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Purpose/background: Alzheimer disease (AD) is a public health issue because of the low number of symptomatic drugs and the difficulty to diagnose it at the prodromal stage. The need to develop new treatments and to validate sensitive tests for early diagnosis could be met by developing a challenge model reproducing cognitive impairments of AD. Therefore, we implemented a 24-hour sleep deprivation (SD) design on healthy volunteers in a randomized, double-blind, placebo-controlled, crossover study on 36 healthy volunteers., Methods/procedure: To validate the SD model, cognitive tests were chosen to assess a transient worsening of cognitive functions after SD and a restoration under modafinil as positive control (one dose of 200 mg). Then, the same evaluations were replicated after 15 days of donepezil (5 mg/d) or memantine (10 mg/d). The working memory (WM) function was assessed by the N-back task and the rapid visual processing (RVP) task., Findings/results: The accuracy of the N-back task and the reaction time of the RVP revealed the alteration of the WM with SD and its restoration with modafinil (changes in score after SD compared with baseline before SD), respectively, in the placebo group and in the modafinil group (-0.2% and +1.0% of satisfactory answers, P = 0.022; +21.3 and +1.9 milliseconds of reaction time, P = 0.025). Alzheimer disease drugs also tended to reverse this deterioration: the accuracy of the N-back task was more stable through SD (compared with -3.0% in the placebo group, respectively, in the memantine group and in the donepezil group: -1.4% and -1.6%, P = 0.027 and P = 0.092) and RVP reaction time was less impacted (compared with +41.3 milliseconds in the placebo group, respectively, in the memantine group and in the donepezil group: +16.1 and +29.3 milliseconds, P = 0.034 and P = 0.459)., Implications/conclusions: Our SD challenge model actually led to a worsening of WM that was moderated by both modafinil and AD drugs. To use this approach, the cognitive battery, the vulnerability of the subjects to SD, and the expected drug effect should be carefully considered.

Sleep is involved in metabolic system, mental health and cognitive functions. Evidence shows that sleep deprivation (SD) negatively affects mental health and impairs cognitive functions, including learning and memory. Furthermore, the metabotropic glutamate receptor subtype 5 (mGluR5) is a metabolic biomarker, which is affected by various conditions, including stress, sleep deprivation, and cognitive and psychiatric disorders. In this research, we investigated the effect of SD and reverse circadian (RC), and two models of napping (continuous and non-continuous) combined with SD or RC on fear-conditioning memory, anxiety-like behavior and mGluR5 fluctuations in the amygdala. 64 male Wistar rats were used in this study. The water box apparatus was used to induce SD/RC for 48 h, and fear-conditioning memory apparatus was used to assess fear memory. The results showed, fear-conditioning memory was impaired following SD and RC, especially in contextual stage. However, anxiety-like behavior was increased. Furthermore, mGluR5 was increased in the left amygdala more than the right amygdala. Additionally, continuous napping significantly improved fear-conditioning memory, especially freezing behavior. In conclusion, following SD and RC, fear-conditioning memory in contextual stage is more vulnerable than in auditory stage. Furthermore, increase in anxiety-like behavior is related to increase in the activity of left amygdala and mGluR5 receptors., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objective: The purpose of this study was to quantify the impact that self-quarantine has on behaviors associated with weight gain., Methods: This was a quantitative descriptive/correlational research design. Research announcement was sent out via Facebook to 1200 possible participants. Six surveys were condensed into a single Survey Monkey questionnaire for participants to complete. Surveys asked questions relating to risk factors linked to weight gain., Results: Ninety-one percent of our sample stated they spend more time at home now than before COVID-19. Twenty-two percent of the sample stated they gained 5-10 pounds. Within those who gained 5-10 pounds, there was a significantly higher percentage of the total sample who reported they increased eating in response to sight and smell (p = .048), eating in response to stress (p = .041), and snacking after dinner (p = .016) compared to those who stated they did not change those behaviors at all. There were significant relationships between predictor variables hours of sleep per night and physical activity time on reported weight gain (r = -.195, p = .021, r = -.155, p = .034, respectively)., Conclusion: Risk factors for weight gain during self-quarantine are inadequate sleep, snacking after dinner, lack of dietary restraint, eating in response to stress, and reduced physical activity., (Copyright © 2020 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.)

Background: Studies assessing the impact of sleep restriction (SR) on blood pressure (BP) are limited by short study length, extreme SR (<4 hours a night), and lack of attention to psychological distress as a possible mediator., Methods: A community-based cohort was assembled with 237 women (age 34.1 ± 13.5 years; body mass index 25.4 ± 5.4 kg/m 2 ), and a randomized, crossover, intervention study was conducted in 41 women (24 completed: age 30.2 ± 6.5 years; body mass index 24.3 ± 2.8 kg/m 2 ) to determine the causal effect of SR on BP. Sleep was maintained as usual (HS) or reduced by 1.5 hours a night (SR) for 6 weeks. In the cohort, associations between sleep and psychosocial factors were evaluated using multivariable models adjusted for demographic and clinical confounders. In the intervention study, in-office BP was measured weekly; ambulatory BP was measured at end point. Psychological factors were assessed at baseline and end point. Mixed-model analyses with total sleep time (TST, main predictor), week and fraction of time spent in physical activity (covariates), and subject (random effect) were performed., Results: Among the community cohort, higher perceived stress, stressful events and distress, and lower resilience were associated with shorter sleep, worse sleep quality, and greater insomnia symptoms (P < .05). In the intervention, systolic BP increased as TST decreased (TST × week interaction, [coefficient ± standard error] -0.0097 ± 0.0046, P = .036). Wake ambulatory diastolic blood pressure (-0.059 ± 0.022, P = .021) and mean arterial pressure (-0.067 ± 0.023, P = .018) were higher after SR versus HS. Psychological distress variables were not affected by TST and did not mediate the effects of SR on BP., Conclusions: These results suggest that SR influences CVD risk in women via mechanisms independent of psychological stressors., Competing Interests: Declaration of competing interest None of the authors have any conflicts of interest to declare. All authors have made substantial contributions to the conception or design of the work, or the acquisition, analysis, or interpretation of the data; drafted or revised the manuscript for important intellectual content; approved the final version; and agree to be accountable for all aspects of the work reported herein. M. P. S. O. and B. A. had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis., (Copyright © 2020 Elsevier Inc. All rights reserved.)

The objective of this study was to examine the association between insufficient sleep and suicidal ideation among adolescents. Data for this study came from the 2017 Youth Risk Behavior Surveillance System. A sample of 13,659 adolescents aged 14-18 years (51.8% female) were analyzed using logistic regression with suicidal ideation as the outcome variable and insufficient sleep as the main explanatory variable. Of the 13,659 adolescents, 2,409 representing 17.6% experienced suicidal ideation during the past 12 months and three out of four adolescents (75.2%) had insufficient sleep on an average school night. Controlling for all other predictors, the odds of experiencing suicidal ideation were 1.35 times higher for adolescents who had insufficient sleep relative to those who had sufficient sleep on an average school night (AOR = 1.35, 95% CI = 1.16-1.58). Other factors associated with suicidal ideation include female gender, sexual minority, history of traditional bullying and cyberbullying victimization, feeling sad or hopeless, being slightly or very overweight, and substance use. Physical activity was inversely associated with suicidal ideation. School counselors, clinicians, and practitioners should consider adequate sleep as an important intervention in suicide prevention., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflicts of interests with respect to the authorship and/or the publication of this paper., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objective: To determine the factors associated with sleep deprivation and their impact on academic performance of students living in a hostel setting., Methods: It was a correlational study conducted from January to June, 2018 in Rawalpindi and Islamabad, Pakistan, and comprised university students of either sex aged 18-25 years who were studying at different universities of the twin cities. A semi-structured questionnaire was used along with Pittsburgh Sleep Quality Index to collect data which was analysed using SPSS 21., Results: Of the 850 students, 450(50%) each were males and females. The overall mean age was 21.10±1.84 years. There was academic stress in 672(79%) students which disturbed the normal sleep cycle. Other factors affecting students; sleep were financial issues 632(74%), uncomfortable bed mattresses 671(79%), environmental noise 468 (53%), poor ventilation 666 (78%), hostel near commercial places 233(27%), and the habit of playing mobile games 545(65%). Female students had more sleep problems than males (p<0.05). Bivariate correlation showed no association of these factors and cumulative grade point average (p>0.05)., Conclusion: The most common factors found to be influencing hostelites' sleep were stress, financial issues, uncomfortable mattresses, environmental noise and playing games on mobile before sleep. Disturbed sleep did not affect academic performance.

