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The article examines the impact of sleep on the outcomes people value, such as time use, financial well-being, health, and happiness, over long periods of time. Topics discussed include causal effect of improved sleep in natural environment, neurobiology of sleep and its importance for physical and mental functioning, and the link between insufficient sleep and declines in cognitive and physiological function.

For young children, sleep is essential for healthy development. Inadequate sleep can affect emotional, behavioural, cognitive, and health outcomes. Low family income and resources can put children at risk for poor sleep quality, impairing their subsequent cognitive abilities. The current study examined low socioeconomic status (SES) as a factor that increases vulnerability to the negative effects of poor sleep quality on young children's executive functioning (EF). It was hypothesized that sleep quality would be more strongly associated with EF skills for children from low-SES homes than for children from high-SES home. Results indicated that low family income predicted poorer performances in working memory. In addition, sleep quality was associated with working memory, but only for children from low-SES homes. These results suggest that sleep quality may be especially important for EF skills for children from low-SES homes. [ABSTRACT FROM AUTHOR]

Background: Sleep is a natural periodic state of rest for body and mind and daily sleep affects physical and mental health. However, it is essential to address intensity of sleep characteristics affecting the memory capacity of humans positively or negatively.Objective: Using wearable devices to observe and assess the effect of daily sleep on memory capacity of college students.Methods: This study assessed the daily sleep characteristics and memory capacity of 39 college students who used wrist-worn devices. The spatial span test (SST) was used to evaluate the memory capacity.Results: The study indicated a negative correlation between memory capacity and awake count on the test date and during the week before the test date (r=-0.153 (95% CI: -0.032, -0.282), r=-0.391 (95% CI: -0.520, -0.235), respectively). However, the minutes asleep on the test date and during the week before the test date positively affected memory capacity (r= 0.127 (95% CI: 0.220, 0.025), r= 0.370 (95% CI: 0.208, 0.500), respectively). In addition, spending ⩾ 6 hours and 42 minutes asleep on the test date or ⩾ 6 hours and 37 minutes asleep per day on average during the week before the test date resulted in a better memory capacity.Conclusions: A lower awake count led to a higher memory capacity in college students, as did more minutes asleep. [ABSTRACT FROM AUTHOR]

Highlights • Heat-rain test is realised most effective test to find out durability problem of BRC. • Aim is to eliminate accumulation of hydration products on fibre surface in BRC, BFRC. • Positive effect of pozzolanic admixtures on strength-strain degradation is addressed. • Results after standard curing and aging tests reveal most effective additive is metakaolin. • High reactivity of Al 2 O 3 and fineness largely prevent accumulations on fibre. Abstract In this study, the effects of pozzolanic admixtures (ground granulated blast furnace slag, nano-clay, metakaolin) are investigated in chopped basalt fibre cementitious composites (BRC). First, the variations in compressive strengths and flexural characteristics during 3, 7, 28, 56, 90 and 120-day curing periods are addressed. Afterwards, most importantly, the degradation in the flexural performance during aging tests (freeze-thaw test, heat-rain test) are focused. The main aim is considerably to save the pull-out behaviour of BRC, even when exposed to harsh atmospheric conditions. All the test results are compared with control specimens (100% cement). The results arising from the experiments including metakaolin are promising to enhance the durability performance of BRC. The implications in this experimental study are valid for basalt fibre reinforced concrete (BFRC) subjected to those atmospheric conditions as well. [ABSTRACT FROM AUTHOR]

Background: REM sleep (REMS) is considered vital for supporting well-being and normal cognition. However, it remains unclear if and how decreases in REMS impair cognitive abilities. Rare case studies of patients with REMS abolishment due to pontine lesions remain sporadic, and formal evaluation of cognitive status is lacking. In 1984, Lavie and colleagues described the case of Y.C. - a man with a pontine lesion and near-total absence of REMS who led a normal life. Here, we set out to re-evaluate this individual's REMS status 30 years after the original report, and formally assess his cognitive abilities.Methods: Four whole-night polysomnographic sleep recordings were conducted to evaluate sleep architecture. Sleep scoring was performed according to the American Academy of Sleep Medicine (AASM) guidelines. Cranial Computed Tomography (CT) imaging was performed, as well as formal neuropsychological testing to evaluate cognitive functions.Results: Y.C. averaged 4.5% of sleep time in REMS, corresponding to the 0.055 percentile of normal values for his age. Furthermore, residual REMS episodes were short and only occurred towards the end of the night. CT imaging revealed damage and metallic fragments in pons, cerebellum, and thalamus. Neuropsychological evaluation demonstrated average to high-average cognitive skills, normal memory, and motor difficulties including speech and left hand dyspraxia.Conclusions: To our knowledge, this is the only case where REMS loss resulting from pontine lesion was re-evaluated after many years. We find a near-total absence of REMS with no signs of significant compensation throughout adult life, along with normal cognitive status. The results provide a unique perspective on the ongoing debate regarding the functional role of REMS in supporting cognition. [ABSTRACT FROM AUTHOR]

Purpose: Previous research has found links between involvement in bullying and sleep duration in adolescents. However, little is known about the factors that might mediate these relationships. This study examined the associations between cyberbullying victimization and school bullying involvement (bully, victim, bully-victim) with short sleep duration in a large sample of middle and high school students and tested whether psychological distress mediates these relationships.Methods: Data on 5061 students (49% females; mean age = 15.1 years) from the 2015 Ontario Student Drug Use and Health Survey were used. Participants self-reported their sleep duration and their levels of bullying involvement over the past year. Psychological distress was assessed using the Kessler 6 (K6) scale. Covariates in multiple linear regression analyses included age, sex, racial background, socioeconomic status, and substance use.Results: Being a victim of cyberbullying (β = - 1.179; 95% CI - 0.238; - 0.120) or school bullying (β = - 0.119; 95% CI - 0.190; - 0.049) was associated with short sleep duration. Mediation analyses suggested that psychological distress fully mediates the relationships between being cyberbullied, a school bullying victim or bully-victim with short sleep duration. There was a complementary mediation by psychological distress on the relationship between being a bully at school and short sleep duration.Conclusions: These results suggest that higher levels of bullying involvement place adolescents at risk of developing higher psychological distress which, in turn, can lead to short sleep duration. Longitudinal research is necessary to confirm the mediating role of psychological distress on the relationship between bullying involvement and short sleep duration among adolescents. [ABSTRACT FROM AUTHOR]

