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Sean Pradhan

Publications and source records attributed to Sean Pradhan.

Sex Differences in Perceptions of Sleep Inertia Following Nighttime Awakenings

Study Objectives: The influence of biological sex on sleep inertia symptoms is currently unknown. We investigated the role of sex differences in the subjective experience and objective cognitive manifestation of sleep inertia following nighttime awakenings. Methods: Thirty-two healthy adults (16 female, 25.91 ± 5.63 years) completed a one-week at-home study with one experimental night during which sleep was measured by polysomnography and participants were awakened during their habitual sleep time. Participants completed a psychomotor vigilance task (PVT), Karolinska Sleepiness Scale (KSS), visual analog mood scales, and a descending subtraction task (DST) prior to sleep (baseline) and at 2, 12, 22, and 32 minutes after awakening. A series of mixed-effects models with Bonferroni-corrected post-hoc tests were used to examine the main effects of test bout and sex, and their interaction, with a random effect of participant, and order of wake-up and sleep history as covariates. Results: All outcomes except for percent correct on the DST showed a significant main effect of test bout, with worse performance after waking compared to baseline (all p s < .003). Significant effects of sex ( p = .002) and sex × test bout ( p = .01; R 2 M = .49, R 2 C = .69) were observed for KSS, with females reporting a greater increase in sleepiness from baseline to after waking compared to males. Conclusions : These results suggest that while females reported feeling sleepier than males following nighttime awakenings, their cognitive performance was comparable. Future research is needed to determine whether perceptions of sleepiness influence decision-making during the transition from sleep to wakefulness.

Sleep inertia↗

Rise and Shine: The Use of Polychromatic Short-Wavelength-Enriched Light to Mitigate Sleep Inertia at Night Following Awaking From Slow-Wave Sleep

Sleep inertia is the brief period of performance impairment and reduced alertness experienced after waking, especially from slow-wave sleep. We assessed the efficacy of polychromatic short-wavelength-enriched light to improve vigilant attention, alertness and mood immediately after waking from slow-wave sleep at night. Twelve participants (six female, 23.3 ± 4.2 years) maintained an actigraphy-confirmed sleep schedule of 8.5 hr for 5 nights, and 5 hr for 1 night prior to an overnight laboratory visit. In the laboratory, participants were awakened from slow-wave sleep, and immediately exposed to either dim, red ambient light (control) or polychromatic short-wavelength-enriched light (light) for 1 hr in a randomized crossover design. They completed a 5-min Psychomotor Vigilance Task, the Karolinska Sleepiness Scale, and Visual Analogue Scales of mood at 2, 17, 32 and 47 min after waking. Following this testing period, lights were turned off and participants returned to sleep. They were awakened from their subsequent slow-wave sleep period and received the opposite condition. Compared with the control condition, participants exposed to light had fewer Psychomotor Vigilance Task lapses (χ 2 [1] = 5.285, p = 0.022), reported feeling more alert (Karolinska Sleepiness Scale: F 1,77 = 4.955, p = 0.029; Visual Analogue Scale alert : F 1,77 = 8.226, p = 0.005), and reported improved mood (Visual Analogue Scale cheerful : F 1,77 = 8.615, p = 0.004). There was no significant difference in sleep-onset latency between conditions following the testing period (t 10 = 1.024, p = 0.330). Our results suggest that exposure to polychromatic short-wavelength-enriched light immediately after waking from slow-wave sleep at night may help improve vigilant attention, subjective alertness, and mood. Future studies should explore the potential mechanisms of this countermeasure and its efficacy in real-world environments.

alertness↗

Examining Circadian Disadvantages in the National Basketball Association's (NBA) Playoffs