Objectives: This study identified daily associations between sleep, emotion, and marital functioning in the context of chronic pain. Because spouses' sleep is compromised on nights when patients experience more pain, we set out to identify implications of spouses' sleep for their own emotion (anger) upon waking and marital interaction (marital tension) throughout the rest of the day. We further considered whether spouses' critical attitudes about patients' pain-related coping exacerbated associations between their sleep, morning anger, and marital tension., Method: Data came from a study of knee osteoarthritis patients (50+ years old) and spouses (N = 138 couples) who completed daily diaries across 22 days. Multilevel models were estimated to test hypotheses., Results: Spouses woke up angrier on mornings when they reported that their sleep was more unrefreshing than usual. This association was stronger among more critical spouses. Morning anger resulting from unrefreshing sleep, however, did not predict marital tension throughout the rest of the day., Discussion: Findings highlight the potential value of intervention efforts aimed at promoting spouses' sleep quality in an effort to offset negative emotional consequences that may undermine spouses' and patients' adjustment in the context of chronic pain., (© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Total sleep deprivation (TSD) impairs attention as well as higher-order cognitive processes. Because attention is a core component of many tasks, it may fully mediate the effect of sleep deprivation on higher-order processes. We examined this possibility using the Psychomotor Vigilance Task as a measure of attention and the UNRAVEL task as a measure of placekeeping, a higher-order process that involves memory operations and supports performance in a wide range of complex tasks. A large sample of participants (N = 138 contributing data) performed the Psychomotor Vigilance Task and UNRAVEL under rested or sleep-deprived conditions. TSD impaired placekeeping generally and memory maintenance processes specifically, above and beyond the effect of participants' attentional state. The results suggest that TSD may impair a range of higher-order cognitive processes directly, not just fundamental processes such as attention, and that interventions that benefit attention may have limited scope. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Although sleep loss increases state anxiety, the effects of partial sleep restriction on specific anxiety symptoms and mechanisms that may influence this relation remain unknown. It is also unknown whether prior sleep buffers the impact of sleep restriction on anxiety symptoms. Thus, the present study examined the relations between inhibition and repetitive negative thinking (RNT), obsessions, and other OCD symptoms following sleep restriction and the moderating role of prior night's sleep efficiency. Healthy sleeping adults (n = 73) completed measures of inhibition, anxiety symptoms, and sleep before and after one night of sleep restriction (4 h between 4:00am and 8:00am). Results indicate significant associations between decreased post-sleep restriction inhibition and increased post-sleep restriction RNT and obsessions. Prior night's subjective and objective sleep efficiency significantly moderated these relations, such that the highest post-sleep restriction anxiety symptoms were reported by those with the lowest post-sleep restriction inhibition and the lowest pre-sleep restriction sleep efficiency. These findings suggest decreased inhibition may be one mechanism by which sleep loss affects anxiety, and those with worse sleep prior to acute sleep loss may be particularly vulnerable. The implications for the prevention and treatment of anxiety-related disorders characterized by intrusive cognition are discussed., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2020. Published by Elsevier Ltd.)

Sleep is a key function that takes up one third of our lives. Sleep deprivation may lead to physical and psychological disorders in the short and long term. Hospitalization, regardless of its cause, does not favor good enough and restorative sleep. It is affected by both external (light, noise) and internal (procedures, drugs, care) factors. The intensive care unit is the place where falling asleep and maintaining sleep is more difficult. This is in addition to disease severity and the characteristics of its structure and functioning. A poor sleep quantity or quality may trigger an acute confusional state, which often affects hospitalized children, known as delirium. Promoting a joint effort among all sectors of the hospital setting targeted at protecting sleep as much as possible is the required task., Competing Interests: The authors report no conflicts of interest in this work., (Sociedad Argentina de Pediatría.)

Sleep deprivation has been widely reported to cause cognitive dysfunction, and elevation in oxidative stress and inflammation in the body, including the brain, have been suggested as the main factors. Genistein (GE) is an isoflavone widely present in leguminous plants, and it was found to exert a wide spectrum of biological activities, including antioxidant, anti-inflammatory, hepatoprotective, neuroprotective, and antimetastatic effects. In this study, the protective effect of GE on chronic sleep deprivation (CSD)-induced cognitive dysfunction was investigated. The mice were subjected to the sleep interruption apparatus and continuously sleep deprived for 25 days. GE was orally administrated (10, 20, and 40 mg/kg) during the sleep deprivation process totally for 25 days. Cognitive behavioral tests were conducted to study the learning and memory using the object location recognition (OLR) task, novel object recognition (NOR) test, and the Morris water maze (MWM) task. Additionally, the cortex and hippocampus were dissected to measure the oxidative stress markers and the antioxidant element nuclear erythroid-2-related factor 2 (Nrf2) and its downstream targets, including glutamate cysteine ligase catalytic, glutamate cysteine ligase modifier, heme oxygenase 1, and quinone oxidoreductase 1, as well as nuclear factor kappa B (NF-κB) p65, nitric oxide synthase (iNOS), and cyclooxygenase 2 (COX-2) protein expression. Moreover, the pro-inflammatory cytokines (TNF-α, interleukin [IL]-6, and IL-1β) level was examined in the serum. The current results showed that GE could dose-dependently ameliorate the cognitive deficits of CSD-treated mice in the OLR, NOR, and MWM tasks. In addition, GE treatment significantly elevated the activities of total antioxidant capacity and superoxide dismutase and the level of glutathione and lowered the content of malondialdehyde in the cortex and hippocampus of CSD-treated mice. Furthermore, GE administration effectively activated the antioxidant element Nrf2 and its downstream targets in the cortex and hippocampus of CSD-treated mice. Moreover, GE treatment significantly suppressed CSD-induced NF-κB p65, iNOS, and COX-2 activation in the cortex and hippocampus, as well as inhibited CSD-induced pro-inflammatory cytokines (TNF-α, IL-6, and IL-1β) release in the serum. Taken together, all these results suggested that GE has substantial potential as a therapeutic intervention for the alleviation of CSD-induced deleterious effects., (© 2020 John Wiley & Sons, Ltd.)

