Getting back in the loop: Does autonomous driving duration affect driver's takeover performance?

The level 3 autonomous driving function allows the driver to perform non-driving-related tasks such as watching movies or reading while the system manages the driving task. However, when a difficult situation arises, the driver is requested to return to the loop of control. This switching from driver to passenger then back to driver may modify the driving paradigm, potentially causing an out-of-the-loop state. We tested the hypothesis of a linear (progressive) impact of various autonomous driving durations: the longer the level 3 autonomous function is used, the poorer the driver's takeover performance. Fifty-two participants were divided into 4 groups, each group being assigned a specific period of autonomous driving (5, 15, 45, or 60 min), followed by a takeover request with a time budget of 8.3 s. Takeover performance was assessed over two successive drives via reaction times and manual driving metrics (trajectories). The initial hypothesis (linearity) was not confirmed: there was a nonlinear relationship between autonomous driving duration and takeover performance, with one duration (15 min) appearing safer overall and mixed performance within groups. Repetition induced a major change in performance during the second drive, indicating rapid adaptation to the situation. The non-driving-related task appears critical in several respects (dynamics, content, driver interest) to proper use of level 3 automation. All this supports previous research prompting reservations about the prospect of car driving becoming like train travel.

Perceived discomfort and neuromuscular fatigue during long-duration real driving with different car seats.

INTRODUCTION: Identification of the seat features that could improve driving experience is a main issue for automotive companies. OBJECTIVE: Long duration real driving sessions were performed to assess the effect of three seats (soft-S1, firm-S2 and suspended-S3) on perceived discomfort and neuromuscular fatigue (NMF). MATERIALS & METHODS: For each seat, the muscular activity of bilateral Trapezius Descendens (TD), Erector Spinae (ES) and Multifidus (MF) muscles of twenty-one participants was recorded during real driving sessions of 3-hours each lasting approximately 3 hours and following the same itinerary. During each driving session, participants were also regularly asked to self-evaluate their level of whole-body and local discomfort. In addition, an endurance static test (EST) was performed before (ESTpre) and after (ESTpost) each driving session to assess the seat effect on physical capacity. RESULTS: Whole-body discomfort increased with driving time for all seats, but this increase became significant latter for S3. The highest scores of local discomfort occurred for neck and lower back. Contrary to S1 and S2, the duration of ESTpost was not significantly lower compared to ESTpre with the S3. Interestingly, muscular activity of S1 remained stable throughout the driving task which could be attributed to sustained muscular contraction, while muscular recruitment adjustments occurred for S2 and S3 from 1H00 of driving. This muscular compensation concerns mostly the right side for S2 and S3 but with different profiles. On the left side, the muscular adjustments concern only the MF with S2 and the ES with S3. CONCLUSION: Overall, our results demonstrated that S3 could be considered as the most suitable seat to delay discomfort and NMF appearance.

Strategies to Limit Cognitive Impairments under Sleep Restriction: Relationship to Stress Biomarkers.

Adding relaxation techniques during nap or auditory stimulation of EEG slow oscillation (SO) during nighttime sleep may limit cognitive impairments in sleep-deprived subjects, potentially through alleviating stress-releasing effects. We compared daytime sleepiness, cognitive performances, and salivary stress biomarker responses in 11 volunteers (aged 18-36) who underwent 5 days of sleep restriction (SR, 3 h per night, with 30 min of daily nap) under three successive conditions: control (SR-CT), relaxation techniques added to daily nap (SR-RT), and auditory stimulation of sleep slow oscillations (SO) during nighttime sleep (SR-NS). Test evaluation was performed at baseline (BASE), the fifth day of chronic SR (SR5), and the third and fifth days after sleep recovery (REC3, REC5, respectively). At SR5, less degradation was observed for percentage of commission errors in the executive Go-noGo inhibition task in SR-RT condition compared to SR-CT, and for sleepiness score in SR-NS condition compared both to SR-CT and SR-RT. Beneficial effects of SR-RT and SR-NS were additionally observed on these two parameters and on salivary α-amylase (sAA) at REC3 and REC5. Adding relaxation techniques to naps may help performance in inhibition response, and adding nocturnal auditory stimulation of SO sleep may benefit daytime sleepiness during sleep restriction with persistent effects during recovery. The two strategies activated the autonomic nervous system, as shown by the sAA response.

