Daytime rest and short sleep, and what they do to performance and mood.
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301 to 325 of 645Diagnosis of circadian rhythm sleep disorders.
Insomnia and excessive sleepiness are common in the investigation of sleep-disordered breathing. Circadian rhythm sleep disorders are perhaps the most often overlooked conditions in the differential diagnosis of these symptoms. Circadian rhythm sleep disorders manifest as misalignment between the sleep period and the physical/social 24-h environmental cycle. The two most prevalent circadian rhythm sleep disorders are delayed sleep phase (common in adolescents) and advanced sleep phase (common in the elderly), situations in which the sleep period is displaced to a later or earlier time, respectively. It is important to keep these two disorders in mind, since they can be confused with insomnia and excessive sleepiness. However, there are nine possible diagnoses, and all nine are of clinical interest. Since light is the principal cue used in synchronizing the biological clock, blind individ…
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Exercise, energy balance and the shift worker.
Shift work is now common in society and is not restricted to heavy industry or emergency services, but is increasingly found amongst 'white collar' occupations and the growing number of service industries. Participation in shift work is associated with increased body mass index, prevalence of obesity and other health problems. We review the behavioural and biological disturbances that occur during shift work and discuss their impact on leisure-time physical activity and energy balance. Shift work generally decreases opportunities for physical activity and participation in sports. For those shift workers who are able to exercise, subjective and biological responses can be altered if the exercise is taken at unusual times of day and/or if the shift worker is sleep deprived. These altered responses may in turn impact on the longer-term adherence to an exercise programme. The favourable effe…
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A clinical approach to circadian rhythm sleep disorders.
Circadian rhythm sleep disorders are characterized by complaints of insomnia and excessive sleepiness that are primarily due to alterations in the internal circadian timing system or a misalignment between the timing of sleep and the 24-h social and physical environment. In addition to physiological and environmental factors, maladaptive behaviors often play an important role in the development of many of the circadian rhythm sleep disorders. This review will focus on the clinical approach to the diagnosis and management of the various circadian rhythm sleep disorders, including delayed sleep phase disorder, advanced sleep phase disorder, non-entrained type, irregular sleep-wake rhythm, shift work sleep disorder and jet lag disorder. Diagnostic tools such as sleep diaries and wrist activity monitoring are often useful in confirming the diagnosis. Because behavioral and environmental fact…
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Biological clocks and shift work: circadian dysregulation and potential long-term effects.
Long-term epidemiologic studies on large numbers of night and rotating shift workers have suggested an increase in the incidence of breast and colon cancer in these populations. These studies suffer from poor definition and quantification of the work schedules of the exposed subjects. Against this background, the pathophysiology of phase shift and phase adaptation is reviewed. A phase shift as experienced in night and rotating shift work involves desynchronization at the molecular level in the circadian oscillators in the central nervous tissue and in most peripheral tissues of the body. There is a change in the coordination between oscillators with transient loss of control by the master-oscillator (the Suprachiasmatic Nucleus, SCN) in the hypothalamus. The implications of the pathophysiology of phase shift are discussed for long-term health effects and for the design of ergonomic work …
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Napping behaviour, daytime sleepiness, and arousal in high performance athletes and non-athlete controls.
Napping offers a strategy to manage sleep, aid recovery and enhance performance in elite sport. However, relatively little research attention has focussed on the natural history of athlete napping or tested the widely held assumption that athlete napping is mainly a consequence of degraded night-time sleep. Within a sample of 158 team (n = 76) and individual (n = 80) sport athletes, and 82 non-athlete controls, we analysed napping behaviour in relation to sleep quality, daytime sleepiness, and pre-sleep somatic and cognitive arousal. There was no significant association between athlete/non-athlete status and the prevalence, frequency, or duration of naps. Comparisons of athlete nappers and non-nappers found no significant differences in sleep quantity or quality. While nap propensity was significantly related to higher daytime sleepiness, this influence was moderated or augmented by leve…
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Objective measurement of daytime napping, cognitive dysfunction and subjective sleepiness in Parkinson's disease.
Introduction: Sleep-wake disturbances and concomitant cognitive dysfunction in Parkinson's disease (PD) contribute significantly to morbidity in patients and their carers. Subjectively reported daytime sleep disturbance is observed in over half of all patients with PD and has been linked to executive cognitive dysfunction. The current study used daytime actigraphy, a novel objective measure of napping and related this to neuropsychological performance in a sample of PD patients and healthy, age and gender-matched controls. Furthermore this study aimed to identify patients with PD who may benefit from pharmacologic and behavioural intervention to improve these symptoms.