The relation between sleep and different forms of memory formation continues to be a relevant topic in our daily life. Sleep has been found to affect cerebellum-dependent procedural memory formation, but it remains to be elucidated to what extent the level of sleep deprivation directly after motor training also influences our ability to store and retrieve memories. Here, we studied the effect of disturbed sleep in mice during two different time-windows, one covering the first four hours following eyeblink conditioning (EBC) and another window following the next period of four hours. Compared to control mice with sleep ad libitum, the percentage of conditioned responses and their amplitude were impaired when mice were deprived of sleep directly after conditioning. This impairment was still significant when the learned EBC responses were extinguished and later reacquired. However, consolidation of eyeblink responses was not affected when mice were deprived later than four hours after acquisition, not even when tested during a different day-night cycle for control. Moreover, mice that slept longer directly following EBC showed a tendency for more conditioned responses. Our data indicate that consolidation of motor memories can benefit from sleep directly following memory formation., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Sleep is a circadian rhythm that is modulated by endogenous circadian clock located in the suprachiasmatic nucleus (SCN). Sleep modulates memory acquisition and promotes memory consolidation. Studies have shown that sleep deprivation (SD) impairs different types of memory including passive avoidance. Furthermore, the hippocampus plays a significant role in modulating passive avoidance memory. On the other hand, 5-HT4 receptors are expressed in the hippocampus and involved in learning and memory processes. In this study, we aimed to investigate the role of CA1 hippocampal 5-HT4 receptors in memory acquisition impairment induced by total sleep deprivation (TSD: 24 h) and REM sleep deprivation (RSD: 24 h). The water box apparatus was used to induce TSD, while multi-platform apparatus was applied to induce RSD. Passive avoidance memory test was also used to evaluate memory acquisition. The results showed that, intra-CA1 pre-training injection of RS67333 (5-HT4 agonist) and RS23597 (5-HT4 antagonist) at the doses of 0.01 and 0.1 µg/rat decreased memory acquisition, but did not alter pain perception and locomotor activity. Furthermore, TSD and RSD decreased memory acquisition; however, only TSD decreased locomotor activity and induced analgesic effect. The sub-threshold doses of RS67333 and RS23597, 0.001 and 0.0001 µg/rat, respectively, reversed the effect of TSD on memory acquisition and locomotor activity. In addition, only RS23597 reversed TSD-induced analgesia. In RSD condition, the subthreshold dose of RS23597 improved RSD-induced memory acquisition deficit. In conclusion, CA1 hippocampal 5-HT4 receptors play an important role in TSD/RSD-induced cognitive alterations., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Standard deviation of lateral position (SDLP) has been accepted as a reliable parameter for measuring driving impairment due to lowered vigilance caused by sleepiness or the use of sedating drugs. Recently, lane drifts were proposed as an additional outcome measure quantifying momentary lapses of attention. The purpose of this study was to validate lane drifts as outcome measure of driver impairment in a large data pool from two independent research centers., Methods: Data from 11 placebo-controlled studies that assessed the impact of alcohol, hypnotics, and sleep deprivation on actual driving performance were pooled. In total, 717 on-the-road tests performed by 315 drivers were subjected to an automated algorithm to detect occurrences of lane drifts. Lane drifts were defined as deviations > 100 cm from the mean (LD mlp ) and from the absolute lateral position (LD alp ) for 8 s., Results: The number of LD mlp was low and did not differ between treatments and baseline, i.e., 14 vs. 3 events, respectively. LD alp were frequent and significantly higher during treatment relative to baseline, i.e., 1646 vs. 470 events. The correlation between LD alp and SDLP in the treatment conditions was very high (r s  = 0.77). The frequency of the occurrence of treatment-induced lane drifts however depended on baseline SDLP of drivers, whereas treatment-induced changes in SDLP occurred independent of baseline SDLP., Conclusion: LD mlp is not useful as an outcome measure of driver impairment due to its rare occurrence, even when treatment-induced increments in SDLP are evident. Treatment effects on LD alp and SDLP are closely related.

Background : College students are at increased risk for sleep disorders, including insomnia disorder and obtaining less than 6.5 hr of sleep per night by choice, or behaviorally induced insufficient sleep syndrome (BIISS). These disorders can have deleterious daytime consequences, including depression. This study aims to establish the prevalence of insomnia and BIISS disorders and examine associations of insomnia and BIISS with other sleep characteristics and depression. Methods : A subset of data from Spit for Science, a college risk behaviors and health study ( n = 989) was used. Insomnia and BIISS were defined as mutually exclusive disorders, based on diagnostic criteria. Results : A majority (68%) of students were categorized as normal sleepers, followed by insomnia (22%), and BIISS (10%). Sleep duration was comparable between BIISS and insomnia, while daytime sleepiness was significantly higher in BIISS, and sleep latency was longer in insomnia ( m = 44 vs. m = 13 min). Insomnia was associated with the highest depression symptoms, followed by BIISS, and normal sleep, controlling for demographics. Insomnia was associated with twice the risk of moderate or higher depression compared to normal sleep (CI: 1.60, 2.70, p < .001). Conclusion : These findings highlight the sleep difficulties endemic to college populations. Further, this study provides the first prevalence estimation of BIISS in college students and the first comparison of insomnia and BIISS on sleep characteristics and depressive symptoms. This study underscores the importance of targeted screening and intervention to improve both sleep and depression in this vulnerable population.

Objective: The purpose of this study is to examine how the sleep duration changes during adolescence across the seventh, eighth, ninth, and 10th grade periods, and to determine whether there is a difference between the cohorts., Method: For these purposes, we used the latent growth curve modeling and the multi-group analysis involving 2081 students (2000-birth cohort data) and 2254 students (1997-birth cohort data) who participated in the Korean Children and Youth Panel Survey. The data were collected using a stratified multistage cluster sampling method., Results: Sleep duration became shorter as age increased. Furthermore, the sleep duration of the 2000-birth cohort became shorter than the sleep duration of the 1997-birth cohort. Specifically, the mean value of the initial sleep duration of the 2000-birth cohort was 8.09 h, which was significantly shorter than the initial value 8.36 h of the sleep duration of the 1997-birth cohort. In addition, multi-group analysis revealed that the trajectories of sleep duration and its predictors were varied by cohort. Specifically, parent supervision, peer relationship, and electronic media factors (smartphone overuse, time spent on using computer and playing games) explained the cohort effect., Conclusion: These findings suggest that environmental factors such as increasing use of electronic media or pressure regarding higher education to adolescents could be associated with reduced sleep duration., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The ability to retain an action plan to execute another is necessary for most complex, goal-directed behavior. Research shows that executing an action plan to an interrupting event can be delayed when it partly overlaps (vs. does not overlap) with the retained action plan. This phenomenon is known as partial repetition costs (PRCs). PRCs reflect proactive interference, which may be resolved by inhibitory, executive control processes. We investigated whether these inhibitory processes are compromised due to one night of sleep deprivation. Participants were randomized to a sleep-deprived group or a well-rested control group. All participants performed an action planning task at baseline after a full night of sleep, and again either after a night of sleep deprivation (sleep-deprived group) or a full night of sleep (control group). In this task, two visual events occurred in a sequence. Participants retained an action plan to the first event in working memory while executing a speeded action to the second (interrupting) event; afterwards, they executed the action to the first event. The two action plans either partly overlapped (required the same hand) or did not (required different hands). Results showed slower responses to the interrupting event during sleep deprivation compared to baseline and the control group. However, the magnitude of the PRCs was no different during sleep deprivation compared to baseline and the control group. Thus, one night of sleep deprivation slowed global responses to the interruption, but inhibitory processes involved in reducing proactive interference while responding to an interrupting event were not compromised. These findings are consistent with other studies that show sleep deprivation degrades global task performance, but does not necessarily degrade performance on isolated, executive control components of cognition. The possibility that our findings involve local as opposed to central inhibition is also discussed.