Influence of car seat firmness on seat pressure profiles and perceived discomfort during prolonged simulated driving.

During a driving task, the seat-driver interface is particularly influenced by the external environment and seat features. This study compares the effect of two different seats (S1 - soft & S2 - firm) and the effect of visual simulation of different road types (city, highway, mountain, country), on pressure distribution and perceived discomfort during prolonged driving. Twenty participants drove two 3-h sessions (one per seat) on a static simulator. Contact Pressure (CP), Contact Surface (CS), and Seat Pressure Distribution Percentage (SPD%) were analyzed throughout, using two pressure mats positioned on seat cushion and backrest. Whole-body and local discomfort for each body part were rated every 20 min. The softer seat, S1, induced a greater contact surface on cushion and backrest and a lower SPD%, reflecting better pressure distribution. Pressure profiles were asymmetrical for both S1 and S2, with higher CP under left buttock (LBu) and right lower back (RLb) and greater CS under thighs and RLb. Pressure distribution was less homogeneous on mountain and city roads than on monotonous roads (highway and country). Despite the pressure differences between the seats, however, both led to similar increases in perceived whole-body discomfort throughout the driving session. Moreover, the highest discomfort scores were in the neck and the lower back areas, whatever the seat. These findings on pressure variables may have implications for the design of backrests and cushions to ensure more homogeneous pressure distribution, even though this is not shown to minimize perceived driver discomfort.

Car seat impact on driver's sitting behavior and perceived discomfort during prolonged real driving on varied road types.

Prolonged driving under real conditions can entail discomfort linked to driving posture, seat design features, and road properties like whole-body vibrations (WBV). This study evaluated the effect of three different seats (S1 = soft; S2 = firm; S3 = soft with suspension system) on driver's sitting behavior and perceived discomfort on different road types in real driving conditions. Twenty-one participants drove the same 195 km itinerary alternating highway, city, country, and mountain segments. Throughout the driving sessions, Contact Pressure (CP), Contact Surface (CS), Seat Pressure Distribution Percentage (SPD%) and Repositioning Movements (RM) were recorded via two pressure mats installed on seat cushion and backrest. Moreover every 20 minutes, participants rated their whole-body and local discomfort. While the same increase in whole-body discomfort with driving time was observed for all three seats, S3 limited local perceived discomfort, especially in buttocks, thighs, neck, and upper back. The pressure profiles of the three seats were similar for CP, CS and RM on the backrest but differed on the seat cushion. The soft seats (S1 & S3) showed better pressure distribution, with lower SPD% than the firm seat (S2). All three showed highest CP and CS under the thighs. Road type also affected both CP and CS of all three seats, with significant differences appearing between early city, highway and country segments. In the light of these results, automotive manufacturers could enhance seat design for reduced driver discomfort by combining a soft seat cushion to reduce pressure peaks, a firm backrest to support the trunk, and a suspension system to minimize vibrations.

Evaluating sleep deprivation and time-of-day influences on crash avoidance maneuvers of young motorcyclists using a dynamic simulator.

INTRODUCTION: Motorcyclists are particularly at risk of being injured when involved in a road traffic accident. To avoid such crashes, emergency braking and/or swerving maneuvers are frequently performed. The recent development of dynamic motorcycle simulators may allow to study the influences of various disturbance factors such as sleep deprivation (SD) and time-of-day (TOD) in safe conditions. METHODS: Twelve young healthy males took part in 8 tests sessions at 06:00 h, 10:00 h, 14:00 h, 18:00 h after a night with or without sleep, in a random order. Participants had to perform an emergency braking and a swerving maneuver, both realized at 20 and 40 kph on a motorcycle dynamic simulator. For each task, the total distance/time necessary to perform the maneuver was recorded. Additional analysis was conducted on reaction and execution distance/time (considered as explanatory variables). RESULTS: Both crash avoidance maneuvers (emergency braking and swerving) were affected by increased speed, resulting in longer time and distance at 40 kph than at 20 kph. Emergency braking was mainly influenced by sleep deprivation, which significantly increased the total distance necessary to stop at 40 kph (+1.57 m; + 20%; p < 0.01). These impaired performances can be linked to an increase in reaction time (+21%; p < 0.01). Considering the swerving maneuver, TOD and SD influences remained limited. TOD only influenced the reaction time/distance measured at 40 kph with poorer performance in the early morning (+30% at 06:00 h vs 18:00 h; p < 0.05). DISCUSSION: Our results confirm that crash avoidance capabilities of young motorcyclists were influenced by the lack of sleep, mainly because of increased reaction times. More complex tasks (swerving maneuver) remained mostly unchanged in this paradigm. Practical Applications: Prevention campaigns should focus on the dangers of motorcycling while sleepy. Motorcycling simulators can be used to sensitize safely with sleep deprivation and time-of-day influences.

