Daytime Alertness in Relation to Mood, Performance, and Nocturnal Sleep in Chronic Insomniacs and Noncomplaining Sleepers

Wf, Seidel; Ball, S. M.; Cohen, Sidney; Patterson, N; D, Yost; Wc, Dement

doi:10.1093/sleep/7.3.230

Cited by 139 publications

(51 citation statements)

References 8 publications

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“…The authors also failed to find a significant correlation between ESS and MSLT scores. Similarly, many investigators have reported poor or no association between sleep latency of MSLT and ESS and other subjective tests, such as Stanford sleepiness scale [50,51]. A possible explanation might be that subjective and objective tests evaluate different aspects of sleepiness.…”

Section: Discussionmentioning

confidence: 99%

The role of mean inspiratory effort on daytime sleepiness

Pelin¹,

Karadeniz²,

Öztürk³

et al. 2003

Eur Respir J

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This study has investigated the role of average maximum inspiratory effort in excessive daytime sleepiness in patients with obstructive sleep apnoea syndrome (OSAS) and upper airway resistance syndrome (UARS).Fifteen patients diagnosed with UARS and 32 patients with OSAS, withw5.5 h total sleep time (TST) during 8 h of nocturnal polygraphic recordings, were included in the study. Demographical data, polysomnographical data and data about daytime sleepiness, including Epworth sleepiness scale (ESS) and multiple sleep latency test (MSLT), were evaluated. In order to compute the average maximum inspiratory effort from oesophageal pressure (Poes) measurements, maximum Poes was obtained from 20 representative obstructive respiratory events (obstructive apnoeas, hypopnoeas or flow limitations) for each sleep stage in both supine and side positions. From Poes measurements during sleep, the increase in Poes (DPoes) during respiratory events was also calculated.The average maximum Poes, DPoes, respiratory disturbance index (RDI) and arousal index were significantly correlated with ESS in OSAS patients. In patients with UARS, the only significant correlation was obtained between average maximum Poes and ESS. The MSLT score did not show any significant correlation with arousal index, number of stage variations, RDI, average Poes, DPoes, minimum oxygen saturation (Sa,O 2 ) and percentage of TST with an Sa,O 2 v90% in both UARS and OSAS patients. The results of multiple regression analysis showed that average maximum Poes correlates best with the variance in ESS for OSAS patients.In conclusion, the data from this study indicate the possible important role of average inspiratory effort in determining subjective sleepiness in both obstructive sleep apnoea syndrome and upper airway resistance syndrome patients.

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Section: Discussionmentioning

confidence: 99%

The role of mean inspiratory effort on daytime sleepiness

Pelin¹,

Karadeniz²,

Öztürk³

et al. 2003

Eur Respir J

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“…Numerous studies in clinical samples have demonstrated that individuals with primary insomnia (PI) report more daytime symptoms of depression and anxiety than good sleeper control subjects (GSC) (8)(9)(10)even when individuals with syndromal psychiatric disorders are excluded, as reviewed by Reidel and Lichstein. (11) However, not all studies have found significant differences (12)(13)(14). Daytime symptoms of hyperarousal are also relevant to the study of insomnia.…”

Section: Introductionmentioning

confidence: 99%

Daytime symptoms in primary insomnia: A prospective analysis using ecological momentary assessment

et al. 2007

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Objectives-To prospectively characterize and compare daytime symptoms in primary insomnia (PI) and good sleeper control (GSC) subjects using ecological momentary assessment; to examine relationships between daytime symptom factors, retrospective psychological and sleep reports, and concurrent sleep diary reports.Methods-Subjects included 47 PI and 18 GSC. Retrospective self-reports of daytime and sleep symptoms were collected. Daytime symptoms and sleep diary information were then collected for one week on hand-held computers. The Daytime Insomnia Symptom Scale (DISS) consisted of 19 visual analog scales completed four times per day. Factors for the DISS were derived using functional principal components analysis. Nonparametric tests were used to contrast DISS, retrospective symptom ratings, and sleep diary results in PI and GSC subjects, and to examine relationships among them.Results-Four principal components were identified for the DISS: Alert Cognition, Negative Mood, Positive Mood, and Sleepiness/Fatigue. PI scored significantly worse than GSC on all four factors (p < .0003 for each). Among PI subjects DISS scales and retrospective psychological symptoms were related to each other in plausible ways. DISS factors were also related to self-report measures of sleep, whereas retrospective psychological symptom measures were not.Conclusions-Daytime symptom factors of alertness, positive and negative mood, and sleepiness/ fatigue, collected with ecological momentary assessment, showed impairment in PI versus GSC. DISS factors showed stronger relationships to retrospective sleep symptoms and concurrent sleep diary reports than retrospective psychological symptoms. The diurnal pattern of symptoms may inform studies of the pathophysiology and treatment outcome of insomnia.

