Chronic Sleep Loss Research Articles

A PER3 Polymorphism Interacts with Sleep Duration to Influence Transient Mood States in Women.

Background: Expression of the clock family of genes in the suprachiasmatic nuclei (SCN) regulates the molecular control of circadian timing. Increasing evidence also implicates clock gene activity in the development of mood disorders. In particular, variation in the PER3 clock gene has been shown to influence diurnal preference and sleep homeostasis. However, there is not currently a clear association between PER3 polymorphisms and mood. This is possibly because the PER3 gene has been shown to influence homeostatic sleep drive, rather than circadian timing, and the PER3 gene may be behaviorally relevant only under chronic sleep loss conditions.Methods: To test the association between PER3 allele status and impaired mood, a total of 205 healthy women were genotyped for PER3 allele status and responded to previously-validated psychological questionnaires surveying self-reported sleep habits (MEQ, PSQI) and mood. Our mood measures included two measures of short-term, transient mood (state anxiety and mood disturbance) and two measures of longer term, ongoing mood (trait anxiety and depressive symptomology).Results: The PER3 genotype distribution was 88 (42.9%) for PER3(4/4), 98 (47.8%) for PER3(4/5), and 19 (9.3%) for PER3(5/5). Our sleep duration x genotype interaction analyses showed that, relative to longer allele carriers, PER3(4/4) genotypes were at greater risk for transient psychological effects (mood and state anxiety) when they reported reduced sleep durations.Conclusion: Sleep duration plays a critical role in understanding the extent to which PER3 allele status relates to mood states.

Effects of Partial Sleep Deprivation on Information Processing Speed in Adolescence.

Although chronic sleep loss is highly common among teens, few objective sleep studies have examined its effects on cognitive performance, and specifically on information processing speed (IPS), a measure of cognitive proficiency. Forty-five adolescents underwent four consecutive nights of monitored sleep restriction (6-6.5 hr/night) and four nights of sleep extension (10-10.5 hr/night), in counterbalanced order, and separated by a washout period. Following each sleep period, cognitive performance was assessed, at a fixed morning time, using a computerized neuropsychological battery including an IPS task, a timed test providing both accuracy and reaction time outcome measures. Overall IPS performance was poorer in the restricted when compared to the extended condition. Increasing task load and pace were associated with increased accuracy for both sleep conditions. However, a significant pace by load interaction effect was only found in the extended condition, with post hoc tests showing that for medium and hard loads, IPS accuracies were better with increasing pace of task. Differences in IPS reaction times were not found between the sleep conditions. In addition, sleep-related changes in IPS indices were correlated with changes in executive function, motor skill, and attention performance. Adolescents' ability to process information may be especially vulnerable to sleep loss. Under ideal sleep conditions, however, they seem to be able to achieve optimal performance, particularly on more challenging problems. The functional implications of these findings may be particularly relevant to teens, who are often sleep deprived and are constantly required to process academic, social, and emotional input.

Blood-Brain Barrier Disruption Induced by Chronic Sleep Loss: Low-Grade Inflammation May Be the Link.

Sleep is a vital phenomenon related to immunomodulation at the central and peripheral level. Sleep deficient in duration and/or quality is a common problem in the modern society and is considered a risk factor to develop neurodegenerative diseases. Sleep loss in rodents induces blood-brain barrier disruption and the underlying mechanism is still unknown. Several reports indicate that sleep loss induces a systemic low-grade inflammation characterized by the release of several molecules, such as cytokines, chemokines, and acute-phase proteins; all of them may promote changes in cellular components of the blood-brain barrier, particularly on brain endothelial cells. In the present review we discuss the role of inflammatory mediators that increase during sleep loss and their association with general disturbances in peripheral endothelium and epithelium and how those inflammatory mediators may alter the blood-brain barrier. Finally, this manuscript proposes a hypothetical mechanism by which sleep loss may induce blood-brain barrier disruption, emphasizing the regulatory effect of inflammatory molecules on tight junction proteins.

