睡眠剥夺对免疫功能和内分泌系统的影响

睡眠剥夺是指人的正常睡眠量得不到满足的状态。在现代生活中，睡眠剥夺现象普遍存在。研究表明，在睡眠剥夺时，人的工作能力、认知功能及情绪下降，持续睡眠剥夺可影响自主神经系统、内分泌系统和免疫功能，而易诱发多种心身疾病，严重的睡眠剥夺甚至可导致死亡。睡眠剥夺大致可分为部分睡眠剥夺和完全睡眠剥夺，前者是指总的睡眠时间减少，是现实生活中较为常见的睡眠剥夺方式；后者是指整个睡眠过程均中止。睡眠和免疫功能有关，连续数日睡眠剥夺或睡眠紊乱对免疫功能有严重影响。     

持续军事飞行任务时睡眠剥夺和疲劳对工作能力的影响及其综合对策

目的：分析和综述持续军事飞行任务时睡眠剥夺和疲劳对工作能力的影响及其对策。资料来源与选择：该领域的研究论文、综述、研究报告和论著。资料引用：论文、综述和研究报告41篇，专著3本。资料综合：分析持续军事飞行任务时睡眠与工作负荷的基本特点，简介持续军事飞行任务时睡眠剥夺和疲劳对工作能力的影响及其对策。结论：持续军事飞行任务时睡眠剥夺和疲劳在所难免。综合性对抗措施中强调工作安排和睡眠管理，必要时合理使用中枢兴奋和抑制药物。     

睡眠剥夺对飞行工作能力的影响

睡眠剥夺(sleep deprivation,SD)是指人因环境或自身原因丧失了所需要的睡眠量的过程或状态。正常成人一昼夜需要7～8h 的睡眠。正常量的睡眠得不到满足就会发生睡眠剥夺。飞行工作是十分复杂的高负荷的脑力-体力工作,对飞行员的脑力工作能力要求较高。充足的睡眠是保证飞行员正常飞行的必要条件。然而跨时区长途飞行、夜航、夜间战斗值班都会导致飞行员睡眠剥夺。战场应激也会导致睡眠时间的减少和睡眠质     

心理应激复合睡眠剥夺大鼠血清及抗氧化能力指标的变化

目的 探讨心理应激复合睡眠剥夺大鼠血清超氧化物歧化酶(SOD)、丙二醛(MDA)、总抗氧化能力(T-AOC)和谷胱甘肽-过氧化物酶(GSH-PX)含量的变化.方法 将105只雄性SD大鼠,随机分为空白对照组、心理应激单因素组、心理应激阴性对照组、睡眠剥夺48 h单因素组、睡眠剥夺阴性对照组、心理应激14 d+睡眠剥夺48 h复合因素组和复合因素阴性对照组,每组15只.采用Communication Box建立心理应激模型.采用改良后的小平台法睡眠剥夺模型进行睡眠剥夺.所有动物取血清1.0 ml测定MDA含量、SOD、GSH-PX和T-AOC活力.结果 与正常对照组相比,心理应激组大鼠血清SOD活力、GSH.PX活力增加(P<0.05),T-AOC活力有增加趋势,MDA含量有降低趋势;睡眠剥夺组SOD活力增加(P<0.05)、T-AOC活力有增加趋势,GSH-PX活力、MDA含量有降低趋势;心理应激复合睡眠剥夺组SOD活力及MDA含量增加(P<0.05),T-AOC活力有增加趋势,GSH-PX活力降低(P<0.05).与心理应激和睡眠剥夺单一因素组相比,复合因素组MDA含量和T-AOC活力高于单一因素组(P<0.05),GSH-PX活力有降低趋势,SOD活力高于心理应激组,低于睡眠剥夺组.结论 心理应激、睡眠剥夺及心理应激复合睡眠剥夺后,大鼠的抗氧化能力提高,复合因素组高于单一因素组.     

