Auditory evoked potentials as a function of sleep deprivation

Event-related brain potentials (ERPs) were studied in subjects deprived of sleep over a 48-h test period to assess the effects of different durations of continuous wakefulness on ERP components and to determine whether changes in the ERP components were related to changes in performance. Forty subjects were randomly assigned to either an experimental (sleep deprived) group (n = 30) or a control (not sleep deprived) group (n = 10). For the experimental subjects, ERP and performance measures were obtained in four-h test blocks throughout the 48-h period. Performance was assessed using the Walter Reed performance assessment battery. The control subjects were tested at the same times except during designated sleep periods. Both performance and evoked potential measures showed systematic changes over the experimental test period in association with sleep deprivation, time of day, and repeated testing. The latency of the N2 component of the evoked potential covaried with throughput measures on the performance assessment battery across the 12 four-h test blocks of the experiment. These data suggest that ERPs reflect central processes that change across the sleep deprivation period and that ERP measures might be useful in assessment and prediction of performance degradation under adverse conditions such as sleep loss.     

Sleep hygiene practices and sleep duration in rotating-shift shiftworkers

Alcohol, caffeine and tobacco intake, exercise, activities on going to bed, and sleep-enhancing measures were assessed in 72 rotating-shift shiftworkers to determine whether these variables differ following day shifts and night-shifts, and which are related to sleep duration. Only alcohol intake and exercise prior to sleep, and feeling drowsy when retiring, differed following the night-shift. Workers generally followed recommendations concerning alcohol intake, sleeping immediately on retiring, and exercising, but acted contrary to recommendations concerning caffeine and nicotine intake. The only behaviour clearly associated with poor sleep was smoking, which reduced sleep duration.     

Work performance and health of junior hospital doctors a review of the literature

Concern has been expressed for a number of years about the long working hours and consequent sleep loss often experienced by junior hospital doctors. In recent months there has been renewed pressure for the demanding work schedules, common in many hospitals, to be changed. Concern centres on two related areas, namely the potential effects on the doctors work performance and the effects on their health. This paper reviews the literature relating to both areas and assesses how far the expressed need for change is supported by existing evidence. In addition attention is drawn to aspects of sleep loss and work performance requiring further investigation.     

Using pharmacological aids to improve waking function and sleep while working at night

Non-refreshing or insufficient sleep, and impaired alertness on the job, are two nearly universal consequences of night work. The effects of drugs upon the sleep and alertness of night workers has only recently been studied and much work remains to be done. To date, it is clear that sleep during the day can be improved with sedative-hypnotic compounds, particularly the benzodiazepines. Despite improvement in sleep, alertness at night is improved only mildly, if at all, with short-acting sleeping agents and can be further impaired with long-acting drugs. The limited research examining alertness and performance during night shift hours after administration of CNS stimulants suggests significant benefits. The judicious use of CNS stimulants in this way needs further exploration. Precise pharmacological manipulation of the endogenous sleep/wake rhythm is primarily theoretical at this time but should be pursued.     

Perceived physical work capacity,stress, sleep disturbance and occupational accidents among firefighters working during a strike

Fire-fighting and rescue work are arranged in such a way that various kinds of accidents and catastrophes can be handled. In an understaffed situation, such as a strike, this goal may not be met. The objective of this study was to investigate factors associated with perceived physical work capacity, stress, sleep disturbance, and occupational accidents among firefighters who remained at work during an extended strike. A cross-sectional questionnaire study was carried out among 543 firefighters (83% of the target group) in 71 fire brigades in Finland. After the strike had lasted for 9 to 11 weeks, most of the firefighters perceived their physical work capacity to be rather good or very good. Stress increased along with a decreasing number of personnel in a crew (OR= 2.3, CI= 1.0-5.3, for less than 75% of a normal crew vs. normal crew) and with decreasing number of personnel in a shift (OR= 2.4, CI= 1.1-5.4, for less than 25% of normal shift vs. normal shift). Sleep disturbance was reported to occur as soon as the total working time exceeded 50 h/week. Working more than 70 h/week increased the risk of occupational accidents almost 4-fold compared with working no more than 50 h/week. These results suggest that exceptional situations, such as a strike, are a challenge to human capacity. With time, increased stress and sleep disturbance may lead to serious consequences.     