Diagnosis and Treatment of Common Sleep Disorders in Adolescence

Background: During the past two decades, research has elucidated many aspects of sleep physiology and the importance of sleep in regards to physical and mental health. According to recent epidemiological studies, most adolescents report persistent sleep difficulties that interfere with their daily functioning. Sleep quality is an important public health issue that requires adequate attention from clinicians, parents, and educators. Method: A comprehensive literature review was employed to establish the recommendations in this report. This article provides a review of adolescent sleep physiology and offers various tools to aid in the clinical assessment and treatment of common sleep disorders. It highlights typical sleep changes throughout adolescence and the impact that these changes have on the development of sleep pathology. Results: Chronic sleep loss is commonly reported among teenagers. Understanding the relationship between pubertal development and sleep regulation is essential for establishing clinical guidelines regarding adequate sleep. Benzodiazepine-receptor agonists (BzRAs) and cognitive behavioral therapy (CBT) are the most widely studied treatments for insomnia. In addition, bright light therapy and melatonin administration are often effective in treating circadian rhythm disorders. Sleep hygiene techniques are recommended for individuals with various sleep difficulties, yet there is insufficient data to support them as an evidence-based, standalone treatment. Conclusions: The physiological components of sleep during puberty provide insight into behavioral and psychological changes associated with healthy development. Chronic sleep deprivation, insomnia, and delayed sleep phase disorder are the most common sleep disorders during maturation. Chronic sleep problems during youth can cause an array of symptoms that impact behavioral and psychological functioning. Diagnostic tools are essential to properly detect sleep disorders at early stages. Detecting and treating sleep-related issues among youth can prevent deficits in daily functioning and may halt the progression of psychiatric pathology into adulthood. Keywords: Adolescent, circadian, homeostasis, insomnia, nocturnal, parasomnias, sleep, wakefulness.

In Vivo Imaging of the Central and Peripheral Effects of Sleep Deprivation and Suprachiasmatic Nuclei Lesion on PERIOD-2 Protein in Mice.

That sleep deprivation increases the brain expression of various clock genes has been well documented. Based on these and other findings we hypothesized that clock genes not only underlie circadian rhythm generation but are also implicated in sleep homeostasis. However, long time lags have been reported between the changes in the clock gene messenger RNA levels and their encoded proteins. It is therefore crucial to establish whether also protein levels increase within the time frame known to activate a homeostatic sleep response. We report on the central and peripheral effects of sleep deprivation on PERIOD-2 (PER2) protein both in intact and suprachiasmatic nuclei-lesioned mice. In vivo and in situ PER2 imaging during baseline, sleep deprivation, and recovery. Mouse sleep-recording facility. Per2::Luciferase knock-in mice. N/A. Six-hour sleep deprivation increased PER2 not only in the brain but also in liver and kidney. Remarkably, the effects in the liver outlasted those observed in the brain. Within the brain the increase in PER2 concerned the cerebral cortex mainly, while leaving suprachiasmatic nuclei (SCN) levels unaffected. Against expectation, sleep deprivation did not increase PER2 in the brain of arrhythmic SCN-lesioned mice because of higher PER2 levels in baseline. In contrast, liver PER2 levels did increase in these mice similar to the sham and partially lesioned controls. Our results stress the importance of considering both sleep-wake dependent and circadian processes when quantifying clock-gene levels. Because sleep deprivation alters PERIOD-2 in the brain as well as in the periphery, it is tempting to speculate that clock genes constitute a common pathway mediating the shared and well-known adverse effects of both chronic sleep loss and disrupted circadian rhythmicity on metabolic health.

