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Sleep, performance, circadian rhythms, and light-dark cycles during two space shuttle flights

Sleep, circadian rhythm, and neurobehavioral performance measures were obtained in five astronauts before, during, and after 16-day or 10-day space missions. In space, scheduled rest-activity cycles were 20-35 min shorter than 24 h. Light-dark cycles were highly variable on the flight deck, and daytime illuminances in other compartments of the spacecraft were very low (5.0-79.4 lx). In space, the amplitude of the body temperature rhythm was reduced and the circadian rhythm of urinary cortisol appeared misaligned relative to the imposed non-24-h sleep-wake schedule. Neurobehavioral performance decrements were observed. Sleep duration, assessed by questionnaires and actigraphy, was only approximately 6.5 h/day. Subjective sleep quality diminished. Polysomnography revealed more wakefulness and less slow-wave sleep during the final third of sleep episodes. Administration of melatonin (0.3 mg) on alternate nights did not improve sleep. After return to earth, rapid eye movement (REM) sleep was markedly increased. Crewmembers on these flights experienced circadian rhythm disturbances, sleep loss, decrements in neurobehavioral performance, and postflight changes in REM sleep.

Non-NASA Center↗

Effects of afternoon "siesta" naps on sleep, alertness, performance, and circadian rhythms in the elderly

STUDY OBJECTIVES: To determine the effects of a 90-minute afternoon nap regimen on nocturnal sleep, circadian rhythms, and evening alertness and performance levels in the healthy elderly. DESIGN AND SETTING: Nine healthy elderly subjects (4m, 5f, age range 74y-87y) each experienced both nap and no-nap conditions in two studies each lasting 17 days (14 at home, 3 in the laboratory). In the nap condition a 90-minute nap was enforced between 13:30 and 15:00 every day, in the no-nap condition daytime napping was prohibited, and activity encouraged in the 13:30-15:00 interval. The order of the two conditions was counterbalanced. PARTICIPANTS: N/A INTERVENTIONS: N/A MEASUREMENTS: Diary measures, pencil and paper alertness tests, and wrist actigraphy were used at home. In the 72 hour laboratory studies, these measures were augmented by polysomnographic sleep recording, continuous rectal temperature measurement, a daily evening single trial of a Multiple Sleep Latency Test (MSLT), and computerized tests of mood, activation and performance efficiency. RESULTS: By the second week in the "at home" study, an average of 58 minutes of sleep was reported per siesta nap; in the laboratory, polysomnography confirmed an average of 57 minutes of sleep per nap. When nap and no-nap conditions were compared, mixed effects on nocturnal sleep were observed. Diary measures indicated no significant difference in nocturnal sleep duration, but a significant increase (of 38 mins.) in 24-hour Total Sleep Time (TST) when nocturnal sleeps and naps were added together (p<0.025). The laboratory study revealed a decrease of 2.4% in nocturnal sleep efficiency in the nap condition (p<0.025), a reduction of nocturnal Total Sleep Time (TST) by 48 mins. in the nap condition (p<0.001) which resulted primarily from significantly earlier waketimes (p<0.005), but no reliable effects on Wake After Sleep Onset (WASO), delta sleep measures, or percent stages 1 & 2. Unlike the diary study, the laboratory study yielded no overall increase in 24-hour TST consequent upon the siesta nap regimen. The only measure of evening alertness or performance to show an improvement was sleep latency in a single-trial evening MSLT (nap: 15.6 mins., no nap: 11.5 mins., p<0.005). No significant change in circadian rhythm parameters was observed. CONCLUSIONS: Healthy seniors were able to adopt a napping regimen involving a 90-minute siesta nap each day between 13:30 and 15:00, achieving about one hour of actual sleep per nap. There were some negative consequences for nocturnal sleep in terms of reduced sleep efficiency and earlier waketimes, but also some positive consequences for objective evening performance and (in the diary study) 24-hour sleep totals. Subjective alertness measures and performance measures showed no reliable effects and circadian phase parameters appeared unchanged.

