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Biological Psychology Oct 2020Two independent lines of evidence suggest that drowsiness and mind-wandering share common neurocognitive processes indexed by ocular parameters (e.g., eyeblink frequency...
Two independent lines of evidence suggest that drowsiness and mind-wandering share common neurocognitive processes indexed by ocular parameters (e.g., eyeblink frequency and pupil dynamics). Mind-wandering and drowsiness frequently co-occur, however, such that it remains unclear whether observed oculometric variations are related to mind-wandering, drowsiness, or a mix of both. To address this issue, we assessed fluctuations in mind-wandering and sleepiness during a sustained attention task while ocular parameters were recorded. Results showed that oculometric variations during mind-wandering were fully explained by increased sleepiness. However, mind-wandering and sleepiness had additive deleterious effects on performance that were not fully explained by ocular parameters. These findings suggest that oculometric variations during task performance reflect increased drowsiness rather than processes specifically involved in mind-wandering, and that the neurocognitive processes indexed by oculometric parameters (e.g., regulatory processes of the locus coeruleus norepinephrine system) do not fully explain how mind-wandering and sleepiness cause attentional lapses.
Topics: Attention; Humans; Pupil; Sleepiness; Task Performance and Analysis
PubMed: 32871227
DOI: 10.1016/j.biopsycho.2020.107950 -
Sleep Medicine Dec 2022To examine the association between ethnicity and 90-day post-stroke subjective sleepiness, an important determinant of quality of life, as measured by the Epworth...
OBJECTIVE/BACKGROUND
To examine the association between ethnicity and 90-day post-stroke subjective sleepiness, an important determinant of quality of life, as measured by the Epworth Sleepiness Scale (ESS), among ischemic stroke survivors.
PATIENTS/METHODS
Mexican American (MA) and non-Hispanic white (NHW) recent ischemic stroke patients were identified from the population-based Brain Attack Surveillance in Corpus Christi Project (2010-2016). Subjects completed a baseline interview and 90-day outcome assessment that included the ESS. Excessive daytime sleepiness was defined as an ESS >10. Tobit regression models were used to assess associations between ethnicity and ESS unadjusted and adjusted for multiple potential confounders.
RESULTS
Among 1,181 (62.5% MA) subjects, mean ESS at 90 days was 8.9 (SD 6.0) among MA and 7.4 (SD 4.9) among NHW subjects: 1.45 (95% CI: 0.75, 2.15) points higher among MA than NHW subjects. After adjustment, mean ESS at 90 days was 1.16 (95% CI: 0.38, 1.94) points higher among MAs than NHWs. The prevalence of excessive daytime sleepiness was 39% among MA and 30% among NHW subjects (p = 0.0013).
CONCLUSIONS
Ninety days after stroke, sleepiness is worse in MAs compared to NHWs, even after accounting for potential confounding variables. Further studies should address ways to reduce this disparity.
Topics: Humans; Ischemic Stroke; Sleepiness; Quality of Life; Risk Factors; Stroke; Disorders of Excessive Somnolence
PubMed: 36115141
DOI: 10.1016/j.sleep.2022.08.017 -
International Journal of Environmental... Dec 2021Since seafarers are known to be exposed to numerous job-related stress factors that can cause fatigue, sleepiness, and disturbed sleep behaviour, the aim of this review... (Review)
Review
Since seafarers are known to be exposed to numerous job-related stress factors that can cause fatigue, sleepiness, and disturbed sleep behaviour, the aim of this review was to provide an overview of the subjective and objective measurement methods of these strains. Using a systematic review, 166 studies were identified within the period of January 2010 to December 2020 using the PubMed database. Of the 21 studies selected, 13 used both subjective and objective measurement methods. Six studies used only subjective and two studies only objective methods. For subjective assessment, 12 different questionnaires could be identified as well as activity and sleeping logs. Actigraphy and reaction time tests (RTT) were the most common objective methods. In single cases, electrooculography (EOG), pupillometry and ambulatory polysomnography (PSG) were used. Measurement-related limitations due to vessel-related impacts were less often reported than expected. No restrictions of daily routines on board were described, and only single-measurement disturbances due to ship movements were mentioned. The present literature review reveals that there are various routines to measure fatigue, sleepiness, and sleep behaviour on board. A combination of subjective and objective methods often appears to be beneficial. The frequent use of actigraphy and RTT on board suggests good feasibility and reliable measurements with these methods. The use of ambulatory PSG in maritime-like contexts suggests that this method would also be feasible on board.
