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All sourcesNASA NTRSDOE OSTI
NASA NTRS1999

Time-on-task decrements in "steer clear" performance of patients with sleep apnea and narcolepsy

Loss of attention with time-on-task reflects the increasing instability of the waking state during performance in experimentally induced sleepiness. To determine whether patients with disorders of excessive sleepiness also displayed time-on-task decrements indicative of wake state instability, visual sustained attention performance on "Steer Clear," a computerized simple RT driving simulation task, was compared among 31 patients with untreated sleep apnea, 16 patients with narcolepsy, and 14 healthy control subjects. Vigilance decrement functions were generated by analyzing the number of collisions in each of six four-minute periods of Steer Clear task performance in a mixed-model analysis of variance and linear regression equations. As expected, patients had more Steer Clear collisions than control subjects (p=0.006). However, the inter-subject variability in errors among the narcoleptic patients was four-fold that of the apnea patients, and 100-fold that of the controls volunteers; the variance in errors among untreated apnea patients was 27-times that of controls. The results of transformed collision data revealed main effects for group (p=0.006), time-on-task (p=0.001), and a significant interaction (p=0.022). Control subjects showed no clear evidence of increasing collision errors with time-on-task (adjusted R2=0.22), while apnea patients showed a trend toward vigilance decrement (adjusted R2=0.42, p=0.097), and narcolepsy patients evidenced a robust linear vigilance decrement (adjusted R2=0.87, p=0.004). The association of disorders of excessive somnolence with escalating time-on-task decrements makes it imperative that when assessment of neurobehavioral performance is conducted in patients, it involves task durations and analyses that will evaluate the underlying vulnerability of potentially sleepy patients to decrements over time in tasks that require sustained attention and timely responses, both of which are key components in safe driving performance.

NASA Discipline Space Human Factors↗
NASA NTRSDate not supplied

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 ps < .003). Significant effects of sex (p = .002) and sex × test bout (p = .01; R2M = .49, R2C = .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↗
NASA NTRS2015

Effects of Nighttime Light Radiance on the Sleep of the General Population

The objectives of this study is to verify if the exposure to greater nighttime radiance is associated with changes in the sleep/wake schedule and with greater sleep disturbances. Methods: The target population was the adults (18 years and older) living in California, USA. This represents 24 million of inhabitants. A total of 3,104 subjects participated in the survey (participation rate 85.6%). The participants were interviewed by telephone using the Sleep-EVAL system. The interviews covered several topics including sleeping habits, sleep quality, sleep disturbances, physical symptoms related to menopause. Chronic insomnia was defined as difficulty initiating or maintaining sleep for at least 3 months. Global nighttime light emissions have been collected by the Defense Meteorological Satellite Program's Operational Linescan System (DMSP/OLS) sensors. We extracted the radiance calibrated nighttime lights corresponding to the date of the interviews for a three by three window centered on each coordinate corresponding to an interview address. Results: Dissatisfaction with sleep quantity and/or quality was associated with an increased nighttime radiance (p=0.02). Similarly, excessive sleepiness accompanied with impaired functioning was significantly associated with an increased nighttime radiance (p (is) less than 0.0001). The association remained significant after controlling for age, gender and use of a night lamp in the bedroom. Confusional arousals were also significantly associated with an increased nighttime radiance (p (is) less than 0.0001). Bedtime hour was linearly increasing with the intensity of nighttime radiance: the later the bedtime, the greater the nighttime radiance (p (is) less than 0.0001). Similarly, wakeup time became progressively later as the nighttime radiance increased (p (is) less than 0.0001). Both associations remained significant after controlling for age, gender and use of a night lamp in the bedroom. Circadian Rhythm Disorders were the only sleep disorder significantly associated with increased nighttime radiance (p (is) less than 0.0001). Exposure to increased nighttime light radiance appeared to cause a shift in the sleep/wake schedule, excessive sleepiness and Circadian Rhythm Disorders.

Excessive Sleepiness↗
NASA NTRS2020

Mitigating fatigue on the flight deck: how is controlled rest used in practice?