This article reviews the effects of obstructive sleep apnea on neurocognitive performance, proposed mechanisms of cognitive impairment, and the effects of continuous positive airway pressure on performance. Obstructive sleep apnea can affect several domains of neurocognitive performance to include attention and vigilance, memory and learning, psychomotor function, emotional regulation, and executive function. Proposed mechanisms include intermittent hypoxemia, sleep deprivation and fragmentation, hypercapnia, and disruption of the hypothalamic-pituitary-adrenal-axis. Continuous positive airway pressure can improve cognitive defects associated with obstructive sleep apnea. More data are needed to determine whether other therapies improve cognitive function., Competing Interests: Disclosure The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government., (Published by Elsevier Inc.)

Background: Alzheimer's disease (AD) is the most common form of dementia. It is mainly characterized by a progressive deterioration of cognition, but sleep-wake cycle disturbances frequently occur. Irregular sleep-wake cycle, insomnia, and daytime napping usually occur in patients with AD in the course of the disease., Objective: The aim of the present study was to verify the sleep-wake cycle in mild to moderate AD patients compared to controls, and to evaluate the relationship between the sleep-wake cycle impairment and the neuropsychological testing, CSF AD biomarkers, and CSF orexin concentrations., Methods: Mild to moderate AD patients were enrolled and underwent 14-day actigraphic recording, sleep diary, neuropsychological testing, and CSF biomarkers analysis. All patients were compared to controls., Results: Eighteen AD patients were compared to ten controls. AD patients showed the alteration of the sleep-wake cycle, featured by sleep dysregulation and daytime wake fragmentation, with respect to controls. Considering the correlation analysis, we documented the correlation between tau proteins and orexin CSF levels and sleep-wake cycle dysregulation., Conclusion: This study confirmed the dysregulation of sleep-wake cycle in AD patients, as reflected by the daytime wake fragmentation, irregular sleep-wake rhythm, and nocturnal sleep impairment. This sleep-wake cycle disorder correlates with AD neuropathological in vivo features and brain orexin activity. Hence, we suppose that a more marked AD pathology coupled with orexinergic system dysregulation may promote sleep-wake cycle impairment in AD patients.

Vigilant attention is a major component of a wide range of cognitive performance tasks. Vigilant attention is impaired by sleep deprivation and restored after rest breaks and (more enduringly) after sleep. The temporal dynamics of vigilant attention deficits across hours and days are driven by physiologic, sleep regulatory processes-a sleep homeostatic process and a circadian process. There is also evidence of a slower, allostatic process, which modulates the sleep homeostatic setpoint across days and weeks and is responsible for cumulative deficits in vigilant attention across consecutive days of sleep restriction. There are large inter-individual differences in vulnerability to sleep loss, and these inter-individual differences constitute a pronounced human phenotype. However, this phenotype is multi-dimensional; vulnerability in terms of vigilant attention impairment can be dissociated from vulnerability in terms of other cognitive processes such as attentional control. The vigilance decrement, or time-on-task effect-a decline in performance across the duration of a vigilant attention task-is characterized by progressively increasing response variability, which is exacerbated by sleep loss. This variability, while crucial to understanding the impact of sleep deprivation on performance in safety-critical tasks, is not well explained by top-down regulatory mechanisms, such as the homeostatic and circadian processes. A bottom-up, neuronal pathway-dependent mechanism involving use-dependent, local sleep may be the main driver of response variability. This bottom-up mechanism may also explain the dissociation between cognitive processes with regard to trait vulnerability to sleep loss.

Sleep inertia, the state of reduced alertness upon waking, can negatively impact on-call workers. Anticipation of a stressful task on sleep inertia, while on-call was investigated. Young, healthy males (n = 23) spent an adaptation, control and two counterbalanced on-call nights in the laboratory. When on-call, participants were told they would be woken to a high or low stress task. Participants were not woken during the night, instead were given a 2300-0700 sleep opportunity. Participants slept ∼7.5-h in all conditions. Upon waking, sleep inertia was quantified using the Karolinska Sleepiness Scale and Psychomotor Vigilance and Spatial Configuration Tasks, administered at 15-min intervals. Compared to control, participants felt sleepier post waking when on-call and sleepiest in the low stress compared to the high stress condition (p < .001). Spatial performance was faster when on-call compared to control (p < .001). Findings suggest that anticipating a high-stress task when on-call, does not impact sleep inertia severity., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Cytidine 5-diphosphocholine (CDP-choline) administration has been shown to improve learning and memory deficits in different models of brain disorders. In this study, effects of CDP-choline on the well known negative effects of Rapid Eye Movements (REM) sleep deprivation on learning and memory were investigated. Sleep deprivation was induced by placing adult male Wistar albino rats on 6.5 cm diameter platforms individually for 96 h according to flower pot method. Learning and memory performances were evaluated using Morris Water Maze (MWM) test during the same period of time. Saline or CDP-choline (100 µmol/kg, 300 µmol/kg or 600 µmol/kg) was administered intraperitoneally 30 min prior to the onset of MWM experiments. On completion of behavioral tests, rats were decapitated and hippocampi were assayed for total and phosphorylated Ca 2+ /calmodulin-dependent protein kinase II (tCaMKII and pCaMKII, respectively) and total antioxidant capacity. We observed that while REM sleep deprivation had no effect on learning, it diminished the memory function, which was associated with decreased levels of pCaMKII and total antioxidant capacity in the hippocampus. CDP-choline treatment blocked the impairment in memory function of sleep-deprived rats and, increased pCaMKII levels and total antioxidant capacity. These data suggest that CDP-choline reduces REM sleep deprivation-induced impairment in memory, at least in part, by counteracting the disturbances in biochemical and molecular biological parameters., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Since ancient times it is known that melancholia and sleep disturbances co-occur. The introduction of polysomnography into psychiatric research confirmed a disturbance of sleep continuity in patients with depression, revealing not only a decrease in Slow Wave Sleep, but also a disinhibition of REM (rapid eye movement) sleep, demonstrated as a shortening of REM latency, an increase of REM density, as well as total REM sleep time. Initial hopes that these abnormalities of REM sleep may serve as differential-diagnostic markers for subtypes of depression were not fulfilled. Almost all antidepressant agents suppress REM sleep and a time-and-dose-response relationship between total REM sleep suppression and therapeutic response to treatment seemed apparent. The so-called Cholinergic REM Induction Test revealed that REM sleep abnormalities can be mimicked by administration of cholinomimetic agents. Another important research avenue is the study of chrono-medical timing of sleep deprivation and light exposure for their positive effects on mood in depression. Present day research takes the view on insomnia, i.e., prolonged sleep latency, problems to maintain sleep, and early morning awakening, as a transdiagnostic symptom for many mental disorders, being most closely related to depression. Studying insomnia from different angles as a transdiagnostic phenotype has opened many new perspectives for research into mechanisms but also for clinical practice. Thus, the question is: can the early and adequate treatment of insomnia prevent depression? This article will link current understanding about sleep regulatory mechanisms with knowledge about changes in physiology due to depression. The review aims to draw the attention to current and future strategies in research and clinical practice to the benefits of sleep and depression therapeutics.