Topics: Fatigue; Humans; Ships; Sleep; Sleepiness; Surveys and Questionnaires; Wakefulness
PubMed: 35010383
DOI: 10.3390/ijerph19010120 -
Journal of Clinical Sleep Medicine :... Oct 2022Obstructive sleep apnea (OSA) is a common, identifiable, and treatable disorder with serious health, safety, and financial implications-including sleepiness- related...
UNLABELLED
Obstructive sleep apnea (OSA) is a common, identifiable, and treatable disorder with serious health, safety, and financial implications-including sleepiness- related crashes and incidents-in workers who perform safety-sensitive functions in the transportation industry. Up to one-third of crashes of large trucks are attributable to sleepiness, and large truck crashes result in more than 4,000 deaths annually. For each occupant of a truck who is killed, 6 to 7 occupants of other vehicles are killed. Treatment of OSA is cost-effective, lowers crash rates, and improves health and well-being. A large body of scientific evidence and expert consensus supports the identification and treatment of OSA in transportation operators. An Advanced Notice of Proposed Rulemaking regarding the diagnosis and treatment of OSA in commercial truck and rail operators was issued by the Federal Motor Carrier Safety Administration and Federal Railroad Administration, but it was later withdrawn. This reversal of the agencies' position has caused confusion among some, who have questioned whether efforts to identify and treat the disorder are warranted. In response, we urge key stakeholders, including employers, operators, legislators, payers, clinicians, and patients, to engage in a collaborative, patient-centered approach to address the disorder. At a minimum, stakeholders should follow the guidelines issued by a medical review board commissioned by the Federal Motor Carrier Safety Administration in 2016 alone, or in combination with the 2006 criteria, "Sleep Apnea and Commercial Motor Vehicle Operators," a Statement from the Joint Task Force of the American College of Chest Physicians, the American College of Occupational and Environmental Medicine, and the National Sleep Foundation developed by a joint task force. As research in this area continues to evolve, waiting is no longer an option, and the current standard of care demands action to mitigate the burden of serious health and safety risks due to this common, treatable disorder.
CITATION
Das AM, Chang JL, Berneking M, Hartenbaum NP, Rosekind M, Gurubhagavatula I. Obstructive sleep apnea screening, diagnosis, and treatment in the transportation industry. 2022;18(10):2471-2479.