Car drivers coping with hazardous events in real versus simulated situations: Declarative, behavioral and physiological data used to assess drivers' feeling of presence.

More than 1.3 million people lose their lives every year in traffic accidents. Improving road safety requires designing better vehicles and investigating drivers' abilities more closely. Driving simulators are constantly being used for this purpose, but the question which often arises as to their validity tends to be a barrier to developments in this field. Here we studied the validity of a simulator, defined as how closely users' behavior under simulated conditions resembles their behavior on the road, based on the concept of drivers' feeling of presence. For this purpose, the driving behavior, physiological state and declarative data of 41 drivers were tested in the Sherpa2 simulator and in a real vehicle on a track while driving at a constant speed. During each trial, drivers had to cope with an unexpected hazardous event (a one-meter diameter gym ball crossing the road right in front of the vehicle), which occurred twice. During the speed-maintenance task, the simulator showed absolute validity, in terms of the driving and physiological parameters recorded. During the first hazardous event, the physiological parameters showed that the level of arousal (Low Heart Rate/High Heart Rate ratio x10) increased up to the end of the drive. On the other hand, the drivers' behavioral (braking) responses were 20% more frequent in the simulator than in the real vehicle, and the physiological state parameters showed that stress reactions occurred only in the real vehicle (+5 beats per minute, +2 breaths per minute and the phasic skin conductance increased by 2). In the subjects' declarative data, several feeling of presence sub-scales were lower under simulated conditions. These results suggest that the validity of motion based simulators for testing drivers coping with hazards needs to be questioned.

Changes in Electroencephalography Activity of Sensory Areas Linked to Car Sickness in Real Driving Conditions.

Car sickness is a major concern for car passengers, and with the development of autonomous vehicles, increasing numbers of car occupants are likely to be affected. Previous laboratory studies have used EEG measurements to better understand the cerebral changes linked to symptoms. However, the dynamics of motion in labs/simulators differ from those of a real car. This study sought to identify specific cerebral changes associated with the level of car sickness experienced in real driving conditions. Nine healthy volunteers participated as front passengers in a slalom session inducing lateral movements at very low frequency (0.2 Hz). They were continuously monitored via EEG recordings and subjectively rated their level of symptoms after each slalom, using a 5-point likert scale. Car-sickness symptoms evolved concomitantly with changes in theta and alpha power in the occipital and parietal areas. These changes may reflect altered sensory integration, as well as a possible influence of sleepiness mitigating symptoms.

Neuromuscular fatigue profiles depends on seat feature during long duration driving on a static simulator.

Prolonged driving could induce neuromuscular fatigue and discomfort since drivers have little opportunity to adjust their position. However, better car seat design could play a major role in limiting these effects. This study compared the effect of two different seats (S - soft and F - firm) on neuromuscular fatigue and driver's perceived discomfort during prolonged driving, also assessing the effect of different road types on neuromuscular activity. Twenty participants performed two 3-h driving sessions, one for each seat, on a static simulator. Every 20 min, participants self-evaluated their level of whole-body and individual body-area discomfort. Surface electromyography (sEMG) was recorded for eight muscles including Trapezius descendens (TD), Erector spinae longissimus (ESL), Multifidus (MF), Vastus lateralis (VL) and Tibialis anterior (TA) throughout the driving sessions. Moreover, an endurance static test (EST) was performed prior to and after each driving session. Whole-body discomfort increased with time with both seats, but no difference in discomfort scores was observed between seats throughout the driving sessions. The highest discomfort scores were for neck and lower back areas with both seats. Neuromuscular fatigue was revealed by a shorter endurance time in post-driving EST for both seats. EMG recordings showed different neuromuscular fatigue profiles for the two seats, with earlier onset of fatigue for S. Despite the lack of difference in perceived discomfort level, the two seats have different impacts: the softness of S induces greater activity of the lower back muscles, while F offers greater support for the lower back.