Non-NASA Center↗

Inducing jet-lag in older people: directional asymmetry

Twenty healthy elderly subjects (12 female, 8 male; mean age 81 years, range 67-87 years) each experienced a 15-day time isolation protocol in which they lived individually in a special laboratory apartment in which sleep and circadian rhythm measures could be taken. There were two experiments: one (6 females, 4 males) involved a 6-h phase advance of the sleep/wake cycle, and the other (6 females, 4 males) a 6-h phase delay. Each started with 5 baseline days, immediately followed by the phase shift. The subject was then held to the phase shifted routine for the remainder of the study. Rectal temperatures were recorded minute-by-minute throughout the entire experiment and each night of sleep was recorded using polysomnography. A directional asymmetry in phase-shift effects was apparent, with significantly more sleep disruption and circadian rhythm amplitude disruption after the phase advance than after the phase delay. Sleep disruption was reflected in reduced time spent asleep, and in changed REM latency, which increased in the phase advance direction but decreased in the phase delay direction. Although the phase advance led to a significant increase in wakefulness in the first half of the night, the phase delay did not lead to an equivalent increase in wakefulness during the second half of the night. Examination of both raw and 'demasked' circadian rectal temperature rhythms confirmed that phase adjustment was slow in both directions, but was less slow (and more monotonic) after the phase delay than after the phase advance. Subjective alertness suffered more disruption after the phase advance than after the phase delay.

NASA Discipline Regulatory Physiology↗

Light Improves Alertness and Mood during the Sleep Inertial Period following Slow Wave Sleep

Introduction: Waking from sleep, especially slow wave sleep (SWS), is associated with reduced alertness known as sleep inertia. Light improves alertness during sleep deprivation and circadian misalignment. In this study, we assessed the efficacy of light to improve alertness and mood immediately after waking from SWS. Methods: Twelve participants kept a sleep schedule of 8.5 h for 5 nights and 5 h for one night prior to the overnight laboratory visit (confirmed by actigraphy). Participants went to bed at their scheduled habitual bedtime in the laboratory and were monitored by standard polysomnography. After at least 5 min of SWS, participants were awoken and exposed to either red ambient light (control) or blue-enriched bright light (light) for 1 h. During this time, participants completed a subjective scale of alertness (Karolinska Sleepiness Scale, KSS) and visual analogue scales (VAS) of mood at 2 min, 17 min, 32 min, and 47 min after waking. Following this sleep inertia measurement period, all lights were turned off and participants were allowed to return to sleep. They were then awoken again from their subsequent SWS period and exposed to the opposite condition (control or light). A linear mixed-effects model with fixed effects of condition, time, and condition*time and a random effect of participant was used to determine the impact of light across the testing period. An average of baseline responses (pre-sleep) was included as a covariate. Results: Compared to the control condition, participants exposed to bright blue-enriched light reported feeling more alert (KSS: F1,77=4.955, p=.029; VASalert: F1,77=8.226, p=.005), more cheerful (VAScheerful: F1,77=8.615, p=.004), less depressed (VASdepressed: F1,77=4.649, p=.034), and less lethargic (VASlethargic: F1,77=5.652, p=.020). Discussion: Exposure to blue-enriched bright light immediately after waking from SWS may help to improve subjective alertness and mood. Future analyses will explore whether these findings extend to effects on cognitive performance.

alertness↗

Blue-enriched Light Improves Alertness and Mood Following Abrupt Awakening from Slow Wave Sleep

