Sharp and sleepy: evidence for dissociation between sleep pressure and nocturnal performance.

While sleep restriction decreases performance, not all individuals are equal with regard to sensitivity to sleep loss. We tested the hypothesis that performance could be independent of sleep pressure as defined by EEG alpha-theta power. Twenty healthy subjects (10 vulnerable and 10 resistant) underwent sleep deprivation for 25 h. Subjects had to rate their sleepiness (Karolinska Sleepiness Scale) and to perform a 10-min psychomotor vigilance task (PVT) every 2 h (20:00-08:00 hours). Sleep pressure was measured by EEG power spectral analysis (alpha-theta band 6.0-9.0 Hz). Initial performance, EEG spectral power and KSS score were equal in both groups (ANOVA, NS). The performance of vulnerable subjects significantly increased during the night (rANOVA, P < 0.01), whereas resistant subjects globally sustained their performance. Homeostatic pressure and subjective sleepiness significantly increased during the night (rANOVA, P < 0.01) identically in both categories (rANOVA, NS). Resistant subjects sustained their reaction time independently of the increase in homeostatic pressure. The phenotypic determinants of vulnerability to extended wakefulness remain unknown.

The effects of coffee and napping on nighttime highway driving: a randomized trial.

BACKGROUND: Sleep-related accidents often involve healthy young persons who are driving at night. Coffee and napping restore alertness, but no study has compared their effects on real nighttime driving performances. OBJECTIVE: To test the effects of 125 mL of coffee (half a cup) containing 200 mg of caffeine, placebo (decaffeinated coffee containing 15 mg of caffeine), or a 30-minute nap (at 1:00 a.m.) in a car on nighttime driving performance. DESIGN: Double-blind, randomized, crossover study. SETTING: Sleep laboratory and open highway. PARTICIPANTS: 12 young men (mean age, 21.3 years [SD, 1.8]). MEASUREMENTS: Self-rated fatigue and sleepiness, inappropriate line crossings from video recordings during highway driving, and polysomnographic recordings during the nap and subsequent sleep. INTERVENTION: Participants drove 200 km (125 miles) between 6:00 p.m. and 7:30 p.m. (daytime reference condition) or between 2:00 a.m. and 3:30 a.m. (coffee, decaffeinated coffee, or nap condition). After intervention, participants returned to the laboratory to sleep. RESULTS: Nighttime driving performance was similar to daytime performance (0 to 1 line crossing) for 75% of participants after coffee (0 or 1 line crossing), for 66% after the nap (P = 0.66 vs. coffee), and for only 13% after placebo (P = 0.041 vs. nap; P = 0.014 vs. coffee). The incidence rate ratios for having a line crossing after placebo were 3.7 (95% CI, 1.2 to 11.0; P = 0.001) compared with coffee and 2.9 (CI, 1.7 to 5.1; P = 0.021) compared with nap. A statistically significant interindividual variability was observed in response to sleep deprivation and countermeasures. Sleep latencies and efficiency during sleep after nighttime driving were similar in the 3 conditions. LIMITATIONS: Only 1 dose of coffee and 1 nap duration were tested. Effects may differ in other patient or age groups. CONCLUSIONS: Drinking coffee or napping at night statistically significantly reduces driving impairment without altering subsequent sleep.

Effects of sleep deprivation on Color-Word, Emotional, and Specific Stroop interference and on self-reported anxiety.

The aim of this study was principally to assess the impact of sleep deprivation on interference performance in short Stroop tasks (Color-Word, Emotional, and Specific) and on subjective anxiety. Subjective sleepiness and performance on a psychomotor sustained attention task were also investigated to validate our protocol of sleep deprivation. Twelve healthy young subjects were tested at four-hourly intervals through a 36-h period of wakefulness under a constant routine protocol. Analyses of variance for repeated measurements revealed that self-assessment of sleepiness on a visual analogue scale as well as mean reaction time performance on the sustained attention task, both for the first minute and for 10 min of testing, were worsened by sleep deprivation. Analyses revealed an increase in self-reported anxiety scores on the STAI questionnaire but did not reveal any significant effect after sleep deprivation either on indexes of interference or on accuracy in Stroop tasks. However, analyses showed sensitivity to circadian effect on verbal reaction times in the threat-related (Emotional) and sleep-related (Specific) Stroop tasks. We concluded that 36 h of prolonged wakefulness affect self-reported anxiety and Emotional Stroop task resulting in a cognitive slowing. Moreover, total sleep deprivation does not affect interference control in any of the three short Stroop tasks.