Resilience to stress is critical for the development of depression. Enhanced adenosine A 1 receptor (A 1 R) signaling mediates the antidepressant effects of acute sleep deprivation (SD). However, chronic SD causes long-lasting upregulation of brain A 1 R and increases the risk of depression. To investigate the effects of A 1 R on mood, we utilized two transgenic mouse lines with inducible A 1 R overexpression in forebrain neurons. These two lines have identical levels of A 1 R increase in the cortex, but differ in the transgenic A 1 R expression in the hippocampus. Switching on the transgene promotes robust antidepressant and anxiolytic effects in both lines. The mice of the line without transgenic A 1 R overexpression in the hippocampus (A1Hipp-) show very strong resistance towards development of stress-induced chronic depression-like behavior. In contrast, the mice of the line in which A 1 R upregulation extends to the hippocampus (A1Hipp+), exhibit decreased resilience to depression as compared to A1Hipp-. Similarly, automatic analysis of reward behavior of the two lines reveals that depression resistant A1Hipp-transgenic mice exhibit high sucrose preference, while mice of the vulnerable A1Hipp + line developed stress-induced anhedonic phenotype. The A1Hipp + mice have increased Homer1a expression in hippocampus, correlating with impaired long-term potentiation in the CA1 region, mimicking the stressed mice. Furthermore, virus-mediated overexpression of Homer1a in the hippocampus decreases stress resilience. Taken together our data indicate for first time that increased expression of A 1 R and Homer1a in the hippocampus modulates the resilience to stress-induced depression and thus might potentially mediate the detrimental effects of chronic sleep restriction on mood., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

There is a growing body of studies indicating that extended shift duration has an adverse effect on fatigue, consequently leading to reduced work performance and higher risk of accident. Following modern fatigue risk management systems (FRMS), acceptable performance could be maintained by the mobilization of appropriate mitigation strategies. However, the effective deployment of such strategies assume that workers are able to assess their own level of fatigue-related impairments. In this study, we sought to determine whether emergency physicians' subjective feelings of sleepiness could provide accurate knowledge of actual fatigue-related impairments while working extended shifts. We conducted a prospective observational study with a within-subjects repeated measures component. We collected sleep logs, sleepiness ratings and reaction times on a Psychomotor Vigilance Task (PVT) at different time points during shifts. Our results show that the PVT is sensitive to sleep loss and fatigue, with a 10% increase in mean reaction time across the shift. Subjective sleepiness, however, showed no significant association with time since awakening and was not a significant predictor of PVT performance. Our results are consistent with experimental studies showing that individuals tend to underestimate fatigue-related impairments when sleep deprived or functioning under adverse circadian phase. The discrepancy between subjective sleepiness and actual fatigue-related impairments may give workers the illusion of being in control and hinder the deployment of mitigation strategies. Further research is needed to determine the relative weight of circadian phase shifting and cumulative sleep deprivation in the decline of self-knowledge in extended shifts., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Sleep deprivation negatively influences memory formation and consolidation, which leads to memory impairment associated with oxidative stress and neurotrophic pathways. In this study, a sleep-deprived rat model was used to evaluate the protective effects of round scad hydrolysates (RSH, 333 and 666 mg per kg bw) on memory impairment and the underlying mechanisms. The result of the Morris water maze test revealed that RSH significantly reversed the cognition deficits induced by sleep deprivation. Moreover, RSH supplementation alleviated oxidative stress by increasing the activities of glutathione peroxidase and superoxide dismutase and the ratio of glutathione/oxidized glutathione in the brain. Furthermore, RSH significantly up-regulated the expression of antioxidant defense-related proteins, including nuclear factor E2-related factor 2 (Nrf2) and its downstream heme oxygenase-1 (HO-1), as well as the phosphorylation of Akt in rats. Moreover, RSH improved the expression of brain-derived neurotrophic factor (BDNF), the phosphorylation of cAMP response element-binding (CREB) and tropomyosin-related kinase B (TrkB) in vivo, indicating that RSH can also promote the expression of proteins related to the neurotrophic pathway. Additionally, UPLC-qTOF-MS/MS was further used to identify the peptides in RSH. The results indicated that RSH mainly consists of low molecular weight peptides with hydrophobic, aromatic and positively charged amino acids in sequence. Taken together, these findings demonstrate that RSH exerts memory-improving actions by regulating the antioxidant and neurotrophic pathways, and RSH can be a potential functional ingredient for the prevention and protection of cognitive deficits.

Background: The majority of shift workers experience insufficient sleep as a result of their employment. Insufficient sleep is associated with impaired neurocognitive functioning, affecting key skills required for driving, resulting in shift workers experiencing a disproportionate burden of RTC injuries and fatalities. Yet, to our knowledge, no systematic literature review (SLR) exists to critically appraise and synthesise evidence on the determinants of fitness to drive (assessed on-road) and driving performance (assessed in a driving simulator) in shift workers with insufficient sleep., Objectives: A SLR protocol is established to conduct analysis and synthesis of the level of evidence and confidence in the determinants of fitness to drive and driving performance, among shift workers with insufficient sleep., Methods: This study follows Cooper and Hedges' established SLR methodology: formulate the problem, locate and select studies, collect data, appraise critically, analyse and present data, interpret results and disseminate information. Critical appraisal and analysis follows the 2017 American Academy of Neurology guidelines determining the level of evidence and the level of confidence for each determinant identified in the literature. Protocol and results reporting adhere to the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols guidelines., Conclusions: This SLR contributes to research evidence examining the impact of insufficient sleep and driver sleepiness on fitness to drive and driving performance. Analysis of the level of evidence and level of confidence in the existing literature will advance evidence-informed prevention strategies and critical decision-making, to mitigate adverse effects of insufficient sleep for improving road safety., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. Cognitive impairments occurs in MS patients including learning and memory impairments. More than 50% of MS patients suffer from sleep problems. It has been suggested that in animal models exercise has direct neuroprotective effects on MS and sleep deprivation (SD). In this research, MS impairments were induced using a demyelination model as an indicator of MS disease. Also induction of SD was done using multiple platform. In order to focus on the research question, combination of MS model with SD was studied. In this study, the impact of treadmill exercise on learning and memory impairments was investigated. Material and methods: Male wistar rats were used in the present study. Exercise groups exercised daily for 1 h/day for 10 consecutive days with treadmill (speed: 18 m/min and inclination: 25°). The multiple platform method was applied for the induction of a 72 h SD. The cognitive functions were evaluated using Morris water maze (MWM) and open field tests. Animals were anaesthetized with a certain dose of ketamine and xylazin. After full anesthesia, the rat was placed on rat stereotaxic instrument in the skull-flat position. Demyelination was induced bilaterally by direct single injection of 3 µl of 0.01% ethidium bromide in sterile 0.9% saline at the rate of 1 µl/min into the hippocampal formation. The dose was injected using appropriate stereotaxic coordinates. Results: All of the learning and memory indices in the MWM task showed that SD and hippocampal demyelination destroy learning and memory. It seems that exercise can modulate the destructive effects of SD and demyelination on learning and memory at the behavioral level.