280 Sleep in children with cystic fibrosis. A questionnaire-based case–control study

Background Adult cystic fibrosis (CF) patients with severe lung disease are known to have an impaired neurocognitive function and daytime sleepiness. They reported significantly more daytime sleepiness and poorer sleep quality due to chronic sleep loss and nocturnal hypoxaemia. It is speculated that sleep disruption in CF children may have an impact on quality of life and clinical outcomes. Literature on sleep disturbances in children with CF is scarce without comparison to healthy controls. Aim Investigate the sleep quality using a sleep disturbance questionnaire (SDQC, Bruni et al 1996) in CF children in relation to the Body Mass Index (BMI), overnight tube feeding and pulmonary function. Compare the results of the SDQC with siblings and healthy controls. Method A SDQC was taken from parents of school aged CF patients (2.5–18 years), and also for each sibling and gender and age matched controls. BMI z-score, length z-score, use of overnight tube feeding and pulmonary function (Jaeger Masterscreen Body) (FEV1%, FVC%) were recovered from the CF medical file. Results The inclusions are still going on. Until now 25 CF patients, 12 siblings and 43 controls are already participating. Recruitment will go on until the end of February. Conclusion Whether the presence of sleep disturbances is significantly more common in children with CF compared to their siblings and healthy children. The relation between the sleep characteristics and pulmonary function, nutritional state or nocturnal feeding will be highlighted. Furthermore, by comparing the results of the SDQC with those of the siblings and healthy control children, family context as a bias might be avoided.

Interactions between sleep habits and self-control.

Good sleep habits and effective self-control are important components of successful functioning. Unfortunately chronic sleep loss and impaired self-control are common occurrences for many individuals which can lead to difficulty with daily self-control issues such as resisting impulses and maintaining attentive behavior. Understanding how self-control is depleted and how good sleep habits may help replenish and maintain the capacity for self-control is an important issue. A sleep-deprived individual who has expended the necessary resources for self-control is at an increased risk for succumbing to impulsive desires, poor attentional capacity, and compromised decision making. To date, few studies have investigated how sleep and self-control are inter-related. The goal of this mini-review is to explore the intersection between sleep habits and self-control and encourage researchers to focus on a new area of research that integrates what are at present largely separate areas in psychology and human neurosciences.

CE: The potential effects of sleep loss on a nurse's health.

While much has been written about the effects of extended work hours on quality of nursing care, nurse burnout, and job attrition, the potential adverse effects of acute and chronic sleep loss on the overall health and well-being of nurses has received little attention. The author describes the acute and chronic effects of sleep loss on nurses, strategies nurses can use to increase the quantity and quality of their sleep, and institutional policies that can promote adequate rest and recuperation between work shifts for nursing staff.

School Start Time Change: An In‐Depth Examination of School Districts in the United States

ABSTRACTIn response to the scientific evidence documenting both profound developmental changes in sleep and circadian biology during adolescence and the myriad of negative health, performance, and safety outcomes risks associated with chronic sleep loss, at least 70 public school districts in the United States, representing approximately 1,000 schools, have successfully implemented a delay in high school start times. However, despite the compelling evidence supporting school start time change as a key strategy in addressing the epidemic of adolescent sleep loss, many school districts across the country with early high school start times have not considered the option to implement later bell schedules for adolescents. Moreover, while the current scientific literature has clearly documented the positive outcomes associated with delayed high school start times, these studies contain limited information regarding the process by which school districts consider, approve and implement bell schedule changes. Thus, this in‐depth examination of those school districts that have been successful in changing their bell schedules is intended to support the efforts of other districts in various stages of contemplating this measure. We utilized a multi‐pronged approach (literature review, case studies, telephone interviews, online survey) to summarize the experiences of school districts across the United States in regard to challenges faced, strategies employed, and lessons learned in the hope that this information will be a useful tool for other school districts looking to chart a course forward to promote the health, safety, and academic opportunities of their students.

School Starts Too Early for Teens, Pediatricians Agree

School Starts Too Early for Teens, Pediatricians Agree

Insufficient sleep in adolescents and young adults: an update on causes and consequences.

