Twenty-four-hour patterns in human performance,subjective and physiological variables and differences between morning and evening active subjects

A study was undertaken to investigate differences between habitually morning active and evening active subjects as regards 24-hr patterns in physiological and subjective arousal and performance efficiency under conditions of 72 hr of sleep deprivation. The results were that very consistent 24-hr rhythmic patterns were present in some of the performance variables, subjective alertness, oral temperature and urinary adrenaline excretion. No significant differences in 24-hr patterns could be detected between a group of habitually morning active and a group of evening active subjects. Significant correlations were obtained between oral temperature and some of the performance measures, while adrenaline excretion was not significantly correlated with performance. There were rather high correlations between subjective alertness ratings and some of the performances.     

Subjective sleepiness and physiological sleep tendency in healthy young morning and evening subjects

SUMMARY  The Multiple Sleep Latency Test (MSLT) was performed twice after 8h and after 4h of night sleep in 15 healthy young subjects (mean age: 23 y). Seven subjects could be regarded as morning, 8 subjects as evening types. After 8h of sleep significantly more evening types napped at 08.00 hours and at 12.00 hours. Evening types rated themselves more sleepy on an hourly administered visual analogous scale (VAS). Sleep onset latencies (SOL) decreased, and the amount of Stages 1 and 2 increased in all subjects dependent on the sleep restriction condition. No significant differences between morningness and eveningness concerning SOL and structure of nap structure could be observed. After 4 h of sleep there was a marked increase in subjectively rated sleepiness during the morning hours in both groups.     

Twenty-four-hour structure of sleepiness in morning and evening persons investigated by ultrashort sleep-wake cycle

"Morning" and "evening" persons, defined according to a modified version of the Horne and Ostberg questionnaire, performed the 7/13 min sleep-waking schedule under attempting sleep condition after sleeping for one night in the laboratory, and under the resisting sleep condition after one night of sleep deprivation. Morning types slept significantly more under the attempting sleep condition and showed an earlier rise in nocturnal sleepiness. After sleep deprivation, morning types had a more distinct sleep propensity pattern with well-defined midafternoon and nocturnal sleep gates. In this condition there was a significant interaction between type and time of day with respect to amount of sleep: morning types slept more during the night, and evening types slept more during the day. Based on their amounts of sleep, subjects were also divided into "sleepy" and "alert" types, which were independent from the chronotypology.     

The circadian and homeostatic modulation of sleep pressure during wakefulness differs between morning and evening chronotypes

The purpose of this study was to evaluate homeostatic and circadian sleep process in 'larks' and 'owls' under daily life conditions. Core body temperature, subjective sleepiness and waking electroencephalogram (EEG) theta-alpha activity (6.25-9 Hz) were assessed in 18 healthy men (nine morning and nine evening chronotypes, 21.4 +/- 1.9 years) during a 36-h constant routine that followed a week of a normal 'working' sleep-wake schedule (bedtime: 23.30 h, wake time: 07.30 h). The phase of the circadian rhythm of temperature and sleepiness occurred respectively, 1.5 h (P = 0.01) and 2 h (P = 0.009) later in evening- than in morning-type subjects. Only morning-type subjects showed a bimodal rhythm of sleep-wake propensity. The buildup of subjective sleepiness, as quantified by linear regression, was slower in evening than in morning types (P = 0.04). The time course of EEG theta-alpha activity of both chronotypes could be closely fitted by an exponential curve. The time constant of evening types was longer than that of morning types (P = 0.03), indicating a slower increase in sleep pressure during extended wakefulness. These results suggest that both the circadian signal and the kinetics of sleep pressure buildup differ between the two chronotypes even under prior naturalistic conditions mimicking the usual working day.     

