Risk factors for collisions attributed to microsleep-related behaviors while driving in professional truck drivers.

Sleep-disordered breathing (SDB) is prevalent among professional drivers. Although SDB is a known risk factor for truck collisions attributed to microsleep-related behaviors at the wheel (TC-MRBs), the usefulness of overnight pulse oximetry for predicting TC-MRBs is debatable. This retrospective study assessed the association between overnight pulse oximetry parameters, the Epworth Sleepiness Scale (ESS), and TC-MRBs, confirmed by dashcam footage. This study included 108 matched professional truck drivers (TC-MRBs: N = 54; non-TC-MRBs: N = 54), with a mean age and body mass index of 41.9 ± 11.3 years and 23.0 ± 3.7 kg/m2, respectively. Night-time drivers, 4% oxygen desaturation index (ODI), and nadir oxygen saturation (SpO2) were associated with TC-MRBs (odds ratio [95% confidence interval]: 25.63 [5.88-111.77], p < 0.0001; 2.74 [1.02-7.33], p = 0.045; and 3.87 [1.04-14.39], p = 0.04, respectively). The area under the curve of 4% ODI and nadir SpO2 for TC-MRBs were 0.50 and 0.57, respectively. In conclusion, night-time driving, 4% ODI, and nadir SpO2 were significantly associated with TC-MRBs in professional truck drivers. However, the sensitivity of overnight pulse oximetry parameters to predict TC-MRBs in a real-world application was poor. Therefore, combining subjective and objective assessments such as dashcam video footage may be needed to achieve high accuracy for predicting TC-MRBs among professional truck drivers.

Dashcam video footage-based analysis of microsleep-related behaviors in truck collisions attributed to falling asleep at the wheel.

OBJECTIVE: With the rapid spread of dashcams, many car accidents have been recorded; however, behavioral approaches using these dashcam video footage have not been sufficiently examined. We employed dashcam video footage to evaluate microsleep-related behaviors immediately prior to real-world truck collisions in professional drivers to explore a new solution to reduce collisions attributed to falling asleep at the wheel. METHODS: In total, 3,120 s of video footage (60 s/case × 52 cases) from real-world truck collisions of 52 professional drivers obtained from interior and exterior dashcams were used and visually analyzed in a second-by-second manner to simultaneously evaluate any eye changes and microsleep-related behaviors (the driver's anti-sleepiness behavior, behavioral signs of microsleep, and abnormal vehicle behavior) during driving. RESULTS: Assessment of the frequency of occurrence of each item of microsleep-related behavior in the 52 collisions revealed that the item "touching" in terms of anti-sleepiness behavior, "absence of body movement" in terms of behavioral signs of microsleep, and "inappropriate line crossing" in terms of abnormal vehicle behavior were observed at the highest rate in all drivers (46.2%, 75.0%, and 78.8%, respectively). Decreases in anti-sleepiness behavior coincided with increases in behavioral signs of microsleep and abnormal vehicle behavior, with collisions occurring within approximately 40 s of these changes. Collisions were more common among young people and in the early morning and evening. CONCLUSION: Our dashcam video footage-based analysis in truck collisions attributed to falling asleep at the wheel revealed the process of changes in microsleep-related driver and vehicle behaviors, classified as anti-sleepiness behavior, behavioral signs of microsleep, and abnormal vehicle behavior. Based on these findings, to prevent collisions caused by falling asleep at the wheel, it is crucial to monitor not only the driver's eyes, but also the driver's whole body and vehicle behavior simultaneously to reliably detect microsleep-related behaviors.

Effects of short naps during simulated night shifts on alertness and cognitive performance in young adults.

