Daytime rest and short sleep, and what they do to performance and mood.
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26 to 50 of 645Naps, cognition and performance.
Daytime napping is a frequent habit of many individuals, whether healthy or not, and may occur in a wide variety of contexts. There are several reasons for napping in the human adult, including prophylactic strategies or recuperative need, respectively before or after sleep loss, or even pure appetitive drive. Thus, it is of great theoretical and clinical interest to assess the impact of naps on individuals' performance, especially on cognitive functioning. As the outgrowth of a symposium held by the authors at the 5th Congress of the World Federation of Sleep Research and Sleep Medicine Societies in Cairns, Australia, September 2007, this review will specifically explore: a) the newly developed experimental daytime split-sleep schedules and their effects on recovery, compared with those deriving from a single consolidated sleep episode of equal duration; b) whether naps may be beneficia…
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Alertness management strategies for operational contexts.
This review addresses the problem of fatigue (on-the-job-sleepiness) attributable to sleep loss in modern society and the scientifically proven strategies useful for reducing fatigue-related risks. Fatigue has become pervasive because many people work non-standard schedules, and/or they consistently fail to obtain sufficient sleep. Sleep restriction, sleep deprivation, and circadian desynchronization produce a variety of decrements in cognitive performance as well as an array of occupational and health risks. A number of real-world mishaps have resulted from performance failures associated with operator sleepiness. In some cases, fatigue/sleepiness is unavoidable, at least temporarily, due to job-related or other factors, but in other cases, fatigue/sleepiness results from poor personal choices. Furthermore, some individuals are more vulnerable to the effects of sleep loss than others. F…
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Lived experience of patients with sleep apnea: a systematic synthesis of qualitative evidence.
Background: Sleep apnea (SA) is a prevalent chronic disease with significant morbidity that negatively impacts a patient's perception of health and quality of life (QoL).
Objective: This review synthesized qualitative evidence on the experiences of patients living with SA to understand the disease's impacts on QoL.
Methods: We performed a systematic review of qualitative studies and searched eight electronic databases from inception dates to 22 September 2020. We analyzed the data using Sandelowski's proposed method of meta-synthesis, and applied Critical Appraisal Skills Program (CASP) and GRADE-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) criteria to appraise the studies' qualities, and synthesized findings, respectively.
Results: Fourteen qualitative studies met the selection criteria. Four themes and 16 subthemes emerged: (1) sleep-related manifesta…
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Pharmacological and non-pharmacological interventions to enhance sleep in mild cognitive impairment and mild Alzheimer's disease: A systematic review.
Suboptimal sleep causes cognitive decline and probably accelerates Alzheimer's Disease (AD) progression. Several sleep interventions have been tested in established AD dementia cases. However early intervention is needed in the course of AD at Mild Cognitive Impairment (MCI) or mild dementia stages to help prevent decline and maintain good quality of life. This systematic review aims to summarize evidence on sleep interventions in MCI and mild AD dementia. Seven databases were systematically searched for interventional studies where ≥ 75% of participants met diagnostic criteria for MCI/mild AD dementia, with a control group and validated sleep outcome measures. Studies with a majority of participants diagnosed with Moderate to Severe AD were excluded. After removal of duplicates, 22,133 references were returned in two separate searches (August 2019 and September 2020). 325 full papers we…
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Effects of sleep inertia after daytime naps vary with executive load and time of day.
The effects of executive load on working memory performance during sleep inertia after morning or afternoon naps were assessed using a mixed design with nap/wake as a between-subjects factor and morning/afternoon condition as a within-subject factor. Thirty-two healthy adults (mean 22.5 ± 3.0 years) attended two laboratory sessions after a night of restricted sleep (6 hrs), and at first visit, were randomly assigned to the Nap or Wake group. Working memory (n-back) and subjective workload were assessed approximately 5 and 25 minutes after 90-minute morning and afternoon nap opportunities and at the corresponding times in the Wake condition. Actigraphically assessed nocturnal sleep duration, subjective sleepiness, and psychomotor vigilance performance before daytime assessments did not vary across conditions. Afternoon naps showed shorter EEG assessed sleep latencies, longer sleep duratio…
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Sleep deprivation in resident physicians, work hour limitations, and related outcomes: a systematic review of the literature.