Methods: Eighty-five PD patients and 21 healthy, age-matched controls completed 14 days of wrist actigraphy within two weeks of neuropsychological testing. Objective napping measures were derived from actigraphy using a st…
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Effects of a nap on nighttime sleep and waking function in older subjects.
Objectives: To examine, in older subjects, the effect on waking function of increasing 24-hour sleep amounts by providing a nap opportunity; to assess what effects an afternoon nap may have on subsequent nighttime sleep quality and composition.
Design: Two-session, within-subject laboratory design.
Setting: The study was conducted in the Laboratory of Human Chronobiology at Weill Cornell Medical College.
Participants: Thirty-two healthy men and women aged 55 to 85.
Measurements: Polysomnography (sleep electroencephalogram), cognitive and psychomotor performance, body core temperature.
Results: Napping had little effect on subsequent nighttime sleep quality or duration, resulting in a significant increase in 24-hour sleep amounts. Such increased sleep resulted in enhanced cognitive and psychomotor performance immediately after the nap and throughout the next day.
Conclusion: A behavioral …
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Cheng C, Xue X, Jiao Y, You R, Zhang M, Jia M, Du M, Zeng X, Sun JB, Qin W, Yang XJ (2025)MEDLINE-indexed journal, not yet read by usNeuroscience3 citations External trigeminal nerve stimulation (eTNS) Exhibits relaxation effects in fatigue states following napping deprivation.
Background: In the face of inevitable declines in alertness and fatigue resulting from sleep deprivation, effective countermeasures are essential for maintaining performance. External trigeminal nerve stimulation (eTNS) presents a potential avenue for regulating alertness by activating the locus coeruleus and reticular activating system.
Methods: Here, we conducted a within-subject study with 66 habitual nappers, subjecting them to afternoon nap-deprivation and applying either 20-minute of 120 Hz eTNS or sham stimulation. We compared participants' performance in PVT and N-back tasks, subjective fatigue level and alertness ratings, and changes in heart rate variability, cortisol, and salivary alpha-amylase before and after stimulation.
Results: The results revealed a significant decline in PVT and N-back tasks performance, along with increased subjective fatigue levels in the sham stimula…
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Sleep deprivation among adolescents in urban and indigenous-rural Mexican communities.
Comparing the nature of adolescent sleep across urban and more isolated, rural settings through an ecological, cross-cultural perspective represents one way to inform sleep nuances and broaden our understanding of human development, wellbeing and evolution. Here we tested the Social Jetlag Hypothesis, according to which contemporary, urban lifestyles and technological advances are associated with sleep insufficiency in adolescents. We documented the adolescent sleep duration (11-16 years old; X̅ = 13.7 ± 1.21; n = 145) in two small agricultural, indigenous and one densely urban context in Mexico to investigate whether adolescents in socio-ecologically distinct locations experience sleep deprivation. Sleep data was assembled with actigraphy, sleep diaries and standardized questionnaires. We employed multilevel models to analyze how distinct biological and socio-cultural factors (i.e., pub…
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Sleep of preschoolers during the coronavirus disease 2019 (COVID-19) outbreak.
Coronavirus disease 2019 (COVID-19) has resulted in a significantly large number of psychological consequences, including sleep health. The present study evaluated sleep patterns, sleep disturbances, and associated factors in Chinese preschoolers confined at home during the COVID-19 outbreak. Caregivers of 1619 preschoolers (aged 4-6 years) recruited from 11 preschools in Zunyi, Guizhou province completed the Children's Sleep Habit Questionnaire (CSHQ) between 17th and 19th February 2020. Data were compared to a sociodemographically similar sample of preschoolers (included in the 11 preschools) in 2018. Compared to the 2018 sample, the confined preschoolers demonstrated changes in sleep patterns characterized by later bedtimes and wake times, longer nocturnal and shorter nap sleep durations, comparable 24-hr sleep duration, and fewer caregiver-reported sleep disturbances. Moreover, behav…
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Acute sleep restriction effects on emotion responses in 30- to 36-month-old children.
