a model as it has previously been shown to induce PPI deficits in rats, which could be selectively prevented with antipsychotic but not anxiolytic or antidepressant compounds. Here, in a first proof-of-concept study we tested whether SD induces a deficit in PPI and an increase in psychosis-like symptoms in healthy humans. In two counterbalanced sessions, acoustic PPI and self-reported psychosis-like symptoms (Psychotomimetic States Inventory) were measured in 24 healthy human volunteers after a normal night&#39;s...

Sleep related cognitions (e.g., faulty beliefs and appraisals, unrealistic expectations, perceptual and attention bias) play an important role in perpetuating insomnia. This paper presents new psychometric data on an abbreviated version of the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16), a 16-item self-report measure designed to evaluate a subset of those sleep related cognitions.
Psychometric study of a patient-reported measure of sleep related beliefs based on existing clinical and research databases.
A total of 283 individuals (60% women; mean age of 46.6 years old) with insomnia, including 124 clinical patients and 159 research participants.
Participants completed the DBAS, Insomnia Severity Index, Beck Depression and Anxiety Inventories, daily sleep diaries for 2 weeks, and 3 nights of polysomnography (research sample only) as part of a baseline assessment. The DBAS-16 was found to be reliable, as evidenced by adequate internal consistency (Cronbach alpha = 0.77 for clinical and 0.79 for research samples) and temporal stability (r = 0.83). The factor structure was similar to the original 30-item version, with 4 factors emerging and reflecting: (a) perceived consequences of insomnia, (b) worry/helplessness about insomnia, (c) sleep expectations, and (d) medication. DBAS total scores were significantly correlated with other self-report measures of insomnia severity, anxiety, and depression, but not with specific sleep parameters.
The psychometric qualities of this abbreviated DBAS-16 version seem adequate. This patient-reported measure should prove a useful instrument to evaluate the role of sleep related beliefs and attitudes in insomnia and to monitor change on this cognitive variable as a potential moderator of treatment outcome.