Annoyance, perception, and physiological effects of wind turbine infrasound.

Even though some individuals subjectively associate various symptoms with infrasound, there are very few systematic studies on the contribution of infrasound to the perception, annoyance, and physiological reactions elicited by wind turbine sound. In this study, sound samples were selected among long-term measurement data from wind power plant and residential areas, both indoors and outdoors, and used in laboratory experiments. In the experiments, the detectability and annoyance of both inaudible and audible characteristics of wind turbine noise were determined, as well as autonomic nervous system responses: heart rate, heart rate variability, and skin conductance response. The participants were divided into two groups based on whether they reported experiencing wind turbine infrasound related symptoms or not. The participants did not detect infrasonic contents of wind turbine noise. The presence of infrasound had no influence on the reported annoyance nor the measured autonomic nervous system responses. No differences were observed between the two groups. These findings suggest that the levels of infrasound in the current study did not affect perception and annoyance or autonomic nervous system responses, even though the experimental conditions corresponded acoustically to real wind power plant areas.

Cognitive behavioural therapy interventions for insomnia among shift workers: RCT in an occupational health setting.

INTRODUCTION: The aim of the study was to compare the effectiveness of cognitive behavioural therapy interventions for insomnia (CBT-I) to that of a sleep hygiene intervention in a randomized controlled design among shift workers. We also studied whether the features of shift work disorder (SWD) affected the results. METHODS: A total of 83 shift workers with insomnia disorder were partially randomized into a group-based CBT-I, self-help CBT-I, or sleep hygiene control intervention. The outcomes were assessed before and after the interventions and at 6-month follow-up using questionnaires, a sleep diary, and actigraphy. RESULTS: Perceived severity of insomnia, sleep-related dysfunctional beliefs, burnout symptoms, restedness, recovery after a shift, and actigraphy-based total sleep time improved after the interventions, but we found no significant differences between the interventions. Mood symptoms improved only among the group-based CBT-I intervention participants. Non-SWD participants had more mental diseases and symptoms, used more sleep-promoting medication, and had pronounced insomnia severity and more dysfunctional beliefs than those with SWD. After the interventions, non-SWD participants showed more prominent improvements than those with SWD. CONCLUSIONS: Our results showed no significant differences between the sleep improvements of the shift workers in the CBT-I interventions and of those in the sleep hygiene control intervention. Alleviation of mood symptoms seemed to be the main added value of the group-based CBT-I intervention compared to the control intervention. The clinical condition of the non-SWD participants was more severe and these participants benefitted more from the interventions than the SWD participants did. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02523079.

Correction to: Cognitive behavioural therapy interventions for insomnia among shift workers: RCT in an occupational health setting.

In the original publication of the article, the first name and last name of the authors were interchanged.

Effect of the frequency spectrum of road traffic noise on sleep: A polysomnographic study.

Spectrum of sound affects noise annoyance. Spectral differences of road traffic noise (RTN) transmitted indoors are usual because of spectrally different sound insulation of facades. The purpose was to compare the effect of RTN spectrum on sleep. Twenty-one volunteers slept three nights in a sleep laboratory in three sound conditions: low-frequency (LF) RTN, high-frequency (HF) RTN, and quiet (control). The A-weighted equivalent levels were 37, 37, and 17 dB LAeq,8h, respectively. The nocturnal time profiles of LF and HF were equal. Sleep was measured with polysomnography and questionnaires. HF and LF did not differ from each other in respect to their effects on both objective and subjective sleep quality. The duration of deep sleep was shorter, satisfaction with sleep lower, and subjective sleep latency higher in HF and LF than in quiet. Contrary to subjective ratings given right after the slept night, HF was rated as the most disturbing condition for sleep after the whole experiment (retrospective rating). The finding suggests the sound insulation spectrum of the facade construction might play a role regarding the effects of RTN. More research is needed about the effects of spectrum on sleep because the field is very little investigated.

Sleep and alertness in shift work disorder: findings of a field study.