Efficacy of THN102 (a combination of modafinil and flecainide) on vigilance and cognition during 40-hour total sleep deprivation in healthy subjects: Glial connexins as a therapeutic target.

AIMS: THN102 is a novel combination of modafinil and low-dose flecainide, targeting glial connexin activity to modulate modafinil effects. We investigated THN102 efficacy compared to modafinil and to placebo on vigilance and cognitive function during 40-hour total sleep deprivation (TSD). METHODS: Twenty healthy men participated in a double-blind, randomized, incomplete-block 3-period cross-over trial with 5 treatments (n = 12 per group): placebo (PBO), modafinil 100 mg (MOD100), THN102 100/1, 100/3, 100/9 (modafinil 100 mg and flecainide 1, 3 or 9 mg). Each period included a baseline day and a TSD day with treatments administered 3 times (01:00, 09:00 and 19:00). Reaction time in psychomotor vigilance test, subjective somnolence and vital signs were assessed before and during treatment. Working memory (2-Back) and executive processes (Go/noGo for vigilance and inhibition, Wisconsin card sorting task for mental flexibility, and Tower of London test for planning) were evaluated at 16:30. RESULTS: At 5 hours postdose−1 (after 23 hours TSD, primary endpoint), THN102 100/1 resulted in statistically higher psychomotor vigilance test speed vs MOD100 (3.97 ± 0.09 vs 3.74 ± 0.14, P < .05). No increase in effect was observed with higher flecainide doses in combinations. Most THN102 doses vs MOD100 also improved the number of correct responses in 2-Back and Go errors in Go/noGo (P < .05 for all doses), and perseverative responses in Wisconsin card sorting task (for 100/1 and 100/9). No impact on cardiac conduction was noted with THN102, and safety was similar to MOD100. CONCLUSIONS: THN102 seems more efficient than modafinil on vigilance, working memory and executive functions, opening new perspectives in management of hypersomnolence disorders.

Limited Benefit of Sleep Extension on Cognitive Deficits During Total Sleep Deprivation: Illustration With Two Executive Processes.

Introduction: Sleep extension has been associated with better alertness and sustained attention capacities before, during and after sleep loss. However, less is known about such beneficial effect on executive functions (EFs). Our aim was to investigate such effects on two EFs (i.e., inhibition and working memory) for subjects submitted to total sleep deprivation and one-night of recovery. Methods: Fourteen healthy men (26-37 years old) participated in an experimental cross-over design with two conditions: extended sleep (EXT, 9.8 ± 0.1 h of Time In Bed, TIB) and habitual sleep (HAB, 8.2 ± 0.1 h TIB). During these two conditions subjects underwent two consecutive phases: Six nights of either EXT or HAB followed by 3 days in-laboratory: baseline (BASE), TSD (38 h) and after recovery (REC). EFs capacities were assessed through Go-NoGo (inhibition) and 2N-Back (working memory) tasks. Both EFs capacities were measured at different time (BASE/TSD/REC: 09:30, 13:00, 16:00; TSD: 21:00, 00:00, 03:00, 06:30). Results: In both conditions (HAB and EXT), TSD was associated with deficits in inhibition (higher errors and mean reaction time from TSD 09:30 until the end; p < 0.05) and working memory (lower corrects responses from TSD 06:30 or 09:30; p < 0.05). We observed no significant differences between HAB and EXT conditions on EFs capacities during BASE, TSD, and REC periods. Conclusion: Six nights of sleep extension is neither efficient to reduce core EFs deficits related to TSD nor to improve such capacities after a recovery night. These results highlight that sleep extension (six nights of 10 h of TIB) is not effective to limit EFs deficits related to TSD suggesting a disconnection inside cognition between executive and sustained attention processes. Clinical Trials: NCT02352272.

Adapting artificial neural networks to a specific driver enhances detection and prediction of drowsiness.