While short daytime naps have been found to provide alertness and performance benefits without inducing sleep inertia, the effects of a similar napping strategy during nights shifts are largely unknown. This study examined the effects of a 20-min nap (scheduled at 2:00 a.m.) during night shifts among 16 participants (mean [SD] age 22.0 [1.08] years) who worked in a simulated night shift from midnight (12:00 a.m.) to morning (ending at 6:00 or 8:00 a.m.). The participants underwent both a 'nap condition' and a 'no-nap condition' by engaging in repeated 10-min tasks (four-choice reaction time tasks and vigilance tasks) and 10-min rest. The results showed that compared to the no-nap condition, sleepiness was significantly lower in the nap condition between 3:20 and 5:20 a.m. (p < 0.05). The nap condition also yielded significantly better performance in the vigilance tasks between 2:40 and 5:40 a.m., except at 4:40 am (p < 0.05). However, no significant difference was found in sleepiness and performance in the vigilance task at 5:40 a.m. or immediately after the nap between the two conditions. The results showed that a 20-min nap at 2:00 a.m. did not induce sleep inertia upon waking. Furthermore, it mitigated sleepiness and sustained work performance for 3 h after the nap. However, the effect of napping was no longer observed near the end of the night shift. Considering risks of falling asleep while driving home from work that may cause a traffic accident, further research should examine ways to mitigate sleepiness after a night shift.

Nocturnal hypoxemia is related to morning negative affectivity in untreated patients with severe obstructive sleep apnea.

The relationship between sleep apnea and morning affectivity remains unclear. We aimed to clarify how sleep disturbance in patients with obstructive sleep apnea (OSA) influences their affectivity. The enrolled participants underwent the Positive and Negative Affect Schedule on their beds immediately before and after overnight polysomnography. Thirty patients with OSA were divided into two groups according to the apnea-hypopnea index (AHI): mild to moderate OSA (5 ≤ AHI < 30/h) and severe OSA (AHI ≥ 30/h) groups. Additionally, 11 healthy participants (AHI < 5/h) were included as the control group. No independent association was found between affectivity and OSA severity markers in the whole population; however, the severe OSA group had a significantly higher cumulative percentage of sleep time at saturations < 90% (CT90) and worsened morning negative affectivity. Multiple regression analysis showed that CT90 was an independent factor for increasing negative affectivity in the severe OSA group (p = 0.0422). In patients with OSA, the receiver operating characteristic curve analysis showed that the best cutoff value for CT90 for predicting no decrease in negative affectivity after sleep was 1.0% (sensitivity = 0.56, specificity = 0.86); the corresponding area under the curve was 0.71. Worsening of negative affectivity in the morning was influenced by nocturnal hypoxemia in patients with severe OSA.

Effects of using a snooze alarm on sleep inertia after morning awakening.

BACKGROUND: Many people use the snooze function of digital alarm clocks for morning awakening, but the effects of a snooze alarm on waking are unclear. We examined the effects of a snooze alarm on sleep inertia, which is a transitional state characterized by reduced arousal and impaired cognitive and behavioral performance immediately upon awakening. METHODS: In study 1, healthy Japanese university students responded to a sleep survey during a psychology class (study 1), and we collected 293 valid responses. In study 2, we compared a separate sample of university students (n = 10) for the effects of using or not using a snooze alarm on sleep inertia immediately after awakening from normal nocturnal sleep in a sleep laboratory. RESULTS: Of 293 valid respondents in study 1, 251 often used a tool to wake up in the morning (85.7%). Moreover, 70.5% reported often using the snooze function of their mobile phones, mainly to reduce anxiety about oversleeping. Study 2 indicated no differences in the sleep quality or quantity before awakening with or without the snooze alarm, except in the last 20 min. However, during the last 20 min of sleep with snooze alarm, the snooze alarm prolonged waking and stage N1 sleep. Stage N1 sleep is non-rapid eye movement sleep that is primarily defined as a drowsy state. Furthermore, Global Vigor values were enhanced after awakening compared to pre-sleep in the no-snooze condition. CONCLUSIONS: Using a snooze alarm prolongs sleep inertia compared to a single alarm, possibly because snooze alarms induce repeated forced awakenings.