Tendency toward healthy and health-risk behavior is associated with external factors, and healthy lifestyle affects its quality. Activation of Behavioral Inhibition System (BIS) and Behavioral Activation System (BAS) and its association with sleeping habits provides insight into the correlates of voluntary sleep deprivation. Aim of the study was to evaluate the relationship between BIS/BAS activity and reasons for voluntary sleep deprivation among young adults and to assess benefits and costs of decreasing sleep duration. Participants were 223 college students. The instruments used were the BIS/BAS Scale, Pittsburgh Sleep Quality Index and a newly developed survey. Statistical analysis wasconducted using Mann-Whitney's U -test and Spearman's rho correlation. Increased BIS activity is positively correlated with the frequency of foregoing sleep to study (r = 0.19; p < 0.01), while activation of BAS Fun Seeking is associated with more frequent voluntary sleep deprivation due to work (r = 0.18; p < 0.05), social life (r = 0.34; p < 0.01), and participation in various types of entertainment (p = 0.24; p < 0.01). Analysis yielded a positive correlation between BAS activity and the amount of perceived benefits of cutting down sleep (p = 0.26; p < 0.01 for BAS Fun Seeking and p = 0.25; p < 0.01 for BAS Reward Responsiveness) and the magnitude of BIS activation and the number of perceived losses (r = 0.19; p < 0.01). Individuals with a higher BAS activity in the Reward Responsiveness subscale more often report choosing sleep deprivation voluntarily (r = 0.14; p < 0.5). The quality of sleep is related to BIS/BAS activation. The reasons for voluntary sleep deprivation differ depending on the level of BAS/BIS activation. [ABSTRACT FROM AUTHOR]

Poor sleep quality is highly prevalent in modern societies and can be associated with a multitude of problems for individuals and organizations, and also for society at large. Thus, there is a demand for efficient treatments. We suggest that short self-compassion interventions will improve sleep quality via reducing ruminative thoughts, a key variable associated with poor sleep quality. We ran three studies to test this hypothesis. In Study 1 (correlational data), a positive relationship between self-compassion and sleep quality emerged in students’ self-reports. This effect was mediated by rumination. In Study 2, students in two different self-compassion intervention conditions reported higher sleep quality compared to a control condition. Again, rumination mediated this effect. In Study 3, patients with major depressive disorder reported a significant increase in sleep quality and a significant decrease of ruminative thoughts after one week in a daily self-compassion intervention (compared to patients in a control condition). Limitations and implications for future research, such as the need of placebo control groups, objective sleep quality measures, and person-intervention fit designs are discussed. [ABSTRACT FROM AUTHOR]

Objective: Physical activity benefits executive control, but the mechanism through which this benefit occurs is unclear. Sleep is a candidate mechanism given that it improves with exercise and has restorative effects on the prefrontal cortex. The present cross-sectional study examined the mediating role of sleep in the relationship between physical activity and executive control in young and older adults. Participants: Young (n = 59) and older (n = 53) community-dwelling adults ages 21-30 and 55-80. Methods: Participants wore an accelerometer for one week to assess sleep efficiency, total sleep time, and physical activity, operationalized as metabolic equivalent of task (METs) during time spent awake. Cognition was assessed in the laboratory across multiple measures of executive control, memory recall, and processing speed. Mediation analyses tested the role of sleep efficiency in the cross-sectional relationship between METs and cognitive performance accounting for age, sex, and education. Results: METs were significantly associated with performance before, but not after accounting for covariates. METs were associated with sleep efficiency but not total sleep time. Sleep efficiency, but not total sleep time, mediated the relationship between METs and working memory, switching, verbal ability and fluency, and recall. Age group did not moderate the mediating role of sleep efficiency in the relationship between METs and performance. Conclusion: Sleep efficiency is one pathway by which physical activity may be associated with executive control across young and older adults. [ABSTRACT FROM AUTHOR]

Sleep contributes to cognitive functioning and is sufficient to alter brain morphology and function. However, mechanisms underlying sleep regulation remain poorly understood. In mammals, tumor necrosis factor-alpha (TNFα) is known to regulate sleep, and cytokine expression may represent an evolutionarily ancient mechanism in sleep regulation. Here we show that the Drosophila TNFα homologue, Eiger, mediates sleep in flies. We show that knockdown of Eiger in astrocytes, but not in neurons, significantly reduces sleep duration, and total loss-of-function reduces the homeostatic response to sleep loss. In addition, we show that neuronal, but not astrocyte, expression of the TNFα receptor superfamily member, Wengen, is necessary for sleep deprivation-induced homeostatic response and for mediating increases in sleep in response to human TNFα. These data identify a novel astrocyte-to-neuron signaling mechanism in the regulation of sleep homeostasis and show that the Drosophila cytokine, Eiger, represents an evolutionarily conserved mechanism of sleep regulation across phylogeny. [ABSTRACT FROM AUTHOR]

Poor sleep negatively impacts vigilance and is associated with reduced well-being and work productivity. While many individuals depend on caffeine to counteract the cognitive consequences of poor sleep and restore optimal work performance, few studies have naturalistically evaluated this strategy. This study examined the effects of coffee on vigilance, comparing individuals based on recent sleep quality. Sixty-nine participants completed two randomized, counterbalanced trials consisting of 237 ml water or coffee (100 mg caffeine), followed by a continuous performance test assessing vigilance at 30, 90, and 120 min. While coffee improved and stabilized reaction time at all three assessments regardless of recent sleep history, its effects on omission and commission errors were seen only at 90 min; coffee increased commission errors and only partially reduced omission errors in individuals reporting poor sleep quality. The use of coffee to combat poor sleep may therefore be detrimental in situations requiring inhibitory control. [ABSTRACT FROM AUTHOR]

Research Findings: The primary goal of this study was to determine whether sleep duration moderates the relations of 2 dimensions of children’s temperament—shyness and negative emotion—to academic achievement. In the autumn, parents and teachers reported on kindergartners’ and 1st graders’ (N = 103) shyness and negative emotion and research assistants observed negative emotion in the classroom. In the spring, children wore actigraphs that measured their sleep for 5 consecutive school nights, and they completed the Woodcock-Johnson III Tests of Achievement. Interactions between temperament and sleep duration predicting academic achievement were computed. Interactions of sleep duration with parent-reported shyness, teacher-reported negative emotion, and observed negative emotion indicated that the negative relations of shyness or negative emotion to academic achievement were strongest when children slept less. Practice or Policy: Results suggest that sleep duration may be an important bioregulatory factor to consider in young children’s early academic achievement. [ABSTRACT FROM AUTHOR]

The article offers a report on sleeping presenting sleeping portraits of several people to explore the active nature of sleeping. It mentions sleep is the absence of performance, and the absence of conscious thinking; various concepts related to sleeping research; and observation of psychological aspects while sleeping.

