Vigilance Test Research Articles

An experimental test of epistemic vigilance: Competitive incentives increase dishonesty and reduce social influence.

Cultural evolutionary theory has shown that social learning is adaptive across a broad range of conditions. While existing theory can account for why some social information is ignored, humans frequently under-utilise beneficial social information in experimental settings. One account of this is epistemic vigilance, whereby individuals avoid social information that is likely to be untrustworthy, though few experiments have directly tested this. We addressed this using a two-player online experiment where participants completed the same task in series. Player one provided social information for player two in the form of freely offered advice or their actual answer (termed "spying"). We manipulated the payoff structure of the task such that it had either a cooperative, competitive, or neutral incentive. As predicted, we found that under a competitive payoff structure: (i) player one was more likely to provide dishonest advice; and (ii) player two reduced their use of social information. Also, (iii) spied information was more influential than advice, and (iv) player two chose to spy rather than receive advice when offered the choice. Unexpectedly, the ability to choose between advice and spied information increased social influence. Finally, exploratory analyses found that the most trusting participants preferred to receive advice, while the least trusting participants favoured receiving no social information at all. Overall, our experiment supports the hypothesis that humans both use and provide social information strategically in a manner consistent with epistemic vigilance.

Examining Shift Length and Fatigue: A National Study of Neonatal Advanced Practice Providers.

Neonatal advanced practice providers (APPs) often work prolonged hours in high-acuity neonatal intensive care units (NICUs). It is imperative to understand how fatigue affects the APP's ability to react quickly following long shifts. There is a lack of data on the effects of shift length and fatigue on neonatal APP job performance and clinical decision-making. The purpose of this study was to describe the variation in shift length, knowledge-based competency, personal well-being, and behavioral alertness for neonatal APPs. This study evaluated neonatal APPs before and after a clinical shift. Provider well-being was assessed during the pre-survey. Pretest-posttest surveys evaluated neonatal APP's psychomotor vigilance skills and knowledge. Participants completed an online, anonymous questionnaire to answer a series of knowledge-based questions before and after their shift, along with a psychomotor vigilance test (PVT). A paired t test analysis evaluated the pre- and post-shift PVT values and knowledge-based test scores. Overall, 61 pre-surveys and 42 post-surveys were completed; 36 were matched by participants pre- to post-survey. The mean between pre- and post-knowledge-based questions was statistically significant, with higher posttest scores. There was no statistical difference noted in the paired t test analysis of the PVT values. The small sample size may limit the generalizability of findings, but these results may indicate that shift length does not affect psychomotor vigilance or knowledge-based competency. It is vital that future work assess the associations between APP shift length, fatigue, and critical decision-making.

Symptoms, Quality of Life, and Executive Function in Children Who Snore

Mild sleep-disordered breathing (mSDB) in children is associated with both neurobehavioral morbidity and reduced quality of life (QOL). However, the association between symptom burden and QOL with executive function is not well understood, and it is not known whether QOL and symptom burden may help identify children with neurocognitive dysfunction. To assess associations among executive function, QOL, and symptom burden in children with mSDB. This cross-sectional study was a secondary analysis of the multicenter Pediatric Adenotonsillectomy Trial for Snoring, which included children aged 3 to 12 years randomized to watchful waiting or adenotonsillectomy for mSDB (snoring and an obstructive apnea-hypopnea index <3) between June 29, 2016, and February 1, 2021. The data for this report were analyzed between December 22, 2020, and October 3, 2024. Pediatric mSDB. Quality of life was assessed using the Obstructive Sleep Apnea-18 (OSA-18), and symptom burden was assessed using the Pediatric Sleep Questionnaire-Sleep-Related Breathing Disorder Scale (PSQ-SRBD). Executive function, including self-control and working memory, was measured using the Behavior Rating Inventory of Executive Function Global Executive Composite (BRIEF GEC), and inhibitory control and sustained attention were measured by the GoNoGo vigilance test. Partial Pearson correlations and multiple linear regression models were used to assess the associations among QOL, symptoms, and executive function. The sample included 459 children (mean [SD] age, 6.1 [2.3] years; 230 female [50.1%]). Moderate correlations were found between the BRIEF GEC and the PSQ-SRBD and OSA-18 (r = 0.58 [95% CI, 0.51-0.64] and 0.59 [95% CI, 0.52-0.64], respectively). After adjusting for age, sex, race and ethnicity, body mass index percentile, household income, maternal education, attention-deficit/hyperactivity disorder, test characteristics, and disease severity, both OSA-18 and PSQ-SRBD scores were associated with the BRIEF GEC (β = 0.41 [95% CI, 0.36-0.47] and 3.66 [95% CI, 3.17-4.15], respectively). In the fully adjusted model, PSQ-SRBD was also associated with GoNoGo inhibitory control (β = -0.04 [95% CI, -0.08 to -0.01]) and sustained attention (β = -0.05 [95% CI, -0.10 to -0.01]). In this study, disease-specific QOL and symptom burden were associated with executive function in children with mSDB. These findings may be useful in identifying those children who are at risk for neurocognitive dysfunction.