Yawning in morning and evening types

Yawning occurs more frequently in the early morning and in the late evening, close to sleep onset and after the awakening, and it might be linked to sleep propensity. We aimed to study yawning and its temporal distribution in morning and evening subjects who display different sleep-wake and sleepiness rhythms. Sixteen healthy young adults (8 evening-types and 8 morning-types, matched for age and gender) have been selected and instructed to keep their habitual sleep schedules and to signal every yawning occurrence for three consecutive days. Results show that evening-types yawn more frequently than morning-types, particularly during morning hours. Yawning frequency decreases across daytime in evening-types reaching its lowest level in the early evening and increases thereafter. Instead, in morning-types, yawning frequency remains quite low during daytime and increases in the evening. Moreover, both morning and evening types show a progressive increase of yawning frequency in the hours preceding sleep onset, whereas they differ after the awakening. Evening-types show a higher yawning frequency that remains quite stable in the hours following the awakening, while morning-types display a decline in yawning frequency. Our findings show that the temporal distribution of yawning frequency differs between chronotypes, supporting the hypothesis that differences in sleep-wake rhythm affect yawning, which could represent a behavioural sign of sleep propensity.     

自然夜间睡眠脑电图对癫痫的诊断价值

目的：观察自然夜间睡眠脑电图（ＥＥＧ）对癫痫的诊断价值。方法：对２００例临床拟诊为癫痫的患者行白昼常规ＥＥＧ和夜间自然睡眠ＥＥＧ检查。结果：常规ＥＥＧ３６％（７２例）出现痫样放电，而自然夜间睡眠ＥＥＧ７８％（１５６例）出现痫样放电。痫样波检出率与年龄、临床发作类型、睡眠周期有关。结论：自然夜间睡眠ＥＥＧ可显著地提高痫样放电的检出率，对癫痫的诊断与鉴别诊断有重要的参考价值。     

Increased homeostatic response to behavioral sleep fragmentation in morning types compared to evening types

STUDY OBJECTIVES: To evaluate the influence of chronotype on sleep stages and quantitative sleep EEG when sleep pressure is increased and sleep schedule remains constant. DESIGN: A 5-day session comprising an adaptation night, a baseline night, two nights of sleep fragmentation, and a recovery night. SETTING: Chronobiology laboratory. PARTICIPANTS: Twenty-four healthy subjects aged 19-34 years: 12 morning types and 12 evening types selected by questionnaire. Each group included 6 men and 6 women with a habitual sleep duration of 7 to 9 hours. Interventions: Two nights of behavioral sleep fragmentation induced by forced 5-min awakenings every half-hour. MEASUREMENTS AND RESULTS: Each night of polysomnography recording lasted 8 hours and was based on each subject's preferred sleep schedule. On both nights of sleep fragmentation, stage 1 sleep increased, while both total sleep time and minutes of slow wave sleep decreased. No difference was observed in sleep architecture between morning types and evening types during sleep fragmentation nights or during recovery night. Spectral analysis of all-night NREM sleep EEG showed that during the recovery night, morning types had a larger fronto-central increase in low frequency activities and a larger centro-parietal decrease in 14-15 Hz activity than evening types. The largest group difference was for slow wave activity in the fronto-central area during the first part of the sleep episode. CONCLUSIONS: These results add further support to a postulated difference in homeostatic sleep regulation between morning types and evening types, with morning types showing indications of a higher homeostatic response to sleep disruption.     

Sleep structure and EEG power density in morning types and evening types during a simulated day and night shift

The objective of this study was to examine circadian and homeostatic regulation of sleep in humans. In 8 morning types (M-types) and in 8 evening types (E-types), sleep was recorded during 3 successive nights and, after shifting sleep to the daytime, during 3 consecutive days. Night sleep was highly similar in the M-types and E-types. Day sleep clearly differed from night sleep in both types: Day sleep was shorter and had a longer first REMS episode. Furthermore, EEG power density recorded during non-REMS in the delta and theta frequency bands was higher during all day-sleep periods. Remarkably, the enhancements did not occur in non-REMS episode 1 but were delayed. This was interpreted as an inhibition of EEG power density at the beginning of sleep, possibly caused by the time course of body temperature and/or by the higher REMS propensity. Also, clear differences between the types became apparent: Only in the E-types, the non-REMS episodes shortened in response to the shift in bedtime, and probably related to this, the time course of EEG power density over consecutive non-REMS episodes became almost flat. It was concluded that the circadian system exerts not only an influence on sleep duration and REMS propensity, but also affects the time course of the non-REMS process.     

