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Molecular Metabolism Jun 2018Cytokines such as IL-1 seems to play a role in the pathogenesis of fatigue associated with some chronic diseases and anti-inflammatory treatment has been shown to reduce... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Cytokines such as IL-1 seems to play a role in the pathogenesis of fatigue associated with some chronic diseases and anti-inflammatory treatment has been shown to reduce these symptoms. Ingestion of a calorie rich meal leads to postprandial fatigue, and is associated with increased systemic concentrations of cytokines, which is more pronounced in obese than lean subjects. We investigated whether postprandial fatigue is regulated by IL-1, and therefore reduced by IL-1 antagonism, in lean and obese subjects.
METHODS
In a double-blind, crossover study in 8 lean and 8 obese male subjects, randomized to receive either saline (placebo) or the IL-1 receptor antagonist anakinra, we investigated whether postprandial fatigue was regulated by IL-1. To promote postprandial fatigue, subjects ran 30 min prior to a high-fat, high-carbohydrate meal. Fatigue was determined using the Stanford Sleepiness Scale and blood samples were drawn at baseline and after the intervention.
RESULTS
IL-1 antagonism led to a reduction in postprandial fatigue and this effect was more pronounced in obese than lean individuals.
CONCLUSIONS
We conclude that IL-1 is involved in the regulation of postprandial fatigue under physiologic conditions in lean and obese individuals. It remains to be shown whether this effect translates into clinical relevant effects.
Topics: Adolescent; Adult; Diet, Carbohydrate Loading; Diet, High-Fat; Fatigue; Humans; Interleukin 1 Receptor Antagonist Protein; Interleukin-1; Male; Middle Aged; Obesity; Postprandial Period; Sleepiness
PubMed: 29705519
DOI: 10.1016/j.molmet.2018.04.001 -
Journal of Child Psychology and... Sep 2019Children with attention-deficit/hyperactivity disorder (ADHD) experience greater sleep problems than their peers. Although adolescence is generally a developmental...
BACKGROUND
Children with attention-deficit/hyperactivity disorder (ADHD) experience greater sleep problems than their peers. Although adolescence is generally a developmental period characterized by insufficient sleep, few studies have used a multi-informant, multi-method design, to examine whether sleep differs in adolescents with and without ADHD.
METHODS
Targeted recruitment was used to enroll an approximately equal number of eighth-grade adolescents (mean age = 13 years) with (n = 162) and without ADHD (n = 140). Adolescents and parents completed global ratings of sleep problems; adolescents, parents, and teachers completed ratings of daytime sleepiness. Adolescents wore actigraphs and completed a daily sleep diary for approximately 2 weeks.
RESULTS
Adolescents with ADHD were more likely than adolescents without ADHD to obtain insufficient sleep on school days (per diary) and weekends (per diary and actigraphy). Adolescents with ADHD were also more likely to report falling asleep in class and to have stayed up all night at least twice in the previous 2 weeks (14% and 5% reported all-nighters for ADHD and comparison, respectively). In regression analyses controlling for a number of variables known to impact sleep (e.g. pubertal development, sex, medication use, having an externalizing, anxiety, or depression diagnosis), ADHD remained associated with shorter diary and actigraphy school night sleep duration, adolescent- and parent-reported daytime sleepiness, and parent-reported difficulties initiating and maintaining sleep and total sleep disturbance. Controlling for other variables, the odds of being classified with clinically elevated parent-reported sleep disturbance were 6.20 times greater for adolescents with ADHD.
CONCLUSIONS
Findings provide some of the clearest evidence yet that adolescents with ADHD experience more sleep problems and sleepiness than their peers without ADHD. It may be especially important to assess for sleep problems in adolescents with ADHD and to evaluate whether existing sleep interventions are effective, or can be optimized, for use in adolescents with ADHD who also have sleep problems.
Topics: Actigraphy; Adolescent; Attention Deficit Disorder with Hyperactivity; Child; Female; Humans; Male; Parents; Psychometrics; School Teachers; Self Report; Sleep Wake Disorders; Sleepiness; Time Factors
PubMed: 31032953
DOI: 10.1111/jcpp.13061 -
Nature and Science of Sleep 2022Driving while drowsy is a major cause of traffic accidents globally. Recent technologies for detection and alarm within automobiles for this condition are limited by...