Although there is a general belief that rapid eye movement sleep (REM) is essential for spatial memory tasks such as the Morris water maze (MWM), there is conflicting evidence for this assertion. This study investigated the effects of short-term REM deprivation on acquisition and reversal of the MWM by varying the timing of REM deprivation and the degree of task acquisition in three separate experiments. There was no evidence for a detrimental effect of REM deprivation on acquisition, retention, or reversal in the MWM. These data add to a growing body of evidence that although REM is important for certain types of learning and memory, spatial memory, as assessed by the MWM, is not among them., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Context: Fatigue risk management (FRM) strategies offer a potential solution to the widespread problem of fatigued trainees in the clinical workplace. These strategies assume a shared perception that fatigue is hazardous. Despite the growing body of evidence suggesting that fatigue leads to burnout and medical errors, previous research suggests that residents perceive fatigue as a personal, surmountable burden rather than an occupational hazard. Before we can implement FRM, we need a better understanding of when and how such problematic notions of fatigue are adopted by medical trainees. Thus, we sought to explore how third-year medical students understand and manage the workplace fatigue they experience during their first year of clinical rotations., Methods: A total of 22 third-year medical students participated in semi-structured interviews exploring their perspectives of workplace fatigue. Data collection and analysis occurred iteratively in keeping with constructivist grounded theory methodology and were informed by theoretical sampling to sufficiency., Results: Our participants described unprecedented levels of sleep deprivation combined with uncertainty and confusion that led to significant fatigue during training. Drawing on their workplace experience, trainees believed that fatigue posed three distinct threats, which evoked different coping strategies: (i) threat to personal health, managed by perseverance; (ii) threat to patients, managed by faith in the system, and (iii) threat to professional reputation, managed by stoicism., Conclusions: Our findings highlight how senior medical students grapple with fatigue, as they understand it, within a training context in which they are expected to deny the impact of their fatigue on patients and themselves. Despite empirical evidence to the contrary, the prevailing assumption amongst our participants is that an ability to withstand sleep deprivation without impairment will develop naturally over time. Efforts to implement FRM strategies will need to address this assumption if these strategies are to be successfully taken up and effective., (© 2019 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Age-related reductions in slow wave activity (SWA) and increased fragmentation during sleep play a key role in memory impairment. As the prefrontal cortex is necessary for the control processes relevant to memory encoding, including utilisation of internal heuristics such as semantic clustering, and is preferentially vulnerable to sleep disturbance, our study examined how SWA and sleep fragmentation relates to memory performance in individuals with Subjective Cognitive Decline (SCD). Thirty older adults with SCD (Mean Age = 69.34, SD = 5.34) completed a neurocognitive test battery, including the California Verbal Learning Test, which was used to assess semantic clustering. One week later, participants were admitted to the laboratory for a two night visit. SWA and sleep fragmentation were captured using sleep polysomnography. Next-day memory performance was tested using the Rey Auditory Verbal Learning Test. Poorer sleep (reduced SWA; increased arousals) was associated with reduced semantic clustering, which mediated impairment on verbal memory and learning tests conducted both the day after sleep was recorded (for both SWA and arousals), and a week prior (for arousals only). We demonstrate semantic clustering mediated the well described associations between sleep and verbal memory. As these strategies are a component of cognitive training interventions, future research may examine the role of simultaneous sleep interventions for improving cognitive training outcomes., (Copyright © 2019. Published by Elsevier Inc.)

Acute sleep loss influences visual processes in humans, such as recognizing facial emotions. However, to the best of our knowledge, no study till date has examined whether acute sleep loss alters visual comfort when looking at images. One image statistic that can be used to investigate the level of visual comfort experienced under visual encoding is the slope of the amplitude spectrum, also referred to as the slope constant. The slope constant describes the spatial distribution of pixel intensities and deviations from the natural slope constant can induce visual discomfort. In the present counterbalanced crossover design study, 11 young men with normal or corrected-to-normal vision participated in two experimental conditions: one night of sleep loss and one night of sleep. In the morning after each intervention, subjects performed a computerized psychophysics task. Specifically, they were required to adjust the slope constant of images depicting natural landscapes and close-ups with a randomly chosen initial slope constant until they perceived each image as most natural looking. Subjects also rated the pleasantness of each selected image. Our analysis showed that following sleep loss, higher slope constants were perceived as most natural looking when viewing images of natural landscapes. Images with a higher slope constant are generally perceived as blurrier. The selected images were also rated as less pleasant after sleep loss. No such differences between the experimental conditions were noted for images of close-ups. The results suggest that sleep loss induces signs of visual discomfort in young men. Possible implications of these findings are discussed., (© 2019 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.)

Introduction: We investigated the impact of delayed sleep phase disorder (DSPD) on the daily lives of adolescents and their families., Method: In this qualitative study, six adolescents with DSPD, and six parents were given in-depth interviews. Using thematic analysis, we merged open codes into themes that reflected the impact of the disorder., Result: We identified five themes: (1) Impact on the adolescents' school and social life: describing the negative influence of DSPD on school performance and friendships. (2) Impact on the parents, feeling guilty and powerless: showing the consequences of many unsuccessful attempts to improve the situation, with a lack of understanding from their social support system. (3) Impact on the family, conflicts, and misunderstanding: describing the negative influence on other family members, family relationships, and home atmosphere. (4) Impact on the parents, being weary of everything: describing the effect on the parents' mood and social life. (5) Factors mediating the severity of impact, of which personal characteristics and school support seemed most important. Themes 2 to 4 were highly interrelated., Conclusions: Adolescent DSPD not only affects cognitive functioning and mental health but has a much broader impact, also affecting social life, family life, and parental well-being. This information provides new potential points of engagement for therapy, guidance, and support for these families. Greater awareness and recognition of the impact of DSPD is needed on the part of physicians as well as the general population, to increase support and reduce misunderstanding of these adolescents and their parents., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Mood disorders are amongst the most prevalent and severe disorders worldwide, with a tendency to be recurrent and disabling. Although multiple mechanisms have been hypothesized to be involved in their pathogenesis, just a few integrative theoretical frameworks have been proposed and have yet to integrate comprehensively all available findings. As such, a comprehensive framework would be quite useful from a clinical and therapeutic point of view in order to identify elements to evaluate and target in the clinical practice. Because conditions of sleep loss, which include reduced sleep duration and insomnia, are constant alterations in mood disorders, the aim of this paper was to review the literature on their potential role in the pathogenesis of mood disorders and to propose a novel theoretical model. According to this hypothesis, sleep should be considered the main regulator of several systems and processes whose dysregulation is involved in the pathogenesis of mood disorders. The model may help explain why sleep disturbances are so strikingly linked to mood disorders, and underscores the need to evaluate, assess and target sleep disturbances in clinical practice, as a priority, in order to prevent and treat mood disorders., (© 2019 European Sleep Research Society.)

Although sports activities are generally considered beneficial to people's health and well-being, they can cause injuries and increased fatigue. Guided by the Demand-Induced Strain Compensation Recovery Model, this study hypothesized that physical recovery and mental detachment from sport-related activities would prevent injury and enhance mental energy. A cross-sectional survey study was conducted among 161 recreational athletes. Structural equation modelling analyses showed that mental detachment was negatively associated with injury and positively associated with mental energy. Sleep deprivation partially mediated the relation between mental detachment and mental energy. These findings imply an important role for mental detachment in maintaining people's health and well-being.

Objective : Therapeutic sleep deprivation (SD) is a nonpharmacological treatment that is used most often for depression. The aim of this study was to examine the pattern of use of SD in psychiatric hospitals in Austria, Germany, and Switzerland. Methods : A questionnaire about perceived usage of SD was sent by mail to all 511 psychiatric hospitals in the three countries. Nonresponders were asked to answer the questionnaire by phone. We achieved a response rate of 75.3%. Results : SD was recommended by 61.3% of all hospitals. Despite this degree of recommendation, nearly two thirds of the psychiatric hospitals had not treated a patient with SD during the last 12 months. Of the respondents, 59.5% considered SD to be indicated for major depressive disorder, 17.7% for bipolar depression, and 7.8% for other indications. SD was administered most frequently in inpatient settings and in combination with other therapies. Total SD (patients kept awake entire night) and partial late SD (patients kept awake in second half of night) were judged equally effective. Of the hospitals, 53.0% reported having seen hypomania and 13.2% manic episodes as side effects (rates do not represent actual incident rates). Conclusion : The lack of large controlled studies for SD with its different forms of treatment probably still hinders a broader use of the therapy. Therefore, further efforts should be undertaken to provide high-quality scientific evidence for the usage of SD.