Topics: Accidents, Traffic; Automobile Driving; Humans; Risk Factors; Sleep Apnea, Obstructive; Sleepiness
PubMed: 34546916
DOI: 10.5664/jcsm.9672 -
Inflammopharmacology Apr 2023COVID-19 is often associated with long-lasting pulmonary symptoms. Data are scarce about interstitial lung disease (ILD) in patients following COVID-19 hospitalization... (Review)
Review
COVID-19 is often associated with long-lasting pulmonary symptoms. Data are scarce about interstitial lung disease (ILD) in patients following COVID-19 hospitalization with persistent symptoms. We retrospectively reviewed all cases sent to pulmonary post-COVID evaluation due to persistent symptoms between February 2021 and February 2022 (N = 318). All patients with suspected ILD (N = 44) were reviewed at the multidisciplinary discussion. Patient characteristics, symptoms, time since hospitalization, detailed lung function measurements and 6-min walk test (6MWT) were evaluated. The post-COVID ILD suspected group included more men (68.2 vs. 31.8%) with significantly older age compared to the control group (64.0 ± 12.3 vs. 51.3 ± 14.9 years). Most patient needed hospital care for COVID-19 pneumonia (68.6% of all patients and 84.1% of ILD suspected group) and average time since hospitalization was 2.4 ± 2.3 months. Persisting symptoms included fatigue (34%), dyspnoea (25.2%), cough (22.6%), and sleep disorders (insomnia 13.2%; sleepiness 8.2%). Post-COVID ILD presented more often with new symptoms of cough and sleepiness. Functional impairment, especially decreased walking distance and desaturation during 6-min walk test (6MWT) were detected in the ILD-suspected group. Respiratory function test in the post-COVID ILD group showed slight restrictive ventilatory pattern (FVC: 76.7 ± 18.1%, FEV1: 83.5 ± 19.1%, TLC: 85.6 ± 28.1%) and desaturation during 6MWT were detected in 41% of patients. LDCT changes were mainly ground glass opacities (GGO) and/or reticular abnormalities in most cases affecting < 10% of the lungs. Our data indicate that suspected post-COVID ILD is affecting 13.8% of symptomatic patients. High resolution chest CT changes were mainly low extent GGO/reticulation, while long-term lung structural changes need further evaluation.
Topics: Male; Humans; Cough; Retrospective Studies; Sleepiness; COVID-19; Lung Diseases, Interstitial; Lung
PubMed: 36961666
DOI: 10.1007/s10787-023-01191-3 -
BMC Public Health Aug 2023Insomnia disorder is a highly prevalent, significant public health concern associated with substantial and growing health burden. There are limited real-world data...
BACKGROUND
Insomnia disorder is a highly prevalent, significant public health concern associated with substantial and growing health burden. There are limited real-world data assessing the burden of insomnia disorder on daytime functioning and its association with comorbidities. The objective of this study was to leverage large-scale, real-world data to assess the burden of untreated insomnia disorder in terms of daytime impairment and clinical outcomes.
METHODS
This United States medical claims database study compares patients diagnosed with insomnia disorder but not receiving treatment ('untreated insomnia' cohort) to patients without an insomnia disorder diagnosis and without treatment ('non-insomnia' cohort). International Classification of Disease, Tenth Revision codes were used as a proxy to represent the three symptom domains (Sleepiness, Alert/Cognition, Mood) of the Insomnia Daytime Symptoms and Impacts Questionnaire (IDSIQ), a newly developed and validated tool used in clinical studies to assess daytime functioning in insomnia disorder. Chronic Fatigue (R53.83) and Other Fatigue (R53.83), Somnolence (R40.0) and Disorientation (R41.0) were selected as categories representing one or more IDSIQ domains. Clinical outcomes included cardiovascular events, psychiatric disorders, cognitive impairment and metabolic disorders.
RESULTS
Approximately 1 million patients were included (untreated insomnia: n = 139,959; non-insomnia: n = 836,975). Compared with the 'non-insomnia' cohort, the 'untreated insomnia' cohort was more likely to experience daytime impairments, with mean differences in occurrences per 100 patient-years for: (a) fatigue, at 27.35 (95% confidence interval [CI] 26.81, 27.77, p < 0.01); (b) dizziness, at 4.66 (95% CI 4.40, 4.90, p < 0.01); (c) somnolence, at 4.18 (95% CI 3.94, 4.43, p < 0.01); and (d) disorientation, at 0.92 (95% CI 0.77, 1.06, p < 0.01). During the 1-year look-back period, patients in the 'untreated insomnia' cohort were also more likely to have been diagnosed with arterial hypertension (40.9% vs. 26.3%), psychiatric comorbidities (40.1% vs. 13.2%), anxiety (29.2% vs. 8.5%), depression (26.1% vs. 8.1%) or obesity (21.3% vs. 11.1%) compared with those in the 'non-insomnia' cohort.