INTRODUCTION: All crew on the International Space Station (ISS) have a sleep opportunity at the same time. Emergencies arising during this time require all crew members to be abruptly awoken from sleep and to be alert, ready to work as a team, and to perform safety-critical tasks soon after waking. However, crew may experience sleep inertia after waking, which is associated with reduced alertness, poor mood, and impaired performance, especially if woken from deep sleep (slow wave sleep, SWS). Light has been shown to improve alertness during sleep deprivation and circadian misalignment. In this study, we assessed the efficacy of blue-enriched light to improve alertness and mood immediately after waking from SWS, i.e., during the sleep inertia period. METHODS: Twelve participants kept a sleep schedule of 8.5 h for 5 nights and 5 h for one night prior to the overnight laboratory visit (confirmed by actigraphy). Participants went to bed at their scheduled habitual bedtime in the laboratory and were monitored by standard polysomnography. After at least 5 min of SWS, participants were awoken and exposed to either red ambient light (control) or blue-enriched light (light) for 1 h. During this time, participants completed a subjective scale of alertness (Karolinska Sleepiness Scale, KSS) and visual analogue scales (VAS) of mood at 2 min, 17 min, 32 min, and 47 min after waking. Following this sleep inertia measurement period, all lights were turned off and participants were allowed to return to sleep. They were then awoken again from their subsequent SWS period and exposed to the opposite condition (control or light). A linear mixed-effects model with fixed effects of condition, time, and condition*time and a random effect of participant was used to determine the impact of light across the testing period. An average of baseline responses (pre-sleep) was included as a covariate. RESULTS: Compared to the control condition, participants exposed to blue-enriched light reported feeling more alert (KSS: F1,77=4.955, p=.029; VASalert: F1,77=8.226, p=.005), more cheerful (VAScheerful: F1,77=8.615, p=.004), less depressed (VASdepressed: F1,77=4.649, p=.034), and less lethargic (VASlethargic: F1,77=5.652, p=.020). DISCUSSION: Exposure to blue-enriched light immediately after waking from SWS may help to improve subjective alertness and mood. Future analyses will explore whether these findings extend to effects on cognitive performance. This countermeasure to sleep inertia may be suitable for implementation to alert crew members during mid-sleep emergencies but requires further testing in field settings.

alertness↗

Rise and Shine: Using Light as a Countermeasure to Sleep Inertia

INTRODUCTION: Sleep inertia describes the phenomenon of sleepiness and poor performance experienced after waking from sleep. This period of impaired alertness and performance is of significant concern to workers who nap on shift, or work on-call and are required to perform safety-critical tasks soon after waking (e.g., emergency services, healthcare, military). Light has been shown to acutely improve alertness during sleep deprivation and circadian misalignment. In this study, we assessed the efficacy of blue-enriched light to improve alertness and mood immediately after waking from SWS, i.e., during the sleep inertia period. METHODS: Twelve participants kept a sleep schedule of 8.5 h for 5 nights and 5 h for one night prior to the overnight laboratory visit (confirmed by actigraphy). Participants went to bed at their scheduled habitual bedtime in the laboratory and were monitored by standard polysomnography. After at least 5 min of SWS, participants were awoken and exposed to either red ambient light (control) or blue-enriched light (light) for 1 h. During this time, participants completed a subjective scale of alertness (Karolinska Sleepiness Scale, KSS) and visual analogue scales (VAS) of mood at 2 min, 17 min, 32 min, and 47 min after waking. Following this sleep inertia measurement period, all lights were turned off and participants were allowed to return to sleep. They were then awoken again from their subsequent SWS period and exposed to the opposite condition (control or light). A linear mixed-effects model with fixed effects of condition, time, and condition*time and a random effect of participant was used to determine the impact of light across the testing period. An average of baseline responses (pre-sleep) was included as a covariate. RESULTS: Compared to the control condition, participants exposed to blue-enriched light reported feeling more alert (KSS: F1,77=4.955, p=.029; VASalert: F1,77=8.226, p=.005), more cheerful (VAScheerful: F1,77=8.615, p=.004), less depressed (VASdepressed: F1,77=4.649, p=.034), and less lethargic (VASlethargic: F1,77=5.652, p=.020). DISCUSSION: Exposure to blue-enriched light immediately after waking from SWS may help to improve subjective alertness and mood. Future analyses will explore whether these findings extend to effects on cognitive performance. This countermeasure to sleep inertia may be suitable for implementation to alert crew members during mid-sleep emergencies but requires further testing in field settings.

alertness↗

Investigating the Effects of Exposure to Blue-Enriched Light or Peppermint Odor on Alertness, Mood, and Performance Upon Awakening from Deep Sleep at Night