Abstract: Veksler and Gunzelmann (2017) make an extraordinary claim, which is that sleep deprivation effects and the vigilance decrement are functionally equivalent. Extraordinary claims require extraordinary evidence, which is missing from Veksler and Gunzelmann's study. Their behavioral data offer only weak theoretical constraint, and to the extent their modeling exercise supports any position, it is that these two performance impairments involve functionally distinct underlying mechanisms. [ABSTRACT FROM AUTHOR]

Abstract: Research on sleep loss and vigilance both focus on declines in cognitive performance, but theoretical accounts have developed largely in parallel in these two areas. In addition, computational instantiations of theoretical accounts are rare. The current work uses computational modeling to explore whether the same mechanisms can account for the effects of both sleep loss and time on task on performance. A classic task used in the sleep deprivation literature, the Psychomotor Vigilance Test (PVT), was extended from the typical 10‐min duration to 35 min, to make the task similar in duration to traditional vigilance tasks. A computational cognitive model demonstrated that the effects of time on task in the PVT were equivalent to those observed with sleep loss. Subsequently, the same mechanisms were applied to a more traditional vigilance task—the Mackworth Clock Task—providing a good fit to existing data. This supports the hypothesis that these different types of fatigue may produce functionally equivalent declines in performance. [ABSTRACT FROM AUTHOR]

The intention to forget reduces the accessibility of information in memory, which is commonly explained with temporary retrieval difficulties. Long-term effects have rarely been studied, and results are inconsistent. The present study re-assessed the long-term effects of directed forgetting (DF). Participants encoded a first list of items (L1), and were then instructed to forget or to remember this list. Immediately afterwards, all participants were presented with a second list to remember. In Experiment 1, memory for L1 and L2 was assessed after a 24-h delay. The forget cue reduced the number of items that were recalled from L1. Experiment 2 implemented a 12-h delay between encoding and test that was either filled with day-time wakefulness or night-time sleep. Replicating the findings of Exp. 1, recall of L1 was reduced in the forget in comparison to the remember condition. Sleep in comparison to wakefulness significantly strengthened L1 memory in the remember group only. Taken together, the present study shows that the intention to forget can have long-lasting consequences. This suggests that different mechanisms underlie the short- and long-term effects of DF, with long-term effects potentially reflecting the preferential consolidation of information that has been identified as important during encoding. [ABSTRACT FROM PUBLISHER]

Females are an under-represented research model and the mechanisms through which sleep loss impairs cognition are not clear. Since levels of reproductive hormones and the estrous cycle are sensitive to sleep loss and necessary for learning and memory, we hypothesized that sleep deprivation impacts learning and memory in female mice by interfering with the estrous cycle. We used the object recognition task to assess learning and memory in female mice during separate phases of the estrous cycle and after sleep loss. Mice in metestrus/diestrus attended to sample objects less than mice in proestrus/estrus during object acquisition, the first phase of the object recognition task. Subsequently, during the recognition phase of the task, only mice in proestrus/estrus displayed a preference for the novel object. Sleep deprivation for 12 h immediately before the object recognition task reduced time attending to sample objects and novel object preference for mice in proestrus/estrus, without changing length of the estrous cycle. These results show that sleep deprived mice in proestrus/estrus had learning deficits and memory impairments, like mice in metestrus/diestrus. Since sleep deprivation did not disrupt the estrous cycle, however, results did not support the hypothesis. Cognitive impairments due to acute sleep loss were not due to alterations to the estrous cycle. [ABSTRACT FROM AUTHOR]

This review evaluated the evidence for psychological interventions to improve sleep and reduce fatigue after mild traumatic brain injury (mTBI). Eight electronic databases were searched up until August 2016 for studies that: 1) included adults; 2) tested intervention effectiveness on sleep quality and fatigue post-acutely; and 3) applied a broadly-defined psychological intervention (e.g., cognitive behavioral therapy [CBT], counseling, or education). Only randomized controlled trials were eligible for inclusion. Of the 698 studies identified, four met the eligibility criteria and underwent data extraction. These studies were assessed for risk of bias by two independent reviewers using the Scottish Intercollegiate Guidelines Network Methodology Checklist 2 for randomized controlled trials. One study applied CBT and three studies used enhanced education to improve outcomes. Limited evidence and methodological bias prevents strong conclusions about the effectiveness of psychological interventions for sleep and fatigue after mTBI. All but one study targeted general post-concussion symptoms rather than sleep or fatigue specifically. This runs the risk that the potential benefits of a targeted approach are underestimated in this literature, and future sleep- and fatigue-focused interventions are recommended. It is tentatively concluded that compared with standard care or the provision of generic advice, small improvements in sleep and fatigue are observed through psychological intervention post-mTBI. [ABSTRACT FROM AUTHOR]

Background: Insomnia symptoms are highly prevalent among patients with psychiatric disorders, and this mandates the need to identify the best self-administered sleep measure to screen for clinical insomnia among them.Methods: A total of 400 psychiatric outpatients completed the Pittsburgh Sleep Quality Index, Insomnia Severity Index (ISI), Epworth Sleepiness Scale, Flinders Fatigue Scale, Functional Outcomes of Sleep Questionnaire, and Dysfunctional Beliefs and Attitudes about Sleep Scale in a cross-sectional study. The sensitivity, specificity, positive, and negative predictive values of these six sleep scales were assessed and compared in relation to both ICD-10 and DSM-5 insomnia disorder status established using the interviewer-administered Brief Insomnia Questionnaire.Results: Receiver operator characteristic curves with the area under the curve (AUC) revealed the ISI to be the most accurate measure to discriminate cases and non-cases on both ICD-10 (AUC = 0.88, 95% CI = 0.84-0.92) and DSM-5 (AUC = 0.82, 95% CI = 0.78-0.86) criteria with "good" accuracy. The cut-off scores of ≥14 and ≥ 11 for the ISI provided optimal sensitivity and specificity for the detection of ICD-10 and DSM-5 insomnia, respectively.Discussion: With the new calling from DSM-5 to treat sleep symptoms in the presence of a co-existing mental condition, early detection of psychiatric patients with clinically significantly insomnia using a simple but accurate self-report sleep measure becomes important. Our study suggests that the ISI could be used as a potential screening tool for comorbid insomnia disorder in patients with mental disorders. [ABSTRACT FROM AUTHOR]

There is now a plethora of evidence that children with sleep disordered breathing (SDB) show deficits in neurocognitive performance, behavioral impairments, and school performance. The following review will focus on the neurobehavioral impacts of SDB, pediatric sleep investigation challenges, potential mechanisms of behavioral and cognitive deficits in children with SDB, and the impact of SDB treatment. [ABSTRACT FROM AUTHOR]