The Use of Caregivers' Smartphones to Assist Infants' Circadian Sleep-Wake Cycles.

Parents and caregivers lack knowledge regarding young children's sleep routines due to an absence of general guidelines about sleep development, and this knowledge gap has been associated with infants' sleep problems. Approximately 30% of infants develop sleep problems, including difficulty with falling asleep and night-waking. In this study, we sought to develop a new indicator of regularity in infants' circadian sleep-wake patterns. Our participants were healthy Japanese mothers and their infants (n = 172 infants; Mage = 4.9, SD = 3.5 months). Mothers used their smartphones to record the time when their infants fell asleep and woke up in their natural home environments over 7 days. We conducted least-squares spectrum analysis, a time-series analysis often used in chronobiology, to calculate the percentage variance (PVA) of the best-fitted cosine waves with a 24-hr periodicity in the infants' sleep records. We found that the PVA of the 24-hr cycles in the infants' sleep records were significantly correlated with the infants' age in months (r = 0.554, p < 0.001), variations in their waking-up (r = -0.316, p < 0.001) and falling asleep times (r = -0.430, p < 0.001), and sleep duration (r = -0.343, p < 0.001). Apart from these normative data, which are of potential comparative use by other investigators, we showed in this study that PVA data can be collected by infants' parents and caretakers through smartphones to provide parents an indicator of the regularity of an infant's 24-hr periodicity.

Presentation of familiar odor induces negative dream emotions during rapid eye movement (REM) sleep in healthy adolescents.

OBJECTIVE: Odor presentation is a crucial tool in the experimental investigation of dreaming since odors rarely cause arousal, and are processed in the brain during sleep. Our previous study demonstrated that the presentation of a preferred odor during rapid eye movement (REM) sleep-induced negative dream emotions. However, preference and familiarity of an odor are known to be strongly related to each other in olfactory perception. Consequently, the above result might have been due to the confounding effects of familiarity. Therefore, the present study was designed to clarify the effects of an individual's degree of familiarity with an odor on negative emotions experienced when dreaming. METHODS: The airflow with phenylethyl alcohol (PEA: rose-like smell) was presented as a stimulus of experimental condition, and odorless airflow was presented as the control. Participants who were familiar (n = 7) and unfamiliar (n = 7) with the odor of PEA experienced both conditions during REM sleep in the second and later sleep cycle. Then, they were awakened, and they rated the characteristics of their dream using a questionnaire. RESULTS AND CONCLUSIONS: Participants who were familiar with the odor of PEA rated their dreams more negatively in the experimental condition relative to the control condition. It is concluded based on these results that a familiar odor may induce negative emotion in dreams, possibly because familiar odors tend to be perceived more strongly, and the olfactory pathway has direct connections to the amygdala, which is primarily involved in processing negative emotions.

New application of liquid crystal lens of active polarized filter for micro camera.

Liquid-crystal (LC) lens with low-voltage (3.5V) driving is reported with the experimental results of lens power, wavefront aberration, storage test and also the imaging test. Optical quality can be estimated by interference pattern under two polarizer plates set with the crossed Nichol position, and the optical quality is certified by the measurement of wavefront aberration. Durable stability of over 1000 hours under continuous driving in high temperature (85°C) environment is also verified and obtained less-damaged interference patterns. Finally a new application of active polarized filter for micro camera with focus control function is reported with sufficient quality of images.

[The effects of self-awakening on daytime sleepiness].