Introduction: Prior research on travel in the National Basketball Association’s (NBA) regular season has shown that teams journeying west relative to their home base face circadian disadvantages for evening games, while those traveling east have advantages. The current study extends previous research by examining these effects within the NBA playoffs. We hypothesized that teams would have a greater circadian advantage during eastward compared to westward travel. Methods: In 2013, the NBA implemented a 7-game series playoff structure, in which teams play an alternating home/away 2-2-1-1-1 format for the Finals. Data for all 499 postseason games played during the 2013-14 to 2018-2019 seasons were collected from Basketball-Reference and FiveThirtyEight. We investigated the impact of direction of travel based on home base city (same time zone, westward, eastward) and time zones traveled on actual game outcomes, Elo rating differences (i.e., a team quality metric based on wins and losses), Elo predicted win probability, and team scoring for visiting teams. Results: Teams had lower Elo predicted win probabilities following 3-hour westward than same time zone and all eastward travel, while 3-hour eastward travel related to higher probabilities of winning compared to same time zone and all westward travel (p < .02, d > .95). Teams travelling westward with 2-hour time changes lost significantly more games than those experiencing 1-hour westward (p = .04, OR = 2.45), 1-hour eastward (p = .05, OR = 2.34), and 3-hour eastward changes (p = .02, OR = 4.68). Scoring was significantly higher following eastward travel compared to both westward (p = .001, d = 0.60) and same time zone travel (p = .003, d = 0.44). There were no statistically clear differences in team quality based on overall direction of travel or number of time zones traveled, and game outcomes based on direction of travel (p > .05). Conclusion: Overall direction of travel was related to team scoring, while number of time zones traveled was associated with Elo predicted win probability and game outcomes. Generally, teams travelling eastward and within the same time zone gained an advantage over those travelling westward. Adjustment to travel and time zone changes appear to influence certain aspects of in-game performances and outcomes in the NBA playoffs.

circadian misalignment↗

The Effects of Chronic Sleep Restriction on Multiple Object Tracking

The ability to simultaneously track numerous moving objects in the presence of irrelevant stimuli is essential for carrying out a variety of tasks. Sleep loss has been found to impair neurocognitive functioning and, as a result, attentional processing capacity is reduced. A common form of sleep loss is chronic sleep restriction (CSR), in which an inadequate amount of sleep is obtained over consecutive days. The objective of the current study was to determine if performance on the multiple object tracking (MOT) task was adversely impacted by a week of CSR. Twelve healthy participants (6 males, 6 females) kept a fixed sleep-wake schedule, with a constant waketime, at home for four weeks (activity monitors worn on the participant’s nondominant wrist were used to confirm compliance). Weeks one and three were deemed washout weeks, during which participants maintained a 9-hour sleep-wake schedule. Weeks two and four were deemed experimental weeks, during which participants were randomly assigned a 5-hour (CSR) and 9-hour (sleep satiation) sleep-wake schedule. Following night seven of each experimental week, participants completed a 13-hour laboratory visit under dim light (less than 15 lux) where they maintained a constant posture and were provided with hourly isocaloric snacks. MOT was presented at approximately 6 and 8 hours after waking. Participants were required to track four, five, or six moving targets in the presence of identical distractors (always 12 total objects). It was found that participants slept significantly less during the week of CSR compared to the week of sleep satiation. There was no difference in the overall proportion of correct MOT responses following the CSR and sleep satiation weeks. However, an additional analysis examining only the 6 target condition found that the proportion of correct responses was significantly lower following the week of CSR. These findings suggest that CSR has an adverse impact on tracking performance when the cognitive demand was higher. This has implications for individuals, such as air traffic controllers and truck drivers, who must visually track multiple moving objects under high workload situations, often while chronically sleep deprived.

sleep restriction↗

The Influence of Self-Reported Distractions on the Psychomotor Vigilance Task (PVT) in Laboratory and Field Environments

Introduction: The Psychomotor Vigilance Task (PVT) is a measure of vigilant attention that is commonly used in laboratory environments to assess the neurobehavioral impact of sleep loss and circadian misalignment. The PVT has been increasing in popularity for use in field environments; however, the potential for distraction is higher in the field compared to the lab. It is unclear how distractions experienced by individuals taking the PVT in the real world may influence reaction time metrics. We investigated the influence of self-reported distraction on PVT outcomes across laboratory and field environments. Methods: We examined PVT data from five studies including short (n=36 participants, 3799 PVTs) and long-haul (n=75 participants, 3283 PVTs) airline personnel, control center personnel (n=5 participants, 96 PVTs), and healthy individuals who participated in a study involving at-home and laboratory assessments (n=12 participants, 486 and 310 PVTs). Individuals in all of the studies were asked to complete the five-minute NASA PVT at least three times daily. Participants were asked to indicate the number of distractions they experienced immediately after each PVT. Mean PVT reaction time (RT) and number of distractions were computed for each study and overall. Results: Participants reported more distractions in field environments compared to the lab (short-haul=1.29 +/- 1.48, long-haul=0.66 +/- 1.07, control-center=1.20 +/- 1.37, at-home=0.86 +/- 1.36, laboratory=0.46 +/- 1.07) Across all studies, we found that PVT RT slowed as self-reported distractions increased (all studies combined: 0 distractions=PVT RT 274.4ms; 1=284.6ms; 2=302.9ms; 3=321.2ms; >4=409.3ms). These findings were similar for healthy participants completing PVTs at home (0 distractions=287.1ms; 1=309.9ms; 2=328.3ms; 3=369.8ms; >4=385.1ms) but were less consistent during in-lab assessments (0 distractions=278.7ms; 1=316.2ms; 2=396.2ms; 3=370.4ms; >4=354.4ms). These findings were similar for other PVT outcomes. Conclusion: Participants reported more distractions in field environments compared to the laboratory. Our findings suggest that the number of distractions that individuals report experiencing while taking a PVT increases the reaction time registered by the device. Researchers should collect information about distractions during the PVT and should be aware that distractions may influence the recorded PVT reaction time.