Extended work hours, interrupted sleep, and shift work are integral parts of medical training among all specialties. The need for 24-hour patient care coverage and economic factors have resulted in prolonged work hours for resident physicians. This has traditionally been thought to enhance medical educational experience. These long and erratic work hours lead to acute and chronic sleep deprivation and poor sleep quality, resulting in numerous adverse consequences. Impairments may occur in several domains, including attention, cognition, motor skills, and mood. Resident performance, professionalism, safety, and well-being are affected by sleep deprivation, causing potentially adverse implications for patient care. Studies have shown adverse health consequences, motor vehicle accidents, increased alcohol and medication use, and serious medical errors to occur in association with both sleep…
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Light therapy with boxes or glasses to counteract effects of acute sleep deprivation.
Sleep deprivation, in the context of shift work, is an increasing major public health issue. We aimed to determine whether early light administration can counteract sleep deprivation effects, and to compare LED-glasses with a traditional light therapy box. This cross-over design study included 18 individuals exposed to light therapy for 30 minutes at 5 am after one night of complete sleep deprivation, to mimic the night shift condition. Individuals were randomly exposed to 10,000 Lux light box, 2,000 Lux LED blue-enriched glasses, and control (ambient dim-light at 8 lux). Alertness, cognition and mood were assessed throughout the night and following morning. Five women and 13 men (mean 24.78 year old) presented with a progressive and increasing alteration of alertness, cognition, and mood during each sleep deprivation. A rebound was observed at 8 am resulting from the circadian drive ove…
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Hartzler BM (2014)reviewMEDLINE-indexed journal, not yet read by usAccident; analysis and prevention51 citations Fatigue on the flight deck: the consequences of sleep loss and the benefits of napping.
The detrimental effects of fatigue in aviation are well established, as evidenced by both the number of fatigue-related mishaps and numerous studies which have found that most pilots experience a deterioration in cognitive performance as well as increased stress during the course of a flight. Further, due to the nature of the average pilot's work schedule, with frequent changes in duty schedule, early morning starts, and extended duty periods, fatigue may be impossible to avoid. Thus, it is critical that fatigue countermeasures be available which can help to combat the often overwhelming effects of sleep loss or sleep disruption. While stimulants such as caffeine are typically effective at maintaining alertness and performance, such countermeasures do nothing to address the actual source of fatigue - insufficient sleep. Consequently, strategic naps are considered an efficacious means of …
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Effect of napping on a bean bag chair on sleep stage, muscle activity, and heart rate variability.
Background: Although ample evidence has demonstrated that daytime napping is beneficial for health and cognitive performance, bedding for napping has not yet been scientifically investigated.
Objectives: To explore the effect of a bean bag chair on daytime napping and physiological parameters related to sleep.
Methods: Fourteen healthy participants were enrolled within the context of a randomized, single-blind, crossover study to evaluate the effects of a bean bag chair in comparison with those of a urethane chair manufactured to have a similar shape. Electroencephalogram, electromyogram, and heart rate variability were recorded and compared between wakefulness and napping.
Results: Electroencephalogram analyses revealed no significant differences in sleep architecture or frequency components; however, a significant decrease was found in electromyogram recordings in the trapezius muscle,…
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Memory improvement via slow-oscillatory stimulation during sleep in older adults.
We examined the intriguing but controversial idea that disrupted sleep-dependent consolidation contributes to age-related memory decline. Slow-wave activity during sleep may help strengthen neural connections and provide memories with long-term stability, in which case decreased slow-wave activity in older adults could contribute to their weaker memories. One prediction from this account is that age-related memory deficits should be reduced by artificially enhancing slow-wave activity. In young adults, applying transcranial current oscillating at a slow frequency (0.75 Hz) during sleep improves memory. Here, we tested whether this procedure can improve memory in older adults. In 2 sessions separated by 1 week, we applied either slow-oscillatory stimulation or sham stimulation during an afternoon nap in a double-blind, crossover design. Memory tests were administered before and after slee…
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Sleep deprivation impairs binding of information with its context.