PURPOSE
Driving while drowsy is a major cause of traffic accidents globally. Recent technologies for detection and alarm within automobiles for this condition are limited by their reliability, practicality, cost, and lack of clinical validation. In this study, we developed an early drowsiness detection algorithm and device based on the "gold standard brain biophysiological signal" and facial expression digital data.
METHODS
The data were obtained from 10 participants. Artificial neural networks (ANN) were adopted as the model. Composite features of facial descriptors (ie, eye aspect ratio (EAR), mouth aspect ratio (MAR), face length (FL), and face width balance (FWB)) extracted from two-second video frames were investigated.
RESULTS
The ANN combined with the EAR and MAR features had the most sensitivity (70.12%) while the ANN combined with the EAR, MAR, and FL features had the most accuracy and specificity (60.76% and 58.71%, respectively). In addition, by applying the discrete Fourier transform (DFT) to the composite features, the ANN combined with the EAR and MAR features again had the highest sensitivity (72.25%), while the ANN combined with the EAR, MAR, and FL features had the highest accuracy and specificity (60.40% and 54.10%, respectively).
CONCLUSION
The ANN with DFT combined with the EAR, MAR, and FL offered the best performance. Our direct driver sleepiness detection system developed from the integration of biophysiological information and internal validation provides a valuable algorithm, specifically toward alertness level.
PubMed: 36132745
DOI: 10.2147/NSS.S376755 -
Chest Mar 2024In people with OSA, excessive daytime sleepiness is a prominent symptom and can persist despite adherence to CPAP, the first-line therapy for OSA. Pitolisant was...
BACKGROUND
In people with OSA, excessive daytime sleepiness is a prominent symptom and can persist despite adherence to CPAP, the first-line therapy for OSA. Pitolisant was effective in reducing daytime sleepiness in two 12-week randomized controlled trials (RCTs), one in patients adherent to CPAP (BF2.649 in Patients With OSA and Treated by CPAP But Still Complaining of EDS [HAROSA 1]) and the other in patients refusing or not tolerating CPAP (BF2.649 in Patients With OSA, Still Complaining of EDS and Refusing to be Treated by CPAP [HAROSA 2]).
RESEARCH QUESTION
Does the efficacy and safety of pitolisant persist when these patients take it long-term?
STUDY DESIGN AND METHODS
All adults included in the HAROSA 1 and HAROSA 2 RCTs (both pitolisant and placebo arms) were offered pitolisant (up to 20 mg/d) after completion of the short-term double-anonymized phase (ie, from week 13) in an open-label cohort study. The primary efficacy outcome was the change in Epworth Sleepiness Scale score between baseline and week 52. Safety outcomes were treatment-emergent adverse event(s) (TEAE[s]), serious TEAEs, and special interest TEAEs.
RESULTS
Out of 512 adults included in the two RCTs, 376 completed the 1-year follow-up. The pooled mean difference in Epworth Sleepiness Scale score from baseline to 1 year for the intention-to-treat sample was -8.0 (95% CI, -8.3 to -7.5). The overall proportions of TEAEs, serious TEAEs, and TEAEs of special interest were 35.1%, 2.0%, and 11.1%, respectively, without any significant difference between patients in the initial pitolisant and placebo arms. No cardiovascular safety issues were reported.
INTERPRETATION
Pitolisant is effective in reducing daytime sleepiness over 1 year in adults with OSA, with or without CPAP treatment. Taken for 1 year, it has a good safety profile (including cardiovascular).
TRIAL REGISTRATION
ClinicalTrials.gov; Nos.: NCT01071876 and NCT01072968; URL: www.
CLINICALTRIALS
gov.
Topics: Adult; Humans; Sleepiness; Piperidines; Disorders of Excessive Somnolence; Continuous Positive Airway Pressure; Sleep Apnea, Obstructive; Treatment Outcome
PubMed: 37979718
DOI: 10.1016/j.chest.2023.11.017 -
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 Maritime Health 2023This study investigates how Faroese deep-sea fishers' exposure to work-related stressors affects their sleep, sleepiness, and levels of fatigue. Being constantly exposed...