Association between sleep and morning testosterone levels in older men

STUDY OBJECTIVES: The circulating testosterone levels of healthy men decline with advancing age. This process is characterized by considerable inter-individual variability, the causes of which are of significant biological and clinical interest but remain poorly understood. Since sleep quantity and quality decrease with age, and experimentally-induced sleep loss in young adults results in hormonal changes similar to those that occur spontaneously in the course of aging, this study examined whether some of the variability in circulating testosterone levels of older men can be related to objective differences in their sleep. DESIGN: Observational study. SETTING: General community and university clinical research center. PARTICIPANTS: Twelve healthy men ages 64 to 74 years. INTERVENTIONS: Three morning blood samples were pooled for the measurement of total and free testosterone. In addition to overnight laboratory polysomnography, wrist activity monitoring for 6-9 days was used to determine the amount of nighttime sleep of the participants in everyday life settings. MEASUREMENTS AND RESULTS: The main outcome measures were total sleep time and morning testosterone levels. Sleep time in the laboratory was correlated with the usual amount of nighttime sleep at home (Pearson's r = 0.842; P = 0.001). Bivariate correlation and multiple linear regression analyses revealed that the amount of nighttime sleep measured by polysomnography was an independent predictor of the morning total (Beta 0.792, P = 0.017) and free (Beta 0.741, P = 0.029) testosterone levels of the subjects. CONCLUSIONS: Objectively measured differences in the amount of nighttime sleep are associated with a significant part of the variability in the morning testosterone levels of healthy older men.     

Diurnal preference, sleep habits, circadian sleep propensity and melatonin rhythm in healthy human subjects

We studied the in vitro effects of ethanol (25, 50 and 100 mM) on pyroglutamyl aminopeptidase activity (pGluAP), which has been reported as thyrotrophin-releasing-hormone-degrading activity. pGluAP was measured in presence or absence of calcium, under basal and K(+)-stimulated conditions, in synaptosomes and their incubation supernatant, using pyroglutamyl-beta-naphthylamide as substrate. In basal conditions, in synaptosomes, pGluAP was inhibited by ethanol in a calcium-independent way. In the supernatant, the response differed depending on the concentration of ethanol. Depolarization with K(+) modified pGluAP in synaptosomes and supernatant depending on the presence or not of calcium. In synaptosomes, in absence of calcium, the activity was inhibited at the highest concentrations of ethanol. In contrast, in the supernatant, under depolarizing conditions, ethanol increases pGluAP in absence of calcium. These changes may be in part responsible of the behavioural changes associated to alcohol intake.     

Diurnal preference, sleep habits, circadian sleep propensity and melatonin rhythm in healthy human subjects

After 24-h sleep deprivation, 33 healthy young subjects entered the 10/20 min ultra-short sleep–wake schedule for 26 h. Melatonin rhythm was hourly assessed simultaneously. Results indicated that morning preference was significantly correlated with habitual sleep onset (r=−0.41, P=0.04), habitual sleep offset (r=−0.52, P=0.002), melatonin peak time (r=−0.36, P=0.04), and sleep propensity onset time (r=−0.36, P=0.04). The intervals between habitual sleep mid-point and melatonin peak time and between habitual sleep mid-point and sleep propensity onset time were significantly longer in morning-preference subjects than in evening-preference subjects (P<0.05). These findings suggest that the variance of diurnal preference may be related to differences in phase relations between habitual sleep timing and the circadian pacemaker.     