PURPOSE: Although shift work disorder (SWD) affects a major part of the shift working population, little is known about its manifestation in real life. This observational field study aimed to provide a detailed picture of sleep and alertness among shift workers with a questionnaire-based SWD, by comparing them to shift workers without SWD during work shifts and free time. METHODS: SWD was determined by a questionnaire. Questionnaires and 3-week field monitoring, including sleep diaries, actigraphy, the Karolinska Sleepiness Scale (KSS), EEG-based sleep recordings, and Psychomotor Vigilance Tasks (PVT), were used to study 22 SWD cases and 9 non-SWD workers. RESULTS: The SWD group had a shorter subjective total sleep time and greater sleep debt before morning shifts than the non-SWD group. Unlike the non-SWD group, the SWD group showed little compensatory sleep on days off. The SWD group had lower objective sleep efficiency and longer sleep latency on most days, and reported poorer relaxation at bedtime and sleep quality across all days than the non-SWD group. The SWD group's average KSS-sleepiness was higher than the non-SWD group's sleepiness at the beginning and end of morning shifts and at the end of night shifts. The SWD group also had more lapses in PVT at the beginning of night shifts than the non-SWD group. CONCLUSIONS: The results indicate that SWD is related to disturbed sleep and alertness in association with both morning and night shifts, and to less compensatory sleep on days off. SWD seems to particularly associate with the quality of sleep.

Height gain after two-years-of-age is associated with better cognitive capacity, measured with Raven's coloured matrices at 15-years-of-age in Malawi.

Stunting is a measure of chronic undernutrition, and it affects approximately 160 million children worldwide. Cognitive development of stunted children is compromised, but evidence about the association between height gain in late childhood and adolescent cognitive capacity is scarce. We aimed to determine the association between height gains at different ages, including late childhood, and cognitive capacity at 15-years-of-age. We conducted a prospective cohort study in a rural African setting in Southern Malawi. The study cohort was enrolled between June 1995 and August 1996. It originally comprised mothers of 813 fetuses, and the number of children born live was 767. These children were followed up until the age of 15 years. The anthropometrics were measured at one and 24-months-of-age and 15-years-of-age, and cognitive capacity of participants was assessed at 15-years-of-age with Raven's Coloured Matrices score, mathematic test score, median reaction time (RT) (milliseconds) and RT lapses. The associations between growth and the outcome measures were assessed with linear regression. Raven's Coloured Matrices score was predicted by height gain between 24 months and 15-years-of-age (coefficient 0.85, P = 0.03) and (coefficient 0.69, P = 0.06), but not by earlier growth, when possible confounders were included in the model. The association weakened when school education was further added in the model (coefficient = 0.69, P = 0,060). In conclusion, in rural Malawi, better growth in late childhood is likely to lead to better cognitive capacity in adolescence, partly through more school education. In light of these results, growth promotion should not only be limited to early childhood.

Electro-oculography-based detection of sleep-wake in sleep apnea patients.

INTRODUCTION: Recently, we have developed a simple method that uses two electro-oculography (EOG) electrodes for the automatic scoring of sleep-wake in normal subjects. In this study, we investigated the usefulness of this method on 284 consecutive patients referred for a suspicion of sleep apnea who underwent a polysomnography (PSG). METHOD: We applied the AASM 2007 scoring rules. A simple automatic sleep-wake classification algorithm based on 18-45 Hz beta power was applied to the calculated bipolar EOG channel and was compared to standard polysomnography. Epoch by epoch agreement was evaluated. RESULT: Eighteen patients were excluded due to poor EOG quality. One hundred fifty-eight males and 108 females were studied, their mean age was 48 (range 17-89) years, apnea-hypopnea index 13 (range 0-96) /h, BMI 29 (range 17-52) kg/m(2), and sleep efficiency 78 (range 0-98) %. The mean agreement in sleep-wake states between EOG and PSG was 85% and the Cohen's kappa was 0.56. Overall epoch-by-epoch agreement was 85%, and the Cohen's kappa was 0.57 with positive predictive value of 91% and negative predictive value of 65%. CONCLUSIONS: The EOG method can be applied to patients referred for suspicion of sleep apnea to indicate the sleep-wake state.

A Novel Computerized Flexible Attention Test in Detecting Executive Dysfunction of Patients with Early-Onset Cognitive Impairment and Dementia.