BACKGROUND
This study investigates how Faroese deep-sea fishers' exposure to work-related stressors affects their sleep, sleepiness, and levels of fatigue. Being constantly exposed to the unpredictable and harsh North Atlantic Ocean, having long work hours and split sleep for up to 40 days consecutively, they will arguably suffer from fatigue.
MATERIALS AND METHODS
One hundred and fifty seven fishers participated in this study, and data was gathered throughout 202 days at sea. Subjective data was collected at the start and end of trips via questionnaires, sleep and sleepiness diaries and supplemented by objective sleep data through actigraphs. Ship movements were logged with a gyroscope connected to a laptop. A noise metre measured each work station and resting area, and noise exposure profiles were calculated based on each participant's activity and location. Linear mixed-effect models investigated the effects of work exposure variables on sleep efficiency, and cumulative link mixed models measured effects on the Karolinska Sleepiness Scale and physical fatigue scale.
RESULTS
Time of day followed by ship movement were the exposure variables with the highest impact on the outcome variables of sleep efficiency, sleepiness and physical fatigue. The number of days at sea revealed correlations to outcome variables either by itself or interacting with the sleep periods per day. Crew size, shift system or noise did not impact outcome variables when in the model with other variables. Larger catches improved sleep efficiency but did not affect sleepiness and physical fatigue ratings.
CONCLUSIONS
The findings indicate a chronically fatigued fisher population, and recommends urgent attention being paid to improving the structure of vessels and installing stabilators for greater stability at sea; work schedules being evaluated for protection of health; and work environments being designed that fulfill human physiological requirements in order to ensure the wellbeing and safety of those at sea.
Topics: Humans; Work Schedule Tolerance; Working Conditions; Sleepiness; Sleep; Fatigue
PubMed: 36974488
DOI: 10.5603/IMH.2023.0001 -
Neuromuscular Disorders : NMD May 2022Abnormalities of sleep are common in myotonic dystrophy type 1 (DM1), but few previous studies have combined polysomnography with detailed clinical measures and brain...
Abnormalities of sleep are common in myotonic dystrophy type 1 (DM1), but few previous studies have combined polysomnography with detailed clinical measures and brain imaging. In the present study, domiciliary polysomnography, symptom questionnaires and cognitive evaluation were undertaken in 39 DM1-affected individuals. Structural brain MRI was completed in those without contra-indication (n = 32). Polysomnograms were adequate for analysis in 36 participants. Sleep efficiency was reduced, and sleep architecture altered in keeping with previous studies. Twenty participants (56%) had moderate or severe sleep-disordered breathing (apnoea-hypopnoea index [AHI] ≥ 15). In linear modelling, apnoeas were positively associated with increasing age and male sex. AHI ≥ 15 was further associated with greater daytime pCO and self-reported physical impairment, somnolence and fatigue. Percentage REM sleep was inversely associated with cerebral grey matter volume, stage 1 sleep was positively associated with occipital lobe volume and stage 2 sleep with amygdala volume. Hippocampus volume was positively correlated with self-reported fatigue and somnolence. Linear relationships were also observed between measures of sleep architecture and cognitive performance. Findings broadly support the hypothesis that changes in sleep architecture and excessive somnolence in DM1 reflect the primary disease process in the central nervous system.
Topics: Disorders of Excessive Somnolence; Fatigue; Humans; Male; Myotonic Dystrophy; Sleep; Sleepiness
PubMed: 35361525
DOI: 10.1016/j.nmd.2022.02.003 -
Review of Human Factors and Ergonomics Jun 2015Sleep deficiency, which can be caused by acute sleep deprivation, chronic insufficient sleep, untreated sleep disorders, disruption of circadian timing, and other...