48 h睡眠剥夺对正常人J7-E型模拟器飞行操作能力的影响

目的观察48 h睡眠剥夺(SD)对正常人模拟器飞行操作能力的影响,为制定相应对抗措施进而提高飞行人员的应急工作能力提供有关实验依据.方法采用国产J7-E型飞行模拟器和飞行员心理生理评价系统,以6名健康男性青年志愿者为对象,在48 h睡眠剥夺实验条件下进行模拟器飞行操作测试.实验数据用单因素方差分析方法,比较不同时间点成绩与基础值的差别,并记录不同飞行阶段出现的操纵错误次数.结果睡眠剥夺条件下,模拟器飞行成绩随睡眠剥夺时间延长而下降;在第3天100、300、500、700成绩显著降于基础值(P<0.05);出错次数随着SD延长而增加(在第3天时出错次数较多),并且左上转弯和着陆阶段的操纵错误较多.结论 48 h睡眠剥夺条件下人体模拟器飞行操作能力呈现下降趋势,而且睡眠剥夺时间较长及复合生理节律低谷时下降尤其明显;左上转弯和着陆阶段的操纵错误增加.     

48h睡眠剥夺对追踪作业工效,双手协调能力的影响

目的探讨４８ｈ睡眠剥夺对情绪、追踪作业工效、视反应能力及双手协调能力的影响。方法１４名健康男性青年在睡眠剥夺条件下，每间隔４ｈ进行光标追踪、Ｏｄｄｂａｌ模式视反应双重任务测试、双手追踪测试及ＰＯＭＳ情绪情感量表测试。结果双重任务中，光标追踪距离（Ｄ）在睡眠剥夺３２ｈ、４４ｈ和４８ｈ时显著升高（Ｐ＜０．０５），视反应的平均反应时（ｍＲＴ）、靶刺激反应时（ＴｓＲＴ）、非靶刺激反应时（ＮＴｓＲＴ）及刺激的反应正确率（ＡＲ）在睡眠剥夺２０ｈ及其以后各时程均显著改变，反应时延长，正确率下降（Ｐ＜０．０５）。靶刺激的反应正确率（ＴｓＡＲ）在睡眠剥夺２０ｈ及其以后各时程均显著下降（Ｐ＜０．０５）。双手追踪测试中，光标追踪距离（Ｄ）在睡眠剥夺４８ｈ显著降低（Ｐ＜０．０１）。随睡眠剥夺时程的增加，消极情绪状态值逐步升高（Ｐ＜０．０５），积极情绪状态值逐步下降（Ｐ＜０．０５）。结论睡眠剥夺对目标追踪能力、视反应能力有较大程度的影响；轻度影响双手协调能力；情绪改变明显，不良情绪状态值增加。     

睡眠剥夺对大鼠胃酸分泌和胃运动影响的实验研究

目的：观察急性睡眠剥夺对大鼠胃酸分泌以及胃排空和胃电活动的影响。为防治因睡眠剥夺引起的胃功能紊乱提供理论依据。方法：本研究在成功制作了睡眠剥夺大鼠模型的基础上，采用化学分析测定胃酸浓度，应用放射分析法和液相胃排空的方法检测胃的排空，利用浆膜法检测胃电的变化情况。结果：随着睡眠剥夺发生时间的不断延长，大鼠胃酸分泌逐渐增加，睡眠剥夺3d，其胃酸的水平与睡眠剥夺1d相比，有显著性差异（P〈0．05）；睡眠剥夺5d的胃酸水平增加更为明显，与睡眠剥夺的3d相比有显著性差异（P〈0．01）；而在睡眠剥夺7d时，胃酸的水平不再明显增加，与睡眠剥夺5d相比没有显著性差异（P〉0．05）。急性睡眠剥夺导致胃排空速率改变，随着睡眠剥夺时间的延长，胃的排空速率逐渐降低；胃电活动在餐前逐渐降低，而餐后无明显规律，呈现紊乱状态。结论：急性睡眠剥夺可以导致胃酸分泌的增加以及胃运动功能的紊乱，而且紊乱程度与时间关系密切。     

睡眠剥夺对大鼠下丘脑生长抑素mRNA表达的影响

近年来随着睡眠医学的兴起,睡眠剥夺(sleep deprivation,SD)对机体的影响及其防治逐渐成为人们关注的热点.SD是指机体因环境需要而部分或全部丧失正常睡眠量的状态,其中快动眼睡眠剥夺对人体生理、心理、工作能力都有严重影响,可通过脑内多种神经递质的介导引起感觉、知觉、认知能力、精神运动性操作等方面的复杂变化[1-2].     