Early childhood is a period of dramatic change in sleep and emotion processing, as well as a time when disturbance in both domains are first detected. Although sleep is recognized as central in emotion processing and psychopathology, the great majority of experimental data have been collected in adults. We examined the effects of acute sleep restriction (nap deprivation) on toddlers' emotion expression. Ten healthy children (seven females; 30-36 months old) followed a strict sleep schedule (≥12.5 h time in bed per 24-h) for 5 days, before each of two randomly assigned afternoon emotion assessments following Nap and No-Nap conditions (resulting in an 11-day protocol). Children viewed emotion-eliciting pictures (five positive, three neutral, three negative) and completed puzzles (one solvable, one unsolvable). Children's faces were video-recorded, and emotion displays were coded. When slee…
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Electrophysiological correlates of cognition improve with nap during sleep deprivation.
The efficacy of a 30-min nap as a countermeasure in the reduction of cognitive decline following 24 h of sleep deprivation (SD) on subjective sleepiness scales, event-related potential (ERP) P300, and contingent negative variation (CNV) was evaluated. The experiment was performed in three sessions on different days between 7 and 8 a.m. on nine normal, healthy males, of age 25-30 years: Session 1. Baseline recordings; Session 2, after one night's total sleep deprivation, and; Session 3, after 1 week of Session 1, following one night's sleep deprivation along with a 30-min nap opportunity between 1.00 and 3.00 a.m. Subjective sleepiness scores increased after SD as compared to baseline, but reduced significantly after nap (P < 0.05). There was an increase in P3 peak latency of ERP following SD (16%, P < 0.01), which was reduced with nap (10.7%, P < 0.05).There was an increase in CNV M1 pea…
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Barger LK, Cade BE, Ayas NT, Cronin JW, Rosner B, Speizer FE, Czeisler CA, Harvard Work Hours, Health, and Safety Group (2005)MEDLINE-indexed journal, not yet read by usThe New England journal of medicine545 citations Extended work shifts and the risk of motor vehicle crashes among interns.
Background: Long work hours and work shifts of an extended duration (> or =24 hours) remain a hallmark of medical education in the United States. Yet their effect on health and safety has not been evaluated with the use of validated measures.
Methods: We conducted a prospective nationwide, Web-based survey in which 2737 residents in their first postgraduate year (interns) completed 17,003 monthly reports that provided detailed information about work hours, work shifts of an extended duration, documented motor vehicle crashes, near-miss incidents, and incidents involving involuntary sleeping.
Results: The odds ratios for reporting a motor vehicle crash and for reporting a near-miss incident after an extended work shift, as compared with a shift that was not of extended duration, were 2.3 (95 percent confidence interval, 1.6 to 3.3) and 5.9 (95 percent confidence interval, 5.4 to 6.3), res…
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Effect of a 90-Minute Nap at Different Times of the Day on Physical Performance, Psycho-Cognitive Responses, and Perceived Recovery in Trained Youth Male Athletes.
Napping is recognized as a strategy to enhance athletic performance. However, the optimal timing and duration for maximizing its benefits remain unclear. This study investigated the effects of a 90 min nap at different times on physical performance, psycho-cognitive responses, and perceived recovery in trained youth male athletes. Fourteen athletes (18 ± 1 years) completed four conditions in a randomized crossover design: (1) No-nap-13h, (2) No-nap-15h, (3) Nap-13h, and (4) Nap-15h. After each condition, athletes performed a 5 m shuttle run test (5mSRT) and were assessed on best distance (BD), total distance (TD), and fatigue index (FI). Ratings of perceived exertion (RPE) were recorded after each 5mSRT repetition, whereas muscle soreness (DOMS) and recovery (PRS) were assessed post-test and 24 h later. The digit cancelation test (DCT), feeling scale (FS), Stanford Sleepiness Scale (SSS)…
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Neuroligin-2 shapes individual slow waves during slow-wave sleep and the response to sleep deprivation in mice.
Background: Sleep disturbances are a common comorbidity to most neurodevelopmental disorders and tend to worsen disease symptomatology. It is thus crucial to understand mechanisms underlying sleep disturbances to improve patients' quality of life. Neuroligin-2 (NLGN2) is a synaptic adhesion protein regulating GABAergic transmission. It has been linked to autism spectrum disorders and schizophrenia in humans, and deregulations of its expression were shown to cause epileptic-like hypersynchronized cerebral activity in rodents. Importantly, the absence of Nlgn2 (knockout: KO) was previously shown to alter sleep-wake duration and quality in mice, notably increasing slow-wave sleep (SWS) delta activity (1-4 Hz) and altering its 24-h dynamics. This type of brain oscillation is involved in memory consolidation, and is also a marker of homeostatic sleep pressure. Sleep deprivation (SD) is notabl…
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The melatonin receptor agonist is effective for free-running type circadian rhythm sleep disorder: case report on two sighted patients.