CONCLUSIONS
This large-scale study confirms the substantial burden of insomnia disorder on patients in a real-world setting, with significant daytime impairment and numerous comorbidities. This reinforces the need for timely insomnia disorder diagnosis and treatments that improve both sleep, as well as daytime functioning.
Topics: Humans; Adult; Sleep Initiation and Maintenance Disorders; Sleepiness; Cohort Studies; Wakefulness; Sleep
PubMed: 37537544
DOI: 10.1186/s12889-023-16329-9 -
Journal of Clinical Sleep Medicine :... Sep 2019Drowsiness leads to 20% of fatal road crashes, while inability to assess drowsiness has hampered drowsiness interventions. This study examined the accuracy of eye-blink... (Randomized Controlled Trial)
Randomized Controlled Trial
STUDY OBJECTIVES
Drowsiness leads to 20% of fatal road crashes, while inability to assess drowsiness has hampered drowsiness interventions. This study examined the accuracy of eye-blink parameters for detecting drowsiness related driving impairment in real time.
METHODS
Twelve participants undertook two sessions of 2-hour track-driving in an instrumented vehicle following a normal night's sleep or 32 to 34 hours of extended wake in a randomized crossover design. Eye-blink parameters and lane excursion events were monitored continuously.
RESULTS
Sleep deprivation increased the rates of out-of-lane driving events and early drive terminations. Episodes of prolonged eyelid closures, blink duration, the ratio of amplitude to velocity of eyelid closure, and John's Drowsiness Score (JDS, a composite score) were also increased following sleep deprivation. A time-on-task (drive duration) effect was evident for out-of-lane events rate and most eye-blink parameters after sleep deprivation. The JDS demonstrated the strongest association with the odds of out-of-lane events in the same minute, whereas measures of blink duration and prolonged eye closure were stronger indicators of risk for out-of-lane events over longer periods of 5 minutes and 15 minutes, respectively. Eye-blink parameters also achieved moderate accuracies (specificities from 70.12% to 84.15% at a sensitivity of 50%) for detecting out-of-lane events in the same minute, with stronger associations over longer timeframes of 5 minutes to 15 minutes.
CONCLUSIONS
Eyelid closure parameters are useful tools for monitoring and predicting drowsiness-related driving impairment (out-of-lane events) that could be utilized for monitoring drowsiness and assessing the efficacy of drowsiness interventions.
CLINICAL TRIAL REGISTRATION
This study is registered with the Australian New Zealand Clinical Trial Registry (ANCTR), http://www.anzctr.org.au/TrialSearch.aspx ACTRN12612000102875.
CITATION
Shekari Soleimanloo S, Wilkinson VE, Cori JM,Westlake J, Stevens B, Downey LA, Shiferaw BA, Rajaratnam SMW, Howard ME. Eye-blink parameters detect on-road track-driving impairment following severe sleep deprivation. J Clin Sleep Med. 2019;15(9):1271-1284.
Topics: Adult; Australia; Automobile Driving; Blinking; Cross-Over Studies; Disorders of Excessive Somnolence; Female; Humans; Male; Reaction Time; Reproducibility of Results; Sleep Deprivation; Sleepiness
PubMed: 31538598
DOI: 10.5664/jcsm.7918 -
Sensors (Basel, Switzerland) Dec 2018Drowsiness detection has been studied in the context of evaluating products, assessing driver alertness, and managing office environments. Drowsiness level can be...