Monitoring car drivers for drowsiness is crucial but challenging. The high inter-individual variability observed in measurements raises questions about the accuracy of the drowsiness detection process. In this study, we sought to enhance the performance of machine learning models (Artificial Neural Networks: ANNs) by training a model with a group of drivers and then adapting it to a new individual. Twenty-one participants drove a car simulator for 110 min in a monotonous environment. We measured physiological and behavioral indicators and recorded driving behavior. These measurements, in addition to driving time and personal information, served as the ANN inputs. Two ANN-based models were used, one to detect the level of drowsiness every minute, and the other to predict, every minute, how long it would take the driver to reach a specific drowsiness level (moderately drowsy). The ANNs were trained with 20 participants and subsequently adapted using the earliest part of the data recorded from a 21st participant. Then the adapted ANNs were tested with the remaining data from this 21st participant. The same procedure was run for all 21 participants. Varying amounts of data were used to adapt the ANNs, from 1 to 30 min, Model performance was enhanced for each participant. The overall drowsiness monitoring performance of the models was enhanced by roughly 40% for prediction and 80% for detection.

Daytime microsleeps during 7 days of sleep restriction followed by 13 days of sleep recovery in healthy young adults.

We investigated the consequences of sleep restriction (SR) on maintenance of wakefulness capacities and diurnal sleepiness through microsleeps monitoring. 12 healthy males (20-36 years old) were sleep restricted (4 h per night) during 7 nights followed by 13 nights of recovery sleep. Participants completed Karolinska Sleepiness Scale (KSS) and Maintenance of Wakefulness Test (MWT) at baseline (B), during SR (SR1, SR4 and SR7) and during recovery (R3 and R13), while continuously recorded for EEG analysis. During SR, MWT latencies decreased (SR7: -24.4%), whereas the number, the cumulative duration of microsleeps and KSS scores increased. Recovery nights allowed MWT latencies, KSS scores and all sleep values to return to baseline levels, while a rebound in N3, N3% and REM% sleep stages occurred. During SR, the maintenance of N3 sleep duration seems not sufficient to reduce daytime sleepiness and MWT results did not reflect the sleepiness levels characterized by persistent sleep attacks.

Food restriction alters salivary cortisol and α-amylase responses to a simulated weightlifting competition without significant performance modification.

The aim of this investigation was to evaluate the effect of a 6-day food restriction period on the physiological responses and performance of 11 high-level weightlifters. After a period of weight maintenance (T2), they were assigned into two groups depending on whether they lost (Diet group, n = 6) or maintained their body weight (Control group, n = 5) during the course of those 6 days. An evaluation of performance and the measurement of salivary cortisol concentrations and salivary α-amylase (sAA) activity were performed during a simulated weightlifting competition which took place at T2, after a 6-day period of food restriction (T3). Dietary data were collected using a 6-day diet record. We noted a 41.8% decrease in mean energy intake during the dietary restriction period, leading to a 4.34% weight loss for the Diet group. Dietary restriction did not modify absolute performance levels, whilst a significant improvement was noted for the Control group. Furthermore, we noted a response of decreased salivary cortisol and increased sAA activity to the simulated competition stress at T3 for the Diet group. These results may indicate that dietary reduction led to a dissociation of the hypothalamo-pituitary-adrenal axis and the sympatho-adreno-medullary system, which could impair training adaptations and absolute performance development.

Hyperactivity of the Sympatho-Adrenomedullary System Without Any Modification of the Hypothalamic-Pituitary-Adrenal Axis After Food Restriction Among High-Level Weightlifters.

Durguerian, A, Filaire, E, Drogou, C, Sauvet, F, Bougard, C, and Chennaoui, M. Hyperactivity of the sympatho-adrenomedullary system without any modification of the hypothalamic-pituitary-adrenal axis after food restriction among high-level weightlifters. J Strength Cond Res 32(6): 1643-1655, 2018-We examined the effects of 6 days of food restriction on salivary α-amylase (sAA), cortisol and dehydroepiandrostenedione (DHEA) awakening responses, psychological parameters and performance among 11 international weightlifters. Assessments were made at baseline (T1) and 6 days after a normal period of training while maintaining body weight (T2). Then, participants were assigned to 2 groups depending on whether they lost (Diet group) or maintained (Control group) their body mass. Anthropometric, psychological, physical, and physiological assessments were also realized 6 days (T3) after the restricted dietary period for the Diet group. Food restriction (T3) induced a significant rise of sAA awakening response (364.6%, p ≤ 0.05), whereas no significant variations were observed among the hypothalamic-pituitary-adrenal axis (cortisol and DHEA). Significant alterations of the general Recovery Score and General stress Score, evaluated through the Recovery-Stress Questionnaire for athletes, were noted after food restriction. Weightlifting performance, evaluated during a simulated weightlifting competition, was maintained after the 6-day food restriction; we even noted an increased weightlifting performance related to body mass (Sinclair coefficient). Our findings support the hypothesis that food restriction induces a challenging situation to the organism, resulting in an asymmetry between the 2 stress systems activation. These results reinforce the necessity to cautiously plan and monitor the weight regulation process before competition to avoid potential negative outcomes on psychophysiological parameters. In this regard, the psychobiological approach, especially the awakening responses, seems a useful tool.