Along with urbanization of the living environment, the number of patients with circadian rhythm sleep disorder (CRSD) has been increasing. There are several treatment candidates for CRSD, such as light therapy, drugs (melatonin and vitamin B12), and sleep hygiene education. However, successful treatment method has not been established. In free-running type (FRT) CRSD, the endogenous circadian rhythm cannot be entrained to the 24-h light-dark cycle, resulting in free running on a cycle 0.5-2.5 h longer than the 24-h period. This condition is relatively common in blind individuals and is unusual in sighted individuals. Here we report two sighted patients with FRT, successfully treated with a melatonin receptor agonist, ramelteon. Patient 1 (36-year-old female) had suffered from FRT for nearly 4 months after resigning her job. She was given sleep hygiene education together with ramelteon at…
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Daytime Sleep Behaviors and Cognitive Performance in Middle- to Older-Aged Adults Living with and without HIV Infection.
Purpose: We investigated whether daytime sleep behaviors (DSBs) such as frequent daytime sleepiness or napping are associated with worse cognitive performance, and whether HIV infection moderates this relationship.
Methods: Among 502,507 participants in the UK Biobank study, we identified 562 people living with HIV infection (PLWH; M age= 50.51±7.81; 25.09% female; 78.83% white) and extracted 562 uninfected controls who matched on age, sex, ethnic background, social-economic status, and comorbidities. DSB burden was assessed based on answers to two questions on DSBs. Participants who answered "sometimes" or "often/usually" to one of them were considered to have poor DSB burden, or otherwise were considered not having any. A composite cognition score was computed by averaging the available standardized individual test results from four neurocognitive tests: ie, a reaction time test for in…
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The hippocampus is crucial for forming non-hippocampal long-term memory during sleep.
There is a long-standing division in memory research between hippocampus-dependent memory and non-hippocampus-dependent memory, as only the latter can be acquired and retrieved in the absence of normal hippocampal function1,2. Consolidation of hippocampus-dependent memory, in particular, is strongly supported by sleep3-5. Here we show that the formation of long-term representations in a rat model of non-hippocampus-dependent memory depends not only on sleep but also on activation of a hippocampus-dependent mechanism during sleep. Rats encoded non-hippocampus-dependent (novel-object recognition6-8) and hippocampus-dependent (object-place recognition) memories before a two-hour period of sleep or wakefulness. Memory was tested either immediately thereafter or remotely (after one or three weeks). Whereas object-place recognition memory was stronger for rats that had slept after encoding (ra…
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Working night shifts affects surgeons' biological rhythm.
Background: Chronic sleep deprivation combined with work during the night is known to affect performance and compromise residents' own safety. The aim of this study was to examine markers of circadian rhythm and the sleep-wake cycle in surgeons working night shifts.
Methods: Surgeons were monitored prospectively for 4 days: pre call, on call, post call day 1 (PC1), and post call day 2 (PC2). The urinary metabolite of melatonin and cortisol in saliva were measured to assess the circadian rhythm. Sleep and activity were measured by actigraphy. Subjective measures were assessed by the Karolinska Sleepiness Scale and Visual Analog Scale of fatigue, general well-being, and sleep quality.
Results: For both metabolite of melatonin and cortisol, a significant difference (P < .05) was found in the measurement period between on call and pre call values. There was increased sleep time during the da…
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Sleep loss and circadian disruption in shift work: health burden and management.
About 1.5 million Australians are shift workers. Shift work is associated with adverse health, safety and performance outcomes. Circadian rhythm misalignment, inadequate and poor-quality sleep, and sleep disorders such as sleep apnoea, insomnia and shift work disorder (excessive sleepiness and/or insomnia temporally associated with the work schedule) contribute to these associations. Falling asleep at work at least once a week occurs in 32%-36% of shift workers. Risk of occupational accidents is at least 60% higher for non-day shift workers. Shift workers also have higher rates of cardiometabolic diseases and mood disturbances. Road and workplace accidents related to excessive sleepiness, to which shift work is a significant contributor, are estimated to cost $71-$93 billion per annum in the United States. There is growing evidence that understanding the interindividual variability in sl…
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Aligning work and circadian time in shift workers improves sleep and reduces circadian disruption.