This study investigated the effects of self-awakening on daytime sleepiness. Eleven undergraduate and graduate students without the habit of self-awakening participated. They were instructed to follow their usual sleep-wake schedule at home during the experimental weeks and were required to awaken at their usual time by themselves every morning for one week without the aid of an alarm (self-awakening condition) or in response to a telephone call from the experimenter every morning for another one week (forced-awakening condition). On the last day of each week, daytime tests were conducted in the laboratory. The participants would arrive at the laboratory 2 h after awakening, and 1 h later, they performed the auditory simple reaction time task, the digit-symbol substitution task, the letter cancellation test, and the multiple sleep latency test, and assessment of sleepiness, fatigue, comfort, and work motivation every 2 h. In the week when the participants underwent the self-awakening condition, self-awakening had a higher success rate (82%) than failure rate (18%) on the seventh day. In comparison with forced-awakening, self-awakening resulted in an improvement in subjective fatigue; however, sleepiness did not deteriorate.

Hole transfer in LNA and 5-Me-2'-deoxyzebularine-modified DNA.

We report the measurement of hole-transfer rate constants (k(ht)) in locked nucleic acid (LNA) and 5-Me-2'-deoxyzebularine (B)-modified DNA. LNA modification, which makes DNA more rigid, caused a decrease of more than 2 orders of magnitude in k(ht), whereas B modification, which increases DNA flexibility, increased k(ht) by more than 20-fold. The present results clearly showed that hole-transfer efficiency in DNA can be increased by increasing DNA flexibility.

HOMO energy gap dependence of hole-transfer kinetics in DNA.

DNA consists of two type of base-pairs, G-C and A-T, in which the highest occupied molecular orbital (HOMO) localizes on the purine bases G and A. While the hole transfer through consecutive Gs or As occurs faster than 10(9) s(-1), a significant drop in the hole transfer rate was observed for G-C and A-T mixed random sequences. In this study, by using various natural and artificial nucleobases having different HOMO levels, the effect of the HOMO-energy gap between bases (Δ(HOMO)) on the hole-transfer kinetics in DNA was investigated. The results demonstrated that the hole transfer rate can be increased by decreasing the Δ(HOMO) and can be finely tuned over 3 orders of magnitude by varying the Δ(HOMO).

Longitudinal study of self-awakening and sleep/wake habits in adolescents.

Self-awakening is the ability to awaken without external assistance at a predetermined time. Cross-sectional studies reported that people who self-awaken have sleep/wake habits different from those of people who use external means to wake from sleep. However, no longitudinal study has examined self-awakening. The present study investigated self- awakening, both habitual and inconsistent, compared to awakening by external means in relation to sleep/wake schedules for five consecutive years in 362 students (starting at mean age 15.1 ± 0.3 years). Students who self-awakened consistently for five consecutive years (5% of all students) went to bed earlier than those who inconsistently self-awakened (mixed group, 40%) or consistently used forced awakening by external means (56%). Awakening during sleep was more frequent and sleep was lighter in the consistently self-awakened group than in the mixed and consistently forced-awakened groups. However, daytime dozing was less frequent and comfort immediately after awakening was greater for the consistently self-awakened group than for the mixed and consistently forced-awakened groups. These results indicate that the three groups have different sleep/wake habits. Previous studies of self-awakening using cross-sectional survey data may have confounded both consistent and inconsistent self-awakening habits. A longitudinal study is necessary to clarify the relationship between the self-awakening habit and sleep/wake patterns.

Preparation for awakening: self-awakening vs. forced awakening preparatory hangs in the pre-awakening period.

Self-awakening (SA) is awakening by oneself at predetermined time without external means. Attempting to SA produces various kinds of preparatory changes over the course of a sleep period, including contributing to a decline in the waking threshold immediately before awakening. As a result, one can easily awake from sleep, and sleep inertia immediately after awakening from sleep reduces. In addition, daytime arousal level is higher for those who have the habit of SA. Surveys revealed that not a few people have the habit of SA and that they tend to be morningness chronotypes. Many factors are involved in the successful SA, such as psychological stress, motivation, personality trait, ambient environment, circadian and homeostatic process, and time perception.

The effect of self-awakening from nocturnal sleep on sleep inertia.

