The effects of a 20-min nap before post-lunch dip

Abstract The effects of a 20-min nap before post-lunch dip were studied. The subjects participated in nap and no-nap conditions at intervals of 1 week. Their electroencephalogram (EEG) recordings of relaxed wakefulness, mood, performance, and self-rating of performance level were measured every 20 min from 10.00 to 18.00 h. For nap condition, the subjects went to bed at 12.20 h and were awakened after they slept for 20 min. The nap improved subjective sleepiness and self-rating of task performance, and suppressed EEG alpha activity. The results suggest a positive effect of a 20-min nap upon the maintenance of daytime arousal level.     

Effects of a daytime nap in the aged

This study evaluated the effects of the daytime nap on performance, mood and physiological measures in aged individuals Participants were six healthy aged persons (M=72.2 years old) who habitually napped in the afternoon three or more times a week. They participated under two conditions with an interval of 1 week. In the nap condition, the subjects went to bed at 13:00 h and slept for 30 min. In the rest condition, they just watched television. In both conditions, electroencephalogram (EEG), blood pressure, mood and performance were measured before and after a nap or rest. The daytime nap improved performance, decreased subjective sleepiness and fatigue, and attenuated EEG alpha band activity. Moreover, following a nap diastolic blood pressure significantly decreased. These findings suggest that a habitual daytime nap helps aged individuals to maintain their daytime physiological, psychological and behavioral arousal at an adequate level.     

The alerting effects of caffeine, bright light and face washing after a short daytime nap

OBJECTIVE: The present study examined whether the combination of a short daytime nap with caffeine, bright light and face washing was effective against mid-afternoon sleepiness. METHODS: Ten young healthy adults participated in 5 experimental conditions; those experiments were-Nap only: taking a 20 min nap; Caffeine+Nap: taking 200 mg of caffeine followed by a nap; Nap+Bright-light: being exposed to 2000 lx of bright light for 1 min immediately after napping; Nap+Face-washing: washing their faces immediately after napping; and No-Nap: taking a rest without sleep. These naps were taken at 12:40 hours. The subjects engaged in computer tasks for 15 min before napping and for 1 h after napping. RESULTS: Caffeine+Nap was the most effective for subjective sleepiness and performance level; its effects lasted throughout 1 h after napping. Nap+Bright-light was comparable with Caffeine+Nap, except for performance level. Nap+Face-washing showed mild and transient effects, however, it suppressed subjective sleepiness immediately after napping. CONCLUSIONS: The effects of a short nap against mid-afternoon sleepiness could be enhanced by combining caffeine intake, exposure to bright light, or face washing. SIGNIFICANCE: The present study would provide effective countermeasures against mid-afternoon sleepiness and sleepiness related accidents.     

Recovery after prolonged sleep deprivation: residual effects of slow-release caffeine on recovery sleep, sleepiness and cognitive functions

A long work schedule often results in sleep deprivation, sleepiness, impaired performance and fatigue. We investigated the residual effects of slow-release caffeine (SRC) on sleep, sleepiness and cognitive performance during a 42-hour recovery period following a 64-hour continuous wakefulness period in 16 healthy males, according to a double-blind, randomised, placebo-controlled, crossover study. Three hundred milligrams of SRC or placebo was given twice a day at 21:00 and 9:00 during the first 48 h of wakefulness. Recovery sleep was analysed with electroencephalography (EEG) and wrist actigraphy, daytime sleepiness with continuous EEG, sleep latency tests and actigraphy and cognitive functions with computerized tests from the NATO AGARD STRES battery. Both drug groups exhibited almost the same sleep architecture with a rebound of slow-wave sleep during both recovery nights and of REM sleep during the second night. Wakefulness level and cognitive functions were similarly impaired in both groups on the first day of recovery and partially returned to baseline on the second. To conclude, SRC appears to have no unwanted side-effects on recovery sleep, wakefulness and cognitive performance after a long period of sleep deprivation and might therefore be a useful choice over other psychostimulants for a long work schedule.     