Introduction: Sleep inertia refers the transient neurobehavioral impairments experienced immediately after waking from sleep. This period of reduced alertness and performance poses a significant safety risk to on-call workers who may be required to perform a safety-critical task immediately after waking (e.g., emergency services, health care, and military). In these operations, the need for a rapid return to full alertness is critical to mission safety and success. Several factors may exacerbate sleep inertia, resulting in greater impairment upon waking, including: waking from deep sleep, (i.e., slow wave sleep, SWS), waking at night, and waking following prior sleep loss. Awakenings under these conditions are common for on-call and extended shift workers who may need to perform safety-critical tasks soon after waking from unprotected sleep opportunities. Therefore, there is a need for evidence-based reactive countermeasures (i.e., used upon waking) to the cognitive consequences sleep inertia. Specifically, countermeasures that can rapidly restore alertness and performance immediately following sleep. A recent review of the literature on reactive countermeasures highlighted several research gaps and promising candidates for further investigation. The review also emphasized the need for countermeasures that are operationally viable and readily deployed in occupational settings. This study aims to address the identified gaps and limitations by assessing the efficacy of exposure to two known acute alerting stimuli - blue-enriched light and peppermint odor - to improve cognitive performance, alertness, and mood immediately after waking from SWS at night. Materials and Methods: Twelve participants completed a two-week within-subject, randomized, cross-over intervention study including two in-laboratory overnight visits. During each experimental week, the subjects experienced one intervention (light or peppermint) and a control condition upon awakening from SWS at night. The presentation order of the two conditions (intervention or control) at wake-up and the order of intervention (light or peppermint) by week was randomized by sex. Prior to each in-laboratory visit, participants maintained a sleep schedule of 8.5 h for 5 nights and 5 h for one night. Compliance with this sleep schedule was confirmed by actigraphy. In the laboratory, participants went to bed at their habitual bedtime and were monitored by standard polysomnography. After at least five minutes of continuous SWS, participants were awoken and exposed, in a randomized order, to either the control or intervention condition. During the hour after awakening from SWS (at 2, 17, 32, and 47 minutes after waking), participants completed a battery of tasks including a 5-minute psychomotor vigilance task (PVT), a subjective scale of alertness (Karolinska Sleepiness Scale, KSS), and visual analogue scales (VAS) of mood. Following this sleep inertia measurement period, all lights were turned off and participants were allowed to return to sleep. They were then awoken again from their subsequent SWS period and exposed to the alternative condition (control or intervention). Following this second awakening, participants were allowed to sleep until their habitual wake time and were then released from the laboratory. Participants then followed the at-home sleep schedule and returned to the laboratory for the second intervention (light or peppermint) following the procedures described above. The light intervention involved exposure to a blue-enriched light canvas illuminated for 1 hour at a distance of ~56 cm from the participant (~200 lux and ~60 melanopic lux at angle of gaze). For the peppermint intervention, peppermint oil was pipetted onto a mask, and participants inhaled the odor with the mask covering the nose and mouth for 1 minute. The control condition for both weeks involved a dim, red ambient light (<1 lux). An odorless mask, without any oil pipetted onto the mask, was also worn in the peppermint control condition. Results: Compared to the control condition, participants exposed to blue-enriched light had fewer PVT lapses (χ2 = 5.285, p = .022), reported feeling more alert (KSS: F1,77 = 4.955, p = .029; VASalert: F1,77 = 8.226, p = .005), and had improved mood (VAScheerful: F1,77 = 8.615, p = .004; VASdepressed: F1,77 = 4.649, p = .034; VASlethargic: F1,77 = 5.652, p = .020). Exposure to peppermint oil did not improve any outcome measures on any of the tasks compared to control condition (p > .05). Conclusions: We found that participants had fewer lapses of attention upon awakening when exposed to blue-enriched light compared to dim, red light. In addition, participants reported feeling more alert, more cheerful, less depressed, and less lethargic in the blue-enriched light condition. Brief exposure to a peppermint odor, however, did not appear to improve performance, alertness, or mood under the experimental conditions. Our null results in the peppermint condition may have been due to methodological limitations such as the duration and method of administration. Given the need to mitigate the potential impact of sleep inertia on safety-critical tasks in on-call operations, our findings suggest that blue-enriched light exposure upon awakening may help to improve performance and alertness during the sleep inertia period following awakening from deep, nocturnal sleep. We are currently exploring the potential mechanisms for the effect of light on cognitive performance upon awakening as well as investigating its application in real-world settings to explore the translational efficacy of this countermeasure to occupational environments. Continued exploration into light and other reactive countermeasures, and potentially their combination, is needed in order to provide evidence-based guidance on effective sleep inertia countermeasures to improve the alertness and performance of those required to perform safety-critical tasks soon after waking.