Controlled Rest (CR) refers to a short, voluntary nap opportunity taken by pilots on the flight deck as a countermeasure to unanticipated sleepiness in flight. This study explores the profile of CR use in a long-haul commercial airline. Forty-four pilots wore actiwatches and filled in an application-based sleep/work diary for approximately 2 weeks resulting in complete records from 239 flights. Timing of sleep periods and flight schedules were analyzed relative to home-base time. Pearson correlations were used to assess the influence of pilot demographics on CR use. A mixed-effects logistic regression was used to analyze the impact of schedule factors on CR. CR was taken on 46% (n=110) of flights, with 80% (n=106/133) of all CR attempts estimated by actigraphy to have successfully achieved sleep. Average sleep duration during successful rest periods was estimated as 31.7 ± 12.2 minutes. CR was more frequent on return (60%, n=71) vs. outbound flights (33%, n=39); 2-pilot (69%, n=83) vs. >2-pilot flights (23%, n=27); <10h (63%, n=80) vs. >10h duration flights (27%, n=30); and night (55%, n=76) vs. day flights (34%, n=34) (all p≤0.001). There was no significant difference for direction of travel (eastbound: 51%, n= 57; westbound: 40%, n= 44; p=0.059). Of note, 22% (n=26) of augmented flights contained both CR and bunk rest. Data from this airline show that CR is most commonly used as a countermeasure to sleepiness on flights <10h duration (2-pilot crews) and home-base nighttime flights. Future studies are required to determine the generalizability of these results to other airlines.

sleepiness↗
NASA NTRS1972

Sleep mechanisms: Sleep deprivation and detection of changing levels of consciousness

An attempt was made to obtain information relevant to assessing the need to sleep and make up for lost sleep. Physiological and behavioral parameters were used as measuring parameters. Sleep deprivation in a restricted environment, derivation of data relevant to determining sleepiness from EEG, and the development of the Sanford Sleepiness Scale were discussed.

Dement, W. C.↗
NASA NTRS1986

Is the Cameron River greenstone belt allochthonous?

Many tectonic models for the Slave Province, N.W.T., Canada, and for Archean granite - greenstone terranes in general, are implicitly dependent on the assumption that greenstone belt lithologies rest unconformably upon older gneissic basement. Other models require originally large separations between gneissic terranes and greenstone belts. A key question relating to the tectonics of greenstone belts is therefore the original spatial relationship between the volcanic assemblages and presumed-basement gneisses, and how this relationship has been modified by subsequent deformation. What remains unclear in these examples is the significance of the so-called later faulting of the greenstone - gneiss contacts. Where unconformities between gneisses and overlying sediments are indisputable, such as at Point Lake, the significance of faults which occur below the base of the volcanic succession also needs to be evaluated. As part of an on-going investigation aimed at answering these and other questions, the extremely well-exposed Cameron River Greenstone Belt and the Sleepy Dragon Metamorphic Complex in the vicinity of Webb Lake and Sleepy Dragon Lake was mapped.

Kusky, T. M.↗
NASA NTRS1989

Effectiveness of Circadian countermeasures in simulated transmeridian flight schedules

The symptoms of jet-lag commonly afflict travelers who cross time zones. Insomnia during the new night, daytime fatigue, malaise, sleepiness, and gastrointestinal disturbances can occur for as long as 3 weeks after jet travel across even a few time zones. These symptoms are largely due to the slow rate of adjustment of the internal circadian timing system to the new time zone. Since business (or pleasure) can be seriously interrupted by such symptoms, it is important to determine ways to speed up the adjustment process to ameliorate the symptoms. Airline pilots have reported that they frequently nap to counter jet lag symptoms, and that they view this as a useful technique. Napping as a countermeasure would be attractive since it is practical and would take advantage of a naturally occurring phase of sleepiness after lunch. Napping also makes sense since insomnia is a common jet lag symptom. Thus, a laboratory simulation of jet lag was designed to test the ability of napping to increase the rate of adjustment following a time zone shift in a population of middle-aged men.