Directional information flows between brain hemispheres across waking,non-REM and REM sleep states: An EEG study

The present electroencephalographic (EEG) study evaluated the hypothesis of a preferred directionality of communication flows between brain hemispheres across 24 h (i.e., during the whole daytime and nighttime), as an extension of a recent report showing changes in preferred directionality from pre-sleep wake to early sleep stages.Scalp EEGs were recorded in 10 normal volunteers during daytime wakefulness (eyes closed; first period: from 10:00 to 13:00 h; second period: from 14:00 to 18:00 h; third period: from 19:00 to 22:00 h) and nighttime sleep (four NREM-REM cycles). EEG rhythms of interest were delta (1–4 Hz), theta (5–7 Hz), alpha (8–11 Hz), sigma (12–15 Hz) and beta (16–28 Hz). The direction of the inter-hemispheric information flow was evaluated by computing the directed transfer function (DTF) from these EEG rhythms.Inter-hemispheric directional flows varied as a function of the state of consciousness (wake, NREM sleep, REM sleep) and in relation to different cerebral areas. During the daytime, alpha and beta rhythms conveyed inter-hemispheric signals with preferred Left-to-Right hemisphere direction in parietal and central areas, respectively. During the NREM sleep periods of nighttime, the direction of inter-hemispheric DTF information flows conveyed by central beta rhythms was again preponderant from Left-to-Right hemisphere in the stage 2, independent of cortical areas. No preferred direction emerged across the REM periods.These results support the hypothesis that specific directionality of communication flows between brain hemispheres is associated with wakefulness, NREM (particularly stage 2) and REM states during daytime and nighttime. They also reinforce the suggestive hypothesis of a relationship between inter-hemispheric directionality of EEG functional coupling and frequency of the EEG rhythms.     

Residual effects of daytime administration of melatonin on performance relevant to flight

There is a general consensus that melatonin possesses time-dependent hypnotic effects, but there is no information yet whether it has residual effects on neurobehavioral performance, especially after daytime administration. In the present study we investigated the possible residual effects of 3 mg melatonin on performance relevant to flight and on subjective feelings of sleepiness, arousal, activation and affect after a daytime nap, as a function of nap length. Fifteen reserve pilots of the Israeli Air Force participated in the study. The experiment consisted of four sessions during which either melatonin or placebo was administered at 16:00 h. In two conditions, subjects were allowed to sleep for 2 h (17:00-19:00 h) whereas in the other two only a 0.5-h nap was allowed. After the naps they started performing a flight simulator task every 2 h. Sleep efficiency significantly increased and sleep latency significantly decreased in both melatonin conditions compared to placebo. Flight performance was only mildly affected in the 0.5-h nap condition. Subjective assessment of sleepiness significantly differed between the two treatment conditions, only in the 0.5-h nap condition. Subjects felt sleepier 2-4 h after melatonin administration. To conclude, our data suggest that administration of melatonin before a brief daytime nap (about 0.5 h) may be associated with mild residual effects on psychomotor performance and may significantly affect subjective feeling of sleepiness for 2-4 h.     

Sleep inertia: performance changes after sleep, rest and active waking

Napping benefits and sustains subsequent performance. Prophylactic naps have been recommended as a means to maintain performance during extended wakefulness, as required during shiftwork. However, napping may cause short-term performance impairments, because awakening from sleep is followed by sleep inertia, a period of hypovigilance and impaired cognitive and behavioral performance. We investigated sleep inertia after an afternoon nap. Healthy 18-28 year-olds (n=50, not sleep deprived) were assigned to sleep, active wake or rest groups for a 2-h experimental phase with polysomnography starting either at 14:00 or 16:00 for half of each group. Before (baseline, 12:30 or 14:30) and in five sessions during the hour after the experimental phase (16:00-17:00 or 18:00-19:00), subjects completed an addition task, an auditory reaction time task, and the Stanford Sleepiness Scale. In session one, addition speed in the sleep group was reduced compared with baseline and with active wake controls, whereas calculation accuracy did not change. Addition speed in the sleep and rest groups increased substantially from session one to session two and reached a level similar to that of the active wake group by the fifth session. In the first session, auditory reaction speed of the sleep group was reduced compared with baseline and with rest controls but did not differ from the active wake group. The slowest reaction times showed significant recovery after 20 min. The groups reported similar increases in subjective sleepiness after the experimental period. These findings provide evidence for performance slowing and recovery during the hour following a 2-h nap opportunity. They highlight the importance of employing multiple control groups and various objective and subjective measures to assess sleep inertia.     