Introduction: Loss of REM sleep muscle atonia (RWA) and dream-enactment behavior (DEB) are two associated features of REM sleep behavior disorder (RBD), which is frequently associated with Parkinson's disease (PD). Few studies have examined both DEB and RWA simultaneously in patients with PD. This study aimed to evaluate relationships between RWA, DEB and clinical characteristics of PD.Methods: We conducted overnight polysomnography in 145 patients with PD. DEB (motor behaviors and/or vocalizations during REM) and increased RWA (IRWA; tonic and phasic chin EMG density ≥ 30% and ≥15%, respectively) were identified. Patients were categorized as clinical RBD (DEB and IRWA), sub-DEB positive (DEB only), subclinical RBD (IRWA only), or normal REM sleep.Results: Patients with DEB had higher Hoehn and Yahr (H&Y) stage, Unified Parkinson's Disease Rating Scale (UPDRS) III score, levodopa equivalent dose(LEDs), and worse cognition. RWA was associated with H&Y stage, LEDs, cognition, and sleep structure in all patients. PD duration was associated with RWA, but not DEB. The PD patients who exhibited clinical or subclinical RBD, compared to sub-DEB positive, had higher H&Y stage, UPDRS III score and LEDs, lower cognitive score, worse sleep structure than the PD + cREM group.Conclusion: Both DEB and RWA were associated with severity of PD illness. Subclinical RBD might have different disease progression from sub-DEB positive. DEB symptoms may fluctuate or disappear whereas RWA may continue to develop as PD progresses. Differences in the course of DEB and RWA may reflect the difference in the degeneration process of neurodegenerative disorders. [ABSTRACT FROM AUTHOR]

Sleep modulates motor learning, but its detailed impact on performance curves remains to be fully characterized. This study aimed to further determine the impact of brief daytime periods of NREM sleep on ‘offline’ (task discontinuation after initial training) and ‘on-task’ (performance within the test session) changes in motor skill performance (finger tapping task). In a mixed design (combined parallel group and repeated measures) sleep laboratory study ( n = 17 ‘active’ wake vs. sleep, n = 19 ‘passive’ wake vs. sleep), performance curves were assessed prior to and after a 90 min period containing either sleep, active or passive wakefulness. We observed a highly significant, but state- (that is, sleep/wake)-independent early offline gain and improved on-task performance after sleep in comparison to wakefulness. Exploratory curve fitting suggested that the observed sleep effect most likely emerged from an interaction of training-induced improvement and detrimental ‘time-on-task’ processes, such as fatigue. Our results indicate that brief periods of NREM sleep do not promote early offline gains but subsequent on-task performance in motor skill learning. [ABSTRACT FROM AUTHOR]

Emotionality can increase recall probability of memories as emotional information is highly relevant for future adaptive behavior. It has been proposed that memory processes acting during sleep selectively promote the consolidation of emotional memories, so that neutral memories no longer profit from sleep consolidation after learning. This appears as a selective effect of sleep for emotional memories. However, other factors contribute to the appearance of a consolidation benefit and influence this interpretation. Here we show that the strength of the memory trace before sleep and the sensitivity of the retrieval test after sleep are critical factors contributing to the detection of the benefit of sleep on memory for emotional and neutral stimuli. 228 subjects learned emotional and neutral pictures and completed a free recall after a 12-h retention interval of either sleep or wakefulness. We manipulated memory strength by including an immediate retrieval test before the retention interval in half of the participants. In addition, we varied the sensitivity of the retrieval test by including an interference learning task before retrieval testing in half of the participants. We show that a “selective” benefit of sleep for emotional memories only occurs in the condition with high memory strength. Furthermore, this “selective” benefit disappeared when we controlled for the memory strength before the retention interval and used a highly sensitive retrieval test. Our results indicate that although sleep benefits are more robust for emotional memories, neutral memories similarly profit from sleep after learning when more sensitive indicators are used. We conclude that whether sleep benefits on memory appear depends on several factors, including emotion, memory strength and sensitivity of the retrieval test. [ABSTRACT FROM AUTHOR]

Memory formation can be influenced by sleep and sex hormones in both men and women, and by the menstrual cycle in women. Though many studies have shown that sleep benefits the consolidation of memories, it is not clear whether this effect differs between men and women in general or according to menstrual phase in women. The present study investigated the effect of sex and menstrual cycle on memory consolidation of face-name associations (FNA) following a daytime nap. Recognition memory was tested using a face-name paired associates task with a polysomnographic nap between morning and evening testing. Seventeen healthy women (age: 20.75 (1.98) years) were studied at two time points of their menstrual cycles, defined from self-report and separated by 2 weeks (perimenses: −5 days to +6 days from the start of menses, and non-perimenses: outside of the perimenses phase), and compared with eighteen healthy men (age: 22.01 (2.91) years). Regardless of menstrual phase, women had better pre-nap performance than men. Further, menstrual phase affected post-nap memory consolidation, with women showing greater forgetting in their perimenses phase compared with their non-perimenses phase and men. Interestingly, post-nap performance correlated with electrophysiological events during sleep (slow oscillations, spindles, and temporal coupling between the two), however, these correlations differed according to menstrual phase and sex. Men’s performance improvement was associated with the temporal coupling of spindles and slow oscillations (i.e., spindle/SO coincidence) as well as spindles. Women, however, showed an association with slow oscillations during non-perimenses, whereas when they were in their perimenses phase of their cycle, women appeared to show an association only with sleep spindle events for consolidation. These findings add to the growing literature demonstrating sex and menstrual phase effects on memory formation during sleep. [ABSTRACT FROM AUTHOR]

We conducted two studies of circadian misalignment in non-Hispanic African and European-Americans. In the first, the sleep/wake (light/dark) schedule was advanced 9 h, similar to flying east, and in the second these schedules were delayed 9 h, similar to flying west or sleeping during the day after night work. We confirmed that the free-running circadian period is shorter in African-Americans compared to European-Americans, and found differences in the magnitude and direction of circadian rhythm phase shifts which were related to the circadian period. The sleep and cognitive performance data from the first study (published in this journal) documented the impairment in both ancestry groups due to this extreme circadian misalignment. African-Americans slept less and performed slightly worse during advanced/misaligned days than European-Americans. The current analysis is of sleep and cognitive performance from the second study. Participants were 23 African-Americans and 22 European-Americans (aged 18–44 years). Following four baseline days (8 h time in bed, based on habitual sleep), the sleep/wake schedule was delayed by 9 h for three days. Sleep was monitored using actigraphy. During the last two baseline/aligned days and the first two delayed/misaligned days, beginning 2 h after waking, cognitive performance was assessed every 3 h using the Automated Neuropsychological Assessment Metrics (ANAM) battery. Mixed model ANOVAs assessed the effects of ancestry (African-American or European-American) and condition (baseline/aligned or delayed/misaligned) on sleep and performance. There was decreased sleep and impaired cognitive performance in both ancestry groups during the two delayed/misaligned days relative to baseline/aligned days. Sleep and cognitive performance did not differ between African-Americans and European-Americans during either baseline/aligned or delayed/misaligned days. While our previous work showed that an advance in the sleep/wake schedule impaired the sleep of African-Americans more than European-Americans, delaying the sleep/wake schedule impaired the sleep and cognitive performance of African-Americans and European-Americans equally. [ABSTRACT FROM AUTHOR]