Sleep deprivation is a common phenomenon among older population and is commonly linked to behavioral, physiological, and psychosocial factors. Not much is known about sleep deprivation among older population in Africa. Therefore, in this study we aimed to investigate the basic sociodemographic and psychosocial predictors of self-reported sleep deprivation among older population.In this study we analyzed cross-sectional data on 1495 community dwelling men and women aged 50 years and above. Data were collected from the SAGE Well-Being of Older People Study conducted in South Africa and Uganda. Outcome variable was self-reported sleep difficulty last 30 days. Multivariable logistic regression models were used to identify the variables significantly associated with sleep difficulty.The prevalence of mild-moderate sleep difficulty was 32.6% (27.9, 37.6) and severe/extreme 23.0% (20.3, 26.0) respectively. Multivariable analysis revealed that sleep difficulty was associated with several behavioral, environment, and illness conditions. In South Africa, those who reported dissatisfaction with living condition had 1.592 [1.087, 2.787] times higher odds of reporting mild/moderate sleep difficulty. Poor subjective quality of life (QoL) was associated with higher odds of severe/extreme sleep difficulties (odds ratios [OR] = 4.590, 95% confidence interval [CI] = 2.641, 7.977 for South Africa, and OR = 4.461, 95% CI = 2.048 and 9.716 for Uganda). In Uganda, perceived depression was associated with higher odds of severe/extreme (OR = 2.452, 95% CI = 1.073, 5.602) sleep difficulties among men, and both mild/moderate (OR = 1.717; 95% CI = 1.011, 2.914) and severe/extreme sleep difficulties among women (OR = 2.504, 95% CI = 1.408, 4.453).More than half of the participants had sleep difficulty of certain degrees, emphasising an urgent need for intervention for sleep deprivation in the population. Interventions targeting to promote subjective health, quality of life, and living environment may prove beneficial for improving sleep health in this regard.

Although studies have examined the association between television viewing and poor sleep quality, few studies have considered the association between excessive screen-time behaviors and insufficient sleep among adolescents drawing on a large nationally representative sample. The objective of this study was to examine the association between excessive screen-time behaviors and insufficient sleep among adolescents. Data for this study came from the 2017 Youth Risk Behavior Survey. A sample of 14,603 adolescents aged 14-18 years (51.5% female) was analyzed using logistic regression with insufficient sleep as the outcome variable and excessive screen-time behaviors as the main explanatory variable. Of the 14,603 adolescents, almost three out of four (74.8%) had less than 8 h of sleep on an average school night, and about 43% engaged in excessive screen-time behaviors on an average school day. Controlling for all other predictors, odds were 1.34 times higher for adolescents who engaged in excessive screen-time behaviors to have insufficient sleep when compared to adolescents who did not engage in excessive screen-time behaviors (AOR = 1.34, p < .001, 95% CI = 1.22-1.48). School-based behavior interventions that focus on reduction in excessive screen-time and sedentary behaviors might be beneficial in reducing excessive screen-time behaviors and consequently improve sleep quality among adolescents., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Sleep plays a critical role in body health maintenance, whereas sleep deprivation (SD) negatively affects cognitive function. Cognitive defects mainly memory impairment resulting from sleep deprivation were related to an increase in the level of oxidative stress in the body, including the brain hippocampus region. Edaravone is a potent free radical scavenger having antioxidant effect. In the current study, edaravone's ability to prevent SD induced cognitive impairment was tested in rats. Animals were sleep deprived 8 h/day for 4 weeks. Concurrently, edaravone was administrated intraperitoneally for four weeks. Animals performance during cognitive testing was evaluated to display if edaravone has a role in the prevention of sleep deprivation induced memory impairment. Additionally, the role of antioxidant biomarkers glutathione peroxidase (GPx), catalase, glutathione (GSH), oxidized glutathione (GSSG), GSH/GSSG in this effect was investigated. The results showed that SD impaired both short- and long- term memories, and chronic edaravone administration prevented such effect. Additionally, edaravone prevented decreases in hippocampal GPx, catalase, GSH/GSSG ratio and normalized increases in GSSG levels, which were impaired by SD model. In conclusion, current result showed a protective effect of edaravone administration against SD induction that could be related to edaravone's ability to normalizing mechanisms related to oxidative balance., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background/Objective : Bedtime procrastination is a prevalent cause of sleep deprivation, but little is known about why people delay their bedtimes. In the present research, we conducted a qualitative study with bedtime procrastinators to classify their self-reported reasons for later-than-intended bedtime. Participants : Participants ( N  = 17) were selected who frequently engaged in bedtime procrastination, but whose sleep was not otherwise affected by diagnosed sleep disorders or shift work. Method : We conducted in-depth, semistructured interviews and used thematic analysis to identify commonly recurring themes in the interviews. Results and conclusions : Three emerging themes were identified: deliberate procrastination, mindless procrastination , and strategic delay . For the form of procrastination we classified as deliberate procrastination, participants typically reported wilfully delaying their bedtime because they felt they deserved some time for themselves. For the category of mindless procrastination, a paradigmatic aspect was that participants lost track of the time due to being immersed in their evening activities. Finally, participants who engaged in strategic delay reported going to bed late because they felt they needed to in order to fall asleep (more quickly), which suggests that despite describing themselves as "procrastinating," their bedtime delay may actually be linked to undiagnosed insomnia. The conceptual distinctions drawn in this paper deepen our understanding of bedtime delay and may be helpful for designing effective interventions.

Background: Studies have shown that sleep deprivation may reduce empathy among medical students. Yet, little is known about the empathy after a night on call or an overnight shift among resident physicians. Hence, we aimed to examine whether a night on call or an overnight shift reduces the physicians' empathy., Methods: We conducted a multicenter randomized crossover survey using the Jefferson Scale of Physician Empathy (JSE). A total of 260 physicians who worked at academic hospitals and community hospitals in Japan in 2016 were recruited and randomized into two groups. Group A first completed the JSE prior to a night on call or an overnight shift; then, 8 weeks later, Group A completed the JSE after a night on call or an overnight shift. Group B first completed the JSE after a night on call or an overnight shift; then, 8 weeks later, Group B completed the JSE prior to a night on call or an overnight shift. Statistical analyses were performed to compare the JSE scores of pre- and post-night on call or overnight shifts., Results: A total of 117 Group A physicians and 112 Group B physicians returned a completed JSE. The overall response rate was 88.08%. There was no significant difference in the JSE scores between pre- and post-night on call or overnight shift. (Group A before night vs Group B after night, p = 0.40, Group A after night vs Group B before night, p = 0.68)., Conclusion: As per our results, a night on call or an overnight shift did not reduce the Japanese physicians' empathy. To the best of our knowledge, this is the first study on physicians' empathy after a night on call or an overnight shift.