OBJECTIVE: The number of computer-based cognitive tests has increased in recent years, but there is a need for tests focusing on the assessment of executive function (EF), as it can be crucial for the identification of early-onset neurodegenerative disorders. This study aims to examine the ability of the Flexible Attention Test (FAT), a new computer-based test battery for detecting executive dysfunction of early-onset cognitive impairment and dementia patients. METHOD: We analyzed the FAT subtask results in memory clinic patients with cognitive symptom onset at ≤65 years. The patients were divided into four groups: early onset dementia (EOD, n = 48), mild cognitive impairment due to neurological causes (MCI-n, n = 34), MCI due to other causes (MCI-o, n = 99), and subjective cognitive decline (SCD, n = 14). The test accuracy to distinguish EOD patients from other groups was examined, as well as correlations with pen-and-paper EF tests. We also reported the 12-months follow-up results. RESULTS: The EOD and MCI-n patients performed significantly poorer (p ≤ .002) than those in the MCI-o and SCD groups in most of the FAT subtasks. The accuracies of the FAT subtasks to detect EOD from other causes were mainly moderate (0.34 ≤ area under the curve < 0.74). The FAT subtasks correlated logically with corresponding pen-and-paper EF tests (.15 ≤ r ≤ .75). No systematic learning effects were detected in the FAT performance at follow-up. CONCLUSIONS: The FAT appears to be a promising method for the precise evaluation of EF and applicable distinguishing early-onset neurodegenerative disorders from patients with other causes of cognitive problems.

Long-term cognitive and neurovascular changes after carotid endarterectomy.

BACKGROUND: Carotid endarterectomy (CEA) has been associated with both cognitive decline and improvement, but the underlying neurovascular mechanisms are unclear. The aim of this study was to investigate the relationship between neurovascular indices and cognitive changes after CEA. METHODS: We studied 55 patients with severe (≥70%) symptomatic or asymptomatic carotid stenosis before and six months after CEA. A wide array of neuropsychological tests was arranged in eight cognitive domains and cognitive functions specific to hemisphere ipsilateral to operation. Differences in cognitive performance between patients and 38 matching healthy controls were studied with linear mixed models. Neurovascular functioning and microembolic signals were assessed with transcranial Doppler ultrasound of the middle cerebral artery. Associations between neurovascular indices and cognitive change were assessed with linear regression analyses. RESULTS: On group level, the CEA patients improved more than controls in working memory, whereas no cognitive deterioration was detected. Also on individual level, improvement was most frequently observed in working memory. Worse preoperative cerebrovascular reactivity was related with improvement in cognitive functions of the ipsilateral hemisphere. Low preoperative pulsatility index was associated with improvement in executive functioning and ipsilateral cognitive functions. Poorer preoperative blood flow velocity associated with improvement in complex attention. Microembolic signals were rare. CONCLUSION: The present findings suggest that CEA may have beneficial long-term effects on cognition. These effects may specifically involve patients with impaired preoperative circulatory adaptive mechanisms.

Effects of cumulative sleep restriction on self-perceptions while multitasking.

This study addressed a rarely studied question of self-perceptions of performance and overall functional state during cumulative sleep restriction and the ensuing recovery period. Twenty healthy male volunteers, aged 19-29 years, were divided into a sleep restriction group (n = 13) and a control group (n = 7). On the first 2 nights, the sleep restriction group had an 8-h sleep opportunity that was restricted to 4 h for the next 5 nights, and then restored to 8 h for the last 2 nights. The control group had an 8-h sleep opportunity each night. Each day participants accomplished 50-min multitask sessions and gave self-ratings in their connection. Similar to our previous findings on multitasking performance, self-perceived task performance, sleepiness and mental fatigue impaired during the sleep restriction and returned to baseline during the recovery phase. Self-perceived mental effort, tension, task difficulty and task pace showed no sensitivity to the sleep restriction. We concluded that sleep-restricted individuals can probably make use of some self-perceptions when assessing their 'fitness for duty'. However, at the individual level these measures seem to be inaccurate in revealing actual performance impairments.

Association of job strain with working hours, shift-dependent perceived workload, sleepiness and recovery.

