AbstractObjective To evaluate the effectiveness of a behavioural-educational sleep intervention delivered in the early postpartum in improving maternal and infant sleep.Design Randomised controlled trial.Setting Postpartum units of two university affiliated hospitals.Participants 246 primiparous women and their infants randomised while in hospital with an internet based randomisation service to intervention (n=123) or usual care (n=123) groups.Interventions The behavioural-educational sleep intervention i
AbstractObjective To determine whether there is an association between use of substances that contain caffeine and the risk of crash in long distance commercial vehicle drivers.Design Case-control study.Setting New South Wales (NSW) and Western Australia (WA), Australia.Participants 530 long distance drivers of commercial vehicles who were recently involved in a crash attended by police (cases) and 517 control drivers who had not had a crash while driving a commercial vehicle in the past 12 months.Main ou
Persistent hiccup can cause anorexia, weight loss, disabling sleepdeprivation, anxiety, and depression. Therefore, relief of persistent hiccup is important for advanced cancer patients and their family. Most reports on this condition are case series reports advocating the use of baclofen, haloperidol, gabapentin, and midazolam. However, these medications are occasionally ineffective or accompanied by intolerable side effects. The sodium channel blocker lidocaine has been shown to be effective in trea
AbstractObjective To evaluate the risk of narcolepsy in children and adolescents in England targeted for vaccination with ASO3 adjuvanted pandemic A/H1N1 2009 vaccine (Pandemrix) from October 2009.Design Retrospective analysis. Clinical information and results of sleep tests were extracted from hospital notes between August 2011 and February 2012 and reviewed by an expert panel to confirm the diagnosis. Vaccination and clinical histories were obtained from general practitioners.Setting Sleep centres and p
Sleepdeprivation and cold air exposure are both experienced in occupational and military settings but the combined effects of these 2 stressors is unknown. The purpose of this study was to determine the effects of 53 hours of total sleepdeprivation on thermoregulation during the rewarming phase (25C air) after acute cold air exposure (10C air).|Eight young men underwent 2 trials in which they either received 7 hours of sleep at night or were totally sleep deprived. On 3 consecutive mornings, the subjects underwent 2 hours of cold air exposure followed by 2 hours of rewarming. Rectal temperature, mean skin temperature, oxygen consumption, and thermal sensation were measured.|Rewarming from acute cold air exposure caused a decline in rectal temperature (~0.5C) each day but this was not different between subjects who were totally sleep deprived and subjects who received 7 hours of sleep at night. During this same period, mean skin temperature increased (from ~22C to 27C),
Sleepdeprivation is common among resident physicians and clinical fellows. Current evidence about sleep science, performance, shift work, and medical errors consistently demonstrates positive impact from reduction of excessive duty hours, particularly when shift length is shortened. This article provides an overview of this literature, highlighting research on diminished physician cognitive performance due to sleepdeprivation and the increase in the number of medical errors that is seen under these conditions. Accreditation Council on Graduate Medical Education trainee duty hour guidelines are reviewed. Practical approaches to evidence-based scheduling of shift-work are also discussed, with attention to improving patient safety.
Sleepdeprivation may slow reaction time, cloud judgment, and impair the ability to think. Our purpose was to study the cognitive and psychomotor performances of orthopaedic trauma surgeons on the basis of the amount of sleep that they obtained.|We prospectively studied the performances of thirty-two orthopaedic trauma surgeons (residents, fellows, and attending surgeons) over two four-week periods at an urban academic trauma center. Testing sessions used handheld computers to administer validated cognitive and psychomotor function tests. We conducted a multivariate analysis to examine the independent association between test performance and multiple covariates, including the amount of sleep the night before testing.|Our analysis demonstrated that orthopaedic surgeons who had slept four hours or less the night before the test had 1.43 times the odds (95% confidence interval, 1.04 to 1.95; p = 0.03) of committing at least one error on an individual test compared with orthopaedic
Prefrontal cortex (PFC) mediated cognitive and emotional processing deficits in bipolar disorder lead to functional limitations even during periods of mood stability. Alterations of sleep and circadian functioning are well-documented in bipolar disorder, but there is little research directly examining the mechanistic role of sleep and/or circadian rhythms in the observed cognitive and emotional processing deficits. We systematically review the cognitive and emotional processing deficits reliant upon PFC functioning of euthymic patients with bipolar disorder and in healthy individuals deprived of sleep. The evidence from two parallel lines of investigation suggests that sleep and circadian rhythms may be involved in the cognitive and emotional processing deficits seen in bipolar disorder through overlapping neurobiological systems. We discuss current models of bipolar highlighting the PFC-limbic connections and discuss inclusion of sleep-related mechanisms. Sleep and circadian
During the past 30 years, rates of partial sleepdeprivation and obesity have increased in the United States. Evidence linking partial sleepdeprivation, defined as sleeping <6 hours per night, to energy imbalance is relevant to weight gain prevention and weight loss promotion. With a majority of Americans overweight or obese, weight loss is a recommended strategy for reducing comorbid conditions. Our purpose was to review the literature regarding the role of partial sleepdeprivation on energy balance and weight regulation. An inverse relationship between obesity and sleep duration has been demonstrated in cross-sectional and prospective studies. Several intervention studies have tested mechanisms by which partial sleepdeprivation affects energy balance. Reduced sleep may disrupt appetitive hormone regulation, specifically increasing ghrelin and decreasing leptin and, thereby, influence energy intake. Increased wakefulness also may promote food intake episodes and energy imbalance.