Chronic sleep loss and associated sleepiness and daytime impairments in adolescence are a serious threat to the academic success, health, and safety of our nation's youth and an important public health issue. Understanding the extent and potential short- and long-term repercussions of sleep restriction, as well as the unhealthy sleep practices and environmental factors that contribute to sleep loss in adolescents, is key in setting public policies to mitigate these effects and in counseling patients and families in the clinical setting. This report reviews the current literature on sleep patterns in adolescents, factors contributing to chronic sleep loss (ie, electronic media use, caffeine consumption), and health-related consequences, such as depression, increased obesity risk, and higher rates of drowsy driving accidents. The report also discusses the potential role of later school start times as a means of reducing adolescent sleepiness.

School Start Times for Adolescents

The American Academy of Pediatrics recognizes insufficient sleep in adolescents as an important public health issue that significantly affects the health and safety, as well as the academic success, of our nation's middle and high school students. Although a number of factors, including biological changes in sleep associated with puberty, lifestyle choices, and academic demands, negatively affect middle and high school students' ability to obtain sufficient sleep, the evidence strongly implicates earlier school start times (ie, before 8:30 am) as a key modifiable contributor to insufficient sleep, as well as circadian rhythm disruption, in this population. Furthermore, a substantial body of research has now demonstrated that delaying school start times is an effective countermeasure to chronic sleep loss and has a wide range of potential benefits to students with regard to physical and mental health, safety, and academic achievement. The American Academy of Pediatrics strongly supports the efforts of school districts to optimize sleep in students and urges high schools and middle schools to aim for start times that allow students the opportunity to achieve optimal levels of sleep (8.5-9.5 hours) and to improve physical (eg, reduced obesity risk) and mental (eg, lower rates of depression) health, safety (eg, drowsy driving crashes), academic performance, and quality of life.

Sleep duration in Chinese adolescents: biological, environmental, and behavioral predictors

ObjectiveTo examine sleep duration-related risk factors from multidimensional domains among Chinese adolescents. MethodsA random sample of 4801 adolescents aged 11–20 years participated in a cross-sectional survey. A self-reported questionnaire was used to collect information about the adolescents' sleep behaviors and possible related factors from eight domains. ResultsIn all, 51.0% and 9.8% of adolescents did not achieve optimal sleep duration (defined as <8.0 h per day) on weekdays and on weekends, respectively. According to multivariate logistic regression models, after adjusting for all possible confounders, 17 factors were associated with sleep duration <8 h. Specifically, 13 factors from five domains were linked to physical and psychosocial condition, environment, and behaviors. These factors were overweight/obesity, chronic pain, bedtime anxiety/excitement/depression, bed/room sharing, school starting time earlier than 07:00, cram school learning, more time spent on homework on weekdays, television viewing ≥2 h/day, physical activity <1 h/day, irregular bedtime, and shorter sleep duration of father. ConclusionBiological and psychosocial conditions, sleep environments, school schedules, daily activity and behaviors, and parents' sleep habits significantly may affect adolescents' sleep duration, indicating that the existing chronic sleep loss in adolescents could be, at least partly, intervened by improving adolescents' physical and psychosocial conditions, controlling visual screen exposure, regulating school schedules, improving sleep hygiene and daytime behaviors, and changing parents' sleep habits.

Prevalence of sleep deficiency and use of hypnotic drugs in astronauts before, during, and after spaceflight: an observational study