We explored the relationship of job strain with working hours, shift-dependent perceived workload, sleepiness and recovery. Nurses/nursing assistants (n = 95) were recruited from wards that belonged to either the top (high-strain group, HJS) or the bottom (low-strain group, LJS) job strain quartiles of a Job Content Questionnaire survey of employees in five health care districts and four cities in Finland. Three-week field measurements during naturally occurring shift schedules and a subset of pre-selected shift arrangements consisted of the Karolinska Sleepiness Scale, perceived workload and recovery. The HJS group (n = 42) had more single days off and quick returns than the LJS group (n = 53, p < 0.01), and both mental workload and physical workload were rated as higher (p < 0.01). During naturally occurring shift arrangements, severe sleepiness was more common in the HJS group only in quick returns (p = 0.04) and the HJS group recovered on average more poorly from work after all shifts (p = 0.01) and morning shifts (p = 0.02). During pre-selected shift arrangements, the differences between the groups were only minor. In conclusion, job strain-related differences in sleepiness and recovery were mostly attributable to differences in shift arrangements.

[Commencement of and adherence to CPAP treatment of patients with sleep-disordered breathing]. / Uniapneapotilas 2000-luvulla: kenelle CPAP-hoito aloitetaan ja miten siihen sitoudutaan?

BACKGROUND: We evaluated the changes in nasal CPAP treatment and adherence in patients with sleep-disordered breathing (SDB). MATERIAL AND METHODS: Information from the clinic database of 4,385 patients commencing CPAP treatment during 2002-2009. RESULTS: Average CPAP adherence was 74%. In mild SDB over 60% were adherent whereas in severe SDB 18% did not accept the treatment. Low hours of CPAP use right after commencing the treatment indicated poor long-term adherence. CONCLUSIONS: In the 2000s the number of patients starting CPAP treatment increased, but the selection of patients did not change much. Overall CPAP adherence was good.

Is boredom at work bad for your health? Examining the links between job boredom and autonomic nervous system dysfunction.

Job boredom refers to an unpleasant state of passiveness at work that has been found to negatively relate to self-reported health. To date, however, the relation between job boredom and physiological indicators of health has not been examined. The present study investigates whether job boredom relates to dysfunction in autonomic nervous system (ANS) activity as indicated by reduced heart rate variability (HRV) during night sleep. The sample of this study consisted of Finnish public sector workers (n = 125). Job boredom was assessed with an electronic questionnaire and HRV with an ambulatory monitoring period of two nights of sleep. The results supported the hypothesis by showing a negative relation between job boredom and HRV, after controlling for demographic and lifestyle factors. The findings extend previous knowledge on the detrimental consequences of job boredom by showing that it is related to dysfunction in ANS activity. Consequently, it is important to acknowledge boredom at work as a threat to occupational health and well-being and pay more attention to how it can be prevented at workplaces.

rTMS targeted to the secondary somatosensory cortex influences sleep in CRPS patients, as measured with the OURA ring.

INTRODUCTION: Chronic pain associates with various sleep problems. Patients with complex regional pain syndrome (CRPS) often report impaired sleep, but objective measurements of sleep in CRPS patients are scarce. Neuromodulation with repetitive transcranial magnetic stimulation (rTMS) can alleviate pain and improve sleep. Secondary somatosensory cortex (S2) is a possible rTMS target for the treatment of chronic pain, but the effect of S2-targeted rTMS on sleep is unknown. METHODS: This randomized, sham-controlled trial assessed the effect of S2-targeted rTMS on sleep in patients with CRPS. Patients (n = 31) received either S2-targeted rTMS (10 Hz) or sham stimulation for 3 weeks. The effect of treatment on sleep was assessed with validated questionnaires, with a sleep and pain diary, and with a consumer-grade sleep tracker, the Oura ring. In addition to an ordinary univariate analysis of the results, we conducted multivariate testing of the Oura data using linear discriminant analysis (LDA). RESULTS: S2-targeted rTMS decreased sleep restlessness that significantly differed between the rTMS and sham stimulation patient groups (p = .028). In the multivariate analysis of the Oura data, LDA classification accuracy to separate the rTMS and sham groups exceeded 95% confidence level in four out of the seven tested models. In the subjective evaluation of sleep, the effect of rTMS and sham did not differ. CONCLUSION: S2-targeted rTMS influenced sleep in patients with CRPS. Improved sleep may enhance CRPS symptom alleviation and be of clinical importance. A univariate analysis could separate the rTMS and sham treatments. The multivariate analysis revealed that including multiple sleep-related parameters can be beneficial when analyzing rTMS effects on sleep. As sleep is related both to pain and quality of life, and sleep rTMS can be directly affected by rTMS, objective monitoring of sleep in various future rTMS trials could be fruitful.