Moline, Margaret L.↗
NASA NTRS1997

Individual Differences in Response to Sleep Deprivation: Assessment of Fatigue Following Sleep Loss

Previous work has indicated that a small but significant number of participants in sleep deprivation studies or in simulated shift work experiments manifests an exaggerated performance decrement when they reach a critical point in the experiment, usually near the trough of the circadian cycle or the middle of the night. Those who show this exaggerated response do not appear to differ from other non-nal volunteers in any substantial way according to usual screening criteria or baseline values. The present study aims to examine factors that may provide the basis for this extreme response. We propose that a preexisting sleep deficit-as manifested by low values on the Multiple Sleep Latency Test (MSLT)-may account for extreme responders. Roth and colleagues (1993) have shown that among normal volunteers screened for a variety of studies, approximately 20 to 25 percent show low (< 6 minutes) MSLT scores on a consistent basis, whereas a like proportion shows consistently high MSLT scores (> 13 minutes). Additionally, studies by this group have indicated that subjects with low MSLT scores may suffer from chronic insufficient sleep (Roth et al., 1993), as further substantiated by the finding that they have consistently higher nocturnal sleep efficiency and that their MSLT scores rise to normal values when sleep is extended (Roehrs et al., 1996). We hypothesize that the short MSLT subjects have a significant long-term sleep deficit that leads to a marked intolerance for sleep deprivation or shift work. We further suggest that this sleep debt may signify an increased sleep need in these individuals that is not met either due to personal preference or to societal pressures (or both). If this speculation is accurate, then we predict that the tolerance for sleep deprivation in such individuals can be increased by "pretreatment" with sleep extension. Thus, the present study is designed to test the following two hypotheses: subjects with nominal sleep patterns who have low MSLT scores (e.g., Sleepy subjects) will show an exaggerated response (performance decrement) to sleep loss compared to subjects who have high MSLT scores (Alert subjects) on a nominal sleep schedule. when permitted to extend sleep-thus discharging their sleep debt-the Sleepy subjects will show a sleep-loss response resembling that of the Alert subjects.

Carskadon, Mary A.↗
NASA NTRS1997

Individual Differences in Response to Sleep Deprivation: Assessment of Fatigue Following Sleep Loss

Previous work has indicated that a small but significant number of participants in sleep deprivation studies or in simulated shift work experiments manifests an exaggerated performance decrement when they reach a critical point in the experiment, usually near the trough of the circadian cycle or the middle of the night. Those who show this exaggerated response do not appear to differ from other non-nal volunteers in any substantial way according to usual screening criteria or baseline values. The present study aims to examine factors that may provide the basis for this extreme response. We propose that a preexisting sleep deficit-as manifested by low values on the Multiple Sleep Latency Test (MSLT)-may account for extreme responders. It has been shown that among normal volunteers screened for a variety of studies, approximately 20 to 25 percent show low (< 6 minutes) MSLT scores on a consistent basis, whereas a like proportion shows consistently high MSLT scores (> 13 minutes). Additionally, studies by this group have indicated that subjects with low MSLT scores may suffer from chronic insufficient sleep, as further substantiated by the finding that they have consistently higher nocturnal sleep efficiency and that their MSLT scores rise to normal values when sleep is extended. We hypothesize that the short MSLT subjects have a significant long-term sleep deficit that leads to a marked intolerance for sleep deprivation or shift work. We further suggest that this sleep debt may signify an increased sleep need in these individuals that is not met either due to personal preference or to societal pressures (or both). If this speculation is accurate, then we predict that the tolerance for sleep deprivation in such individuals can be increased by "pretreatment" with sleep extension. Thus, the present study is designed to test the following two hypotheses: (1) subjects with nominal sleep patterns who have low MSLT scores (e.g., Sleepy subjects) will show an exaggerated response (performance decrement) to sleep loss compared to subjects who have high MSLT scores (Alert subjects) on a nominal sleep schedule; (2) when permitted to extend sleep--thus discharging their sleep debt-the Sleepy subjects will show a sleep-loss response resembling that of the Alert subjects.