Effect of Acute Hypoxia Exposure on the Availability of A1 Adenosine Receptors and Perfusion in the Human Brain.

In animal studies it has been observed that the inhibitory neuromodulator adenosine is released into the cerebral interstitial space during hypoxic challenges. Adenosine's actions on the A1 adenosine receptor (A1AR) protect the brain from oxygen deprivation and overexertion through adjustments in cerebral blood flow, metabolism, and electric activity. Methods: Using 8-cyclopentyl-3-(3-[18F]fluoropropyl)-1-propylxanthine ([18F]CPFPX), a PET tracer for the A1AR, we tested the hypothesis that hypoxia-induced adenosine release reduces A1AR availability in the human brain. Furthermore, we investigated whether this response is associated with altered brain perfusion and psychomotor vigilance. Ten healthy volunteers completed a 110-min bolus-plus-constant-infusion [18F]CPFPX PET/MRI hybrid experiment including a 30-min interval of normobaric hypoxia with peripheral oxygen saturation between 70% and 75%. We obtained blood samples to calculate metabolite-corrected steady-state A1AR distribution volumes and measured gray matter brain perfusion via arterial spin labeling in high temporal resolution. A 3-min psychomotor vigilance test was conducted every 10 min, and heart rate and peripheral blood oxygen saturation were continuously measured. Results: In all 7 examined brain regions, hypoxia reduced A1AR availability significantly (e.g., frontal lobe, 13.5%; P = 0.0144) whereas gray matter brain perfusion increased (e.g., frontal lobe, 42.5%; P = 0.0007). Heart rate increased by 19% (P = 0.0039). Mean reaction speed decreased by 4.3% (P = 0.0021). Conclusion: Our study is the first, to our knowledge, to demonstrate that acute hypoxia, corresponding to a mean altitude of 5,500 m (18,000 ft), reduces A1AR availability in the human brain. The finding is consistent with hypoxia-induced cerebral adenosine release leading to increased A1AR occupancy.

Attentional Characteristics of Fencers: a Comparison with Swimmers and Non-Athletes and their Pedagogical Implications

The aim of this study was to identify the attentional profile of fencers, comparing them to non-athletes and swimmers. Three groups of subjects were studied (N=90; Mage=21.3; SD=4.1): thirty-seven fencers (20 female, 17 male), twenty-one swimmers (10 female, 11 male); thirty-two non-athletes (16 female, 16 male). Results of the alertness test (warning condition) showed swimmers were overall faster than non-athletes. In the no-warning condition, results of the alertness test showed a significant interaction between group x gender: in particular, it was the group of female non-athletes in the condition in which the warning signal was not present who recorded higher reaction times than the other groups. In the divided attention (only in the visual task), and the go/no-go tests, the fencers showed faster reaction times than the swimmers and the non-athletes, while the latter groups did not differ from each other. In the vigilance test, only the gender factor was significant: overall, males showed greater speed than females. In conclusion, our data show that fencers, compared to swimmers and non-athletes, possess better management of visual attention and a better ability to manage situations in which a response must be inhibited, suggesting that these differences affect more selective aspects of attention.

Sleep deprivation alters utilization of negative feedback in risky decision-making.