Can job crafting eLearning intervention boost job crafting and work engagement, and increase heart rate variability? Testing a health enhancement process.

Applying job demands-resources theory, this quasiexperimental, three-wave study investigated whether work engagement can be increased via an eLearning intervention aiming to increase job crafting behavior. Furthermore, proposing a refinement to job demands-resources theory, that is, adding "a health enhancement process," this study also investigated whether through improvements in work engagement, the intervention would yield health-related benefits, utilizing an objective indicator of physical health (i.e., optimal functioning of autonomic nervous system activity indicated by increased heart rate variability [HRV]). The study was conducted among all the employees of a municipality (n = 69/experimental group, n = 45/control group), and the effects were assessed 2 weeks and 4 months after the intervention. Job crafting and work engagement were measured using an electronic questionnaire, and HRV using ambulatory monitoring period of two nights' sleep. Latent change score modeling revealed, as expected, that job crafting increased both immediately and delayed after the intervention. Furthermore, as hypothesized, the intervention increased work engagement via increased job crafting when measured immediately after the intervention, but there was no indirect delayed effect on work engagement. There were no indirect immediate or delayed effects on HRV. However, unexpectedly, HRV decreased among the control group after the intervention. Thus, an eLearning intervention based on the principles of job crafting is a promising tool to increase job crafting and consequently work engagement. Furthermore, the findings provide an initial indication that a job crafting eLearning intervention could have a buffering effect on autonomic nervous system activity and help to maintain its optimal functioning. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Subjective vs informant-reported cognitive complaints have differential clinical significance in covert cerebral small vessel disease.

Objective: Subjective cognitive complaints are common in patients with cerebral small vessel disease (cSVD), yet their relationship with informant evaluations, objective cognitive functions and severity of brain changes are poorly understood. We studied the associations of subjective and informant reports with findings from comprehensive neuropsychological assessment and brain MRI. Method: In the Helsinki SVD Study, 152 older adults with varying degrees of white matter hyperintensities (WMH) but without stroke or dementia were classified as having normal cognition or mild cognitive impairment (MCI) based on neuropsychological criteria. The measures also included continuous domain scores for memory and executive functions. Cognitive complaints were evaluated with the subjective and informant versions of the Prospective and Retrospective Memory Questionnaire (PRMQ) and Dysexecutive Questionnaire (DEX); functional abilities with the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL); and depressive symptoms with the Geriatric Depression Scale (GDS-15). Results: Subjective cognitive complaints correlated significantly with informant reports (r=0.40-0.50, p<0.001). After controlling for demographics, subjective and informant DEX and PRMQ were not related to MCI, memory or executive functions. Instead, subjective DEX and PRMQ significantly associated with GDS-15 and informant DEX and PRMQ with WMH volume and A-IADL. Conclusions: Neither subjective nor informant-reported cognitive complaints associated with objective cognitive performance. Informant-evaluations were related to functional impairment and more severe WMH, whereas subjective complaints only associated with mild depressive symptoms. These findings suggest that awareness of cognitive impairment may be limited in early-stage cSVD and highlight the value of informant assessments in the identification of patients with functional impairment.

The self-reported stress and stressors in tram and long-haul truck drivers.

Work stress may compromise professional drivers' health and driving capacity. Differences between driver groups in terms of on-duty stress are understudied. Therefore, we examined self-reported stress (Stockholm University Stress Scale) of shift-working tram and long-haul truck drivers (n = 75) across 2-3 weeks. Furthermore, stressors were self-reported retrospectively and categorised as related to the job, driving conditions, personal, or other causes. Stress levels were generally low, but moderate to high stress (≥6) was more frequently reported among the tram drivers. Stressors related to the job (54%) and driving conditions (19% of all shifts) were frequently reported among the tram and truck drivers, respectively. Moderate to high stress was associated with categorised stressors related to the job and other causes among the tram drivers, and all categorised stressors among the truck drivers. Altogether, self-reported stress and stressors differ by driver group, but the role of shift type is less significant.