Drowsiness detection has been studied in the context of evaluating products, assessing driver alertness, and managing office environments. Drowsiness level can be readily detected through measurement of human brain activity. The electroencephalogram (EEG), a device whose application relies on adhering electrodes to the scalp, is the primary method used to monitor brain activity. The many electrodes and wires required to perform an EEG place considerable constraints on the movement of users, and the cost of the device limits its availability. For these reasons, conventional EEG devices are not used in practical studies and businesses. Many potential practical applications could benefit from the development of a wire-free, low-priced device; however, it remains to be elucidated whether portable EEG devices can be used to estimate human drowsiness levels and applied within practical research settings and businesses. In this study, we outline the development of a drowsiness detection system that makes use of a low-priced, prefrontal single-channel EEG device and evaluate its performance in an offline analysis and a practical experiment. Firstly, for the development of the system, we compared three feature extraction methods: power spectral density (PSD), autoregressive (AR) modeling, and multiscale entropy (MSE) for detecting characteristics of an EEG. In order to efficiently select a meaningful PSD, we utilized step-wise linear discriminant analysis (SWLDA). Time-averaging and robust-scaling were used to fit the data for pattern recognition. Pattern recognition was performed by a support vector machine (SVM) with a radial basis function (RBF) kernel. The optimal hyperparameters for the SVM were selected by the grind search method so as to increase drowsiness detection accuracy. To evaluate the performance of the detections, we calculated classification accuracy using the SVM through 10-fold cross-validation. Our model achieved a classification accuracy of 72.7% using the PSD with SWLDA and the SVM. Secondly, we conducted a practical study using the system and evaluated its performance in a practical situation. There was a significant difference (* < 0.05) between the drowsiness-evoked task and concentration-needed task. Our results demonstrate the efficacy of our low-priced portable drowsiness detection system in quantifying drowsy states. We anticipate that our system will be useful to practical studies with aims as diverse as measurement of classroom mental engagement, evaluation of movies, and office environment evaluation.
Topics: Adult; Electrodes; Electroencephalography; Female; Humans; Male; Prefrontal Cortex; Probability; ROC Curve; Sleep; Support Vector Machine
PubMed: 30567347
DOI: 10.3390/s18124477 -
Environment International Jun 2020To investigate whether exposure to dampness and mold at home and at work induce sleep disturbances and daytime sleepiness among adults.
AIM
To investigate whether exposure to dampness and mold at home and at work induce sleep disturbances and daytime sleepiness among adults.
MATERIALS AND METHODS
Associations between onset of sleep disturbances and dampness, mold and mold odor at home and at work were investigated in a cohort of 11,318 adults from the population in Iceland, Norway, Sweden, Denmark and Estonia. The participants answered a questionnaire at baseline and 10 years later, with questions on sleep disturbances, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), insomnia symptoms, snoring and excessive daytime sleepiness (EDS). Multiple logistic regression models were applied to estimate associations adjusting for potential confounders including gender, age, smoking habit at baseline, change of smoking habit from baseline to follow up, BMI at baseline, change of BMI from baseline to follow up, education level at follow up, allergic rhinitis at baseline, doctor diagnosed asthma at baseline and chronic bronchitis at baseline.
RESULTS
Baseline floor dampness, visible mold and mold odor at home increased onset of DIS, DMS, EMA, insomnia symptoms and snoring during follow up (OR 1.29-1.87). Any sign of dampness at baseline increased onset of DIS (OR 1.28, 95%CI 1.06-1.55), DMS (OR 1.17, 95%CI 1.02-1.34) and insomnia symptoms (OR 1.18, 95%CI 1.03-1.36). Dampness at home during follow up increased onset of DIS, DMS, EMA, insomnia symptoms and EDS (OR 1.17-1.36). Dampness at work during follow up increased onset of DIS, EMA, insomnia symptoms and EDS (OR 1.16-1.34). Combined dampness at home and at work during follow up increased the risk of onset of DIS, DMS, EMA, insomnia symptoms and EDS (OR 1.29-1.74).
CONCLUSIONS
Dampness and mold at home and at work can increase the development of insomnia symptoms, snoring and EDS among adults.
Topics: Adult; Humans; Norway; Sleep Initiation and Maintenance Disorders; Sleepiness; Snoring; Surveys and Questionnaires; Sweden
PubMed: 32272294
DOI: 10.1016/j.envint.2020.105691 -
Neurology India 2023
Topics: Humans; Intracranial Hypotension; Sleepiness; Retrospective Studies; Magnetic Resonance Imaging
PubMed: 38174503
DOI: 10.4103/0028-3886.391367