behavior↗

Investigating the Effects of Exposure to Blue-Enriched Light or Peppermint Odor on Alertness, Mood, and Performance Upon Awakening from Deep Sleep at Night

Introduction: Sleep inertia refers the transient neurobehavioral impairments experienced immediately after waking from sleep. This period of reduced alertness and performance poses a significant safety risk to on-call workers who may be required to perform a safety-critical task immediately after waking (e.g., emergency services, health care, and military). In these operations, the need for a rapid return to full alertness is critical to mission safety and success. Several factors may exacerbate sleep inertia, resulting in greater impairment upon waking, including: waking from deep sleep, (i.e., slow wave sleep, SWS), waking at night, and waking following prior sleep loss. Awakenings under these conditions are common for on-call and extended shift workers who may need to perform safety-critical tasks soon after waking from unprotected sleep opportunities. Therefore, there is a need for evidence-based reactive countermeasures (i.e., used upon waking) to the cognitive consequences sleep inertia. Specifically, countermeasures that can rapidly restore alertness and performance immediately following sleep. A recent review of the literature on reactive countermeasures highlighted several research gaps and promising candidates for further investigation. The review also emphasized the need for countermeasures that are operationally viable and readily deployed in occupational settings. This study aims to address the identified gaps and limitations by assessing the efficacy of exposure to two known acute alerting stimuli - blue-enriched light and peppermint odor - to improve cognitive performance, alertness, and mood immediately after waking from SWS at night. Materials and Methods: Twelve participants completed a two-week within-subject, randomized, cross-over intervention study including two in-laboratory overnight visits. During each experimental week, the subjects experienced one intervention (light or peppermint) and a control condition upon awakening from SWS at night. The presentation order of the two conditions (intervention or control) at wake-up and the order of intervention (light or peppermint) by week was randomized by sex. Prior to each in-laboratory visit, participants maintained a sleep schedule of 8.5 h for 5 nights and 5 h for one night. Compliance with this sleep schedule was confirmed by actigraphy. In the laboratory, participants went to bed at their habitual bedtime and were monitored by standard polysomnography. After at least five minutes of continuous SWS, participants were awoken and exposed, in a randomized order, to either the control or intervention condition. During the hour after awakening from SWS (at 2, 17, 32, and 47 minutes after waking), participants completed a battery of tasks including a 5-minute psychomotor vigilance task (PVT), a subjective scale of alertness (Karolinska Sleepiness Scale, KSS), and visual analogue scales (VAS) of mood. Following this sleep inertia measurement period, all lights were turned off and participants were allowed to return to sleep. They were then awoken again from their subsequent SWS period and exposed to the alternative condition (control or intervention). Following this second awakening, participants were allowed to sleep until their habitual wake time and were then released from the laboratory. Participants then followed the at-home sleep schedule and returned to the laboratory for the second intervention (light or peppermint) following the procedures described above. The light intervention involved exposure to a blue-enriched light canvas illuminated for 1 hour at a distance of ~56 cm from the participant (~200 lux and ~60 melanopic lux at angle of gaze). For the peppermint intervention, peppermint oil was pipetted onto a mask, and participants inhaled the odor with the mask covering the nose and mouth for 1 minute. The control condition for both weeks involved a dim, red ambient light (<1 lux). An odorless mask, without any oil pipetted onto the mask, was also worn in the peppermint control condition. Results: Compared to the control condition, participants exposed to blue-enriched light had fewer PVT lapses (χ2 = 5.285, p = .022), reported feeling more alert (KSS: F1,77 = 4.955, p = .029; VASalert: F1,77 = 8.226, p = .005), and had improved mood (VAScheerful: F1,77 = 8.615, p = .004; VASdepressed: F1,77 = 4.649, p = .034; VASlethargic: F1,77 = 5.652, p = .020). Exposure to peppermint oil did not improve any outcome measures on any of the tasks compared to control condition (p > .05). Conclusions: We found that participants had fewer lapses of attention upon awakening when exposed to blue-enriched light compared to dim, red light. In addition, participants reported feeling more alert, more cheerful, less depressed, and less lethargic in the blue-enriched light condition. Brief exposure to a peppermint odor, however, did not appear to improve performance, alertness, or mood under the experimental conditions. Our null results in the peppermint condition may have been due to methodological limitations such as the duration and method of administration. Given the need to mitigate the potential impact of sleep inertia on safety-critical tasks in on-call operations, our findings suggest that blue-enriched light exposure upon awakening may help to improve performance and alertness during the sleep inertia period following awakening from deep, nocturnal sleep. We are currently exploring the potential mechanisms for the effect of light on cognitive performance upon awakening as well as investigating its application in real-world settings to explore the translational efficacy of this countermeasure to occupational environments. Continued exploration into light and other reactive countermeasures, and potentially their combination, is needed in order to provide evidence-based guidance on effective sleep inertia countermeasures to improve the alertness and performance of those required to perform safety-critical tasks soon after waking.