Sleep loss has sometimes catastrophic effects on risky decision-making. However, it is unknown to what extent such deficits are exacerbated with increasing duration of sleep deprivation (SD) and whether sustained vigilant attention mediates this sleep deprivation-induced deficit. The present study aimed to investigate the effect of 36 hours of SD on 37 male college students' arousal, emotion, vigilant attention, and risky decision-making, using the Psychomotor Vigilance Test, the Game of Dice Task, and scales assessing fatigue, sleep, and emotions. Compared to baseline, SD significantly increased sleepiness, fatigue, and negative emotions, decreased positive emotions and vigilant attention, and led to a shift toward risky decision-making, and these effects often appeared 15 or 20 hours after SD. Interestingly, participants' ability to employ positive feedback was maintained, whereas their performance to utilize negative feedback was impaired even after 8 hours of sleep deprivation. Meanwhile, vigilant attention acted as a mediator between SD and risky decision-making (z = -1.97, 95% [-6.00, -0.30]). These results suggest that sleep-deprived individuals are unable to use negative feedback to optimize their judgments, which may account for their poor decision-making under risk.

Associating EEG functional networks and the effect of sleep deprivation as measured using psychomotor vigilance tests

People are routinely forced to undertake cognitive challenges under the effect of sleep deprivation, due to professional and social obligations forcing them to ignore their circadian clock. However, low intra-individual and high inter-individual differences in behavioural outcomes are known to occur when people are sleep deprived, leading to the conclusion that trait-like differences to sleep deprivation could explain the differing levels of resilience. Within this study we consider if trait-like resilience to sleep deprivation, measured using psychomotor vigilance tests over a 40 h protocol, could be associated with graph metrics (mean node strength, clustering coefficient, characteristic path length and stability) calculated from EEG functional networks acquired when participants (\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$n=13$$\\end{document}) are well rested (baseline). Furthermore, we investigated how stability (the consistency of a participant’s functional network over time measured using 2-D correlation) changed over the constant routine. We showed evidence of strong significant correlations between high mean node strength, low characteristic path length and high stability at baseline with a general resilience to extended sleep deprivation, although the same features lead to vulnerability during the period of natural sleep onset, highlighting non-uniform correlations over time. We also show significant differences in the levels of stability between resilient and vulnerable groups.

Effects of one night of sleep deprivation on whole brain intrinsic connectivity distribution using a graph theory neuroimaging approach

Neuroimaging studies have revealed disturbances in brain functional connectivity (FC) after one night of sleep deprivation (SD). These researches explored the alterations of FC using classical regions of interest (ROI)-based analysis or functional connectivity density. However, these methods need for a priori information about the selected ROIs and a specific correlation threshold to define a connection between two ROIs or voxels, which may bring inconsistent results. In the present study, we adopted a data-driven, whole brain voxel-based graph-theoretical approach, intrinsic connectivity distribution (ICD) analysis, to examine changes of brain connectivity after SD in 52 normal young subjects without any prior knowledge. The cross-hemisphere ICD (ch-ICD) analysis was also performed to discover the effect of SD on cerebral lateralization. We found that sleep-deprived subjects showed significant reduced ICD in default mode network (DMN) and limbic network, and increased ICD in sensorimotor network. Furthermore, after SD, the ICD in the right precuneus showed significant correlation with psychomotor vigilance test (PVT) performance following the stepwise regression analysis after Bonferroni correction (ICD = 0.43 - 0.62∗10 % fast reaction time + 0.31∗the standard deviation of reaction time, p = 0.0012). Follow-up seed-based FC analyses in the right precuneus revealed decreased FC to regions in DMN, visual network, ventral attentional network and frontal-parietal network. Nevertheless, no striking difference of ch-ICD was found following SD. In conclusion, these findings suggested that DMN, especially precuneus may be hubs of FC disturbances associated with vigilance after SD, and may provide new insights into the intervention for SD.

Sleep Disruption Impairs Sustained Attention in Food-Restricted Rats Using a Food-Reinforced Rodent Psychomotor Vigilance Test.