sleep inertia↗

Sex Differences in Perceptions of Sleep Inertia Following Nighttime Awakenings

Study Objectives: The influence of biological sex on sleep inertia symptoms is currently unknown. We investigated the role of sex differences in the subjective experience and objective cognitive manifestation of sleep inertia following nighttime awakenings. Methods: Thirty-two healthy adults (16 female, 25.91 ± 5.63 years) completed a one-week at-home study with one experimental night during which sleep was measured by polysomnography and participants were awakened during their habitual sleep time. Participants completed a psychomotor vigilance task (PVT), Karolinska Sleepiness Scale (KSS), visual analog mood scales, and a descending subtraction task (DST) prior to sleep (baseline) and at 2, 12, 22, and 32 minutes after awakening. A series of mixed-effects models with Bonferroni-corrected post-hoc tests were used to examine the main effects of test bout and sex, and their interaction, with a random effect of participant, and order of wake-up and sleep history as covariates. Results: All outcomes except for percent correct on the DST showed a significant main effect of test bout, with worse performance after waking compared to baseline (all p s < .003). Significant effects of sex ( p = .002) and sex × test bout ( p = .01; R 2 M = .49, R 2 C = .69) were observed for KSS, with females reporting a greater increase in sleepiness from baseline to after waking compared to males. Conclusions : These results suggest that while females reported feeling sleepier than males following nighttime awakenings, their cognitive performance was comparable. Future research is needed to determine whether perceptions of sleepiness influence decision-making during the transition from sleep to wakefulness.

Sleep inertia↗

Sex Differences in Perceptions of Sleep Inertia Following Nighttime Awakenings

Study Objectives: The influence of biological sex on sleep inertia symptoms is currently unknown. We investigated the role of sex differences in the subjective experience and objective cognitive manifestation of sleep inertia following nighttime awakenings. Methods: Thirty-two healthy adults (16 female, 25.91 ± 5.63 years) completed a one-week at-home study with one experimental night during which sleep was measured by polysomnography and participants were awakened during their habitual sleep time. Participants completed a psychomotor vigilance task (PVT), Karolinska Sleepiness Scale (KSS), visual analog mood scales, and a descending subtraction task (DST) prior to sleep (baseline) and at 2, 12, 22, and 32 minutes after awakening. A series of mixed-effects models with Bonferroni-corrected post-hoc tests were used to examine the main effects of test bout and sex, and their interaction, with a random effect of participant, and order of wake-up and sleep history as covariates. Results: All outcomes except for percent correct on the DST showed a significant main effect of test bout, with worse performance after waking compared to baseline (all ps < .003). Significant effects of sex (p = .002) and sex × test bout (p = .01; R2M = .49, R2C = .69) were observed for KSS, with females reporting a greater increase in sleepiness from baseline to after waking compared to males. Conclusions: These results suggest that while females reported feeling sleepier than males following nighttime awakenings, their cognitive performance was comparable. Future research is needed to determine whether perceptions of sleepiness influence decision-making during the transition from sleep to wakefulness.