Effort-reward imbalance,overcommitment and sleep in a working population

The relationship between workplace characteristics and nocturnal sleep in a working population was investigated. Data from 709 employees (mean age=39 years; 87% men) from two German companies were analysed at the entry of the longitudinal cohort study (overall accrual 73%). We investigated the association between the effort-reward imbalance model at work (Siegrist, ) and self-reported sleep quality and sleep disturbances, as assessed by the Jenkins Sleep Quality Index. Effort and overcommitment were found to be higher, and reward was lower in participants with lower (N=328) vs. higher sleep quality (N=381), as well as in participants with (N=217) vs. without (N=492) disturbed sleep (all ps<.001). In regression analyses, lower sleep quality (R ²=.33) and sleep disturbances (R ² _Nagelkerke=.33) were predicted by older age, female gender (only significant for sleep disturbances), shift-work, lower physical and mental health functioning, and higher overcommitment. Individuals were 1.7 times more likely to report disturbed sleep per standard deviation increase in overcommitment. Gender-stratified analyses revealed that higher overcommitment was associated with unfavourable sleep in men, while in women poor sleep was related to lower reward. The findings suggest that overcommitment at work interferes with restful sleep in men, while in women disturbed sleep may be associated with the amount of overcommitment and perceived job reward and sleep quality associated with the perceived reward.     

Is there an optimum number of night shifts? Relationship between sleep,health and well-being

Abstract

By concentrating on the impact of a specific shift-system feature on the well-being of those concerned, rather than on the impact of the shift system as a whole, one might be able to offer more meaningful suggestions as to what constitutes a better form of shift system. The present study focused on the impact of the number of consecutive night shifts worked on the health and well-being of two groups of nurses (permanent night and rotating shift). All nurses completed a copy of the Standard Shiftwork Index, which is a set of questionnaires designed for comparing the effects of different types of shift system on large groups of workers. It includes measurements of psychological ill-health, physical ill-health, chronic fatigue, social and domestic disruption, attitudes towards shiftwork, sleep quality and sleep habits. Results showed clearly the impact of the number of consecutive nights worked on health and well-being, not directly, but indirectly through the impact on sleep duration and sleep quality. Sleep duration was shown to increase with more consecutive nights worked. This in turn was found to predict sleep quality, which in turn was found to be the stronger direct predictor of psychological and physical ill-health: i.e. better health was associated with longer and better quality sleeps. Explanations in terms of circadian adaptation are discussed.     

Sleep quality at 3 months postpartum considering maternal age: A comparative study

Background

Poor sleep quality is related to old age among the general population, but few studies have focused on postpartum women of advanced maternal age. The present study aimed to describe and compare sleep quality between women younger or older than 35 years of age at 3 months postpartum, and to examine the related factors.

阻塞性睡眠呼吸暂停对老年卒中患者认知功能障碍的影响研究

目的探讨阻塞性睡眠呼吸暂停对老年卒中患者认知功能障碍的影响及其发病机制。方法确诊脑卒中患者配带手握式脉博血氧监测仪,确诊OSAS和并脑卒中患者48例,未患OSAS的脑卒中患者56例,作为对照组。进行身高、体质量测量;收集晨起空腹血标本,进行血浆黏度、纤维蛋白原、血糖及血脂、血压的测定;进行临床记忆量表检测。结果SAS组与对照组平均动脉压、血脂、血糖、血浆黏度、纤维蛋白原比较差异有统计学意义,SAS组与对照组指向记忆、联想记忆、无意义图形再认、记忆商等指标比较差异有统计学意义。结论OSAS可以加重卒中患者的认知功能障碍,并探讨其发病机制。     

Integrated Group Program for Improving Sleep Quality of Elderly People

ABSTRACT

This article reports an exploratory study on the effects of an integrated group program for improving the sleep quality of elderly people in Hong Kong. Elderly people aged over 55 who had obtained a Pittsburgh Sleep Quality Index (PSQI) score >5 were recruited as subjects of the study. While 19 subjects of the treatment group were taking part in an integrated group program involving social group work intervention as well as Chinese medicine therapeutics, 9 subjects of comparison group received no intervention. Using a pretest and posttest design, the study revealed positive effects of the integrated group program. It has added knowledge serving the development of interventions that can help to improve the sleep quality of elderly people.