Effects of habitual variations in napping on psychomotor performance, memory and subjective states

Effects of habitual variations in napping on psychomotor performance, short-term memory and subjective states were investigated. The subjects were 32 healthy male university students who napped twice or more weekly in themorning and at night. Sixteen were randomly assigned to a control group and 16 to a nap(treatment) group. The experiment comprised two conditions of electrographically (EEG) recorded sleep for the nap group and two EEG monitored conditions of wakefulness for the controls. These conditions were scheduled from 9:35 to 11:35 a.m. and 12 hr later between 9:35 p.m. and 11:35 p.m. Measurements were obtained from: (a) a continuous 10-min auditory reaction time task, (b) a free recall task of short-term memory, (c) an activation-mood adjective check list, and (d) the Stanford Sleepiness scale. Except for memory the dependent variables of waking function were assessed 20 min before and 20 min after all conditions. Following each sleep condition the nap group as opposed to the controls showed a statistically significant improvement in reaction time performance, higher short-term retention, less reported sleepiness and elevated subjective states reflected by fice factors on the adjective mood-activation check list. Among the correlations computed the largest significant coefficients were of stage 4 and REM with posttreatment Stanford Sleepiness ratings. After naps, increased postdormital sleepiness was correlated with stage 4 and decreased sleepiness with REM sleep. Although few strikingly divergent functional effects were associated with morning and nocturanal naps, these did covary with sleep psychophysiology. It is postulated that the phase, the EEG-sleep stages and possibly the duration of accustomed naps are less salient factors influencing performance when the time since awakening until behavioral assessment can be kept constant.     

Recording of electroencephalograms and electrocardiograms during daytime sleep in trained canines: Preparation of the sleeping dogs

Abstract  Although respiration in trained canines is well investigated, the process of preparing dogs has not been described in any great detail. Moreover, their daytime patterns of sleep and wakefulness during 1 or 2 h of electroencephalogram (EEG) and electrocardiogram (ECG) recordings are not clear. Therefore, we describe the process of selecting and training dogs, in which we recorded EEG and ECG in the laboratory. First, 14 of 1242 dogs dealt with over a 1 year period were chosen. They were trained for 2 h to lie quietly and to sleep in the laboratory; this training procedure was repeated 152 times. Three dogs were then selected and a permanent tracheostomy was performed in one. Finally, EEG and ECG were recorded with the bipolar fine needle electrodes; respiration was recorded simultaneously through a tube inserted to a tracheostomy in one dog. Wakefulness, slow wave sleep (SWS) and rapid eye movement (REM) sleep (REMS) were identified according to the EEG pattern and on the basis of the behavioral criteria. Recordings were performed 12 or 13 times in each dog. Complete sleep cycles, including wakefulness, SWS and REMS in this sequence, were observed 3.9–4.1 times. The mean duration of SWS was 2.2–4.4 min and that of REMS was 3.5–4.6 min. The REMS latency was 33.9–41.8 min. Fluctuation of heart rate with respiration, termed respiratory sinus arrhythmia, was noted in the ECG. Heart beat increased with inspiration and decreased with expiration. The present study demonstrates how to select and train sleeping dogs and shows their undisturbed daytime sleep and wakefulness patterns.     

