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Annual International Conference of the... Jul 2022Prolonged sleepiness can lead to impairment of cognitive and physical performance and may cause unfortunate accidents. Speech signals are easily accessible using a...
Prolonged sleepiness can lead to impairment of cognitive and physical performance and may cause unfortunate accidents. Speech signals are easily accessible using a simple microphone or other means, hence, automated approaches for accurate sleepiness detection from speech signals are desired to prevent degradation in human performance and accidental injury. Sleepiness is known to affect acoustic patterns of speech so that they are different from those of normal speech, and this change is also independent of the language being spoken. To date, there have been no studies examining linguistic-independent sleepy speech detection. We used two different languages, English and German, to detect sleepy speech, where the former was used to train/validate and the latter to test the effectiveness of machine and deep learning models. Specifically, we trained ResNet50, a deep learning model, and five machine learning models with relevant vocal features. Speech data segments from three English-speaking subjects were used for training the model and segments from an English-speaking subject were used for validation. We then tested ResNet50 and the five different machine-learning models using speech data segments from one German-speaking subject. Deep learning far outperformed all of the machine learning approaches. The accuracy, sensitivity, specificity, and geometric mean values were found to be 0.96, 0.92, 0.99, and 0.95, respectively, using ResNet50 on the test data. Our preliminary results suggest that sleepiness can be accurately detected independently from linguistic speech. Clinical Relevance-It is not known if sleepiness can be detected regardless of the language spoken. Our results show the feasibility of accurate sleepiness detection using deep learning even when tested with a different language than trained on.
Topics: Acoustics; Humans; Language; Linguistics; Sleepiness; Speech
PubMed: 36085715
DOI: 10.1109/EMBC48229.2022.9870900 -
The Journal of Clinical Psychiatry Oct 2023To determine if there are differences in the number needed to treat (NNT), number needed to harm (NNH), and likelihood to be helped or harmed (LHH) between lemborexant...
Lemborexant and Daridorexant for the Treatment of Insomnia: An Indirect Comparison Using Number Needed to Treat, Number Needed to Harm, and Likelihood to Be Helped or Harmed.
To determine if there are differences in the number needed to treat (NNT), number needed to harm (NNH), and likelihood to be helped or harmed (LHH) between lemborexant and daridorexant and to compare lemborexant with daridorexant indirectly. Dichotomous efficacy and tolerability outcomes reported for Phase 3 daridorexant trials (conducted May 29, 2018-May 14, 2020) for months 1 and 3 were identified from published literature and regulatory documents. Analogous data were extracted for lemborexant from Phase 3 studies (conducted May 31, 2016-January 8, 2019). NNT, NNH, and LHH were then calculated. Lemborexant 5 mg and 10 mg had clinically relevant therapeutic effect sizes, evidenced by most NNT values versus placebo < 10 for Insomnia Severity Index [ISI], subjective total sleep time [sTST], and polysomnography outcomes. NNH values for adverse events (AEs) were > 10, suggesting relative tolerability. Somnolence was the most common AE. Discontinuation rates of lemborexant because of an AE were low, including for somnolence. Efficacy outcomes for daridorexant 25-mg and 50-mg doses pooled resulted in most NNT values versus placebo ≥ 10, with more robust NNT estimates for the 50-mg dose than for the 25-mg dose. Discontinuation rate because of an AE at month 3 was higher for placebo than for daridorexant, rendering favorable LHH calculations. Daridorexant evidenced low rates of somnolence or fatigue. In Phase 3 trials, the benefit-risk ratios for both lemborexant and daridorexant were favorable as measured by NNT, NNH, and LHH. Indirect comparisons of lemborexant with daridorexant suggest an efficacy advantage for lemborexant and a tolerability advantage for daridorexant. NCT02783729, NCT02952820, NCT03545191, NCT03575104.