Background: Chronotype manifestation often has a broad influence on sleep quality. One possible explanation for daytime impairments in evening types is the concept of 'social jetlag'. Social jetlag is caused by an incompatibility between circadian preference and the socially accepted rhythm. This can be declared as a social stressor. Objective: The association between chronotype, stress coping, and sleep quality was assessed in a pilot study. Materials and methods: A total of 75 female adults aged 20-41 years participated in the study and completely answered all questions. Various questionnaires including sociodemographic data, information about sleep quality (Pittsburgh Sleep Quality Index, PSQI), chronotype (morningness-eveningness questionnaire, MEQ), and stress coping (Stress Coping Style Questionnaire, SVF78) were applied. Results: Heightened use of maladaptive coping strategies is associated with a reduction in sleep quality. Chronotypes did not differ in terms of sleep quality and the coping strategies used. Conclusion: Maladaptive coping strategy use seems to have a negative influence on sleep quality. Preventive education in adaptive stress coping strategies and avoidance of maladaptive stress coping thus seems useful to reduce these adverse influences on sleep quality. [ABSTRACT FROM AUTHOR]

Sleep quality of medical students has generated conflicting results in China. The aim of this study was to evaluate the sleep quality of medical students in China by meta-analysis. Electronic databases were searched for studies concerning the sleep quality of medical students using the Pittsburgh sleep quality index (PSQI) published before March 6, 2017. Pooled weighted mean difference (WMD) and 95% confidence interval (95% CI) were estimated with fixed or random effect models depending on the heterogeneity. Subgroup analyses, sensitivity analyses and publication bias were also performed. Eleven studies (7154 medical students and 9073 non-medical students) were included in this meta-analysis. The sleep quality of medical students was significantly higher in scores of subjective sleep quality (WMD, 0.137; 95% CI 0.049-0.224; P = 0.002), sleep duration (WMD, 0.147; 95% CI 0.069-0.225; P < 0.001), daytime dysfunction (WMD, 0.194; 95% CI 0.077-0.311; P = 0.001) and the total scores (WMD, 0.524; 95% CI 0.152-0.896; P = 0.006). On the contrary, there was no significant difference in sleep latency, habitual sleep efficiency, sleep disturbance and use of sleeping medications. This meta-analysis indicates that the sleep quality of medical students is worse than non-medical students in China. Further large and well-designed studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Objectives: Chronic sleep restriction is highly prevalent in modern society and is, in its clinical form, insufficient sleep syndrome, one of the most prevalent diagnoses in clinical sleep laboratories, with substantial negative impact on health and community burden. It reflects every-day sleep loss better than acute sleep deprivation, but its effects and particularly the underlying mechanisms remain largely unknown for a variety of critical cognitive domains, as, for example, risky decision making.Methods: We assessed financial risk-taking behavior after 7 consecutive nights of sleep restriction and after 1 night of acute sleep deprivation compared to a regular sleep condition in a within-subject design. We further investigated potential underlying mechanisms of sleep-loss-induced changes in behavior by high-density electroencephalography recordings during restricted sleep.Results: We show that chronic sleep restriction increases risk-seeking, whereas this was not observed after acute sleep deprivation. This increase was subjectively not noticed and was related to locally lower values of slow-wave energy during preceding sleep, an electrophysiological marker of sleep intensity and restoration, in electrodes over the right prefrontal cortex.Interpretation: This study provides, for the first time, evidence that insufficient sleep restoration over circumscribed cortical areas leads to aberrant behavior. In chronically sleep restricted subjects, low slow-wave sleep intensity over the right prefrontal cortex-which has been shown to be linked to risk behavior-may lead to increased and subjectively unnoticed risk-seeking. Ann Neurol 2017;82:409-418. [ABSTRACT FROM AUTHOR]

Objective: Sleep is an important marker of healthy development and has been associated with emotional, behavioral, and cognitive development. There is limited longitudinal data on children's sleep with only a few reports from low- and middle-income countries (LMICs). We investigate sleep parameters and associated sociodemographic characteristics in a population-based longitudinal study in Pelotas, Brazil.Methods: Data from the Pelotas 2004 Birth Cohort were used (N = 3842). Infant sleep was collected through maternal report at 3, 12, 24, and 48 months: sleep duration, bed and wake time, nighttime awakenings, co-sleeping and sleep disturbances (24 and 48 months).Results: Compared to children in high-income countries (HICs), children in Brazil showed a substantial shift in rhythms with later bed and wake times by approximately 2 hours. These remain stable throughout the first 4 years of life. This population also shows high levels of co-sleeping which remain stable throughout (49.0-52.2%). Later bedtime was associated with higher maternal education and family income. Higher rates of co-sleeping were seen in families with lower income and maternal education and for children who were breastfed. All other sleep parameters were broadly similar to data previously reported from HICs.Conclusion: The shift in biological rhythms in this representative community sample of children in Brazil challenges our understanding of optimal sleep routine and recommendations. [ABSTRACT FROM AUTHOR]

It is increasingly recognized that sleep disturbances and Alzheimer’s disease (AD) share a bidirectional relationship. AD patients exhibit sleep problems and alterations in the regulation of circadian rhythms; conversely, poor quality of sleep increases the risk of development of AD. The aim of the current study was to determine whether chronic sleep restriction potentiates the brain impact of amyloid-β oligomers (AβOs), toxins that build up in AD brains and are thought to underlie synapse damage and memory impairment. We further investigated whether alterations in levels of pro-inflammatory mediators could play a role in memory impairment in sleep-restricted mice. We found that a single intracerebroventricular (i.c.v.) infusion of AβOs disturbed sleep pattern in mice. Conversely, chronically sleep-restricted mice exhibited higher brain expression of pro-inflammatory mediators, reductions in levels of pre- and post-synaptic marker proteins, and exhibited increased susceptibility to the impact of i.c.v. infusion of a sub-toxic dose of AβOs (1 pmol) on performance in the novel object recognition memory task. Sleep-restricted mice further exhibited an increase in brain TNF-α levels in response to AβOs. Interestingly, memory impairment in sleep-restricted AβO-infused mice was prevented by treatment with the TNF-α neutralizing monoclonal antibody, infliximab. Results substantiate the notion of a dual relationship between sleep and AD, whereby AβOs disrupt sleep/wake patterns and chronic sleep restriction increases brain vulnerability to AβOs, and point to a key role of brain inflammation in increased susceptibility to AβOs in sleep-restricted mice. [ABSTRACT FROM AUTHOR]