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“…Earlier studies produced surprising fi ndings that insomnia patients, in spite of complaints about fatigue and chronically shorter or poorer night sleep, were not sleepier during the day than normal subjects, as measured with the MSLT (41,53,54). Stepanski (55) found that insomniacs were even more alert than normal sleepers on the MSLT and hypothesised that these results were the consequence of chronic physiological hyperarousal in insomnia patients.…”

Section: Chronic Insomnia and The Hyperarousal Hypothesismentioning

confidence: 99%

Regulation of Sleepiness: The Role of the Arousal System

Bakotić¹,

Radošević-Vidaček²

2012

Archives of Industrial Hygiene and Toxicology

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It is generally accepted that two basic physiological processes regulate sleepiness: homeostatic and circadian rhythmic processes. Recent research has proposed the third component regulating sleepiness, that is, the wake drive or the arousal system. The role of the arousal system in regulating sleepiness has partly been addressed by the studies of the pathophysiology of insomnia, which is often described as a disorder of hyperarousal. Experimental and correlational studies on the relation between sleepiness and arousal in good sleepers have generally indicated that both physiological and cognitive arousal are related to the standard measures of sleepiness. Taking into account the role of the arousal system in regulating sleepiness widens the possibilities for the management of sleep disorders and could also help in solving the problem of excessive sleepiness at work and the wheel. KEY WORDS: circadian rhythms, insomnia, shift work, sleep homeostasis, wake driveBakotić M, and Radošević-Vidaček B. WAKE DRIVE IN SLEEPINESS REGULATION Arh Hig Rada Tokiskol 2012;63 Supplement 1: 23-34 Sleep research and sleep medicine often defi ne sleepiness as a state refl ecting physiological sleep need (1). Other terms used in addition to sleepiness are sleep propensity and sleep tendency. Sleepiness is measured by how long it takes to fall asleep, with tests such as the Multiple Sleep Latency Test (MSLT) (2) and the Maintenance of Wakefulness Test (MWT) (3). Sleepiness is also measured by behaviour such as eye closing, yawning, specifi c head movement (bobbing), facial expressions, and performance in various psychomotor and cognitive tasks (4). In the subjective domain, measurements include various single-or multi-facetted sleepiness rating scales (5, 6) and scales assessing the tendency to fall asleep in various situations (7).Although sleepiness is a normal physiological state related to sleep need, in certain cases it can be a symptom of a serious disease or condition. In such cases the term pathological or excessive sleepiness is used. The American Academy of Sleep Medicine defi nes excessive sleepiness as sleepiness that occurs in situations when a person is expected to be awake and alert (8), which interferes with person's daily functioning such as work or school performance, cognitive functioning, mood, and social interaction.Empirical data indicate that sleepiness signifi cantly contributes to vehicle accidents and that mortality in these accidents is very high, especially in persons younger than 25 years (9-12). Furthermore, sleepiness at the workplace is associated with lower performance and greater risk of occupational accidents and injuries, especially in industrial operations and transportation services (10,(13)(14)(15). Shift workers run the greatest risk of sleepiness at the workplace because their working time often coincides with the time of the day when humans are biologically programmed to sleep. 24On the other hand, shift workers often sleep at the time when circadian factors promote wakefulness, which c...

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Daytime Alertness in Relation to Mood, Performance, and Nocturnal Sleep in Chronic Insomniacs and Noncomplaining Sleepers

Cited by 139 publications

References 8 publications

The role of mean inspiratory effort on daytime sleepiness

The role of mean inspiratory effort on daytime sleepiness

Daytime symptoms in primary insomnia: A prospective analysis using ecological momentary assessment

Regulation of Sleepiness: The Role of the Arousal System

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