Topics: Humans; Sleep Initiation and Maintenance Disorders; Sleepiness; Treatment Outcome; Clinical Trials, Phase III as Topic
PubMed: 37796657
DOI: 10.4088/JCP.23m14851 -
European Journal of Sport Science Mar 2021Daytime napping is a common practice in high-performance athletes, and is widely assumed to reflect sleepiness arising from sports-related sleep debt. The possibility...
Daytime napping is a common practice in high-performance athletes, and is widely assumed to reflect sleepiness arising from sports-related sleep debt. The possibility that athlete naps may also be indicative of 'sleepability', a capacity to nap on demand that is only weakly related to homeostatic sleep pressure, has not previously been tested. The present study compared daytime sleep latencies in high-performance athletes and non-athlete controls using a single nap opportunity model. Elite ( = 10), and sub-elite ( = 10) athletes, and non-athlete controls ( = 10) attended the laboratory for a first adaption trial, and a subsequent experimental trial. Subjective sleepiness was assessed using the Karolinska Sleepiness Scale (KSS) at 14:00, 14:30 and immediately prior to a 20-minute nap opportunity at 15:00. Sleep latencies were measured using polysomnography, and defined as the time from lights out to the first epoch of any stage of sleep (N1, N2, N3, REM). In unadjusted comparisons with non-athlete controls, elite athletes showed significantly shorter sleep latencies in both the adaptation ( < 0.05) and experimental trials ( < 0.05). These significant differences were maintained in models controlling for pre-trial KSS scores and pre-trial total sleep time (all < 0.05). Sleep latency scores for sub-elite athletes showed similar trends, but were more labile. These results are consistent with a conclusion that, among elite athletes, napping behaviour can reflect sleepability and may not necessarily result from nocturnal sleep disruption and daytime sleepiness.
Topics: Analysis of Variance; Athletes; Athletic Performance; Female; Humans; Male; Polysomnography; Rest; Sleep; Sleep Latency; Sleepiness; Time Factors; Young Adult
PubMed: 32174283
DOI: 10.1080/17461391.2020.1743765 -
International Journal of Environmental... Jan 2021Scheduled naps in the workplace are an effective countermeasure to drowsiness in safety-sensitive industries. This quasi-experimental study with a one-group, pre- and...
Scheduled naps in the workplace are an effective countermeasure to drowsiness in safety-sensitive industries. This quasi-experimental study with a one-group, pre- and post-test design aimed to examine the effects of scheduled naps on nurses working 12-h shifts. Nurses in two pediatric intensive care units at a tertiary hospital were provided 30-min scheduled nap opportunities during their shifts. A total of 38 nurses completed pre- and post-test work diaries for sleepiness, fatigue, work demands and pace, and quality of nursing care at the end of each shift. The drowsiness of 13 nurses was continuously assessed during their shifts using infrared reflectance oculography. Nurses who reached naps reported improved levels of fatigue on the first night shift and better quality of nursing care the second night and day shifts post-test, while nurses who did not reach naps showed no significant improvements. The oculography successfully assessed drowsiness during 73% and 61% of the pre- and post-test total work hours, respectively. The total cautionary and cautionary or higher levels of drowsiness decreased. Nurse managers should consider scheduled naps in clinical settings to improve nurses' alertness during their shifts.
Topics: Child; Fatigue; Humans; Sleep; Sleep Disorders, Circadian Rhythm; Sleepiness; Wakefulness; Work Schedule Tolerance
PubMed: 33498593
DOI: 10.3390/ijerph18030891 -
American Journal of Orthodontics and... Aug 2023The study aimed to assess (1) the effect of the treatment with cervical headgear on patients' sleep-related attributes and well-being and (2) whether these sleep-related...
INTRODUCTION
The study aimed to assess (1) the effect of the treatment with cervical headgear on patients' sleep-related attributes and well-being and (2) whether these sleep-related parameters (ie, sleep quality and quantity) were associated with patients' compliance during the orthodontic treatment.