sleep inertia↗

Is "Sleepy Supervision" the New "Drowsy Driving"?

Human error has been implicated as a causal factor in a large proportion of road accidents. Automated driving systems purport to mitigate this risk, but self-driving systems that allow a driver to entirely disengage from the driving task also require the driver to monitor the environment and take control when necessary. Given that sleep loss impairs monitoring performance and there is a high prevalence of sleep deficiency in modern society, we hypothesized that supervising a self-driving vehicle would unmask latent sleepiness compared to manually controlled driving among individuals following their typical sleep schedules. We found that participants felt sleepier, had more involuntary transitions to sleep, had slower reaction times and more attentional failures, and showed substantial modifications in brain synchronization during and following an autonomous drive compared to a manually controlled drive. Our findings suggest that the introduction of partial self-driving capabilities in vehicles has the potential to paradoxically increase accident risk.

sleepiness↗

Can Pre-Flight Subjective Sleepiness Predict the Use of Controlled Rest on the Flight Deck?

Pilot sleepiness in flight continues to be an issue in aviation due to irregular and extended working hours. In some regions of the world, pilots are allowed to use an in-flight countermeasure called controlled rest, which involves taking a short nap on the flight deck. The use of this countermeasure in practice is understudied. We aimed to investigate whether subjective sleepiness ratings taken pre-flight are predictive of controlled rest use.

aviation↗

Investigating the Causes and Consequences of Controlled Rest on the Flight Deck

INTRODUCTION: Long and irregular working hours can lead to fatigue in aviation operations. In some regions, a short nap taken on the flight deck (known as controlled rest) can be used as a countermeasure to unexpected in-flight sleepiness. We aimed to investigate the impact of taking controlled rest on self-reported sleepiness at top-of-descent. METHODS: Data from 120 long-haul (> 6 h flight duration), unaugmented flights were analyzed (n = 31 pilots). Pilots wore actigraphs and completed sleep logs before and during trips. At pre-flight and top-of-descent, pilots completed a Karolinska Sleepiness Scale (KSS). A mixed-effects model was used to assess the impact of controlled rest on KSS at top-of-descent. Sleep duration in the 48 hours prior to departure, timing of the flight (day vs. night), and pre-flight KSS scores were included as covariates. RESULTS: Due to missing data, complete data from 83 flights (n = 29 participants) were available in the analyses of the KSS. There were no differences by controlled rest status for KSS scores at top-of-descent (estimated marginal means ± SEM with controlled rest: 5.10 ± 0.22, without controlled rest: 5.37 ± 0.29; p = .45, η2p = 0.01). DISCUSSION: Our results suggest that there is no difference in self-reported sleepiness at top-of-descent on flights in which controlled rest was taken compared to flights without controlled rest. Further research is necessary to determine the impact of controlled rest on objective measures of performance at top-of-descent.