Background: The Auckland Stillbirth study demonstrated a two-fold increased risk of late stillbirth for women who did not go to sleep on their left side. Two further studies have confirmed an increased risk of late stillbirth with supine sleep position. As sleep position is modifiable, we surveyed self-reported late pregnancy sleep position, knowledge about sleep position, and views about changing going-to-sleep position.Methods: Participants in this 2014 survey were pregnant women (n = 377) in their third trimester from South Auckland, New Zealand, a multi-ethnic and predominantly low socio-economic population. An ethnically-representative sample was obtained using random sampling. Multivariable logistic regression was performed to identify factors independently associated with non-left sided going-to-sleep position in late pregnancy.Results: Respondents were 28 to 42 weeks' gestation. Reported going-to-sleep position in the last week was left side (30%), right side (22%), supine (3%), either side (39%) and other (6%). Two thirds (68%) reported they had received advice about sleep position. Non-left sleepers were asked if they would be able to change to their left side if it was better for their baby; 87% reported they would have little or no difficulty changing. Women who reported a non-left going-to-sleep position were more likely to be of Maori (aOR 2.64 95% CI 1.23-5.66) or Pacific (aOR 2.91 95% CI 1.46-5.78) ethnicity; had a lower body mass index (BMI) (aOR 0.93 95% CI 0.89-0.96); and were less likely to sleep on the left-hand side of the bed (aOR 3.29 95% CI 2.03-5.32).Conclusions: Maternal going-to-sleep position in the last week was side-lying in 91% of participants. The majority had received advice to sleep on their side or avoid supine sleep position. Sleeping on the left-hand side of the bed was associated with going-to-sleep on the left side. Most non-left sleepers reported their sleeping position could be modified to the left side suggesting a public health intervention about sleep position is likely to be feasible in other multi-ethnic communities. [ABSTRACT FROM AUTHOR]

We investigate how the sleep disruptions and irregular physical activity levels that are prominent features of bipolar disorder (BD) relate to white matter microstructure in patients and controls. Diffusion tension imaging (DTI) and 14-day actigraphy recordings were obtained in 51 BD I patients and 55 age-and-gender-matched healthy controls. Tract-based spatial statistics (TBSS) was used for voxelwise analysis of the association between fractional anisotropy (FA) and sleep and activity characteristics in the overall sample. Next, we investigated whether the relation between sleep and activity and DTI measures differed for patients and controls. Physical activity was related to increased integrity of white matter microstructure regardless of bipolar diagnosis. The relationship between sleep and white matter microstructure was more equivocal; we found an expected association between higher FA and effective sleep in controls but opposite patterns in bipolar patients. Confounding factors such as antipsychotic medication use are a likely explanation for these contrasting findings and highlight the need for further study of medication-related effects on white matter integrity. [ABSTRACT FROM AUTHOR]

Sleep has been shown to facilitate the consolidation of prospective memory, which is the ability to execute intended actions at the appropriate time in the future. In a previous study, the sleep benefit for prospective memory was mainly expressed as a preservation of prospective memory performance under divided attention as compared to full attention. Based on evidence that intentions are only remembered as long as they have not been executed yet (cf. 'Zeigarnik effect'), here we asked whether the enhancement of prospective memory by sleep vanishes if the intention is completed before sleep and whether completed intentions can be reinstated to benefit from sleep again. In Experiment 1, subjects learned cue-associate word pairs in the evening and were prospectively instructed to detect the cue words and to type in the associates in a lexical decision task (serving as ongoing task) 2 h later before a night of sleep or wakefulness. At a second surprise test 2 days later, sleep and wake subjects did not differ in prospective memory performance. Specifically, both sleep and wake groups detected fewer cue words under divided compared to full attention, indicating that sleep does not facilitate the consolidation of completed intentions. Unexpectedly, in Experiment 2, reinstating the intention, by instructing subjects about the second test after completion of the first test, was not sufficient to restore the sleep benefit. However, in Experiment 3, where subjects were instructed about both test sessions immediately after learning, sleep facilitated prospective memory performance at the second test after 2 days, evidenced by comparable cue word detection under divided attention and full attention in sleep participants, whereas wake participants detected fewer cue words under divided relative to full attention. Together, these findings show that for prospective memory to benefit from sleep, (i) the intention has to be active across the sleep period, and (ii) the intention should be induced in temporal proximity to the initial learning session. [ABSTRACT FROM AUTHOR]

Sleep is known to play an important role in cognition, learning and memory. As Drosophila melanogaster have stable circadian rhythms and behavioral states similar to those of human sleep, they have been a useful model to investigate the effects of sleep on learning and memory. General anesthesia has been shown to cause cognitive impairments in humans. However, anesthesia also induces a behavioral state similar to sleep and may activate sleep pathways. This study examined learning and memory after an acute exposure of isoflurane in a Drosophila mutant model of restless leg syndrome. There were two possible outcomes: isoflurane (an anesthetic) could have impaired cognitive functioning or enhanced learning and memory by activating sleep pathways. Given the acute cognitive impairments often observed postoperatively, we believed the former outcome to be the most likely. Flies with fragmented sleep had impaired performance on an aversive phototaxic suppression learning and memory task compared to wildtype flies. This deficit was rescued with isoflurane exposure, as no differences in learning were observed between mutant and wildtype flies treated with anesthesia. This result suggests that anesthesia exposure can ameliorate impaired learning and memory due to sleep fragmentation. Further investigations are required to determine the type of memory impacted by anesthesia and the mechanisms by which anesthesia induces this effect. [ABSTRACT FROM AUTHOR]

The Pittsburgh Sleep Quality Index (PSQI) is a rigorously validated questionnaire with extensive use in sleep assessment. Findings from numerous factor analytic studies of the PSQI have been interpreted to support a heterogeneous factor structure model for the test. Nevertheless, the literature continues to lack a focused evaluation of whether this heterogeneous factor structure is justified. A consideration of this issue led to a conclusion that a closer analysis of the PSQI’s factor structure was merited. To address this need a comparative confirmatory factor analysis for assessing the performance of the accepted factors models of the PSQI was conducted. A sample of university students (n = 418), age = 20.92 ± 1.81 years, BMI = 23.30 ± 2.57 kg/m2completed the multi-structured sleep survey at Jamia Millia Islamia, New Delhi, India. Seventeen putative factor structures (three 1-Factor, eight 2-Factor, and six 3-Factor) of the PSQI from the existing literature were selected for analysis. Fourteen models (82.35%) had almost similar values for model fit indices. Two models were misfits, and one model was a poor fit. The two misfit models incorporated gender and age as covariates. The third poor fit model was used to produce a unique path diagram, which made it distinct from the remaining 16 models. The overlapping values in the fit range of the model fit indices did not support the often projected heterogeneous factor structures of the PSQI for the vast majority of the models. [ABSTRACT FROM PUBLISHER]