Objective measurement of sleepiness in summer vacation long-distance drivers

The study investigated whether sleepiness at the wheel is a problem in non-commercial drivers going on summer vacation. All drivers, who stopped at a rest area on a large European freway while one of the interviewers was available, were systematically approached and asked to respond to a questionnaire. All subjects who had driven at least 400 km (240 miles), whose age was between 20 and 46 years of age, and who agreed to participate were asked to undergo a longer investigation that included a short sleep/wake diary describing overall sleep habits during the year, a sleep/wake log covering the days just prior to departure, an analog visual scale indicating sleepiness at time of interview, and a polygraphically monitored two nap sleep test (TNST). A control group was recruited that consisted of subjects of the same age range, normal sleep habits, and normal nocturnal sleep time before administration of the TNST. One hundred and four drivers (2 women) participated between 08:00 and 20:00 h. The total group was subdivided into 6 subgroups based upon the time of day of their investigation (08:00–10:00 h, 10:01–12:00 h, etc.). The control group included 50 men with 50–55% of control subjects, relative to the total number of index-cases, in each subgroup. Eighty-eight percent (n =92) of studied drivers had experienced acute sleep deprivation within one day prior to departure due to the planned long driving. The TNST demonstrated that, overall, drivers had a significantly shorter sleep latency in nap 1 and nap 2 than controls, had a significantly longer sleep duration in nap 1 and nap 2, and there was a significant correlation between the sleep debt prior to departure and the sleep stage reached during the TNST. It is concluded that the TNST is a test which allows the objective study of sleepiness in drivers without the burden of the multiple sleep latency test. Many drivers are excessively sleepy when making long summer vacation journeys.     

Timing of naps: effects on post-nap sleepiness levels

The present study investigated the effects of timing of naps on nap content and sleep inertia, and the relationship between pre- and post-nap sleepiness level and nap content. Nine subjects were tested twice on the 13 min waking-7 min resisting sleep paradigm after one night of total sleep deprivation for 24 h. The ultrashort sleep-wake paradigms started at 07.00 h and were interrupted at 15.00 and 19.00 h for 2 h naps. The 2 experimental conditions were counterbalanced across subjects and separated by a 7 day rest period. The results showed that the early nap was significantly more efficient, contained more stage 3/4, and produced less sleep inertia than the late nap. The late nap was more efficient in reducing sleepiness during the last 5 h of the experiments (23.00-04.00). Only the early nap was significantly related to pre- and post-nap sleepiness levels. Overall sleepiness level and the timing of the nocturnal sleepiness gates were significantly correlated between the two parts of the study. The results were interpreted to support the priority of the ultradian phase on prior wakefulness with respect to sleep structure.     

Sleep and wakefulness in the southern sea lion

We recorded an electroencephalogram from the two hemispheres, a neck musculature electromyogram, an electrooculogram, and respiratory acts during sleep and wakefulness on land in three 1-year-old sea lion females for 3 or 4 consecutive days. On average active wakefulness (AW) occupied 20.4+/-2.0% of the 24-h period; quiet wakefulness (QW) 54.9+/-2.5%; slow wave sleep (SWS) 15.0+/-2.5% and paradoxical sleep (PS) 9.7+/-2.0%. Between 30 and 50% (average 39.1+/-3.4%) of total sleep time was spent in PS. From 8 to 31 episodes of PS were recorded per day (average 17+/-6 per day), with the longest episode lasting 20 min (average 5.6+/-0.5 min). Episodes of interhemispheric EEG asymmetry accounted for 5.5+/-1.3% of total SWS time. Respiratory pauses in these animals varied in QW between 4 and 36 s (average 15.7+/-0.4 s), in SWS between 11 and 37 s (20.9+/-0.6 s) and in PS between 2 and 69 s (15.0+/-1.5 s). AW, QW, SWS and PS were approximately equally distributed between light (07:00-19:00) and dark time (19:00-07:00). The low amount of SWS with interhemispheric EEG asymmetry, the high proportion of PS in total sleep time and the nearly even distribution of sleep and wakefulness over the 24-h period could be both species-specific features and/or ontogenetic characteristics of the animals studied.     