睡眠剥夺对军事人员的影响及对策

现代高技术战争和多样化的非战争军事行动中,军事人员随时可能面临睡眠剥夺与保持良好工作状态的矛盾与挑战。睡眠不足会导致运动、警戒和决策等能力下降,对军事行动造成较大影响。笔者梳理总结了睡眠剥夺对机体的影响、各国军事人员对抗睡眠剥夺所采取的对策措施,并对未来的研究方向提出建议。     

睡眠剥夺对幼鼠延髓孤束核放电、海马谷氨酸受体及其转运体表达的影响

目的观察睡眠剥夺对幼鼠延髓内脏带（MVZ）中孤束核（NTS）电生理活动、海马中谷氨酸受体（NMDAR2）及其转运体（GLAST）的影响,为防治睡眠剥夺引起的中枢功能及学习、记忆损害提供理论依据。方法采用同步实验,应用电生理学的方法观察NTS神经元放电的变化情况,免疫组织化学的方法观察与学习、记忆密切相关的海马组织中NMDAR2及GLAST的变化情况。结果在睡眠剥夺的第3天,NTS放电明显增加,睡眠剥夺的第7天,NTS放电明显增加更为明显,而在睡眠剥夺的第2周,NTS放电呈抑制状态。在海马组织中,睡眠剥夺第3天,NMDAR2和GLAST开始增加,睡眠剥夺第5天增加更为明显,睡眠剥夺第7天,NMDAR2和GLAST增加的程度有所降低,睡眠剥夺第14天,海马中NMDAR2和GLAST表达程度与正常对照组比较无明显差异。结论睡眠剥夺对幼鼠睡眠诱导区的电生理活动有较为显著的影响。     

Naps and modafinil as countermeasures for the effects of sleep deprivation on cognitive performance.

Disruptions in wake-sleep rhythms, particularly induced by sleep deprivation are limiting factors for military personnel in operations. The role of sleep and naps in the recovery of performance is generally accepted. Pharmacological aids, for example hypnotic or stimulant substances can also be effective countermeasures. Recently, a new stimulant compound, modafinil (MODIODAL) has also proven effective. Considering the excellent results obtained with napping and modafinil, we have studied the combined effect of these two countermeasures on psychomotor performance under conditions simulating an operational situation. Beneficial effects of a few hours' nap on performance were confirmed. Consequently naps should be encouraged, even if limited and diurnal. Modafinil, which combines wakening and stimulating properties without any known side effects, was useful for longer periods of sleep deprivation and when there was no real possibility of sleep recovery. Modafinil did not prevent sleep if sleep opportunities were available. The combination of naps and modafinil demonstrated the best cognitive performance during sleep deprivation.     

Sleep, circadian rhythms, and psychomotor vigilance

Psychomotor vigilance performance is highly relevant to athletic performance. It is influenced by a sleep homeostatic process, which builds up pressure for sleep during wakefulness and dissipates this pressure during sleep, and a circadian rhythm process, which produces a waxing and waning of pressure for wakefulness over a 24 hours of the day. During total sleep deprivation, these two processes cause performance to deteriorate progressively over days, modulated within days by further performance reductions at night and relative improvements during the daytime. As the homeostatic pressure for sleep builds up higher across prolonged wakefulness, the rate of dissipation of that pressure during subsequent sleep is enhanced exponentially, so that even brief periods of sleep provide significant performance recuperation. Nevertheless, sleep restriction practiced on a chronic basis induces cumulative performance deficits of the same order of magnitude as observed during total sleep deprivation. There are also considerable individual differences in the degree of vulnerability to performance impairment from sleep loss, and these differences represent a trait.     