The complaints of people suffering from Insomnia Disorder (ID) concern both sleep and daytime functioning. However, little is known about wake brain temporal dynamics in people with ID. We therefore assessed possible alterations in Long-Range Temporal Correlations (LRTC) in the amplitude fluctuations of band-filtered oscillations in electroencephalography (EEG) recordings. We investigated whether LRTC differ between cases with ID and matched controls. Within both groups, we moreover investigated whether individual differences in subjective insomnia complaints are associated with LRTC. Resting-state high-density EEG (256-channel) was recorded in 52 participants with ID and 43 age- and sex-matched controls, during Eyes Open (EO) and Eyes Closed (EC). Detrended fluctuation analysis was applied to the amplitude envelope of band-filtered EEG oscillations (theta, alpha, sigma, beta-1, beta-2) to obtain the Hurst exponents (H), as measures of LRTC. Participants rated their subjective insomnia complaints using the Insomnia Severity Index (ISI). Through general linear models, we evaluated whether H, aggregated across electrodes and frequencies, differed between cases and controls, or showed within-group associations with individual differences in ISI. Additionally, we characterized the spatio-spectral profiles of group differences and associations using non-parametric statistics. H did not differ between cases with ID and controls in any of the frequency bands, neither during EO nor EC. During EO, however, within-group associations between H and ISI indicated that individuals who experienced worse sleep quality had stronger LRTC. Spatio-spectral profiles indicated that the associations held most prominently for the amplitude fluctuations of parietal theta oscillations within the ID group, and of centro-frontal beta-1 oscillations in controls. While people suffering from insomnia experience substantially worse sleep quality than controls, their brain dynamics express similar strength of LRTC. In each group, however, individuals experiencing worse sleep quality tend to have stronger LRTC during eyes open wakefulness, in a spatio-spectral range specific for each group. Taken together, the findings indicate that subjective insomnia complaints involve distinct dynamical processes in people with ID and controls. The findings are in agreement with recent reports on decreasing LRTC with sleep depth, and with the hypothesis that sleep balances brain excitability. [ABSTRACT FROM AUTHOR]

When individuals witness an event and are exposed to misleading postevent information, they often incorporate the misleading information into their memory for the original event, a phenomenon known as the misinformation effect. The present study examined the role of sleep in the misinformation effect. Participants (N = 177) witnessed two events; were exposed to misleading postevent information immediately, 12 hours later the same day, 12 hours later the next day, or 24 hours later; and then took a recognition test. All groups demonstrated the misinformation effect, and this effect was larger in groups with an overnight retention interval. Signal detection analyses revealed that sleep decreased sensitivity. These results suggest that sleep increases susceptibility to the misinformation effect, which may occur because sleep results in gist-based representations of original events or because sleep improves learning of postevent information. Implications for interviewing eyewitnesses are discussed. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives To investigate the association between sleep complaints and suicidal behaviors among severely depressed children and adolescents. Methods The sample was 214 youths (56.1% males, mean age 12.5 years) with diagnosis of DSM- IV major depressive disorder consecutively recruited from a university-based outpatient clinic specialized in mood disorders. The structured interview for children and adolescents was applied to participants. The Children's Depression Rating Scale-revised version-scored the severity of depression, and the Children's Global Assessment Scale assessed the global functioning. Subgroups of patients were compared for psychopathological association by means of logistic regression, in accordance with presence and absence of sleep complaints and suicidality. Results The frequency of sleep complaints and suicidal behaviors was, respectively, 66.4% and 52.3%, and both symptoms were observed in 37.9% of patients. Initial insomnia was the most frequent manifestation (58%), followed by night awakening (36%), daytime sleepiness (31%), and early awakening (29.9%). Significant association between sleep disturbance and suicidal behavior was found (odds ratio range of 2.3-10.8). Conclusion Sleep disturbances are potential warning manifestations of suicidal behaviors in depressed youth. Possibly, the severity of the active affective episode likely underlies in both sleep complaints and suicidal behaviors among depressed underage patients. [ABSTRACT FROM AUTHOR]

Introduction Disrupted sleep is common among children with autism spectrum disorder ( ASD). Aims Our goal was to (1) examine the contribution of sleep problems to parenting stress in children with ASD as compared to typically developing ( TD) and (2) to address maternal sleep-related cognitions and behaviors in both groups. Methods Mothers of 34 ASD (mean age = 39.29 months, SD = 5.22) and 31 TD children (mean age = 36.23 months, SD = 5.75) completed questionnaires measuring maternal stress, sleep-related cognitions and settling to sleep interactions, and the child's sleep problems; mothers in the ASD group completed a symptom severity questionnaire. Results In accord with previous research, children with ASD had more sleep problems compared to the TD group, and their mothers reported higher levels of stress. In the ASD group, sleep problems contributed to the experience of maternal stress, over and above symptom severity. Across groups, maternal cognitions and bedtime interactions were significantly associated with children's sleep problems. Conclusion The results highlight the interplay between sleep-related cognitions, bedtime interactions, and sleep problems and underscore the contribution of disrupted sleep to mothers' experience of parenting stress. As sleep problems in ASD children are common, clinicians are advised to include sleep in consultations with parents. [ABSTRACT FROM AUTHOR]

Background and methods We present the preliminary results of a prospective case-control sleep study in children with a diagnosis of attention-deficit hyperactivity disorder ( ADHD). A deep sleep assessment including sleep questionnaires, sleep habits, a video-polysomnographic recording with full high-density electroencephalography ( EEG) and cardiorespiratory polygraphy, multiple sleep latency test, and 1-week actigraphic recording were performed to verify whether children with ADHD may be classified into one of the following five phenotypes: (1) hypoarousal state, resembling narcolepsy, which may be considered a 'primary' form of ADHD; (2) delayed sleep onset insomnia; (3) sleep-disordered breathing; (4) restless legs syndrome and/or periodic limb movements; and (5) sleep epilepsy and/or EEG interictal epileptiform discharges. Results Fifteen consecutive outpatients with ADHD were recruited (two female, mean age 10.6 ± 2.2, age range 8-13.7 years) over 6 months. The narcolepsy-like sleep phenotype was observed in three children, the sleep onset insomnia phenotype was observed in one child, mild obstructive sleep apnea was observed in three children, sleep hyperkinesia and/or PLMs were observed in five children, while IEDs and or nocturnal epilepsy were observed in three children. Depending on the sleep phenotype, children received melatonin, iron supplementation, antiepileptic drugs, or stimulants. Conclusions Our study further highlights the need to design an efficient sleep diagnostic algorithm for children with ADHD, thereby more accurately identifying cases in which a full sleep assessment is indicated. [ABSTRACT FROM AUTHOR]

The term neurodevelopmental disorder (NDD) implies an impairment of the growth and development of the CNS caused by genetic, metabolic, toxic, or traumatic factors. Childhood neuropsychiatric disorder is a subset of NDD. Sleep disturbance is reported in many children with NDD although the details of this association, including extent and types of sleep disturbance, etiology, and assessment and treatment issues, need to be clarified by further research. This review considers the nature of sleep disturbance in NDD. Emphasis is placed on sleep disorders (i.e., the specific conditions that cause sleep problems) of which many are now recognized in the International Classification of Sleep Disorders (ICSD-3), and also intrinsic pathophysiological factors, physical and psychiatric comorbidities, and pharmacological and parental influences, which might contribute to the sleep disorders in children with NDD. The implications of this complexity for assessment and treatment in such children are then discussed. Appropriate treatment based on precise diagnosis of the causes of sleep disturbance is required to mitigate the harmful developmental effects of disordered sleep on children with NDD and their families. [ABSTRACT FROM AUTHOR]