aviation↗

The Impact of Controlled Rest on Neurobehavioral Outcomes at Top-of-Descent

INTRODUCTION: Long and irregular working hours can lead to fatigue in aviation operations. In some regions, a short nap taken on the flight deck (known as controlled rest) can be used as a countermeasure to unexpected in-flight sleepiness. We aimed to investigate the impact of taking controlled rest on neurobehavioral measures at top-of-descent. METHODS: Data from 120 long-haul (> 6 h flight duration), unaugmented flights were analyzed (n = 31 pilots). Pilots wore actigraphs and completed sleep logs before and during trips. At pre-flight and top-of-descent, pilots completed a 5-minute psychomotor vigilance task (PVT) and Karolinska Sleepiness Scale (KSS). A series of mixed-effects models were conducted to assess the impact of controlled rest on outcome measures at top-of-descent. Sleep duration in the prior 48 hours, timing of the flight, and pre-flight scores for each measure were included as covariates. RESULTS: Due to missing data, complete data from 76 flights (n = 28 participants) were available in the models examining the PVT metrics, and data from 83 flights (n = 29 participants) were available in the analyses of the KSS. Pilots who took controlled rest had faster response speeds at top-of-descent (p = .03, η2p = 0.07; estimated marginal mean [EMM] = 4.19, standard error [SE] = 0.07, 95% CI [4.08, 4.29]) than those who did not take controlled rest (EMM = 4.00, SE = 0.05, 95% CI [3.86, 4.14]). There were no differences by controlled rest status for KSS scores and PVT lapses (p values > .05, η2p values ≤ 0.01). DISCUSSION: Our results suggest that taking controlled rest may improve vigilant attention at critical phases of flight and, thus, may be a useful fatigue management tool during unaugmented flights. Further research is necessary to determine the impact of factors on the decision to take controlled rest (e.g., airline culture, personal preference) and how the controlled rest policy is applied in practice.

aviation↗

The Impact of Controlled Rest on Self-Reported Sleepiness at Top-of-Descent

INTRODUCTION: Long and irregular working hours can lead to fatigue in aviation operations. In some regions, a short nap taken on the flight deck (known as controlled rest) can be used as a countermeasure to unexpected in-flight sleepiness. We aimed to investigate the impact of taking controlled rest on self-reported sleepiness at top-of-descent. METHODS: Data from 120 long-haul (> 6 h flight duration), unaugmented flights were analyzed (n = 31 pilots). Pilots wore actigraphs and completed sleep logs before and during trips. At pre-flight and top-of-descent, pilots completed a Karolinska Sleepiness Scale (KSS). A mixed-effects model was used to assess the impact of controlled rest on KSS at top-of-descent. Sleep duration in the 48 hours prior to departure, timing of the flight (day vs. night), and pre-flight KSS scores were included as covariates. RESULTS: Due to missing data, complete data from 83 flights (n = 29 participants) were available in the analyses of the KSS. There were no differences by controlled rest status for KSS scores at top-of-descent (estimated marginal means ± SEM with controlled rest: 5.10 ± 0.22, without controlled rest: 5.37 ± 0.29; p = .45, η2p = 0.01). DISCUSSION: Our results suggest that there is no difference in self-reported sleepiness at top-of-descent on flights in which controlled rest was taken compared to flights without controlled rest. Further research is necessary to determine the impact of controlled rest on objective measures of performance at top-of-descent.

aviation↗

Cabin Crew Alertness and Performance During Long-Haul Flights

INTRODUCTION: -Sleep loss and circadian disruption pose a significant risk in aviation. -Previous literature has shown that inflight rest facilities influence alertness and performance among pilots, but few studies have evaluated cabin crew. -The aim of this research was to assess alertness and performance among cabin crew members sleeping in different rest locations during a long-haul out-and-back trip. METHODS: -Twenty-nine cabin crewmembers flew the same long-haul route (outbound and inbound). -Participants were randomly assigned to fly on an aircraft with a bunk in both directions or to fly an aircraft with a bunk in one direction and with a high comfort jump seat (HCJS) in the other direction. -Throughout the study they completed a Karolinska Sleepiness Scale (KSS) and a 5-minute Psychomotor Vigilance Task (PVT) at the beginning and at the end of each flight. RESULTS: -A series of mixed-effects models were performed to assess the changes in KSS and PVT when crewmembers slept in the bunk during both directions of flight (bunk-only) compared to when sleep was obtained in the HCJS during one direction and bunk in the other (bunk + HCJS). -There was no significant difference in KSS alertness between the two conditions. - There were no significant differences in PVT response speed or lapses between the two conditions. CONCLUSIONS: -Limitations: small number of participants. Our study stopped abruptly because of the COVID-19 pandemic which limited our sample size. -Further research is needed to understand how other factors such as duty start time and workload might influence the sleep of cabin crewmembers during long-haul flights.

long-haul↗