Sleep deprivation and fatigue are common subjective complaints among astronauts. Previous studies of sleep and hypnotic drug use in space have been limited to post-flight subjective survey data or in-flight objective data collection from a small number of crew members. We aimed to characterise representative sleep patterns of astronauts on both short-duration and long-duration spaceflight missions. For this observational study, we recruited crew members assigned to Space Transportation System shuttle flights with in-flight experiments between July 12, 2001, and July 21, 2011, or assigned to International Space Station (ISS) expeditions between Sept 18, 2006, and March 16, 2011. We assessed sleep-wake timing objectively via wrist actigraphy, and subjective sleep characteristics and hypnotic drug use via daily logs, in-flight and during Earth-based data-collection intervals: for 2 weeks scheduled about 3 months before launch, 11 days before launch until launch day, and for 7 days upon return to Earth. We collected data from 64 astronauts on 80 space shuttle missions (26 flights, 1063 in-flight days) and 21 astronauts on 13 ISS missions (3248 in-flight days), with ground-based data from all astronauts (4014 days). Crew members attempted and obtained significantly less sleep per night as estimated by actigraphy during space shuttle missions (7·35 h [SD 0·47] attempted, 5·96 h [0·56] obtained), in the 11 days before spaceflight (7·35 h [0·51], 6·04 h [0·72]), and about 3 months before spaceflight (7·40 h [0·59], 6·29 h [0·67]) compared with the first week post-mission (8·01 h [0·78], 6·74 h [0·91]; p<0·0001 for both measures). Crew members on ISS missions obtained significantly less sleep during spaceflight (6·09 h [0·67]), in the 11 days before spaceflight (5·86 h [0·94]), and during the 2-week interval scheduled about 3 months before spaceflight (6·41 h [SD 0·65]) compared with in the first week post-mission (6·95 h [1·04]; p<0·0001). 61 (78%) of 78 shuttle-mission crew members reported taking a dose of sleep-promoting drug on 500 (52%) of 963 nights; 12 (75%) of 16 ISS crew members reported using sleep-promoting drugs. Sleep deficiency in astronauts was prevalent not only during space shuttle and ISS missions, but also throughout a 3 month preflight training interval. Despite chronic sleep curtailment, use of sleep-promoting drugs was pervasive during spaceflight. Because chronic sleep loss leads to performance decrements, our findings emphasise the need for development of effective countermeasures to promote sleep. The National Aeronautics and Space Administration.

Drugs That Negatively Affect Sleep

Getting adequate sleep is a healthy lifestyle activity that is important for the body to function optimally both physically and mentally. Unfortunately, 70 million Americans suffer from chronic sleep loss or sleep disorders. Secondary causes of sleep disorders are often overlooked and can occur from the consumption of social or medicinal drugs. Common social drugs that can disrupt sleep include alcohol, caffeine, and nicotine. Certain medications can also have side-effects that can induce sleep disruptions. This article briefly reviews common social drugs and prescription medications that can negatively impact sleep.

Role of orexin in respiratory and sleep homeostasis during upper airway obstruction in rats.

Chronic upper airway obstruction (UAO) elicits a cascade of complex endocrine derangements that affect growth, sleep, and energy metabolism. We hypothesized that elevated hypothalamic orexin has a role in maintaining ventilation during UAO, while at the same time altering sleep-wake activity and energy metabolism. Here, we sought to explore the UAO-induced changes in hypothalamic orexin and their role in sleep-wake balance, respiratory activity, and energy metabolism. The tracheae of 22-day-old Sprague-Dawley rats were surgically narrowed; UAO and sham-operated control animals were monitored for 7 weeks. We measured food intake, body weight, temperature, locomotion, and sleep-wake activity. Magnetic resonance imaging was used to quantify subcutaneous and visceral fat tissue volumes. In week 7, the rats were sacrificed and levels of hypothalamic orexin, serum leptin, and corticosterone were determined. The effect of dual orexin receptor antagonist (almorexant 300 mg/kg) on sleep and respiration was also explored. UAO increased hypothalamic orexin mRNA and protein content by 64% and 65%, respectively. UAO led to 30% chronic sleep loss, excessive active phase sleepiness, decreased body temperature, increased food intake, reduction of abdominal and subcutaneous fat tissue volume, and growth retardation. Administration of almorexant normalized sleep but induced severe breathing difficulties in UAO rats, while it had no effect on sleep or on breathing of control animals. In upper airway obstruction animals, enhanced orexin secretion, while crucially important for respiratory homeostasis maintenance, is also responsible for chronic partial sleep loss, as well as considerable impairment of energy metabolism and growth.