sleep inertia↗

The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation

OBJECTIVES: To inform the debate over whether human sleep can be chronically reduced without consequences, we conducted a dose-response chronic sleep restriction experiment in which waking neurobehavioral and sleep physiological functions were monitored and compared to those for total sleep deprivation. DESIGN: The chronic sleep restriction experiment involved randomization to one of three sleep doses (4 h, 6 h, or 8 h time in bed per night), which were maintained for 14 consecutive days. The total sleep deprivation experiment involved 3 nights without sleep (0 h time in bed). Each study also involved 3 baseline (pre-deprivation) days and 3 recovery days. SETTING: Both experiments were conducted under standardized laboratory conditions with continuous behavioral, physiological and medical monitoring. PARTICIPANTS: A total of n = 48 healthy adults (ages 21-38) participated in the experiments. INTERVENTIONS: Noctumal sleep periods were restricted to 8 h, 6 h or 4 h per day for 14 days, or to 0 h for 3 days. All other sleep was prohibited. RESULTS: Chronic restriction of sleep periods to 4 h or 6 h per night over 14 consecutive days resulted in significant cumulative, dose-dependent deficits in cognitive performance on all tasks. Subjective sleepiness ratings showed an acute response to sleep restriction but only small further increases on subsequent days, and did not significantly differentiate the 6 h and 4 h conditions. Polysomnographic variables and delta power in the non-REM sleep EEG-a putative marker of sleep homeostasis--displayed an acute response to sleep restriction with negligible further changes across the 14 restricted nights. Comparison of chronic sleep restriction to total sleep deprivation showed that the latter resulted in disproportionately large waking neurobehavioral and sleep delta power responses relative to how much sleep was lost. A statistical model revealed that, regardless of the mode of sleep deprivation, lapses in behavioral alertness were near-linearly related to the cumulative duration of wakefulness in excess of 15.84 h (s.e. 0.73 h). CONCLUSIONS: Since chronic restriction of sleep to 6 h or less per night produced cognitive performance deficits equivalent to up to 2 nights of total sleep deprivation, it appears that even relatively moderate sleep restriction can seriously impair waking neurobehavioral functions in healthy adults. Sleepiness ratings suggest that subjects were largely unaware of these increasing cognitive deficits, which may explain why the impact of chronic sleep restriction on waking cognitive functions is often assumed to be benign. Physiological sleep responses to chronic restriction did not mirror waking neurobehavioral responses, but cumulative wakefulness in excess of a 15.84 h predicted performance lapses across all four experimental conditions. This suggests that sleep debt is perhaps best understood as resulting in additional wakefulness that has a neurobiological "cost" which accumulates over time.

NASA Discipline Regulatory Physiology↗

Obstructive apnea during sleep is associated with peripheral vasoconstriction

Obstructive apnea during sleep is associated with a substantial transient blood pressure elevation. The mechanism of this pressor response is unclear. In this study we measured muscle sympathetic nerve activity (MSNA), mean arterial pressure (Psa), and mean limb blood velocity as an index of blood flow (MBV, Doppler) and calculated changes in limb vascular resistance during and after apneas during both wakefulness and sleep in patients with the obstructive sleep apnea syndrome. Immediately postapnea during sleep Psa increased significantly compared with the earlier stages of apnea and this was preceded by a rise of MSNA (n = 5). In contrast to blood pressure, MBV remained unchanged. Because resistance = blood pressure/blood flow, limb vascular resistance increased by 29 +/- 8% from late apnea to postapnea (n = 7, p < 0.002). Voluntary breathhold maneuvers during room air exposure evoked similar responses (n = 10). Supplemental oxygen administered via nonrebreather face mask attenuated the MSNA and vasoconstrictor responses to obstructive (n = 2) and voluntary apneas (n = 10). Our data suggest that obstructive apneas in patients with the obstructive apnea syndrome are accompanied by transient limb vasoconstriction. This vasoconstrictor response appears to be, at least in part, mediated by the sympathetic nervous system and may be linked to hypoxia.