Carskadon, Mary A.↗
NASA NTRS1997

Individual Differences in Response to Sleep Deprivation: Assessment of Fatigue Following Sleep Loss

Previous work has indicated that a small but significant number of participants in sleep deprivation studies or in simulated shift work experiments manifests an exaggerated performance decrement when they reach a critical point in the experiment, usually near the trough of the circadian cycle or the middle of the night. Those who show this exaggerated response do not appear to differ from other normal volunteers in any substantial way according to usual screening criteria or baseline values. The present study aims to examine factors that may provide the basis for this extreme response. We propose that a preexisting sleep deficit-as manifested by low values on the Multiple Sleep Latency Test (MSLT)-may account for extreme responders. Roth and colleagues (1993) have shown that among normal volunteers screened for a variety of studies, approximately 20 to 25 percent show low (< or = 6 minutes) MSLT scores on a consistent basis, whereas a like proportion shows consistently high MSLT scores (> or = 13 minutes). Additionally, studies by this group have indicated that subjects with low MSLT scores may suffer from chronic insufficient sleep (Roth et al., 1993), as further substantiated by the finding that they have consistently higher nocturnal sleep efficiency and that their MSLT scores rise to normal values when sleep is extended (Roehrs et al., 1996). We hypothesize that the short MSLT subjects have a significant long-term sleep deficit that leads to a marked intolerance for sleep deprivation or shift work. We further suggest that this sleep debt may signify an increased sleep need in these individuals that is not met either due to personal preference or to societal pressures (or both). If this speculation is accurate, then we predict that the tolerance for sleep deprivation in such individuals can be increased by "pretreatment" with sleep extension. Thus, the present study is designed to test the following two hypotheses: subjects with nominal sleep patterns who have low MSLT scores (e.g., Sleepy subjects) will show an exaggerated response (performance decrement) to sleep loss compared to subjects who have high MSLT scores (Alert subjects) on a nominal sleep schedule. When permitted to extend sleep-thus discharging their sleep debt-the Sleepy subjects will show a sleep-loss response resembling that of the Alert subjects.

Carskadon, Mary A.↗
NASA NTRS1994

Alertness Management In Flight Operations: A NASA Education and Training Module

Since 1980, the NASA Ames Fatigue Countermeasures Program has been conducting research on sleep, circadian rhythms, and fatigue in a variety of flight operations 1. An original goal of the program was to return the scientific and operational knowledge to the aviation industry. To meet this goal, the NASA Ames Fatigue Countermeasures Program has created an Education and Training Module entitled, "Strategies for Alertness Management in Flight Operations." The Module was designed to meet three objectives: 1) explain the current state of knowledge about the physiological mechanisms underlying fatigue, 2) demonstrate how this knowledge can be applied to improve flight crew sleep, performance, and alertness, and 3) offer countermeasure recommendations. The Module is composed of two components: 1) a 60-minute live presentation provided by a knowledgeable individual and 2) a NASA/FAA Technical Memorandum (TM) that contains the presentation materials and appendices with complementary information. The TM is provided to all individuals attending the live presentation. The Module content is divided into three parts: 1) basic information on sleep, sleepiness, circadian rhythms, fatigue, and how flight operations affect these physiological factors, 2) common misconceptions about sleep, sleepiness, and fatigue, and 3) alertness management strategies. The Module is intended for pilots, management personnel, schedulers, flight attendants, and the many other individuals involved in the aviation system.

Rosekind, Mark R.↗
NASA NTRS1997

Sleep and Rest Requirements: Physiological Considerations

Sleep is a vital physiological need which must be met to insure optimal functioning. A single night of significantly shortened sleep negatively impacts performance, alertness, and mood. Restricted sleep studies have shown that even a relatively small amount of sleep loss over several consecutive days can be additive and result in a cumulative sleep debt with similar detrimental effects. Compounding the problem of sleep loss in the operational environment is the poor correlation between subjective reports of sleepiness and objective measures of physiological sleep need. Some of the factors determining how sleepy an individual is at a given point in time are: (1) individual characteristics (e.g., amount of prior sleep and wakefulness, circadian phase, age), (2) environmental conditions (e.g., noise, temperature, amount of social interaction), and (3) task variables (e.g., signal rate, workload). Although sleep need can be masked with medications, the only way to reduce it is with sleep itself. The timing of the sleep period can affect sleep duration and quality and thus its restorative strength. The data are clear that increasing sleep time results in improved alertness. This paper will briefly review the scientific findings on sleep need, the effects of sleep loss, napping strategies, and the implications of incorporating physiologically sound sleep and rest strategies into the operational aviation environment.