Protective effects of exercise training on endothelial dysfunction induced by total sleep deprivation in healthy subjects.

BACKGROUND: Sleep loss is a risk factor for cardiovascular events mediated through endothelial dysfunction. AIMS: To determine if 7weeks of exercise training can limit cardiovascular dysfunction induced by total sleep deprivation (TSD) in healthy young men. METHODS: 16 subjects were examined during 40-h TSD, both before and after 7weeks of interval exercise training. Vasodilatation induced by ACh, insulin and heat (42°C) and pulse wave velocity (PWV), blood pressure and heart rate (HR) were assessed before TSD (controlday), during TSD, and after one night of sleep recovery. Biomarkers of endothelial activation, inflammation, and hormones were measured from morning blood samples. RESULTS: Before training, ACh-, insulin- and heat-induced vasodilatations were significantly decreased during TSD and recovery as compared with the control day, with no difference after training. Training prevented the decrease of ACh-induced vasodilation related to TSD after sleep recovery, as well as the PWV increase after TSD. A global lowering effect of training was found on HR values during TSD, but not on blood pressure. Training induces the decrease of TNF-α concentration after TSD and prevents the increase of MCP-1 after sleep recovery. Before training, IL-6 concentrations increased. Cortisol and testosterone decreased after TSD as compared with the control day, while insulin and E-selectin increased after sleep recovery. No effect of TSD or training was found on CRP and sICAM-1. CONCLUSIONS: In healthy young men, a moderate to high-intensity interval training is effective at improving aerobic fitness and limiting vascular dysfunction induced by TSD, possibly through pro-inflammatory cytokine responses.(ClinicalTrial:NCT02820649).

Differential Kinetics in Alteration and Recovery of Cognitive Processes from a Chronic Sleep Restriction in Young Healthy Men.

Chronic sleep restriction (CSR) induces neurobehavioral deficits in young and healthy people with a morning failure of sustained attention process. Testing both the kinetic of failure and recovery of different cognitive processes (i.e., attention, executive) under CSR and their potential links with subject's capacities (stay awake, baseline performance, age) and with some biological markers of stress and anabolism would be useful in order to understand the role of sleep debt on human behavior. Twelve healthy subjects spent 14 days in laboratory with 2 baseline days (B1 and B2, 8 h TIB) followed by 7 days of sleep restriction (SR1-SR7, 4 h TIB), 3 sleep recovery days (R1-R3, 8 h TIB) and two more ones 8 days later (R12-R13). Subjective sleepiness (KSS), maintenance of wakefulness latencies (MWT) were evaluated four times a day (10:00, 12:00 a.m. and 2:00, 4:00 p.m.) and cognitive tests were realized at morning (8:30 a.m.) and evening (6:30 p.m.) sessions during B2, SR1, SR4, SR7, R2, R3 and R13. Saliva (B2, SR7, R2, R13) and blood (B1, SR6, R1, R12) samples were collected in the morning. Cognitive processes were differently impaired and recovered with a more rapid kinetic for sustained attention process. Besides, a significant time of day effect was only evidenced for sustained attention failures that seemed to be related to subject's age and their morning capacity to stay awake. Executive processes were equally disturbed/recovered during the day and this failure/recovery process seemed to be mainly related to baseline subject's performance and to their capacity to stay awake. Morning concentrations of testosterone, cortisol and α-amylase were significantly decreased at SR6-SR7, but were either and respectively early (R1), tardily (after R2) and not at all (R13) recovered. All these results suggest a differential deleterious and restorative effect of CSR on cognition through biological changes of the stress pathway and subject's capacity (ClinicalTrials-NCT01989741).