NASA Discipline Cardiopulmonary↗

Sleep and respiration in microgravity

Sleep studies conducted during the STS-90 Neurolab mission are explored. The relationship between sleep, melatonin, and circadian phase is reviewed. The study contained both sleep and awake components. The objectives of the sleep component were to test five hypotheses: that circadian rhythms of core body temperature and urinary melatonin are synchronized to required sleep-wake schedules, that spaceflight results in substantial disruption of sleep, that the pattern of chest and abdominal wall motion alters during the different sleep stages in microgravity, that arterial oxygen saturation is reduced during some stages of sleep in microgravity, and that pre-sleep administration of melatonin during microgravity results in improved sleep quality. The awake component tested three hypotheses: that ventilatory response to carbon dioxide is increased during exposure to microgravity and that this exacerbates sleep disruption, that ventilatory response to hypoxia is increased by exposure to microgravity, and that the improved sleep resulting from the pre-sleep administration of melatonin enhances next day cognition when compared to placebo.

Non-NASA Center↗

The Pittsburgh Sleep Diary

Increasingly, there is a need in both research and clinical practice to document and quantify sleep and waking behaviors in a comprehensive manner. The Pittsburgh Sleep Diary (PghSD) is an instrument with separate components to be completed at bedtime and waketime. Bedtime components relate to the events of the day preceding the sleep, waketime components to the sleep period just completed. Two-week PghSD data is presented from 234 different subjects, comprising 96 healthy young middle-aged controls, 37 older men, 44 older women, 29 young adult controls and 28 sleep disorders patients in order to demonstrate the usefulness, validity and reliability of various measures from the instrument. Comparisons are made with polysomnographic and actigraphic sleep measures, as well as personality and circadian type questionnaires. The instrument was shown to have sensitivity in detecting differences due to weekends, age, gender, personality and circadian type, and validity in agreeing with actigraphic estimates of sleep timing and quality. Over a 12-31 month delay, PghSD measures of both sleep timing and sleep quality showed correlations between 0.56 and 0.81 (n = 39, P < 0.001).

NASA Discipline Number 00-00↗

Microgravity reduces sleep-disordered breathing in humans

To understand the factors that alter sleep quality in space, we studied the effect of spaceflight on sleep-disordered breathing. We analyzed 77 8-h, full polysomnographic recordings (PSGs) from five healthy subjects before spaceflight, on four occasions per subject during either a 16- or 9-d space shuttle mission and shortly after return to earth. Microgravity was associated with a 55% reduction in the apnea-hypopnea index (AHI), which decreased from a preflight value of 8.3 +/- 1.6 to 3.4 +/- 0.8 events/h inflight. This reduction in AHI was accompanied by a virtual elimination of snoring, which fell from 16.5 +/- 3.0% of total sleep time preflight to 0.7 +/- 0.5% inflight. Electroencephalogram (EEG) arousals also decreased in microgravity (by 19%), and this decrease was almost entirely a consequence of the reduction in respiratory-related arousals, which fell from 5.5 +/- 1.2 arousals/h preflight to 1.8 +/- 0.6 inflight. Postflight there was a return to near or slightly above preflight levels in these variables. We conclude that sleep quality during spaceflight is not degraded by sleep-disordered breathing. This is the first direct demonstration that gravity plays a dominant role in the generation of apneas, hypopneas, and snoring in healthy subjects.

short duration↗

Wrist actigraphic measures of sleep in space

STUDY OBJECTIVES: To determine whether wrist actigraphy is useful as a tool for space-based sleep research. Specifically, to determine whether bedtimes and waketimes can be identified from the actigraphic record, and whether actigraphic measures of sleep in space are related to polysomnographic (PSG) ones. DESIGN AND SETTING: Actigraphy, sleep diary, and Polysomnographic (PSG) measures of sleep were obtained from four subjects in two 72h measurement blocks occurring 2d and 12d into a 17d Space Shuttle mission in orbiting the earth in microgravity. PATIENTS: Four healthy male astronauts aged 38y - 47y. INTERVENTIONS: NA. MEASUREMENTS AND RESULTS: Sleep onset and offset at "night" could be quite clearly identified from the actigraphic record and were better estimated by actigraph than by diary. There was a high correlation between actigraphic and PSG estimates of sleep duration (r = 0.96) and sleep efficiency (r = 0.88), and a similarity in the mean estimates obtained. On a minute-by-minute basis, there was a good correlation between sleep stage and actigraphic movement counts, with a higher level of counts per minute recorded in epochs with lighter PSG sleep stages. There was also a high correlation (r = 0.90) between minutes of stage 0 (wake) occurring between bedtime and wake time, and number of non-zero actigraph epochs during the same interval. CONCLUSIONS: Actigraphy worked well in space both as a way of detecting bedtimes and waketimes, and as an indicant of sleep restlessness.