Effects of one night of sleep deprivation on hormone profiles and performance efficiency

This study examined the effects of one night of sleep deprivation on melatonin and cortisol profiles, as well as performance efficiency of military service members. Sleep intervention consisted of total lack of sleep (N = 7) or 8 hours of sleep (control group; N = 7) during the night. All parameters were measured at selected time intervals before (day 1), during (only in sleep-deprived individuals), and after (day 2) sleep intervention. Rotary pursuit scores and handgrip strength data were used as indices of psychomotor and physical performance, respectively. In sleep-deprived individuals, more salivary melatonin, but not cortisol, was secreted than in subjects who slept adequately. Significant increases in melatonin and cortisol were noted, especially at 1:30 p.m. on the day after nighttime sleep deprivation. In contrast, the tracking scores for rotary pursuit and grip strength among sleep-deprived and rested individuals were comparable. Across a normal working day (day 1), all parameters studied revealed time-specific fluctuations in both control and sleep-deprived groups. Irrespective of nighttime sleep schedule, the patterns of performance on day 2 differed from those on day 1. The tracking performance improved on day 2, whereas grip strength worsened, which may reflect inherent learning and muscle fatigue, respectively. During the night of sleep deprivation, performance declined. In conclusion, the present study showed that one night of sleep deprivation (8 hours) resulted in significant hormonal changes on the next afternoon but did not modify tracking and muscular strength performance.     

Caffeine effects on recovery sleep following 27 h total sleep deprivation

INTRODUCTION: Caffeine is widely used to reverse alertness and performance decrements. However, caffeine's effects on subsequent recovery sleep and post-recovery performance are not well documented and, therefore, were evaluated. METHODS: Six habitually low (LC: < or = 100 mg x d(-1)) and three habitually high (HC: > or = 400 mg x d(-1)) caffeine users completed a randomized crossover design. After 20 h of wakefulness, repeated doses of caffeine gum [0 (placebo) mg, 100 (low dose) mg, or 300 (high dose) mg] were administered at 03:00, 05:00, and 07:00. At 10:00 (27 h sleep deprivation) subjects slept for 8 h, followed by Psychomotor Vigilance Task (PVT) administration at 33 and 65 min post-awakening. RESULTS: Low dose caffeine increased stage 1 minutes only. However, high dose caffeine impaired sleep maintenance (reduced total sleep time/increased wake) and reduced sleep depth (increased stage 1 minutes/percentage and slow-wave sleep (SWS) latency, and reduced SWS minutes during the first third of the sleep period). With high dose caffeine, LC users had less SWS percentage as compared with HC users. The HC users had reduced stage 2 percentage with high dose caffeine as compared with placebo and low dose caffeine. Caffeine dose and habitual caffeine use did not influence post-recovery sleep PVT performance. DISCUSSION: Caffeine exerts mild deleterious dose-response effects on recovery sleep following total sleep deprivation, primarily early in the sleep period, with potential recovery from these effects after sufficient sleep as suggested by lack of post-recovery sleep performance deficits. Habitual caffeine use appears to minimally reduce caffeine effects.     

睡眠剥夺对大鼠胃运动及相关胃肠激素影响的研究

目的观察睡眠剥夺对胃排空、胃电活动及降钙素基因相关肽(CGRP)和一氧化氮(NO)的影响。方法将192只SD大鼠随机均分为3组，即急性睡眠剥夺组(A组)、慢性睡眠剥夺组(B组)、空白对照组(C组)；每组又随机均分为2个亚组．每亚组32只大鼠，即AI、AII．BI、BII．CI、CII；每个亚组再随平均分为4个小组．每小组8只大鼠。利用放射分析法．使用放射性核素锝(^99m Tc)．采取液相胃排空的方法检测胃的排空，利用浆膜法检测胃电的变化；利用生化法和放免分析法测定大鼠血浆中的CGRP、NO含量。结果急性睡眠剥夺导致胃排空速率改变．随着睡眠剥夺时间的延长，胃的排空速率逐渐降低；胃电活动在餐前逐渐降低．而餐后无明显规律．呈现紊乱状态；随着睡眠剥夺时间的延长血浆中CGRP的水平，逐渐降低，而NO水平却逐渐升高。慢性睡眠剥夺导致胃排空速率降低．但随着睡眠剥夺时间的延长，胃的排空速率未再发生更为明显的变化．呈现低排空状态；胃电活动在餐前、餐后均无明显规律，呈现紊乱状态；血浆中CGRP的水平随着睡眠剥夺时间的延长。呈现低水平状态．但与干预时间的关系不明显；NO水平呈现相对较高状态．且与干预时间关系不明显。结论睡眠剥夺对胃运动有较为明显的影响。急性睡眠剥夺产生的影响相对显著．导致胃运动功能的降低．而且可以引起大鼠血浆中某些胃肠道激素水平的改变；慢性睡眠剥夺对胃运动也产生影响．导致其功能紊乱，而且影响作用较为持久。     

Vigilance performance of men sleeping under arctic conditions.