Neri, David F.↗
NASA NTRS2003

The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation

OBJECTIVES: To inform the debate over whether human sleep can be chronically reduced without consequences, we conducted a dose-response chronic sleep restriction experiment in which waking neurobehavioral and sleep physiological functions were monitored and compared to those for total sleep deprivation. DESIGN: The chronic sleep restriction experiment involved randomization to one of three sleep doses (4 h, 6 h, or 8 h time in bed per night), which were maintained for 14 consecutive days. The total sleep deprivation experiment involved 3 nights without sleep (0 h time in bed). Each study also involved 3 baseline (pre-deprivation) days and 3 recovery days. SETTING: Both experiments were conducted under standardized laboratory conditions with continuous behavioral, physiological and medical monitoring. PARTICIPANTS: A total of n = 48 healthy adults (ages 21-38) participated in the experiments. INTERVENTIONS: Noctumal sleep periods were restricted to 8 h, 6 h or 4 h per day for 14 days, or to 0 h for 3 days. All other sleep was prohibited. RESULTS: Chronic restriction of sleep periods to 4 h or 6 h per night over 14 consecutive days resulted in significant cumulative, dose-dependent deficits in cognitive performance on all tasks. Subjective sleepiness ratings showed an acute response to sleep restriction but only small further increases on subsequent days, and did not significantly differentiate the 6 h and 4 h conditions. Polysomnographic variables and delta power in the non-REM sleep EEG-a putative marker of sleep homeostasis--displayed an acute response to sleep restriction with negligible further changes across the 14 restricted nights. Comparison of chronic sleep restriction to total sleep deprivation showed that the latter resulted in disproportionately large waking neurobehavioral and sleep delta power responses relative to how much sleep was lost. A statistical model revealed that, regardless of the mode of sleep deprivation, lapses in behavioral alertness were near-linearly related to the cumulative duration of wakefulness in excess of 15.84 h (s.e. 0.73 h). CONCLUSIONS: Since chronic restriction of sleep to 6 h or less per night produced cognitive performance deficits equivalent to up to 2 nights of total sleep deprivation, it appears that even relatively moderate sleep restriction can seriously impair waking neurobehavioral functions in healthy adults. Sleepiness ratings suggest that subjects were largely unaware of these increasing cognitive deficits, which may explain why the impact of chronic sleep restriction on waking cognitive functions is often assumed to be benign. Physiological sleep responses to chronic restriction did not mirror waking neurobehavioral responses, but cumulative wakefulness in excess of a 15.84 h predicted performance lapses across all four experimental conditions. This suggests that sleep debt is perhaps best understood as resulting in additional wakefulness that has a neurobiological "cost" which accumulates over time.

NASA Discipline Regulatory Physiology↗
NASA NTRS1989

Impaired driving performance in shiftworkers: the role of the circadian system in a multifactorial model

A substantial and growing percentage of the U.S. work force now works on a rotating shift schedule. The repeated changes in sleep-wake, meal and work times inherent in such schedules conflict with the dictates of the internal biological clock and have adverse consequences for the health of the shiftworker population. An important consequence of this conflict is impaired performance, both on and off the job, as indexed by the increased incidence of motor vehicle accidents in shift workers. In this paper we report the results of a survey administered to rotating shift and straight day workers at a manufacturing plant in the eastern U.S. This survey documents an increased incidence of motor vehicle accidents or "near misses" in which sleepiness was implicated as a cause by the respondent. Complaints of poor sleep and increased sleepiness were also significantly more common in shiftworkers than day workers. Last, shiftworkers reported higher caffeine and alcohol consumption, and were more likely to use alcohol as a sleep aid. Although causal links cannot be established using these associative observations alone, previously reported experience with alteration of shift schedules, improvement of levels of alertness, and reduction in adverse performance outcomes corroborate the possibility of a causal link and suggest potential interventions.