Sleep duration and caffeine consumption in a French middle-aged working population.

OBJECTIVE/BACKGROUND: To explore the association between sleep duration and daily caffeine intake in a working population. Caffeine acutely disrupts sleep in the laboratory, but the inter-relations between sleep and caffeine intake in daily life are ill-known. METHODS: Questionnaire and diary based survey of 1498 persons from the GAZEL cohort of employees of the National Electricity and Gas Company (EDF-GDF) working in various locations in the Paris and South-West France areas. We analyzed total sleep time, our primary measure, and time in bed, both by sleep logs. We assessed daily intake of caffeine, consumption of alcohol and tobacco, use of hypnotics, and daytime somnolence, all by questionnaire. RESULTS: Multiple linear regression analysis did not find a significant relationship between total sleep time and daily caffeine intake less than 8 cups of coffee per day, after controlling for age, gender, alcohol intake, smoking status, and use of hypnotics. By contrast, time in bed was reduced as caffeine intake increased (beta=-0.125; P<0.001). Higher caffeine intake was not related to a higher daytime somnolence. CONCLUSION: Despite the well-known acute effects of caffeine on sleep, habitual use of up to 7 cups of coffee (or 600 mg of caffeine equivalent) per day was not associated with decreased duration of sleep.

Fatigue, sleepiness, and performance in simulated versus real driving conditions.

STUDY OBJECTIVES: To determine whether real-life driving would produce different effects from those obtained in a driving simulator on fatigue, performances and sleepiness. DESIGN: Cross-over study involving real driving (1200 km) or simulated driving after controlled habitual sleep (8 hours) or restricted sleep (2 hours). SETTING: Sleep laboratory and open French Highway. PARTICIPANTS: Twelve healthy men (mean age +/- SD = 21.1 +/- 1.6 years, range 19-24 years, mean yearly driving distance +/- SD = 6563 +/- 1950 miles) free of sleep disorders. MEASUREMENTS: Self-rated fatigue and sleepiness, simple reaction time before and after each session, number of inappropriate line crossings from the driving simulator and from video-recordings of real driving. RESULTS: Line crossings were more frequent in the driving simulator than in real driving (P < .001) and were increased by sleep deprivation in both conditions. Reaction times (10% slowest) were slower during simulated driving (P = .004) and sleep deprivation (P = .004). Subjects had higher sleepiness scores in the driving simulator (P = .016) and in the sleep restricted condition (P = .001). Fatigue increased over time (P = .011) and with sleep deprivation (P = .000) but was similar in both driving conditions. CONCLUSIONS: Fatigue can be equally studied in real and simulated environments but reaction time and self-evaluation of sleepiness are more affected in a simulated environment. Real driving and driving simulators are comparable for measuring line crossings but the effects are of higher amplitude in the simulated condition. Driving simulator may need to be calibrated against real driving in various condition.

Age, performance and sleep deprivation.

Young subjects are frequently involved in sleep-related accidents. They could be more affected than older drivers by sleep loss and therefore worsen their driving skills quicker, or have a different perception of their level of impairment. To test these hypotheses we studied variations of reaction time (RT), a fundamental prerequisite for safe performing, as measured by lapses, i.e. responses > or = 500 ms and self-assessment of performance and sleepiness after a night awake and after a night asleep in a balanced crossover design in young versus older healthy subjects. Ten young (20-25 years old) and 10 older volunteers (52-63 years old) were tested with and without 24 h of sleep deprivation. Without sleep deprivation, RTs were slower in older subjects than in the younger ones. However, after sleep deprivation, the RTs of young subjects increased while that of the older subjects remained almost unaffected. Sleepiness and self-perception of performance were equally affected in both age groups showing different perception of performance in the age groups. Our findings are discussed in terms of vulnerability to sleep-related accidents.