METHODS
The study protocol was based on a prospective longitudinal quasi-experimental design. Participants (n = 26; 9 males; mean age, 12.4 ± 1.68 years) were patients in the Postgraduate Orthodontic Clinic, National and Kapodistrian University of Athens. All patients received treatment with a cervical headgear having an embedded TheraMon microsensor. Sleep was assessed by wrist-worn actigraphy for 59 ± 19 days. The Epworth Sleepiness Scale was used to assess average daytime sleepiness, whereas we used the Athens Insomnia Scale for insomnia symptoms. Oral health-related quality of life (OHRQOL) was assessed by the Oral Health Impact Profile (OHIP-14).
RESULTS
Patients slept on average 7.35 ± 0.42 h/d. Compared with the lowest sleep duration recommended for their age group, patients had an average chronic sleep deficit of 1.40 ± 0.49 h/d. Patients wore the headgear 90.9% of the days for 10.40 ± 4.17 h/d. However, only 7 (28%) patients reached or exceeded the wear-time recommendation of 12 h/d. In contrast, 2 (8%) patients wore headgear <5 h/d, 11 (44%) 5-10 h/d, and 12 (48%) patients wore headgear >10 h/d. Aggregated by participants, the median Epworth Sleepiness Scale score during the study was 3.40 (interquartile range [IQR], 4.85; range, 0.2-13.6), the median Athens Insomnia Scale score was 3.00 (IQR, 4.25; range, 0-7), and the median Oral Health Impact Profile score was 1.40 (IQR, 4.17; range, 0.0-20.8). Compared with patients who wore the orthodontic appliance >7.8 h/d, patients who wore it <7.8 h/d had worse average daytime sleepiness (P = 0.050) and worse OHRQOL (P = 0.019).
CONCLUSIONS
Orthodontic treatment with cervical headgear has no substantive negative effect on sleep attributes (quantity and quality), average daytime sleepiness and OHRQOL. However, poor compliance with orthodontic treatment seems to be associated with higher levels of daytime sleepiness.
Topics: Male; Humans; Child; Adolescent; Sleep Initiation and Maintenance Disorders; Prospective Studies; Quality of Life; Sleepiness; Sleep; Disorders of Excessive Somnolence
PubMed: 37002113
DOI: 10.1016/j.ajodo.2022.12.017 -
International Journal of Environmental... Feb 2023Airline cabin crew operate in dynamic work environments that are continuously changing, from unpredictable shift work hours to travelling through multiple time zones.... (Review)
Review
Airline cabin crew operate in dynamic work environments that are continuously changing, from unpredictable shift work hours to travelling through multiple time zones. These likely impact cabin crews' overall health and may affect their performance on safety-related tasks. Research on this population has been limited; therefore, the aim was to summarise the relevant literature regarding fatigue, sleepiness and mental health of cabin crew. This review followed the PRISMA-ScR guidelines and conducted a systematic search utilising five databases. The initial search identified 1223 studies, and through vigorous screening processes, 27 studies were selected for this review. Over half of the selected studies focused on international or long-haul flights, and a large proportion of the sample participants were women. Findings suggested a high prevalence of fatigue and sleepiness as well as unsatisfactory sleep quality with elevated susceptibility to sleep disorders. Factors identified with health outcomes were associated with flight operations (e.g., rosters) and individual differences (e.g., age and coping strategies). Regarding mental health, cabin crews are potentially at a greater risk for depression and anxiety compared to the general public. This review draws attention to the importance of using a standardised approach, such as validated measures for fair and consistent inferences.
Topics: Humans; Female; Male; Sleepiness; Sleep; Wakefulness; Fatigue
PubMed: 36768014
DOI: 10.3390/ijerph20032652 -
Traffic Injury Prevention 2020The National Highway Traffic Safety Administration in the USA estimated that the effects of drowsiness while driving led to approximately 72,000 crashes, 44,000...