NASA Discipline Regulatory Physiology↗
NASA NTRS2019

Schedule Factors Associated with the Use of Controlled Rest in a Long-Haul Airline

Controlled Rest (CR) refers to a short, voluntary nap opportunity taken by pilots on the flight deck as a countermeasure to unanticipated sleepiness in flight. This study explores the profile of CR use in a long-haul commercial airline. Forty-four pilots wore actiwatches and filled in an application-based sleep/work diary for approximately 2 weeks. After merging sleep diary, actigraphy, and schedule data, complete records were analyzed from 240 flights. Sleep was estimated during CR intervals using the Philips Actiware 6.0.9 (Bend, OR) software with wake threshold set to medium. Timing of sleep periods and flight schedules were analyzed relative to home-base time. A mixed-effects binary logistics regression was used to analyze the impact of schedule factors on CR. Preliminary analyses revealed that CR was taken on 45% (n=107) of flights. Average sleep duration within these rest periods was estimated as 24.8 ± 16.1 minutes. CR was more frequent on return flights (arriving at home-base; 58%, n=69) vs. outbound flights (departing from home-base, 31%, n=38; p<0.001). There was no difference for direction of travel (eastbound: 49%, n= 56; westbound: 40%, n= 44; northbound/southbound: 50%, n=7; p=0.272). CR was more frequent on 2-pilot flights (62%, n=81) compared to augmented crew flights (24%, n=26; p<0.001). Of note, 21% (n=23) of augmented flights contained both CR and Bunk Rest. CR was more frequent on flights <10h duration (<10h: 59%, n=78; >10h: 27%, n=29; p<0.001). Flights departing between 12:00h-19:59h (25%, n=23; p<0.026) had the lowest frequency of CR. Data from this airline show that CR is most commonly used as a countermeasure to sleepiness on return, unaugmented, <10h duration, and nighttime flights. The direction of travel did not influence the use of CR. Future studies are required to determine generalizability of these results to other airlines.

Hilditch, Cassie↗
NASA NTRSDate not supplied

Rise and Shine: Using Light as a Countermeasure to Sleep Inertia

INTRODUCTION: Sleep inertia describes the phenomenon of sleepiness and poor performance experienced after waking from sleep. This period of impaired alertness and performance is of significant concern to workers who nap on shift, or work on-call and are required to perform safety-critical tasks soon after waking (e.g., emergency services, healthcare, military). Light has been shown to acutely improve alertness during sleep deprivation and circadian misalignment. In this study, we assessed the efficacy of blue-enriched light to improve alertness and mood immediately after waking from SWS, i.e., during the sleep inertia period. METHODS: Twelve participants kept a sleep schedule of 8.5 h for 5 nights and 5 h for one night prior to the overnight laboratory visit (confirmed by actigraphy). Participants went to bed at their scheduled habitual bedtime in the laboratory and were monitored by standard polysomnography. After at least 5 min of SWS, participants were awoken and exposed to either red ambient light (control) or blue-enriched light (light) for 1 h. During this time, participants completed a subjective scale of alertness (Karolinska Sleepiness Scale, KSS) and visual analogue scales (VAS) of mood at 2 min, 17 min, 32 min, and 47 min after waking. 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 opposite condition (control or light). A linear mixed-effects model with fixed effects of condition, time, and condition*time and a random effect of participant was used to determine the impact of light across the testing period. An average of baseline responses (pre-sleep) was included as a covariate. RESULTS: Compared to the control condition, participants exposed to blue-enriched light reported feeling more alert (KSS: F1,77=4.955, p=.029; VASalert: F1,77=8.226, p=.005), more cheerful (VAScheerful: F1,77=8.615, p=.004), less depressed (VASdepressed: F1,77=4.649, p=.034), and less lethargic (VASlethargic: F1,77=5.652, p=.020). DISCUSSION: Exposure to blue-enriched light immediately after waking from SWS may help to improve subjective alertness and mood. Future analyses will explore whether these findings extend to effects on cognitive performance. This countermeasure to sleep inertia may be suitable for implementation to alert crew members during mid-sleep emergencies but requires further testing in field settings.