This study investigated the effect of cold exposure on vigilance performance in men working and sleeping under Arctic conditions. The results were compared with changes in the amount of REM sleep. EEG sleep recordings were made on six subjects during five baseline nights in laboratory conditions, 16 experimental nights in Arctic conditions, and four recovery nights in the laboratory. Vigilance tests were administered every second day during the experimental period and two times during each of the baseline and recovery periods. During the first night in the Arctic, the amount of REM sleep fell to 50% of baseline and a large decrement occurred in detection performance on the following morning. During the remaining nights in the cold, REM deprivation averaged about 25% with somewhat greater deprivation occurring during colder nights. Reaction time measures generally increased throughout the experimental period and subsequently showed incomplete recovery. However, detection performance gradually improved during the experimental period but showed some regression following colder-than-usual nights, when REM deprivation increased. This suggested that performance on this type of task may be related to temperature variations and changes in REM deprivation.     

Modafinil vs. caffeine: effects on fatigue during sleep deprivation

INTRODUCTION: The extent to which modafinil and caffeine reverse fatigue effects (defined as performance decrements with time on task) during total sleep deprivation was investigated. METHODS: There were 50 healthy young adults who remained awake for 54.5 h (06:30 day 1 to 13:00 day 3). A 10-min vigilance test was administered bi-hourly from 08:00 day 1 until 22:00 day 2. At 23:55 day 2 (after 41.5 h awake), double-blind administration of one of five drug doses (placebo; modafinil 100, 200, or 400 mg; or caffeine 600 mg; n = 10 per group) was followed by hourly testing from 00:00 through 12:00 day 3. Response speed (reciprocal of reaction time) across the 10-min task (by 1-min block) was analyzed prior to and after drug administration. RESULTS: A fatigue effect (response speed degradation across the 10-min task) was exacerbated by sleep deprivation and circadian rhythmicity. Prior to the drug, this effect was maximal between 08:00 and 12:00 day 3 (24-28 h sleep deprivation). Modafinil 400 mg attenuated fatigue in a manner comparable to that seen with caffeine 600 mg; these effects were especially salient during the circadian nadir of performance (06:00 through 10:00); modafinil 200 mg also reversed fatigue, but for a shorter duration (3 min) than modafinil 400 mg (8 min) or caffeine 600 mg (6 min). DISCUSSION AND CONCLUSIONS: Time-on-task effects contributed to the performance degradation seen during sleep deprivation; effects which were reversed by caffeine and, at appropriate doses, by modafinil. Because the duration of efficacy for reversing time-on-task effects was shorter at lower drug dosages, the latter must be considered when determining the appropriate dose to use during sustained operations.     

睡眠剥夺条件下服用莫达芬尼对正常男性青年认知能力的影响

目的：观察48h睡眠剥夺（SD）条件下正常人服用新型中枢兴奋药莫达芬尼对提高认知能力的效果，为此药在我军飞行人员的进一步应用提供有关的试验依据。方法：6名健康男性青年志愿者，在两次SD试验（间隔两周）中交叉服用莫达芬尼和安慰剂，SD时间从第1日8：00至第3日8：00，于第2日0：00、16：00和第3日0：00分别服用莫达芬尼200mg或安慰剂，采用随机双盲设计给药，并在第1日21：00及每次服药后第1h、3h、5h和7h各完成1次认知能力测试：（1）4数连加：计算4个个位数相加的正确率；（2）心理运动：观察通过操纵杆控制计算机模拟的飞机飞行姿态的能力；（3）两者复合的双重任务。每阶段的试验数据用重复测量的两因素方差分析方法，分析各次服药后药物的主效应；再用两因素方差分析比较各个时间点药物与安慰剂的差别。结果：与安慰剂组比较，莫达芬尼能明显提高第2次服药后单、双重任务4数连加正确率，第3次服药后各项指标均较安慰剂组有显著提高（P＜0．05）。结论：莫达芬尼对SD条件下人体认知能力有明显的改善作用，使持续48h的工作绩效保持相对稳定的水平。