Binding information to its context in long-term memory is critical for many tasks, including memory tasks and decision making. Failure to associate information to its context could be an important aspect of sleep deprivation effects on cognition, but little is known about binding problems from being sleep-deprived at the time of encoding. We studied how sleep deprivation affects binding using a well-established paradigm testing the ability to remember auditorily presented words (items) and their speakers (source context). In a laboratory study, 68 healthy young adults were randomly assigned to total sleep deprivation or a well-rested control condition. Participants completed an affective item and source memory task twice: once after 7-hour awake during baseline and again 24 hours later, after nearly 31 hours awake in the total sleep deprivation condition or 7 hours awake in the control c…
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Acute sleep deprivation: the effects of the AMPAKINE compound CX717 on human cognitive performance, alertness and recovery sleep.
AMPA receptor modulation is a potential novel approach to enhance cognitive performance. CX717 is a positive allosteric modulator of the AMPA receptor that has shown efficacy in rodent and primate cognition models. CX717 (100 mg, 300 mg and 1000 mg) and placebo were studied in 16 healthy male volunteers (18-45 years) in a randomized, crossover study. Cognitive function, arousal and recovery sleep (by polysomnography) were assessed during the extended wakefulness protocol. Placebo condition was associated with significant decrements in cognition, particularly at the circadian nadir (between 03:00 and 05:00). Pre-specified primary and secondary analyses (general linear mixed modelling, GLMM) at each separate time point did not reveal consistent improvements in performance or objective alertness with any dose of CX717. Exploratory repeated measures analysis, a method used to take into accou…
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The effect of daytime napping on the athletic performance of team ball sports athletes: systematic review and meta-analysis.
This systematic review and meta-analysis aimed to estimate the effects of daytime napping on athletic performance across multiple domains in team ball sports athletes. Five electronic databases (PubMed, Scopus, Web of Science, Cochrane Library, and SPORTDiscus) were systematically searched from their inception to December 18, 2025, to identify randomized controlled trials (RCTs) investigating the association between daytime napping and objective performance measures compared with a no-nap control condition. Twelve trials encompassing 179 team ball sports athletes met the inclusion criteria. Nap interventions were consistently scheduled in the early afternoon (13:00-15:30), most frequently commencing at 14:00. Following presumed normal nocturnal sleep, napping demonstrated a large positive effect on endurance performance (SMD = 0.96, 95% CI 0.62 to 1.29, p < 0.001) and a moderate improvem…
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Benefits and risks of napping in older adults: A systematic review.
A growing body of evidence indicates that napping is common among older adults. However, a systematic review on the effect of napping on the elderly is lacking. The aim of this systematic review was to (i) determine how studies evaluated napping behavior in older adults (frequency, duration and timing); (ii) explore how napping impacts perceptual measures, cognitive and psychomotor performance, night-time sleep and physiological parameters in the elderly (PROSPERO CRD42022299805). A total of 738 records were screened by two researchers using the PICOS criteria. Fifteen studies met our inclusion criteria with a mean age ranging from 60.8 to 78.3 years and a cumulative sample size of n = 326. Daytime napping had an overall positive impact on subjective measures (i.e., sleepiness and fatigue), psychomotor performances (i.e., speed and accuracy) and learning abilities (i.e., declarative and …
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Psychological and behavioural interventions in bipolar disorder that target sleep and circadian rhythms: A systematic review of randomised controlled trials.
Sleep and circadian disruptions are prominent symptoms of bipolar disorder (BD) and potential targets for adjunctive interventions. The aim of this review was to appraise the effectiveness of psychological and behavioural interventions in BD that target sleep and circadian rhythms, as reported by randomised controlled trials. Nineteen studies met the inclusion/exclusion criteria. They were summarised via narrative synthesis and meta-analysis wherever appropriate. Six studies delivered bright light therapy, five interpersonal and social rhythm therapy, two blue-light blocking glasses, one cognitive behavioural therapy for insomnia, one total sleep deprivation, and four combination treatments. More than half of the studies (N = 10, 52 %) did not measure sleep or circadian rhythms despite being the principal target of the intervention. Overall, the evidence base for the effectiveness of the…
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Sleep hygiene education as a treatment of insomnia: a systematic review and meta-analysis.