Sleep disruption (SD) impairs sustained attention, and impairment is quantified with the psychomotor vigilance test (PVT) in humans. In rats, food restriction attenuates SD's effects on sustained attention, limiting translation of rodent vigilance tests. The goal of the current study was to determine if a rodent PVT (rPVT) requiring high baseline performance using food restriction and reinforcement is sensitive to the effects of SD. Male Long-Evans rats (n=4) were trained on the rPVT using food reinforcement. Once baseline acquisition criteria were achieved, rats experienced acute SD using an automated sweep bar that moved across the home cage. Rats were tested in the rPVT the day following SD to assess performance-impairing effects. SD significantly increased lapses, and this effect was specific to shorter response-stimulus intervals. Decreased percent correct responses and increased slow reaction times were also found. These data suggest that many of the performance-impairing effects of SD are not attenuated by food restriction in this procedure. The rPVT is sensitive to the performance impairing effects of SD in food restricted rats, a common methodology used to train and maintain performance on operant behavioral tests. Thus, food restriction does not appear to attenuate the effects of SD in all attention-related behavioral procedures.

Training load, sleep, reaction time, sports performance, and mood in paralympic swimmers before a competition.

Coaches usually reduce the training load (tapering) before competition to improve performance; however, in paralympic athletes this strategy had not yet been tested and we did not know which variables are associated with improved performance. Therefore, the objective was to compare the sleep, mood, sports performance, and reaction time (RT) of paralympic swimmers (PS) during tapering and to investigate whether there is a relationship between the variables during this training phase. Eight PS were monitored for 17 days before the main competition, with an actigraphy to record sleep in 16 days. Evaluations were performed on Mondays (Evaluation 1 = E1) and Fridays (E2) during the first and second weeks (E3 and E4), and on Tuesday (E5) of the third week, the day traveling to the competition. Brunel Mood Scale, RT (Psychomotor Vigilance Test), and sports performance (50 m in the pool) were assessed before training on each assessment day. Internal training load (ITL) was evaluated using ratings of perceived exertion. ITL decreased gradually between assessments. Performance and RT were better on E5 than on E1. Fatigue was higher on E1 and E2 than on E4 and E5. Sleep parameters (total sleep time [TST], awakenings after sleep onset, and sleep efficiency) improved in the second week compared with the first week. Furthermore, TST from the previous night was correlated with RT, and RT and fatigue correlated with sports performance. The increase in TST and the reduction in fatigue just before competition achieved by tapering correlated with the improvement in RT and sports performance. In addition, the tapering improved sports performance, RT, sleep parameters, and decreased fatigue.

Interhemispheric asynchrony of NREM EEG at the beginning and end of sleep describes evening vigilance performance in patients undergoing diagnostic polysomnography

Objective.Obstructive sleep apnea (OSA) is associated with deficits in vigilance. This work explored the temporal patterns of OSA-related events during sleep and vigilance levels measured by the psychomotor vigilance test (PVT) in patients undergoing polysomnography (PSG) for suspected OSA.Approach.The PVT was conducted prior to in-laboratory PSG for 80 patients suspected of having OSA. Three groups were formed based on PVT-RT-outcomes and participants were randomly allocated into Training (n= 55) and Test (n= 25) samples. Sleep epochs of non-rapid-eye movement (NREM) electroencephalographic (EEG) asynchrony data, and REM and NREM data for respiratory, arousal, limb movement and desaturation events were analysed. The data were segmented by sleep stage, by sleep blocks (SB) of stable Stage N2, Stage N3, mixed-stage NREM sleep (NXL), and, by Time of Night (TN) across sleep. Models associating this data with PVT groups were developed and tested.Main Results.Amodel using NREM EEG asynchrony data segmented by SB and TN achieved 81.9% accuracy in the Test Cohort. Models based on interhemispheric asynchrony SB data and OSA data segmented by TN achieved 80.6% and 79.5% respectively.Significance.Novel data segmentation methods via blocks of NXL and TN have improved our understanding of the relationship between sleep, OSA and vigilance.

Mechanism of cognitive processing for acupuncture action on generalized anxiety with naturally occurring consecutive partial sleep deprivation in early adulthood: a randomized controlled study and evaluation of event-related potentials.