The National Highway Traffic Safety Administration in the USA estimated that the effects of drowsiness while driving led to approximately 72,000 crashes, 44,000 injuries, and 800 deaths in 2013. Keeping this in mind, the risk and injuries of drowsy driving remain a major safety issue that clearly needs to be studied. Our purpose was to conduct a systematic review of international literature including studies on driving behavior associated to drowsy and fatigued drivers. The research focused on the prediction and effects of drowsiness, and particularly on studies based on driving in simulated environments. Additionally, we searched for studies related to driving simulators, in general, to better understand the tool's efficacy and its advantages and disadvantages. This review was made in accordance with PRISMA statement guidelines. After conducting in-depth research in targeted databases, 23 studies met the inclusion criteria; the papers were analyzed regarding the type of experiment and procedures and driving performance of 690 participants was studied. Studies revealed that drowsiness have effects on driving performance and these effects become more relevant with time-on-task and in monotonous scenarios and landscapes. In addition, some documents include validations of several technologies to detect and predict sleepiness. Overall, we can conclude that drowsiness and fatigue impair driving performance, resulting in drivers who are more exposed to risky situations.
Topics: Automobile Driving; Computer Simulation; Humans; Sleepiness
PubMed: 31986057
DOI: 10.1080/15389588.2019.1706088 -
Sleep Medicine Reviews Feb 2023Sleepiness involves many dimensions that require investigation. Since sleepiness is often defined operationally, we exhaustively inventoried all the assessment tools... (Review)
Review
Sleepiness involves many dimensions that require investigation. Since sleepiness is often defined operationally, we exhaustively inventoried all the assessment tools designed to measure it in an umbrella review, without any preconceptions, i.e. a review of reviews. We included all reviews and systematic reviews related to sleepiness assessment tools published up to March 2021. Three investigators independently assessed the eligibility of studies for inclusion and identified 36 relevant reviews. In total, 99 tools were identified and classified into 8 categories. We classified them depending on their category, their publication year and the number of mentions in the 36 included reviews. The 6 most frequently cited were the Epworth sleepiness scale, the multiple sleep latency test, the maintenance of wakefulness test, the Stanford sleepiness scale, the Karolinska sleepiness scale, and the psychomotor vigilance task. Despite the limitation that we may have missed some recently developed tools, this historical perspective on sleepiness measurement is a first step toward a better delineation of the different dimensions underlying the constructs of sleepiness, and will serve as a basis for further discussion in the clinical and research sleep community.
Topics: Adult; Humans; Wakefulness; Disorders of Excessive Somnolence; Sleepiness; Sleep; Polysomnography
PubMed: 36455433
DOI: 10.1016/j.smrv.2022.101718 -
Sleep & Breathing = Schlaf & Atmung Mar 2023This article focuses on recent evidence linking rapid eye movement (REM) obstructive sleep apnea (OSA) (REM-OSA) to neurocognitive dysfunction and mood changes; the... (Review)
Review
PURPOSE
This article focuses on recent evidence linking rapid eye movement (REM) obstructive sleep apnea (OSA) (REM-OSA) to neurocognitive dysfunction and mood changes; the proposed mechanisms for increased risk of neurocognitive dysfunction in REM-OSA, and future research prospects.
METHODS
PubMed and Google Scholar records were examined for articles utilizing pre-defined keywords. In this work, we mainly included studies published after 2017; nevertheless, critical studies published prior to 2017 were considered.
RESULTS
REM-OSA is an under-recognized stage-related sleep-disordered breathing in which obstructive respiratory events happen chiefly in stage REM. The disorder is commonly seen amongst younger patients and females and has recently been linked to cardiometabolic complications. Although less symptomatic than non-REM-OSA and non-stage-specific OSA, current findings indicate that REM-OSA may have neurocognitive repercussions and mood changes and could be linked to insomnia, increased dreams, and nightmares.