Background: Sleep hygiene education (SHE) is commonly used as a treatment of insomnia in general practice. Whether SHE or cognitive-behavioural therapy for insomnia (CBT-I), a treatment with stronger evidence base, should be provided first remains unclear.
Objective: To review the efficacy of SHE for poor sleep or insomnia.
Methods: We systematically searched six key electronic databases up until May 2017. Two researchers independently selected relevant publications, extracted data and evaluated methodological quality according to the Cochrane criteria.
Results: Twelve of 15 studies compared SHE with CBT-I, three with mindfulness-based therapy, but none with sham or no treatment. General knowledge about sleep, substance use, regular exercise and bedroom arrangement were commonly covered; sleep-wake regularity and avoidance of daytime naps in seven programs, but stress management in only …
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Exploring the physiological mechanisms of sleep's influence on athletic performance and recovery: a narrative review.
Purpose: This narrative review explores the complex relationship between sleep, athletic performance, and recovery, emphasizing the physiological mechanisms at play.
Methods: This review included papers reporting physiological mechanisms linking sleep, athletic performance, and recovery. Literature was identified through targeted searches in relevant databases and bibliographies of referenced scientific articles. Retrieved studies were analyzed thematically according to major domains, enabling integration of foundational mechanisms with applied evidence to inform practice and future research.
Results: Slow-wave sleep (SWS) plays an important role in physical recovery, with its increase during the night being linked to rises in metabolic stress and growth hormone production. When training volume and/or intensity increase, a corresponding increase in SWS is usually observed, but a fine lin…
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Daytime Napping Benefits Passing Performance and Scanning Activity in Elite Soccer Players.
The present study explored the effect of a daytime napping opportunity on scanning activity, which is an essential component of successful soccer performance. Fourteen male elite collegiate soccer players performed the Trail Making Test (TMT), which was used to assess complex visual attention. In addition, a soccer passing test, modified with reference to the Loughborough Soccer Passing Test, was used to evaluate passing performance as well as scanning activity. A cross-over design was applied to examine nap and no-nap interventions. Participants (N = 14, mean age: 21.6 SD = 0.5 years, height: 1.73 ± 0.06 m, body mass: 67.1 ± 4.5 kg) were randomly allocated to a midday nap (40 minutes) or no-nap group. Subjective sleepiness was measured using the Karolinska Sleepiness Scale, and perceptive fatigue was evaluated by the visual analog scale. There were no significant differences in subjecti…
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Pharmacotherapies for sleep disturbances in dementia.
Background: Sleep disturbances, including reduced nocturnal sleep time, sleep fragmentation, nocturnal wandering, and daytime sleepiness are common clinical problems in dementia, and are associated with significant caregiver distress, increased healthcare costs, and institutionalisation. Drug treatment is often sought to alleviate these problems, but there is significant uncertainty about the efficacy and adverse effects of the various hypnotic drugs in this vulnerable population.
Objectives: To assess the effects, including common adverse effects, of any drug treatment versus placebo for sleep disorders in people with dementia, through identification and analysis of all relevant randomised controlled trials (RCTs).
Search methods: We searched ALOIS (www.medicine.ox.ac.uk/alois), the Cochrane Dementia and Cognitive Improvement Group's Specialized Register, in March 2013 and again in Marc…
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The Impact of Sleep Interventions on Athletic Performance: A Systematic Review.
Background: Sleep is essential for maximal performance in the athletic population. Despite that, the sport context has many factors that can negatively influence athletes' sleep and subsequent recovery.
Objectives: The purpose of this systematic review was to synthesize the most recent literature regarding sleep interventions aimed at improving sleep and subsequent performance in athletes.
Methods: The present systematic review was conducted based on the PRISMA guidelines and the PICOS approach. The search was conducted in May 2022 using the electronic database PubMed, SPORTDiscus via EBSCOhost, and Web of Science. Once extracted, studies were included if they met the following criteria: (1) participants were athletes of individual or team sports; (2) implemented an intervention aimed at improving sleep; (3) measured at least one objective performance/recovery outcome; and (4) reported t…
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Physical frailty and gait speed in community elderly: a systematic review.
Objective: To identify the outcomes of studies on gait speed and its use as a marker of physical frailty in community elderly.