Periodic movements in sleep and sleep-wake complaint

Periodic movements during sleep (PMS) are frequent, involuntary movements, usually of the lower extremities, that disrupt sleep. Twelve patients (nine men and three women, mean age 53.9 years) with a complaint of persistent insomnia (DIMS) were compared with 11 patients (eight men and three women, mean age 53.0 years) complaining of excessive daytime sleepiness (DOES). DIMS patients had more PMS (both absolute and relative), a longer delay to sleep onset and to REM onset, more wakefulness after sleep onset, and less total sleep time. Although the fragmentation of physiological sleep was more severe in the DIMS patients, those individuals with DOES reported cognitive intrusions during their sleep. While DOES patients may be regarded as "sleeping through" the brief arousals associated with leg activity during sleep, there appears to be sufficient cognitive awareness of the nocturnal interruption to precipitate a complaint of daytime sleepiness. Insomnia patients, however, appear to experience longer and more frequent awakenings, which are proportional to increased fragmentation of sleep.     

CaMKII is essential for the cellular clock and coupling between morning and evening behavioral rhythms

Daily behavioral rhythms in mammals are governed by the central circadian clock, located in the suprachiasmatic nucleus (SCN). The behavioral rhythms persist even in constant darkness, with a stable activity time due to coupling between two oscillators that determine the morning and evening activities. Accumulating evidence supports a prerequisite role for Ca²⁺ in the robust oscillation of the SCN, yet the underlying molecular mechanism remains elusive. Here, we show that Ca²⁺/calmodulin-dependent protein kinase II (CaMKII) activity is essential for not only the cellular oscillation but also synchronization among oscillators in the SCN. A kinase-dead mutation in mouse CaMKIIα weakened the behavioral rhythmicity and elicited decoupling between the morning and evening activity rhythms, sometimes causing arrhythmicity. In the mutant SCN, the right and left nuclei showed uncoupled oscillations. Cellular and biochemical analyses revealed that Ca²⁺–calmodulin–CaMKII signaling contributes to activation of E-box-dependent gene expression through promoting dimerization of circadian locomotor output cycles kaput (CLOCK) and brain and muscle Arnt-like protein 1 (BMAL1). These results demonstrate a dual role of CaMKII as a component of cell-autonomous clockwork and as a synchronizer integrating circadian behavioral activities.     

The relationship between long-term job strain and morning and evening saliva cortisol secretion among white-collar workers

The objective of this study was to assess long-term job strain impact on morning and evening salivary cortisol secretion. In all 77 white-collar workers (31% women; sample mean age, 42 years at baseline) volunteered to sample morning (immediately after waking up) and evening (10 p.m.) salivary cortisol for 7 consecutive days. By median split on aggregated self-reported isostrain from three consecutive questionnaires distributed in a period of approximately 3.5 years the participants were classified into a high or low long-term isostrain condition. Regardless of strain condition, there was a significant reduction in morning salivary cortisol secretion from the working week to the weekend, whereas evening salivary cortisol secretion showed no significant variation during the week. Although chronic isostrain did not affect the morning saliva cortisol measures, evening cortisol secretion was significantly elevated in the chronic high isostrain group throughout the whole week. The elevated evening cortisol measures associated with chronic high strain are concordant with the findings in other studies on long-term strain.     

Spectral analysis of all-night human sleep EEG in narcoleptic patients and normal subjects

To investigate the pathophysiology of narcoleptic patients' sleep in detail, we analysed and compared the whole-night polysomnograms of narcoleptic patients and normal human subjects. Eight drug-naive narcoleptic patients and eight age-matched normal volunteers underwent polysomnography (PSG) on two consecutive nights. In addition to conventional visual scoring of the polysomnograms, rapid eye movement (REM)-density and electroencephalograph (EEG) power spectra analyses were also performed. Sleep onset REM periods and fragmented nocturnal sleep were observed as expected in our narcoleptic patients. In the narcoleptic patients, REM period duration across the night did not show the significant increasing trend that is usually observed in normal subjects. In all narcoleptic patient REM periods, eye movement densities were significantly increased. The power spectra of narcoleptic REM sleep significantly increased between 0.3 and 0.9 Hz and decreased between 1.0 and 5.4 Hz. Further analysis revealed that non-rapid eye movement (NREM) period duration and the declining trend of delta power density in the narcoleptic patients were not significantly different from the normal subjects. Compared with normal subjects, the power spectra of narcoleptic NREM sleep increased in the 1.0-1.4 Hz and 11.0-11.9 Hz frequency bands, and decreased in a 24.0-26.9 Hz frequency band. Thus, increased EEG delta and decreased beta power densities were commonly observed in both the NREM and REM sleep of the narcoleptic patients, although the decrease in beta power during REM sleep was not statistically significant. Our visual analysis revealed fragmented nocturnal sleep and increased phasic REM components in the narcoleptic patients, which suggest the disturbance of sleep maintenance mechanism(s) and excessive effects of the mechanism(s) underlying eye movement activities during REM sleep in narcolepsy. Spectral analysis revealed significant increases in delta components and decreases in beta components, which suggest decreased activity in central arousal mechanisms. These characteristics lead us to hypothesize that two countervailing mechanisms underlie narcoleptic sleep pathology.     