Stress Biomarkers, Mood States, and Sleep during a Major Competition: "Success" and "Failure" Athlete's Profile of High-Level Swimmers.

The aim of this study was to evaluate stress markers, mood states, and sleep indicators in high-level swimmers during a major 7-days competition according to the outcomes. Nine swimmers [six men and three women (age: 22 ± 2 and 22 ± 4 years, respectively)] were examined. Before (PRE) and after (POST) each race (series, semi-finals, and finals), salivary concentrations of cortisol, α-amylase (sAA), and chromogranin-A (CgA) were determined. Mood states were assessed by the profile of mood state (POMS) questionnaire completed before and after the 7-days, and self-reported sleep diaries were completed daily. In the "failure" group, cortisol and sAA significantly increased between PRE-POST measurements (p < 0.05), while sCgA was not changed. Significant overall decrease of cortisol (-52.6%) and increase of sAA (+68.7%) was shown in the "failure group." In this group, fatigue, confusion and depression scores, and sleep duration before the finals increased. The results in the "success" group show tendencies for increased cortisol and sCgA concentrations in response to competition, while sAA was not changed. Cortisol levels before the semi-finals and finals and sCgA levels before the finals were positively correlated to the fatigue score in the "failure" group only (r = 0.89). sAA levels before and after the semi-finals were negatively correlated to sleep duration measured in the subsequent night (r = -0.90). In conclusion, the stress of the competition could trigger a negative mood profile and sleep disturbance which correspond to different responses of biomarkers related to the hypothalamo-pituitary-adrenal axis and the sympathetic nervous system (SNS) activity, cortisol, sAA, and CgA.

Sleepiness, attention and risk of accidents in powered two-wheelers.

In recent years, the role of "sleepiness at the wheel" in the occurrence of accidents has been increasingly highlighted with several national and international public health campaigns based on consensual research publications. However, one aspect of this phenomenon is rarely taken into account, i.e., the risk of sleep-induced accidents while riding powered two-wheelers (PTWs). PTWs are indeed involved in a high percentage of fatal accidents mostly with young male riders. The effects of sleepiness may be different in drivers and riders, partly because riders may be stimulated more by the road environment. But riders (differently from drivers) have also to maintain continuously a balance between their own stability and the need of following the road, even when they are directly exposed to adverse climatic conditions. We, therefore, gathered the limited scientific literature on this topic and tried to analyze how riders may be affected differently by sleepiness. Finally we provide some suggestions as to how this question may be better approached in the future.

Benefits of Sleep Extension on Sustained Attention and Sleep Pressure Before and During Total Sleep Deprivation and Recovery.

OBJECTIVES: To investigate the effects of 6 nights of sleep extension on sustained attention and sleep pressure before and during total sleep deprivation and after a subsequent recovery sleep. DESIGN: Subjects participated in two experimental conditions (randomized cross-over design): extended sleep (EXT, 9.8 ± 0.1 h (mean ± SE) time in bed) and habitual sleep (HAB, 8.2 ± 0.1 h time in bed). In each condition, subjects performed two consecutive phases: (1) 6 nights of either EXT or HAB (2) three days in-laboratory: baseline, total sleep deprivation and after 10 h of recovery sleep. SETTING: Residential sleep extension and sleep performance laboratory (continuous polysomnographic recording). PARTICIPANTS: 14 healthy men (age range: 26-37 years). INTERVENTIONS: EXT vs. HAB sleep durations prior to total sleep deprivation. MEASUREMENTS AND RESULTS: Total sleep time and duration of all sleep stages during the 6 nights were significantly higher in EXT than HAB. EXT improved psychomotor vigilance task performance (PVT, both fewer lapses and faster speed) and reduced sleep pressure as evidenced by longer multiple sleep latencies (MSLT) at baseline compared to HAB. EXT limited PVT lapses and the number of involuntary microsleeps during total sleep deprivation. Differences in PVT lapses and speed and MSLT at baseline were maintained after one night of recovery sleep. CONCLUSION: Six nights of extended sleep improve sustained attention and reduce sleep pressure. Sleep extension also protects against psychomotor vigilance task lapses and microsleep degradation during total sleep deprivation. These beneficial effects persist after one night of recovery sleep.