Method: Systematic review of the literature performed in the following databases: LILACS, SciELO, MEDLINE/PubMed, ScienceDirect, Scopus and ProQuest. The studies were evaluated by STROBE statement, and the PRISMA recommendations were adopted.
Results: There were 6,303 studies, and 49 of them met the inclusion criteria. Of the total number of studies, 91.8% described the way of measuring gait speed. Of these, 28.6% used the distance of 4.6 meters, and 34.7% adopted values below 20% as cutoff points for reduced gait speed, procedures in accordance with the frailty phenotype. Regarding the outcomes, in 30.6% of studies, there was an association between gait speed and variables of disability, frailty, sedentary lifestyle, falls, muscular weakness, diseases, body fat,…
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Go to bed! A systematic review and meta-analysis of bedtime procrastination correlates and sleep outcomes.
Bedtime procrastination is defined as the volitional delay of going to bed, without any external circumstances causing the delay, and is associated with inadequate sleep. Alleviating bedtime procrastination is an important target for interventions promoting adequate sleep, yet the correlates of bedtime procrastination are poorly understood. This study examined (1) correlates of bedtime procrastination, and (2) strength and direction of the association between bedtime procrastination and sleep outcomes. Six databases (CINAHL, EMBASE, PsychINFO, PubMed, Scopus, Web of Science) were searched from inception to September 2021 against pre-determined eligibility criteria. Forty-three studies were included (GRADE = low). Meta-analysis revealed that bedtime procrastination had a moderate negative association with self-control (z = -0.39; CI: -0.45, -0.29) and a moderate positive association with …
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The effect of sleep deprivation and restriction on mood, emotion, and emotion regulation: three meta-analyses in one.
Study objectives: New theory and measurement approaches have facilitated nuanced investigation of how sleep loss impacts dimensions of affective functioning. To provide a quantitative summary of this literature, three conceptually related meta-analyses examined the effect of sleep restriction and sleep deprivation on mood, emotion, and emotion regulation across the lifespan (i.e. from early childhood to late adulthood).
Methods: A total of 241 effect sizes from 64 studies were selected for inclusion, and multilevel meta-analytic techniques were used when applicable.
Results: There was a moderate, positive effect of sleep loss on negative mood (g = 0.45), which was stronger for studies with younger samples, as well as a large, negative effect of sleep loss on positive mood (g = -0.94). For negative mood only, studies that used total sleep deprivation had larger effect sizes than studies t…
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Nonpharmacological Treatments of Insomnia for Long-Term Painful Conditions: A Systematic Review and Meta-analysis of Patient-Reported Outcomes in Randomized Controlled Trials.
Study objectives: Insomnia is a debilitating comorbidity of chronic pain. This study evaluated the effect of nonpharmacological sleep treatments on patient-reported sleep quality, pain, and well-being in people with long-term cancer and non-cancer (e.g., back pain, arthritis, fibromyalgia) pain conditions.
Design: We systematically searched Cochrane CENTRAL, MEDLINE, Embase, and PsychINFO for relevant studies. Search period was set to inception of these databases to March 2014. Studies were included if they were: original randomized controlled trials (RCTs); testing a nonpharmacological intervention; that targets sleep; in adults; with painful health conditions; that has a control group; includes a measure of sleep quality; and at least one other health and well-being outcome.
Measurement and findings: Means and standard deviations of sleep quality, pain, fatigue, depression, anxiety, ph…
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Effects of a month-long napping regimen in older individuals.
Objectives: To examine the effects of a month-long nap regimen using one of two durations (45 minutes or 2 hours) on nighttime sleep and waking function in a group of healthy older participants and to assess the degree to which healthy older individuals are willing and able to adhere to such napping regimens.
Design: Three laboratory sessions, with 2-week at-home recording interspersed, using a between-participants approach.
Setting: Laboratory of Human Chronobiology at Weill Cornell Medical College and participants' homes.
Participants: Twenty-two healthy men and women aged 50 to 88 (mean 70).
Measurements: Polysomnography (sleep electroencephalography), actigraphy, sleep diaries, neurobehavioral performance, sleep latency tests.
Results: With the exception of adherence to the protocol, there were few differences between short and long nap conditions. Napping had no negative effect on s…
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