NASA Discipline Regulatory Physiology↗

Relationship of endogenous circadian melatonin and temperature rhythms to self-reported preference for morning or evening activity in young and older people

BACKGROUND: Morningness-eveningness refers to interindividual differences in preferred timing of behavior (i.e., bed and wake times). Older people have earlier wake times and rate themselves as more morning-like than young adults. It has been reported that the phase of circadian rhythms is earlier in morning-types than in evening types, and that older people have earlier phases than young adults. These changes in phase have been considered to be the chronobiological basis of differences in preferred bed and wake times and age-related changes therein. Whether such differences in phase are associated with changes in the phase relationship between endogenous circadian rhythms and the sleep-wake cycle has not been investigated previously. METHODS: We investigated the association between circadian phase, the phase relationship between the sleep-wake cycle and circadian rhythms, and morningness-eveningness, and their interaction with aging. In this circadian rhythm study, 68 young and 40 older subjects participated. RESULTS: Among the young subjects, the phase of the melatonin and core temperature rhythms occurred earlier in morning than in evening types and the interval between circadian phase and usual wake time was longer in morning types. Thus, while evening types woke at a later clock hour than morning types, morning types actually woke at a later circadian phase. Comparing young and older morning types we found that older morning types had an earlier circadian phase and a shorter phase-wake time interval. The shorter phase-waketime interval in older "morning types" is opposite to the change associated with morningness in young people, and is more similar to young evening types. CONCLUSIONS: These findings demonstrate an association between circadian phase, the relationship between the sleep-wake cycle and circadian phase, and morningness-eveningness in young adults. Furthermore, they demonstrate that age-related changes in phase angle cannot be attributed fully to an age-related shift toward morningness. These findings have important implications for understanding individual preferences in sleep-wake timing and age-related changes in the timing of sleep.

Non-NASA Center↗

Time course of sleep inertia dissipation in human performance and alertness

Alertness and performance on a wide variety of tasks are impaired immediately upon waking from sleep due to sleep inertia, which has been found to dissipate in an asymptotic manner following waketime. It has been suggested that behavioural or environmental factors, as well as sleep stage at awakening, may affect the severity of sleep inertia. In order to determine the time course of sleep inertia dissipation under normal entrained conditions, subjective alertness and cognitive throughput were measured during the first 4 h after habitual waketime from a full 8-h sleep episode on 3 consecutive days. We investigated whether this time course was affected by either sleep stage at awakening or behavioural/environmental factors. Sleep inertia dissipated in an asymptotic manner and took 2-4 h to near the asymptote. Saturating exponential functions fitted the sleep inertia data well, with time constants of 0.67 h for subjective alertness and 1.17 h for cognitive performance. Most awakenings occurred out of stage rapid eye movement (REM), 2 or 1 sleep, and no effect of sleep stage at awakening on either the severity of sleep inertia or the time course of its dissipation could be detected. Subjective alertness and cognitive throughput were significantly impaired upon awakening regardless of whether subjects got out of bed, ate breakfast, showered and were exposed to ordinary indoor room light (approximately 150 lux) or whether subjects participated in a constant routine (CR) protocol in which they remained in bed, ate small hourly snacks and were exposed to very dim light (10-15 lux). These findings allow for the refinement of models of alertness and performance, and have important implications for the scheduling of work immediately upon awakening in many occupational settings.

Non-NASA Center↗