alertness↗
NASA NTRSDate not supplied

An At-Home Evaluation of a Light Intervention to Mitigate Sleep Inertia Symptoms

Introduction: Sleep inertia symptoms typically occur after waking from nocturnal sleep. Under laboratory settings, light exposure upon waking has been shown to improve alertness, mood, and vigilant attention. We investigated whether a field-deployable light-emitting device would help to improve alertness and working memory in a real-world setting. Methods: Thirty-five participants (18 female; 26.4 ± 6.0 y) completed an at-home, within-subject, randomized crossover study. Participants wore actiwatches during their normal sleep-wake schedule for five nights ahead of the adaptation and experimental nights. On the experimental night, participants performed baseline testing before their self-selected bedtime. Forty-five minutes after bedtime, participants received a phone call and were instructed to perform test bouts while wearing light-emitting glasses with the light either on (light condition) or off (control). A 3-minute descending subtraction task (DST) and the Karolinska Sleepiness Scale (KSS) were performed at +7, +17, +27, and +37 minutes after the call. Participants were then instructed to go back to sleep and were called 45 minutes after lights out to repeat the test bouts in the opposite condition. A series of mixed-effects models were performed with fixed effects of condition, test bout, and their interaction, and a random effect of participant. Condition order, sex, and baseline were included as covariates. Results: There was a significant effect of test bout for DST total responses (χ2 [3] = 17.42; p < .001) and total correct (χ2 [3] = 21.29; p < .001) with improved performance at +27 and +37 minutes compared to +7 minutes. Sex was a significant predictor for KSS (F1,30 = 10.26; p = .003), with females (8.20 ± 0.23) rating higher sleepiness than males (7.10 ± 0.25). There were no other significant effects for DST or KSS outcomes (p > .05). Conclusion: These results suggest that the intervention was not able to improve working memory or alertness under naturalistic at-home settings. Further analysis is needed to determine whether these results are applicable to other cognitive performance domains.

light↗
NASA NTRSDate not supplied

Light as a Reactive Countermeasure to Sleep Inertia: Translating Laboratory Findings to the Field

Sleep inertia describes the brief period of impaired alertness, mood, and cognitive performance experienced after waking. Under laboratory settings, light exposure upon waking during a habitual sleep period has been shown to improve sleep inertia symptoms. We investigated whether a field-deployable light-emitting device would help to mitigate sleep inertia in a real-world setting. Thirty-six participants (18 female; 26.6 years ± 6.1) completed an at-home, within-subject, randomized crossover study. Participants followed their habitual sleep-wake schedule for five nights before an adaptation and experimental night. Forty-five minutes after bedtime on the experimental night, participants received a phone call and were instructed to wear light-emitting glasses with the light either on (light condition) or off (control). A 5-minute psychomotor vigilance task (PVT), the Karolinska Sleepiness Scale (KSS), visual analog scales of mood (VASmood), and a 3-minute descending subtraction task (DST) were performed starting at +2, +12, +22, and +32 minutes after the call. Participants then went back to sleep and were called 45 minutes after lights out for the opposite condition. A series of mixed-effects models were performed with fixed effects of test bout, condition, test bout × condition, and a random effect of participant. Covariates included pre-sleep baseline scores, randomization order, sex, and sleep history. Participants rated themselves as more alert and energetic in the light condition compared to the control condition (VASalert-sleepy p = .01; VASlethargic-energetic p = .001). There was no effect of condition for DST outcomes, but there was a significant improvement in DST total responses in the light condition in a subset of participants waking from N3 (p = .03). There was a significant effect of condition for PVT outcomes, with faster responses (p < .001) and fewer lapses (p < .001) in the control condition. Our results under naturalistic at-home settings suggest that, similar to the in-laboratory study findings, the light intervention improved subjective alertness and mood, while working memory improved after waking from N3. Future studies of light interventions should include measures of visual acuity and comfort to assess the full feasibility and efficacy of interventions in real-world environments.

sleep inertia↗