Sleep deficiency, which can be caused by acute sleep deprivation, chronic insufficient sleep, untreated sleep disorders, disruption of circadian timing, and other factors, is endemic in the U.S., including among professional and non-professional drivers and operators. Vigilance and attention are critical for safe transportation operations, but fatigue and sleepiness compromise vigilance and attention by slowing reaction times and impairing judgment and decision-making abilities. Research studies, polls, and accident investigations indicate that many Americans drive a motor vehicle or operate an aircraft, train or marine vessel while drowsy, putting themselves and others at risk for error and accident. In this chapter, we will outline some of the factors that contribute to sleepiness, present evidence from laboratory and field studies demonstrating how sleepiness impacts transportation safety, review how sleepiness is measured in laboratory and field settings, describe what is known about interventions for sleepiness in transportation settings, and summarize what we believe are important gaps in our knowledge of sleepiness and transportation safety.
PubMed: 26056516
DOI: 10.1177/1557234X15573949 -
Frontiers in Physiology 2020We previously constructed a perspiration ratemeter for the measurement of palmar sweating in human subjects. Although galvanic skin response (GSR) has been used to...
Eyes Closing and Drowsiness in Human Subjects Decrease Baseline Galvanic Skin Response and Active Palmar Sweating: Relationship Between Galvanic Skin and Palmar Perspiration Responses.
We previously constructed a perspiration ratemeter for the measurement of palmar sweating in human subjects. Although galvanic skin response (GSR) has been used to evaluate emotional responses in human subjects, little is known about the relationships between the phasic and baseline components in GSR and active palmar sweating. From the aforementioned, we aimed to investigate the relationships in human subjects with handgrip exercise and eyes closing or opening. Fifteen healthy volunteers (mean age: 26.9 ± 8.7 years) participated in the present experiments. We investigated the effects of maximal handgrip exercise, eyes closing or opening, and self-awareness of drowsy on the GSR, active palmar sweating, R-R interval in electrocardiograph (ECG), and percentage of α wave in EEG. The faster phasic component in GSR completely agreed with the starting point of active palmar sweating. Handgrip exercise induced significantly faster spike in GSR, active palmar sweating, and decrease in R-R interval in ECG. Eyes closing produced significant decreases in baseline GSR and active palmar sweating in all human subjects. The percentage of α wave in electroencephalograph (EEG) also increased. In contrast, eyes opening increased significantly the baseline GSR and active palmar sweating. In the equivalent electrical model of human skin, the eyes closing-mediated time-dependent decrease in the baseline GSR completely agreed with the hypothesis that the palmar skin voltage only in the model decreased time dependently to 0.4 of the control during 6 min. The self-awareness of drowsy in mid-night working with computer produced similar decreases in baseline GSR and active palmar sweating to the responses with eyes closing in all human subjects. In conclusion, the faster spike in GSR completely agreed with the starting point of active palmar sweating. Eyes closing and opening or self-awareness of drowsy significantly produced changes in baseline GSR and active palmar sweating, which may become useful tools for evaluating clearness or drowsiness in human subjects.
PubMed: 33362571
DOI: 10.3389/fphys.2020.558047 -
Neural Computing & Applications 2021Vehicle drivers driving cars under the situation of drowsiness can cause serious traffic accidents. In this paper, a vehicle driver drowsiness detection method using...
Vehicle drivers driving cars under the situation of drowsiness can cause serious traffic accidents. In this paper, a vehicle driver drowsiness detection method using wearable electroencephalographic (EEG) based on convolution neural network (CNN) is proposed. The presented method consists of three parts: data collection using wearable EEG, vehicle driver drowsiness detection and the early warning strategy. Firstly, a wearable brain computer interface (BCI) is used to monitor and collect the EEG signals in the simulation environment of drowsy driving and awake driving. Secondly, the neural networks with Inception module and modified AlexNet module are trained to classify the EEG signals. Finally, the early warning strategy module will function and it will sound an alarm if the vehicle driver is judged as drowsy. The method was tested on driving EEG data from simulated drowsy driving. The results show that using neural network with Inception module reached 95.59% classification accuracy based on one second time window samples and using modified AlexNet module reached 94.68%. The simulation and test results demonstrate the feasibility of the proposed drowsiness detection method for vehicle driving safety.
PubMed: 33967397
DOI: 10.1007/s00521-021-06038-y