The present research investigated the causal relationship between daily surface acting and fatigue at the within-person level. With a longitudinal approach – experience sampling method – based on 10 successive days’ data, this study explored the lagged consequence of service employees’ daily surface acting. The results of multilevel analysis showed that the daily performance of surface acting decreased service employees’ subsequent day’s emotional well-being in the form of increased fatigue. Further, sleep conditions were found to alleviate this detrimental effect. This within-person level investigation of the causal lagged effect of daily surface acting and its moderating contextual factor complements the current emotional labor literature that has overly focused on the between-person level. The theoretical and managerial implications were discussed. [ABSTRACT FROM PUBLISHER]

Background Sleep-wake disturbances are common in patients with cirrhosis and have a considerable effect on health-related quality of life; however, the underlying mechanism behind the phenomenon is unclear. Cytokines are involved in the mediation of signalling pathways regulating fibrogenesis, leading to cirrhosis. In addition, increased cytokines could contribute to sleep disturbances. Aim To determine the relationship between pro-inflammatory cytokines and sleep disturbance in cirrhotic patients. Methods Ninety-eight nonalcoholic cirrhotic patients without overt hepatic encephalopathy were enrolled in this cross-sectional study. The Pittsburgh Sleep Quality Index ( PSQI) was used to assess sleep quality. The Psychometric Hepatic Encephalopathy Score ( PHES) was used to examine cognitive performance and define minimal hepatic encephalopathy ( MHE). The Hospital Anxiety and Depression Scale ( HADS) was used to evaluate the mood status of the patients. Pro-inflammatory cytokines that include interleukin 6 ( IL-6) and tumour necrosis factor-α, as well as HBV- DNA or HCV- RNA levels were determined in patients. Results A total of 56 (57%) cirrhotic patients were identified as 'poor' sleepers ( PSQI > 5). After multivariate analysis, IL-6 ( P = 0.001) and HADS scores ( P = 0.002) were found to be independent predictive factors of poor sleep quality. No significant relationships were observed between the sleep indices and the presence of MHE. HCV- RNA, but not HBV- DNA, viraemia was associated with sleep disturbance in cirrhotic patients. Conclusions Sleep disturbance is found commonly in cirrhotic patients and a high serum IL-6 level is predictive of poor sleep quality. Minimal hepatic encephalopathy by itself may not contribute to sleep dysfunction in cirrhotic patients. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate neurocognitive function in adult patients with residual excessive sleepiness (RES) after appropriate treatment of obstructive sleep apnea (OSA) with CPAP and good adherence to treatment.Methods: This was a prospective controlled study. We included patients of both sexes, aged 35-60 years with OSA and an apnea-hypopnea index >20 ev/h, effectively treated with CPAP, but with a residual Epworth Sleepiness Scale score ≥11. The control group consisted of OSA patients adequately treated with CPAP who did not present with excessive sleepiness after treatment. Both groups underwent the following evaluations: polysomnography, multiple sleep latency testing, depression symptoms, and cognitive assessment.Results: Regarding baseline characteristics, the data were matched for age, years of study, and body mass index. Long-term memory result did not show a significant difference between the two groups (RES group 4.7 ± 2.0; control group 6.5 ± 1.9; p = 0.08). The executive functions were the most affected, with alterations in Wisconsin test, number of categories (RES group: 1.6 ± 1.4; control group: 3.0 ± 1.4; p = 0.01), and semantic verbal fluency test (RES group: 13.6 ± 3.3; control group: 16.9 ± 4.3; p = 0.04).Conclusion: In summary, the mean depression scale score in the group with residual excessive sleepiness was significantly higher than that in the control group. Patients with residual excessive sleepiness showed impairment of executive functions but no impairments in other cognitive domains. [ABSTRACT FROM AUTHOR]

Objective: In Sweden, a joint action method called SMADIT is in use, where the police quickly offer help from the social services or the dependency care and treatment service to suspected drink drivers. The objective of this article is to analyze the experiences of suspected drink drivers who accepted the offer of help and what it meant for them. The knowledge can be used to improve procedures and consultations. Furthermore, it can allow the basic premises of the method to be examined; for example, the importance of offering help quickly.Methods: To enable comparisons over time, in-depth interviews were conducted with 12 suspected drink drivers on 2 occasions with 1 year between.Results: To varying degrees the informants knew about their alcohol problems but were unsure whether they would have sought help by themselves. Therefore, the original ideas of the method with an initial contact with the social services or the dependency care and treatment service within 24 h was found to be important. However, the results also showed that some of the informants needed some time before the first meeting because they were in shock from the drink driving incident or in need of sleep. Therefore, the drink driver's situation and individual wishes always have to be considered. The article also shows that an encouraging attitude among the police, the social services, and the dependency care and treatment service is important for the success of the SMADIT method. The informants are satisfied with the method and in retrospect the incident and the SMADIT offer of help are described as a turning point in their lives. One year after being offered help the informants were no longer focused solely on the personal consequences of drink driving, as they were shortly after the incident. Instead, they had gained insights into the harm they could have done to other road users when they drove while drunk.Conclusions: One conclusion from this article is that SMADIT, as an innovative method that can be deployed more rapidly than other alcohol-impaired driving countermeasures, should be considered as a good complement to conventional methods to deal with drink driving. Based on the results, we recommend a trial of the joint action method against drink driving in other jurisdictions. [ABSTRACT FROM AUTHOR]

In the first few years of life children spend a good proportion of time sleeping as well as acquiring the meanings of hundreds of words. There is now ample evidence of the effects of sleep on memory in adults and the number of studies demonstrating the effects of napping and nocturnal sleep in children is also mounting. In particular, sleep appears to benefit children's memory for recently-encountered novel words. The effect of sleep on children's generalization of novel words across multiple items, however, is less clear. Given that sleep is polyphasic in the early years, made up of multiple episodes, and children's word learning is gradual and strengthened slowly over time, it is highly plausible that sleep is a strong candidate in supporting children's memory for novel words. Importantly, it appears that when children sleep shortly after exposure to novel word-object pairs retention is better than if sleep is delayed, suggesting that napping plays a vital role in long-term word retention for young children. Word learning is a complex, challenging, and important part of development, thus the role that sleep plays in children's retention of novel words is worthy of attention. As such, ensuring children get sufficient good quality sleep and regular opportunities to nap may be critical for language acquisition. [ABSTRACT FROM AUTHOR]