Sleep loss and circadian disruption-a state of misalignment between physiological functions and imposed sleep/wake behavior-supposedly play central roles in the etiology of shift work-related pathologies [1-4]. Circadian entrainment is, however, highly individual [5], resulting in different chronotypes [6, 7]. Chronotype in turn modulates the effects of working times: compared to late chronotypes, earlier ones sleep worse and shorter and show higher levels of circadian misalignment during night shifts, while late types experience more sleep and circadian disruption than early types when working morning shifts [8]. To promote sleep and reduce the mismatch between circadian and working time, we implemented a chronotype-adjusted (CTA) shift schedule in a factory. We abolished the most strenuous shifts for extreme chronotypes (i.e., mornings for late chronotypes, nights for early ones) and e…
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The Munich ChronoType Questionnaire for Shift-Workers (MCTQShift).
Sleep is systematically modulated by chronotype in day-workers. Therefore, investigations into how shift-work affects sleep, health, and cognition may provide more reliable insights if they consider individual circadian time (chronotype). The Munich ChronoType Questionnaire (MCTQ) is a useful tool for determining chronotype. It assesses chronotype based on sleep behavior, specifically on the local time of mid-sleep on free days corrected for sleep debt accumulated over the workweek (MSFsc). Because the original MCTQ addresses people working standard hours, we developed an extended version that accommodates shift-work (MCTQ(Shift)). We first present the validation of this new version with daily sleep logs (n = 52) and actimetry (n = 27). Next, we evaluated 371 MCTQ(Shift) entries of shift-workers (rotating through 8-h shifts starting at 0600 h, 1400 h, and 2200 h). Our results support exp…
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Sleep patterns and long-term mortality among older Israeli adults: a population-based study.
Introduction: The joint association of night-time sleep duration and daytime napping (siesta) with mortality remains elusive. We explored sleep patterns and long-term mortality in older adults and tested whether the relationship is modified by cognitive function.
Methods: We analysed data from 1519 participants in the National Health and Nutrition Survey of older adults aged 65+ years ('Mabat Zahav'), conducted by the Israel Center for Disease Control during 2005-2006. A detailed questionnaire was administered at study entry to gather information on sleeping habits, including night-time sleep duration and siesta. A Mini-Mental State Examination was administered to assess cognitive status (score <27 considered impaired). Mortality data were obtained from the Ministry of Health (last follow-up: June 2019; 782 deaths). Cox models were constructed to estimate the HRs for mortality associated…
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Dourte M, Hammad G, de Haan S, Reyt M, Deantoni M, Baillet M, Lesoinne A, Vandewalle G, Collette F, Muto V, Peigneux P, Schmidt C (2026)MEDLINE-indexed journal, not yet read by usGeroScience Breaking the nap habit: one-year nap restriction mitigates memory decline in older adults.
Increased napping in later life is a common behaviour shaped by cultural, environmental and biological factors. Although brief naps can enhance alertness and memory, epidemiological evidence suggests that frequent or prolonged daytime sleep in older adults is associated with poorer physical health and accelerated cognitive decline, including episodic memory, possibly due to the underlying circadian disruption of the sleep-wake cycle. In this study, we tested whether restricting nap habits for 12 months would mitigate the age-related changes in cognitive functioning in healthy retirees (59-82 years). Fifty-eight habitual nappers were randomised either to a nap-control condition (n = 28), where they continued their usual nap routine, or to a nap-intervention condition (n = 30), where they received behavioural coaching to reduce the frequency and duration of daytime napping. A non-nappers g…
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Distinct roles of chronotype, daytime napping, and sleep duration in biological and functional aging: a univariable and multivariable Mendelian randomization study.
Background: Sleep traits have been linked to aging, but observational designs cannot separate correlated sleep behaviors or establish causality. We used Mendelian randomization (MR) to estimate both total and direct effects of chronotype, daytime napping, and sleep duration on multidimensional aging outcomes.
Methods: Two-sample MR used large GWAS instruments for the three sleep traits against leukocyte telomere length, facial ageing, epigenetic clocks (IEAA, HannumAge, PhenoAge, GrimAge), frailty index, and cognitive performance. Inverse-variance weighted (IVW) was primary, with MR-Egger, weighted median, and MR-PRESSO as sensitivity analyses. Univariable MR (UVMR) estimated total effects; multivariable MR (MVMR) estimated direct effects accounting for intercorrelations.
Results: In UVMR, napping was adversely associated with telomere length (β = - 0.11, 95% CI - 0.18 to - 0.05, PFDR = …
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