CONCLUSION
Currently available evidence indicates that REM-OSA may present with insomnia and nightmares and could affect cognitive function and mood.
Topics: Female; Humans; Sleep Initiation and Maintenance Disorders; Sleep, REM; Sleepiness; Sleep Apnea, Obstructive; Sleep Apnea Syndromes
PubMed: 35318576
DOI: 10.1007/s11325-022-02602-5 -
L'Encephale Feb 2023Over the past century a dramatic decline in sleep duration among adolescents, such as more than one hour of sleep loss per night, has been reported. A debt in sleep... (Review)
Review
Over the past century a dramatic decline in sleep duration among adolescents, such as more than one hour of sleep loss per night, has been reported. A debt in sleep duration could lead to sleep deprivation, a major risk factor associated with daytime sleepiness. Sleepiness refers to the inability to maintain an adequate level of alertness during the day which may result in more or less being able to control falling asleep at inappropriate times. This literature review updates on sleepiness regarding its characteristics, etiology and consequences on adolescents. Studies revealed that from 25 % to 78 % of adolescents had reported sleepiness. Its manifestations may include heavy lids, yawns, difficulties to concentrate and emotional irritability. In addition, while it is recommended that adolescents under 18 years-old should sleep from eight to ten hours a night, only 63 % of them actually do so. The etiology of sleep deprivation and sleepiness in this population can be explained by various biological and societal factors. First, the sleep-wake cycle of adolescents shows a biological shift from the beginning of pubertal maturation, described as a perfect storm. It refers to a social jetlag by going to sleep and waking up later and accumulating a sleep debt during weekdays which they try to reimburse during weekends. This phenomenon can be explained by physiological changes such as a slower accumulation of sleep pressure. In addition to this perfect storm, environmental and societal factors contribute to the social jetlag and reduce sleep duration in adolescents. Screen exposure before bedtime can delay sleep and wake onset, which is a risk factor for sleeping debt. Substance use such as caffeine, cigarettes or electronic vaporizer, ADHD or freely available medication, alcohol, cannabis use or drug consumption could further disrupt sleep-wake cycle by stimulating, depressing or otherwise disrupting the central nervous system. Early, before 8:30 am, class start times have been associated with chronic sleep deprivation, higher level of sleepiness and delayed melatonin peak secretion. Adolescents working or doing extracurricular occupations for more than 20hours a week are more at risk for reduced sleep duration and sleepiness. Parental supervision about sleep during the weekdays were associated with more appropriate bedtime. Adolescents from low socio-demographic characteristics and from minority ethnic groups have reported displaying a shorter sleep duration. Finally, sleep disorders of a physiological origin such as narcolepsy, sleep apnea or restless legs syndrome, may explain the sleep deprivation and sleepiness. Sleep deprivation and sleepiness in adolescents have consequences on their health. Cognitive functioning, such as problem solving, attention or memory, as well as school performance, can be compromised by sleep deprivation and sleepiness. At the psychological level, adolescents reporting sleepiness are more prone to display mental health problems: associations were found between sleepiness and subjective perception of depression, anxiety, somatic complaints as well as with antisocial behaviors. Finally, 68 % of 16 year-old adolescents reported they drove a car, and the reported sleepiness could lead to road accidents due to reduced attentional functioning, reaction time and decision-making abilities. In the United-States, from 7 % to 16.5 % of deadly accidents were related to driving while drowsy. Highlighting etiology and problems associated with sleep deprivation and sleepiness in adolescents could guide researchers and clinicians towards the development of possible interventions. Public health measures and knowledge transfer programs regarding modifiable psychosocial and societal factors associated with sleep-wake bioregulation could increase awareness in parents as well as in political and societal decision makers.
Topics: Humans; Adolescent; Sleep Deprivation; Sleepiness; Sleep; Disorders of Excessive Somnolence; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders
PubMed: 35970642
DOI: 10.1016/j.encep.2022.05.004