Generalized anxiety disorder (GAD) is a common mental disorder that often begins in adolescence or early adulthood and is characterized by widespread and persistent anxiety. Partial sleep deprivation (PSD) is an important risk factor for GAD development and a common comorbidity. Adolescence is a period of rapid brain and nervous system development, and during this time, the occurrence of GAD can lead to neurocognitive deficits, such as impaired attention, cognitive control, and attention bias, that significantly affect cognitive function. However, relatively little research has been conducted on GAD comorbid with PSD in early adulthood compared with other psychiatric disorders. Clinical studies have demonstrated the effectiveness of acupuncture in treating GAD and sleep disorders, but the mechanism of how acupuncture modulates neurocognitive processing in patients with GAD comorbid with PSD has not been clarified. In this randomized clinical trial, a total of 56 participants diagnosed with GAD comorbid with naturally occurring PSD and 28 healthy controls (HCs) will be recruited. The participants diagnosed with GAD comorbid with PSD will be randomly assigned to either the acupuncture group or the sham acupuncture group at a 1:1 ratio. The primary outcome measure is the Hamilton Anxiety Rating Scale (HAMA). Secondary outcome measures are the Sleep Deprivation Index (SDI), the Self-Assessment Scale for Anxiety (SAS), the Epworth Sleepiness Scale (ESS), and the State-Trait Anxiety Inventory (STAI). Additionally, three psychological paradigms (the attentional network test, psychomotor vigilance test, and emotional face Go/No-go) and event-related potential (ERP) data. Healthy volunteers will not undergo acupuncture but will instead participate in baseline assessments for the scales, mental paradigms, and ERP data. Acupuncture and sham acupuncture interventions will be conducted for 30 min, three times a week, over a 2-week period. Evaluations will be performed at zero weeks (baseline), 1 week, and 2 weeks, with the data enumerator, outcome assessor, and participant blinded to the treatment assignment. This study contributes to the exploration of the effects of acupuncture on improving anxiety symptoms and cognitive functions in individuals with comorbid GAD and PSD. ClinicalTrials.gov, ChiCTR2400082221. Registered March 25, 2024.

O038 Vigilance Testing Accelerated List (ViTAL) week reduces sleep laboratory waiting times

O038 Vigilance Testing Accelerated List (ViTAL) week reduces sleep laboratory waiting times

Sleep restriction and age effects on distinct aspects of cognition in adolescents.

Insufficient sleep negatively impacts scholastic performance in children and adolescents. Here we use a dose-response time in bed (TIB) restriction study to evaluate associations between sleep loss and multiple aspects of cognition. We evaluated changes in cognitive measures across ages 10 to 23 years and determined whether the effects of sleep loss changed across this age range. A younger cohort (n = 77, age range 9.9 to 16.2 years) was studied annually for 3 years. An older cohort study (n = 82, age range 15 to 22.8 years) was interrupted by the COVID pandemic with 25 participants completing multiple years. Annually participants completed each of three TIB conditions: four consecutive nights with 7, 8.5, or 10 hours in bed. A day of cognitive testing followed the fourth night. Restricting TIB to 7 hours was associated with impaired top-down attentional control and cognitive flexibility, but performance did not differ between 8.5 and 10 hours of TIB conditions. Psychomotor vigilance test performance decreased as TIB was restricted from 10 to 8.5 hours and decreased further with restriction to 7 hours. Sternberg test measures of working memory were not significantly affected by TIB restriction. The effects of sleep loss on these cognitive measures did not change significantly with age, but age-related improvement in many of the measures may compensate for some sleep loss effects. The findings here do not indicate an adolescent decrease in sleep need; however, the minimal duration of sleep needed for optimal performance appears to differ depending on the cognitive measure.