The present study examined the effects of self-awakening on sleep inertia after nocturnal sleep. Ten undergraduate and graduate students participated in the study. Their polysomnograms were recorded for five consecutive nights; the first, second, and third to fifth nights were adaptation, forced-awakening, and self-awakening nights, respectively. Participants rated sleepiness, fatigue, comfort, and work motivation, and these ratings were followed by switching (7 min) and auditory reaction time tasks (6 min), both before bedtime (15 min) and immediately after awakening (4 min x 15 min). Although reaction times on the auditory were task prolonged, and participants complained of feeling uncomfortable immediately after forced-awakening, reaction times were shortened after self-awakening, and the participants did not complain of feeling uncomfortable on these nights. The results of this study suggest that sleep inertia occurs after forced-awakening and that it can be prevented by self-awakening.

Self-awakening, sleep inertia, and P3 amplitude in elderly people.

It is well known that sleepiness is sometimes experienced in the afternoon. A short afternoon nap is thought to be effective in reducing sleepiness. However, sleep inertia occurs even after a short nap, and this could be a major risk factor for injuries from falling by the elderly. In the present study, the effect of self-awakening on sleep inertia after a 20-min. nap was examined. Nine participants (M=74.1 yr., SD=5.0 yr.) took part in the three experimental conditions: the self-awakened nap, the forced-awakened nap, and the control (no-nap) conditon. Analysis showed sleepiness and performance after the nap significantly improved compared with the control condition. P3 amplitude tended to be larger after self-awakening than after forced-awakening. The present study indicates a 20-min. nap reduces afternoon sleepiness, and the application of self-awakening may contribute to higher arousal after a nap taken by this elderly group.

Examination of the first-night effect during the sleep-onset period.

STUDY OBJECTIVES: The present study examined the first-night effect during the sleep-onset period using the 9 electroencephalogram stage scoring system. DESIGN: After a week of monitoring sleep-wake habits with sleep diaries and wrist actigraphy, polysomnography recording was made for 3 consecutive nights. SETTING: Participants slept in their own private, individual, temperature-controlled bedroom in a sleep laboratory at the university. PARTICIPANTS: Eleven healthy student volunteers (5 women and 6 men, 21 to 25 years old, mean 22.7 years) who had no experience sleeping in a laboratory participated in the study. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: The electroencephalogram during the sleep-onset period was scored manually for every 5-second epoch into 9 electroencephalogram stages. Latencies of the electroencephalogram stages were delayed on the first night, especially during the alpha-wave intermittent stages. The average time of the alpha-wave train, intermittent (> 50%) and the electroencephalogram flattening stage increased on Night 1. Stage changes among these stages also increased on Night 1. In contrast, stage changes between the alpha-wave intermittent stage (< 50%) and the theta-wave stage increased on Night 3. CONCLUSIONS: Alpha-wave activity increased on Night 1, demonstrating that the activity of the wake-promoting system during the sleep-onset period was enhanced on the first night. From the second to the third night, the alpha-wave intermittent stage jumped to the theta-wave stage, omitting electroencephalogram flattening, suggesting that the electroencephalogram flattening stage is unlikely to appear during stable sleep-onset period. This is the first study to demonstrate the detail of the first-night effect during the sleep-onset period.

Effects of hypnagogic imagery on the event-related potential to external tone stimuli.