Do holidays change subjective sleep length or sleep debt in shift work disorder?

In shift work disorder (SWD), disturbed sleep acutely impairs employees' recovery, but little attention has been paid to sleep during longer recovery periods. We examined how holidays affect self-estimated sleep length, sleep debt, and recovery in cases of SWD. Twenty-one shift workers with questionnaire-based SWD and nine reference cases without SWD symptoms completed a questionnaire on recovery and sleep need. They also reported sleep length on two separate occasions: during a work period and after ≥ 2 weeks of holidays. Sleep debt was calculated by subtracting sleep length from sleep need. We used parametric tests to compare the groups and the periods. The groups reported shorter sleep on workdays than during holidays (median difference: SWD group 1.7 h, p<0.001; reference group 1.5 h; p<0.05). The SWD group's self-estimated sleep during holidays increased less above the sleep need (median 0.0 h) than the reference group's sleep (1.0 h, p<0.05). In addition, the SWD group reported good recovery from irregular working hours less often (14%) than the reference group (100%, p<0.001). Although holidays were generally associated with longer sleep estimates than workdays, employees with SWD experienced consistently less efficient recovery than those without SWD.

Increased respiratory effort during sleep is non-invasively detected with movement sensor.

INTRODUCTION: Measuring breathing effort during sleep with an oesophageal pressure sensor remains technically challenging and has not become routine practice. The aim of the present work was to investigate whether increased thoracic pressure during sleep can be detected with the Emfit movement sensor. Experimental data suggest that increased respiratory efforts with the intrathoracic pressure variation induce high-frequency spikes in the Emfit signal, but this has not been systematically examined. METHODS: Polysomnography, oesophageal pressure and Emfit signal were recorded in 32 patients with suspected sleep-disordered breathing. Increased respiratory effort was defined as oesophageal pressure below -8 cmH(2)O during inspiration. The epochs of normal breathing, periodic breathing patterns and sustained spiking labelled as increased respiratory resistance (IRR) were defined on the Emfit signal according to established rules. RESULTS: Compared to normal breathing, the proportion of increased respiratory effort was higher during all periodic breathing with spiking. The highest proportion (18-23%) occurred during IRR, which is characterised by sustained spiking. CONCLUSION: The Emfit movement sensor is a non-invasive alternative to the oesophageal pressure sensor in the assessment of the respiratory effort during sleep. In particular, the Emfit sensor enhances detection of non-apnoeic sleep-disordered breathing, the significance of which should not be ignored.

Self-reported view on work capacity predicts abnormal Oxford Sleep Resistance Test results in patients with obstructive sleep apnea.

STUDY OBJECTIVES: The Oxford Sleep Resistance Test is an objective vigilance test based on behavior. It is a modified version of the maintenance of wakefulness test and is considered less burdensome and less expensive than the maintenance of wakefulness test. Although professional drivers with obstructive sleep apnea in Europe must be assessed for their ability to maintain adequate wakefulness on a yearly basis, Oxford Sleep Resistance Test results are usually normal in this population. In this retrospective observational study, we searched for predictive factors of abnormal Oxford Sleep Resistance Test sleep latency. METHODS: We included 1,071 Oxford Sleep Resistance Test results of patients with obstructive sleep apnea (95% men, aged 21-74 years). Mean sleep latency < 40 minutes was considered abnormal. RESULTS: Sleep latency was abnormal in 12.0% of tests. Participants at risk for abnormal test results self-reported as being sleepy, depressed, on sick leave, unemployed, or retired or considered themselves unable to work. In a logistic regression model, the self-reported view on work capacity was the most important predictor of abnormal Oxford Sleep Resistance Test sleep latency (odds ratio, 3.5). Ongoing sick leave was also an important predictor for abnormal test results. CONCLUSIONS: A self-reported good ability to work predicts that a patient with sleep apnea can maintain wakefulness in a vigilance test. This may help in reducing the increasing challenge with frequent tests.