An Evaluation of the Autonomic Nervous Activity and Psychomotor Vigilance Level for Smells in the Work Booth

In this study, we investigated the effects of the smell environment in the work booth on autonomic nervous activity (ANS) and psychomotor vigilance levels (PVLs) using linalool (LNL) and trans-2-nonenal (T2N). The subjects were six healthy males (31 ± 6 years old) and six healthy females (24 ± 5 years old). They sat in the work booth filled with the smells of LNL and T2N for 10 min, and their electrocardiograms (ECGs), skin conductance levels, pulse wave variabilities, skin temperatures, and seat pressure distributions were measured. In addition, the orthostatic load test (OLT) and psychomotor vigilance test (PVT) were performed before and after entering the work booth, and a subjective evaluation of the smell was also performed after the experiment. This paper focused on ECG and PVT data and analyzed changes in heart rate variability indices and PVT scores. Males felt slightly comfortable with the LNL smell and showed promoted sympathetic nerve activity in the OLT after the smell presentation. Females felt slightly uncomfortable with the T2N smell and showed promoted sympathetic nerve activity and a decrease in PVT scores in the OLT after the smell presentation. Gender differences were observed in ANS and PVLs, and it is possible that the comfort of LNL increased sympathetic nervous activity in males, while the uncomfortableness of T2N may have reduced work performance in females.

Effects of Supplementation with a Microalgae Extract from Phaeodactylum tricornutum Containing Fucoxanthin on Cognition and Markers of Health in Older Individuals with Perceptions of Cognitive Decline.

Forty-three males and females (64.3 ± 6.0 years, 79.8 ± 16.0 kg, 27.0 ± 4.0 kg/m2) with perceptions of cognitive and memory decline completed the double-blind, randomized, parallel-arm, placebo-controlled intervention clinical trial. Participants were counterbalanced by sex and BMI and randomly allocated to their respective 12-week supplementation interventions, which were either the placebo (PL) or 1100 mg/day of PT containing 8.8 mg of fucoxanthin (FX). Fasting blood samples were collected, and cognitive assessments were performed during the testing session at 0, 4, and 12 weeks of intervention. The data were analyzed by multivariate and univariate general linear model (GLM) analyses with repeated measures, pairwise comparisons, and mean changes from baseline analysis with 95% confidence intervals (CIs) to assess the clinical significance of the findings. FX supplementation significantly affected (p < 0.05) or exhibited tendencies toward significance (p > 0.05 to p < 0.10 with effect sizes ranging from medium to large) for word recall, picture recognition reaction time, Stroop color-word test, choice reaction time, and digit vigilance test variables. Additionally, FX supplementation promoted a more consistent clinical improvement from baseline values when examining mean changes with 95% CIs, although most differences were seen over time rather than between groups. The results demonstrate some evidence that FX supplementation can improve working and secondary memory, vigilance, attention, accuracy, and executive function. There was also evidence that FX promoted more positive effects on insulin sensitivity and perceptions about sleep quality with no negative effects on clinical blood panels or perceived side effects. Additional research should investigate how FX may affect cognition in individuals perceiving memory and cognitive decline. Registered clinical trial #NCT05759910.

Locus coeruleus microstructural integrity is associated with vigilance vulnerability to sleep deprivation.

Insufficient sleep compromises cognitive performance, diminishes vigilance, and disrupts daily functioning in hundreds of millions of people worldwide. Despite extensive research revealing significant variability in vigilance vulnerability to sleep deprivation, the underlying mechanisms of these individual differences remain elusive. Locus coeruleus (LC) plays a crucial role in the regulation of sleep-wake cycles and has emerged as a potential marker for vigilance vulnerability to sleep deprivation. In this study, we investigate whether LC microstructural integrity, assessed by fractional anisotropy (FA) through diffusion tensor imaging (DTI) at baseline before sleep deprivation, can predict impaired psychomotor vigilance test (PVT) performance during sleep deprivation in a cohort of 60 healthy individuals subjected to a rigorously controlled in-laboratory sleep study. The findings indicate that individuals with high LC FA experience less vigilance impairment from sleep deprivation compared with those with low LC FA. LC FA accounts for 10.8% of the variance in sleep-deprived PVT lapses. Importantly, the relationship between LC FA and impaired PVT performance during sleep deprivation is anatomically specific, suggesting that LC microstructural integrity may serve as a biomarker for vigilance vulnerability to sleep loss.