Prevalence and predictors of subclinical seizures during scalp video-EEG monitoring in patients with epilepsy

Objective: This study first aimed to establish the prevalence and predictors of subclinical seizures in patients with epilepsy undergoing video electroencephalographic monitoring, then to evaluate the relationship of sleep/wake and circadian pattern with subclinical seizures. Methods: We retrospectively reviewed the charts of 742 consecutive patients admitted to our epilepsy center between July 2012 and October 2014. Demographic, electro-clinical data and neuroimage were collected. Results: A total of 148 subclinical seizures were detected in 39 patients (5.3%) during video electroencephalographic monitoring. The mean duration of subclinical seizures was 47.18 s (range, 5–311). Pharmacoresistant epilepsy, abnormal MRI and the presence of interictal epileptiform discharges were independently associated with subclinical seizures in multivariate logistic regression analysis. Subclinical seizures helped localizing the presumed epileptogenic zone in 24 (61.5%) patients, and suggested multifocal epilepsy in five (12.8%). In addition, subclinical seizures occurred more frequently in sleep and night than wakefulness and daytime, respectively, and they were more likely seen between 21:00–03:00 h, and less likely seen between 09:00–12:00 h. Thirty patients (76.9%) had their first subclinical seizures within the first 24 h of monitoring while only 7.7% of patients had their first subclinical seizures detected within 20 min. Conclusion: Subclinical seizures are not uncommon in patients with epilepsy, particularly in those with pharmacoresistant epilepsy, abnormal MRI or interictal epileptiform discharges. Subclinical seizures occur in specific circadian patterns and in specific sleep/wake distributions. A 20-min VEEG monitoring might not be long enough to allow for their detection.     

Vigilance stages and performance in OSAS patients in a monotonous reaction time task.

OBJECTIVES: To develop improved methods for objective assessment of daytime vigilance. This is important in the diagnosis and therapy control of sleep disorders associated with excessive daytime sleepiness (EDS). METHODS: Twenty-one patients with EDS due to obstructive sleep apnea were recorded during a daytime 90 min reaction time (RT) test in a monotonous situation. Two EEG, two EOG and a submental EMG channel were recorded simultaneously. The recordings were divided into short, stationary segments of variable length (0.5-2 s) and classified into 7 stages using our previously described system, which includes additional stages for drowsiness. RESULTS: The duration of RT was linearly correlated to the vigilance state (P<0.05). The appearance of slow eye movements (SEM) was more consistently related to performance impairment than EEG changes. CONCLUSIONS: Our system can provide a better tracking of vigilance changes than the standardized sleep stage scoring. A 1-2 h test is useful in the assessment of the performance of a subject suffering from EDS. We found that SEMs indicate more sensitive and consistent EDS-related performance impairment than changes in EEG activity.     

Topographical characteristics of slow wave activities during the transition from wakefulness to sleep.

OBJECTIVES: This study examined the topographical characteristics of slow wave(delta and theta) activities during the transition from wakefulness to sleep, using topographic mapping of EEG power and coherence. METHODS: Sonography of nocturnal sleep was recorded on 10 male subjects. Each recording, from 'lights-off' to 5 min after the appearance of the first sleep spindles, was analyzed. Typical EEG patterns during the transition from wakefulness to sleep were classified into 9 stages (EEG stages). RESULTS AND CONCLUSIONS: Topographic maps of coherence in delta-and theta-band activities demonstrated that the synchronous component at the anterior-central areas of the scalp appeared corresponding with increasing power. The populations of high coherence pairs among total pairs were computed for each band and each EEG stage to examine the regional differences of EEG. The populations of the delta-band activity increased clearly from EEG stage 6 in the anterior-central areas. The populations of the theta-band activity increased clearly from EEG stage 7 in the anterior-central areas. These results suggest that the dominant synchronous component of slow wave activities during the transition from wakefulness to sleep increased as a function of EEG stages in the anterior-central areas and increased clearly after the appearance of vertex sharp waves.     