Background: Although insufficient sleep has emerged as a strong, independent risk factor for obesity in children, the mechanisms by which insufficient sleep leads to weight gain are uncertain. Observational research suggests that being tired influences what children eat more than how active they are, but only experimental research can determine causality. Few experimental studies have been undertaken to determine how reductions in sleep duration might affect indices of energy balance in children including food choice, appetite regulation, and sedentary time. The primary aim of this study is to objectively determine whether mild sleep deprivation increases energy intake in the absence of hunger., Methods: The Daily, Rest, Eating, and Activity Monitoring (DREAM) study is a randomized controlled trial investigating how mild sleep deprivation influences eating behaviour and activity patterns in children using a counterbalanced, cross-over design. One hundred and ten children aged 8-12 years, with normal reported sleep duration of 8-11 h per night will undergo 2 weeks of sleep manipulation; seven nights of sleep restriction by going to bed 1 hr later than usual, and seven nights of sleep extension going to bed 1 hr earlier than usual, separated by a washout week. During each experimental week, 24-h movement behaviours (sleep, physical activity, sedentary behaviour) will be measured via actigraphy; dietary intake and context of eating by multiple 24-h recalls and wearable camera images; and eating behaviours via objective and subjective methods. At the end of each experimental week a feeding experiment will determine energy intake from eating in the absence of hunger. Differences between sleep conditions will be determined to estimate the effects of reducing sleep duration by 1-2 h per night., Discussion: Determining how insufficient sleep predisposes children to weight gain should provide much-needed information for improving interventions for the effective prevention of obesity, thereby decreasing long-term morbidity and healthcare burden., Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12618001671257 . Registered 10 October 2018.

Susceptibility to interference can be a result of memory retrieval and reconsolidation. Given the fact that addiction develops through the neural mechanisms of learning and memory, it would not be surprising that a consolidated drug reward memory may also be susceptible to interference following retrieval/reconsolidation. Due to the critical role of sleep in memory consolidation, sleep deprivation (SD) has been shown to impair memory. Therefore, the major objective of this study was to investigate the effect of rapid eye movement (REM) sleep deprivation (RSD) on the retrieval and reconsolidation of methamphetamine (METH) reward memory in male rats. The animals were trained to acquire METH-induced CPP (2 mg/kg, i.p.). METH reward memory was then reactivated/retrieved in the drug-paired chamber during a drug-free (memory reactivation) session. A period of 48-h RSD paradigm using the multiple platform technique resulted in persistent deficits in the retrieval of METH reward memory. Nevertheless, the same protocol of RSD, which was conducted immediately after the memory reactivation, did not affect the reconsolidation of METH reward memory. Additionally, the RSD episode induced a temporary potentiation of METH-induced hyperlocomotion. Our findings would seem to suggest that sleep is involved in the retrieval, but not reconsolidation, of METH reward memory. The results may also demonstrate that RSD mimics the effects of METH on locomotor activity. The results of this study, therefore, support the idea that sleep is involved in the processing of METH reward memory which can be considered for further investigations to manage the relapse associated with drug-related memory., (Copyright © 2019 Elsevier Inc. All rights reserved.)

In a large sample ( N = 234), we tested effects of 24-hr of sleep deprivation on error rates in a procedural task that requires memory maintenance of task-relevant information. In the evening, participants completed the task under double-blind conditions and then either stayed awake in the lab overnight or slept at home. In the morning, participants completed the task again. Sleep-deprived participants were more likely to suffer a general breakdown in ability (or willingness) to meet a modest accuracy criterion they had met the night before. Among sleep-deprived participants who could still perform the task, error rates were elevated, and errors reflecting memory failures increased with time-on-task. The results suggest that sleep-deprived individuals should not perform procedural tasks associated with interruptions and costly errors-or, if they must, they should perform such tasks only for short periods. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A close association between the duration of sleep and suicide has been reported in previous studies. This study was designed to investigate whether there is a difference in the effects of sleep duration on suicide by gender. This study was conducted based on the results of a volunteer online survey for adolescents in middle and high school in the Republic of Korea. The results showed that the effect of a depressive mood on short sleep time and on suicide was not different between male and female adolescents. It has been reported that the direct effect of short sleep time on increasing suicidal ideation is 2.50 times higher in female than in male adolescents. Differences in the metabolism of sex hormones and sleep-associated neurotransmitters might have affected this result, but further studies are needed to clarify more obvious mechanisms. In addition, this result should be considered when establishing sleep education for adolescents.

We are suffering a global sleep-loss epidemic. The health consequences within an individual are well characterized. But does society suffer just as much? Here, I discuss how insufficient sleep erodes our societal fabric as much as it does our biological fabric, and offer some prescriptive remedies., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Study Objectives: Over one-third of the United States population sleeps less than the recommended 7 hours a night, which increases risk for chronic diseases. The aim of this study was to evaluate the acceptability of sleep extension interventions and preferences in sleep extension interventions among adults with short sleep duration., Methods: Participants aged 18 to 65 years with self-reported sleep duration ≤ 6.5 hours completed an online survey including reported sleep behaviors, barriers to adequate sleep, interest in sleep extension interventions, and a sleep disturbance questionnaire. Data were analyzed using chi-square and binary logistic regression., Results: Participants (n = 92; 61 females; mean age = 45.6 years, standard deviation = 13.5) reported an average sleep duration of 5:49 (standard deviation = 0:49). More than half of the participants reported current health comorbidities (64%), including insomnia (n = 12, 13%) and sleep apnea (n = 9, 10%). Many participants (38%) reported sleep disturbance. The most common barrier to adequate sleep included insomnia or other sleep problems (55%). Most respondents (84%) indicated an interest in increasing sleep duration. Of the treatment options suggested, most (84% of those interested) were interested in a wrist-worn device. Participants with insomnia or other sleep disorders were more likely to be interested in extending sleep, (χ² = 12.86, P < .001) and in a wrist-worn device (χ² = 5.24, P = .022). Higher Patient-Reported Outcomes Measurement Information System sleep disturbance t scores were also associated with interest in monitoring sleep with a wrist-worn device (b = .18, P < .001)., Conclusions: Sleep extension interventions using wearable technology are attractive to individuals with short sleep duration, particularly those with greater sleep disturbance and comorbid sleep disorders., Citation: Adkins EC, DeYonker O, Duffecy J, Hooker SA, Baron KG. Predictors of intervention interest among individuals with short sleep duration. JClin SleepMed. 2019;15(8):1143-1148., (© 2019 American Academy of Sleep Medicine.)

Sleep deprivation commonly impairs affective regulation and causes worse mood. However, the majority of previous research concerns young adults. Because susceptibility to sleep deprivation and emotion regulation change distinctively across adult age, we tested here the hypothesis that the effect of sleep deprivation on mood is stronger in young than in older adults. In an experimental design, young (18-30 years) and older adults (60-72 years) participated in either a sleep control (young, n = 63; older, n = 47) or a total sleep deprivation condition (young, n = 61; older, n = 47). Sleepiness, mood and common symptoms of sleep deprivation were measured using established questionnaires and ratings. Sleep-deprived participants felt more sleepy, stressed and cold, and reported lower vigour and positive affect, regardless of age. All the other outcome measures (negative affect, depression, confusion, tension, anger, fatigue, total mood disturbance, hunger, cognitive attenuation, irritability) showed a weaker response to sleep deprivation in the older group, as indicated by age*sleep deprivation interactions (ps < 0.05). The results show that older adults are emotionally less affected by sleep deprivation than young adults. This tolerance was mainly related to an attenuated increase in negative mood. This could possibly be related to the well-known positivity effect, which suggests that older adults prioritize regulating their emotions to optimize well-being. The results also highlight that caution is warranted when generalizing results from sleep deprivation studies across the adult lifespan., (© 2018 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.)