Modeling Sensor-based Vigilance Decrement in the Healthcare Environment

Vigilance refers to an individual’s ability to maintain attention over time. Vigilance decrement is particularly concerning in clinical environments where shift work and long working hours are common. This study identifies significant factors and indicators for predicting and monitoring individuals’ vigilance decrement. We enrolled 11 participants and measured their vigilance levels by recording their reaction times while completing the Psychomotor Vigilance Test. Additionally, we measured participants’ physiological responses and collected their sleep deprivation data, demographic information, and self-reported anxiety levels. Using repeated-measures correlation analysis, we found that decreased vigilance levels, indicated by longer reaction times, were associated with higher electrodermal activity ( p &lt; .01), lower skin temperature ( p &lt; .001), shorter fixation durations ( p &lt; .05), and increased saccade frequency ( p &lt; .05). Moreover, sleep deprivation significantly affected vigilance decrement ( p &lt; .001). Our findings provide the potential to develop a predictive model of vigilance decrements using physiological signals collected from non-intrusive devices, as an alternative to current behavior-based methods.

Investigation of current clinical practices and perceptions of patients and caregivers regarding Alport syndrome in South Korea.

Alport syndrome (AS) is a highly prevalent inherited kidney disease. Early diagnosis and intervention are crucial for improved kidney outcomes. This study evaluated awareness among Korean clinicians about AS and assessed the understanding of AS patients and caregivers. An online survey targeting registered members of the Korean Society of Nephrology, the Korean Society of Pediatric Nephrology, AS patients, and their caregivers was conducted from January to April 2023. Out of 103 respondents, most had treated fewer than 10 AS patients. For certain kidney diseases, such as chronic kidney disease of unknown origin and focal segmental glomerulosclerosis, half or fewer considered AS as a potential diagnosis. Only half preferred immediate confirmation tests for suspected AS. Genetic testing was available at half of the medical centers, and fewer than half of the adult nephrologists considered genetic testing to be essential. While all the surveyed nephrologists would prescribe renin-angiotensin system blockade, the majority hesitated to initiate treatment. Vigilant genetic testing for donor candidates was not a common practice. While 80% of patients and 50% of caregivers understood the nature and prognosis of AS, they regretted the delayed diagnoses, insufficient explanations, and the absence of support groups. Not rarely, AS patients may have been unrecognized as AS. Despite the noteworthy advancement of AS, the recent guidelines have not been widely adopted in clinical practice in Korea. Considering the challenges in Korea, there is an urgent need for locally tailored clinical practice recommendations and a dedicated registry to optimize patient outcomes.

Impact of carbon dioxide exposures on sleep latency among healthy volunteers: A randomized order, paired crossover study, evidence from the multiple sleep latency test

BackgroundDaytime sleepiness affects work efficiency, occupational safety, and public health. Although previous studies have reported an association between environmental carbon dioxide (eCO2) and daytime sleepiness, it has been challenging to draw a firm conclusion due to the lack of standardized sampling and profiling protocols. ObjectiveWe examined the effect of pure CO2 exposure at 5000 (ppm, parts per million) on daytime sleepiness. MethodsEleven healthy participants (males of 24 ± 3 years, mean ± SD) completed a four-nap multiple sleep latency test (MSLT) protocol in the environmentally controlled chamber under two conditions: the CO2 condition (4851 ± 229 ppm) and the Control condition (1102 ± 204 ppm). The subjective sleepiness level and cognitive performances were also evaluated using the Stanford Sleepiness Scale (SSS) questionnaire, Psychomotor Vigilance Test (PVT), and Stroop test after each nap session. ResultsA significant reduction in sleep latency was observed in the CO2 exposure condition (Control vs. CO2 = 13.1 ± 3.3 min vs. 9.7 ± 3.2 min). The subjective sleepiness scores were also significantly higher in the CO2 exposure condition than in the Control condition (Control vs. CO2 = 2.7 ± 0.5 vs. 4.7 ± 0.8). Cognitive responses after naps showed no significant difference across conditions. ConclusionThis study revealed that exposure to environmental CO2 at a concentration as high as the upper safety limit at work sites significantly shortened the sleep latency and enhanced subjective sleepiness during naps in the MSLT without affecting cognitive responses after each exposure. Our results demonstrated that exposure to high environmental CO2 induces daytime sleepiness that potentially compromises work efficiency and safety.