Chronic Sleep Restriction Disrupts Sleep Homeostasis and Behavioral Sensitivity to Alcohol by Reducing the Extracellular Accumulation of Adenosine

Sleep impairments are comorbid with a variety of neurological and psychiatric disorders including depression, epilepsy, and alcohol abuse. Despite the prevalence of these disorders, the cellular mechanisms underlying the interaction between sleep disruption and behavior remain poorly understood. In this study, the impact of chronic sleep loss on sleep homeostasis was examined in C57BL/6J mice following 3 d of sleep restriction. The electroencephalographic power of slow-wave activity (SWA; 0.5-4 Hz) in nonrapid eye movement (NREM) sleep and adenosine tone were measured during and after sleep restriction, and following subsequent acute sleep deprivation. During the first day of sleep restriction, SWA and adenosine tone increased, indicating a homeostatic response to sleep loss. On subsequent days, SWA declined, and this was accompanied by a corresponding reduction in adenosine tone caused by a loss of one source of extracellular adenosine. Furthermore, the response to acute sleep deprivation (6 h) was significantly attenuated in sleep-restricted mice. These effects were long-lasting with reduced SWA and adenosine tone persisting for at least 2 weeks. To investigate the behavioral consequences of chronic sleep restriction, sensitivity to the motor-impairing effects of alcohol was also examined. Sleep-restricted mice were significantly less sensitive to alcohol when tested 24 h after sleep restriction, an effect that persisted for 4 weeks. Intracerebroventricular infusion of an adenosine A1 receptor antagonist produced a similar decrease in sensitivity to alcohol. These results suggest that chronic sleep restriction induces a sustained impairment in adenosine-regulated sleep homeostasis and consequentially impacts the response to alcohol.

特別講演I 慢性的睡眠欠乏の神経行動学的・生理学的影響：ラットモデルから学ぶこと

特別講演I 慢性的睡眠欠乏の神経行動学的・生理学的影響：ラットモデルから学ぶこと

School System Partners With Sleep Experts on Start Times

With 1 in 5 Fairfax County, Va., high school seniors reporting an average of less than five hours of sleep a night, many educators and sleep specialists agree that change is needed.

Sleep, School Performance, and a School-Based Intervention among School-Aged Children: A Sleep Series Study in China

BackgroundSufficient sleep during childhood is essential to ensure a transition into a healthy adulthood. However, chronic sleep loss continues to increase worldwide. In this context, it is imperative to make sleep a high-priority and take action to promote sleep health among children. The present series of studies aimed to shed light on sleep patterns, on the longitudinal association of sleep with school performance, and on practical intervention strategy for Chinese school-aged children.Methods and FindingsA serial sleep researches, including a national cross-sectional survey, a prospective cohort study, and a school-based sleep intervention, were conducted in China from November 2005 through December 2009. The national cross-sectional survey was conducted in 8 cities and a random sample of 20,778 children aged 9.0±1.61 years participated in the survey. The five-year prospective cohort study included 612 children aged 6.8±0.31 years. The comparative cross-sectional study (baseline: n = 525, aged 10.80±0.41; post-intervention follow-up: n = 553, aged 10.81±0.33) was undertaken in 6 primary schools in Shanghai. A battery of parent and teacher reported questionnaires were used to collect information on children’s sleep behaviors, school performance, and sociodemographic characteristics. The mean sleep duration was 9.35±0.77 hours. The prevalence of daytime sleepiness was 64.4% (sometimes: 37.50%; frequently: 26.94%). Daytime sleepiness was significantly associated with impaired attention, learning motivation, and particularly, academic achievement. By contrast, short sleep duration only related to impaired academic achievement. After delaying school start time 30 minutes and 60 minutes, respectively, sleep duration correspondingly increased by 15.6 minutes and 22.8 minutes, respectively. Moreover, intervention significantly improved the sleep duration and daytime sleepiness.ConclusionsInsufficient sleep and daytime sleepiness commonly existed and positively associated with the impairment of school performance, especially academic achievement, among Chinese school-aged children. The effectiveness of delaying school staring time emphasized the benefits of optimal school schedule regulation to children’s sleep health.