L-tryptophan: effects on daytime sleep latency and the waking EEG

The effects of L-tryptophan (4 g) on the waking EEG and daytime sleep were studied in a group of 20 normal adults. Subjects were assigned to a morning or afternoon group, and data were collected on two occasions, after L-tryptophan and after placebo, assigned in a counterbalanced order. L-Tryptophan significantly reduced sleep latency without altering nap sleep stages and elevated plasma total and free tryptophan levels. EEGs were digitized on-line and later analyzed for changes in 5 frequency bands: 16-40 c/sec (beta), 13.0-15.5 c/sec (sigma), 8.0-12.5 c/sec (alpha), 4.0-7.5 c/sec (theta) and 0.5-3.5 c/sec (delta). During waking EEGs, L-tryptophan significantly increased alpha time, theta time, and theta intensity and significantly decreased alpha frequency. No wave bands were altered during sleep. L-Tryptophan is an effective daytime hypnotic which can facilitate sleep onset at clock times which do not coincide with biological sleep times. The hypnotic effects may be mediated by lowering arousal level during the awake state, thus setting the stage for more rapid sleep onset.     

Spatio-temporal EEG power spectral patterns during a short daytime nap.

This is an approach to investigate topographic changes in electroencephalographic (EEG) spectral power during pre- and post-nap wakefulness as well as stages 1 (S1) and 2 (S2) NREM sleep in 12 subjects. Delta- and theta-band power significantly increased in the frontal and central regions during S1 and S2 with an increase in inter- and intra-hemispheric correlations. Beta-band power significantly increased in the frontal, central and parietal regions during S2 with an increase in interhemispheric correlation. In contrast, alpha-band power significantly decreased in the parietal-occipital regions during S1 and S2 with a decrease in interhemispheric correlation. Thus, daytime nap modulated spatio-temporal patterns of EEG power spectral patterns in wide scalp regions.     

Effects of brief naps on mood and sleep in sleep-deprived depressed patients

To determine the effects of brief naps on mood and electroencephalographic (EEG) sleep in sleep-deprived depressed patients, data from 19 hospitalized patients with depression were analyzed; all were kept awake from 0700h until the following day, when they were allowed 10-min naps at either 0830h or 1500h. Six of the patients showed a clinically significant improvement (greater than 40% change) on the Hamilton Rating Scale for Depression (HRSD) before the nap after all-night sleep deprivation, and the group as a whole showed a significant improvement on the HRSD, the Profile of Mood States, and the Brief Psychiatric Rating Scale subscale for depression. Naps did not alter mood in the responders, but did improve measured depression on the HRSD in the non-responders. Morning and afternoon naps did not differ significantly in their effects on mood or nap sleep. On the recovery sleep, patients who were classified as responders after the nap showed a significantly greater increase in delta (Stage 3 + 4) sleep compared with baseline than nonresponders.     

Nocturnal and diurnal sleep in Macaca sylvana.

In Macaca sylvana restrained in chairs, continuous 24 h recordings were obtained of scalp EEG, neck EMG, bilateral EOG, motility of the head and lever manipulation. A total of 32 days were studied in 8 monkeys. Recordings were divided into epochs of 30 sec and analyzed in a PDP-12 computer. Four stages of sleep and 5 stages of wakefulness were identified by combination of the above data. Results were as follows: (1) During the night, there was 21% wakefulness and during the day 20% sleep, including a considerable amount of REM. (2) Recordings of spontaneous motility of head and hands proved an excellent indicator of sleep-wakefulness cycles. (3) Spectral analysis revealed the cyclic characteristics of non-REM sleep, with peaks at 360, 149, 72, and 55 min. (4) Stages of wakefulness had ultradian cycles, and stage W-2 was the most important in number and duration of occurrences. (5) Night wakefulness had characteristics different from day wakefulness. (6) Study of sequences showed that stage II was the least differentiated being transitional among the other stages, while stage III-IV was never preceded by wakefulness or REM, and almost always it followed stage II (99.0% of the time). (7) The high statistical significance of results obtained under restraint in different monkeys suggests that this situation has great potential value in the investigation of physiological mechanisms of ultradian rhythms.