Morningness-eveningness, habitual sleep-wake variables and cortisol level

The free cortisol rise immediately after awakening is a distinctive part of the cortisol circadian rhythm. Few studies have focused on the relationship between morningness and cortisol awakening response (CAR). As the suprachiasmatic nucleus may be of major importance for both, one may hypothesise that the CAR should also be associated with morningness. We used saliva samplings and applied questionnaires in adolescents and young adults. Saliva samplings were made at awakening (t1) and 30 min later (t2). Chronotype was measured using the Composite Scale of Morningness (CSM), and habitual time in bed was calculated from habitual rise times and bed times. In both, the adolescent sample and the young adults, positive correlations existed between cortisol measures at t1 immediately after awakening and CSM scores. Using a multivariate model controlling for age group, smoking status and time of t1, we identified CSM scores and bed times as the most relevant variables for CAR. When comparing extreme chronotypes, morning types had higher cortisol levels immediately after awakening than evening types. These results strongly suggest an association between morningness-eveningness and CAR.     

Periodic movements during sleep, sleep fragmentation, and sleep-wake complaints

To better understand the relation of sleep complaint to sleep continuity and periodic movements during sleep (PMS), two groups of patients were studied retrospectively. One group of 51 patients, 26 men and 25 women, with a mean age of 56.4 years, complained of insomnia. The other group of 29 patients, 20 men and nine women, with a mean age of 55.8 years, complained of excessive daytime sleepiness. Sleepy patients differed significantly from insomnia patients in that they fell asleep faster and slept longer. They showed more frequent arousals (shifts to stage 1 sleep and number of awakenings) than insomnia patients who had longer arousals (mean duration of awakenings). Insomnia patients had more series of PMS, but sleepy patients had more PMS bursts per series.     

Sleep and body temperature in "morning" and "evening" people

Three groups of young, normal sleepers were selected as morning types (MTs), evening types (ETs), and neither types (NTs) as determined by the Horne and Ostberg questionnaire. Sleep and rectal temperatures were recorded under three conditions: baseline nights (Cond. 1), sleep on the recovery day after 1 night of sleep deprivation (Cond. 2), and sleep on the recovery night after 1 night and 1 day of sleep deprivation (Cond. 3). During Conds. 1 and 3, when sleep schedules were self-determined, sleep structure and body temperature were similar in MTs, and ETs, and NTs. During Cond. 2, however, MTs had poorer sleep, i.e., a smaller percentage of REM sleep and more awakenings, than ETs. This difference can be related to the evolution of temperature during Cond. 2; i.e., a temperature increase in the MT and NT and a decrease in the ET.     

Differences in parental attitudes towards sleep and associations with sleep-wake patterns in Caucasian and Southeast Asian school-aged children in Australia

Caucasian (N = 47) and Southeast (SE) Asian (N = 36) families completed a questionnaire on their attitudes toward sleep, as well as a 7-day sleep diary for their children aged 5 to 11 years. Cultural differences were found in the perceived importance of sleep, particularly compared to homework and belief of how much sleep a child needs. Differences were also found in sleep-wake behaviors and amount of time spent on homework, with SE Asian children reporting a shift in sleep timing and increased homework load compared to Caucasian counterparts. Parental attitudes toward sleep, perception of sleep need, and homework load were not associated with the regulation of actual sleep behaviors in children, regardless of cultural heritage.