STUDY OBJECTIVES: The purpose of this study was to examine the influence of hypnagogic imagery on the information processes of external tone stimuli during the sleep onset period with the use of event-related potentials. DESIGN: Event-related potentials to tone stimuli were compared between conditions with and without the experience of hypnagogic imagery. To control the arousal level when the tone was presented, a certain criterion named the electroencephalogram stage was used. Stimuli were presented at electroencephalogram stage 4, which was characterized by the appearance of a vertex sharp wave. SETTING: Data were collected in the sleep laboratory at Hiroshima University. PARTICIPANTS: Eleven healthy university and graduate school students participated in the study. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Experiments were performed at night. Reaction times to tone stimuli were measured, and only trials with shorter reaction times than 5000 milliseconds were analyzed. Electroencephalograms were recorded from Fz, Cz, Pz, Oz, T5 and T6. There were no differences in reaction times and electroencephalogram spectra between the conditions of with and without hypnagogic imagery. These results indicated that the arousal levels were not different between the 2 conditions. On the other hand, the N550 amplitude of the event-related potentials in the imagery condition was lower than in the no-imagery condition. CONCLUSIONS: The decrease in the N550 amplitude in the imagery condition showed that experiences of hypnagogic imagery exert some influence on the information processes of external tone stimuli. It is possible that the processing of hypnagogic imagery interferes with the processing of external stimuli, lowering the sensitivity to external stimuli.

Recuperative power of a short daytime nap with or without stage 2 sleep.

STUDY OBJECTIVES: The recuperative effect of a nap of less than 30 minutes has been confirmed. Such naps consist mainly of stages 1 and 2 sleep. The present study examined whether sleep stage 1 or 2 contributed to the recuperative effect of a short nap. DESIGN: Repeated-measurement within-subject design. After sleep was restricted to 1.5 hours less than their usual nocturnal sleep, participants took a rest (No-nap condition) or a nap at 2:00 PM. In the nap condition, they were awakened after 5 minutes of stage 1 sleep (S1-nap condition) or 3 minutes after stage 2 sleep appeared (S2-nap condition). SETTING: University sleep laboratory. PARTICIPANTS: Ten healthy university students (aged 19 to 24 years). MEASUREMENTS: Subjective mood, performance on visual detection and symbol-digit substitution tasks, and the number of slow eye movements during a performance task were measured before and after the nap or rest. RESULTS: In the No-nap condition, subjective mood and performance deteriorated, and Slow eye movements increased during mid-afternoon, suggesting that the post-lunch dip occurred. In contrast, subjective alertness and performance improved and slow eye movements rarely occurred in the S2-nap condition. Although subjective sleepiness and fatigue improved, performance deteriorated and slow eye movements increased in the S1-nap condition. CONCLUSION: A daytime short nap containing 3 minutes of stage 2 sleep has recuperative effects, whereas these effects are limited following only stage 1 sleep.

Self-awakening prevents acute rise in blood pressure and heart rate at the time of awakening in elderly people.

Self-awakening, waking up at a designated time decided before sleeping, could prevent failure in the blood circulation vessel system such as heart attack, acute increases in heart rate or blood pressure upon waking. Previous research showed that anticipatory changes occurred in heart rate prior to awakening from a short nap by means of self-awakening for young participants. However, the effects of self-awakening remained unclear for elderly people. The present study examined the effects of self-awakening on heart rate and blood pressure in a short afternoon nap (20 min) among the elderly. Nine participants [74.1 (SD = 5.01) years old] underwent both self-awakening and forced-awakening conditions. In the self-awakening condition, it was revealed that blood pressure gradually increased before the scheduled time of awakening, and that heart rate did not show a rapid increase at arousal. In contrast, forced-awakening induced acute increases in both heart rate and blood pressure. These results suggest that self-awakening facilitates a more smooth transition from sleep to wakefulness via autonomic activation before the time of self-awakening.

Short nap versus short rest: recuperative effects during VDT work.

The effects of a 20-min nap during 2 h of visual display terminal (VDT) work were examined. Ten young healthy adults took a 20-min nap or a 20-min rest I h after VDT work, followed by another 1 h of VDT work. A 20-min rest temporarily restored subjective sleepiness, but it deteriorated during the additional 1 h of work. In contrast, a 20-min nap maintained subjective alertness and performance level at a higher level and mental fatigue at a lower level for the additional 1 h of work. These results suggest that a short nap would be useful to both fatigue recovery and fatigue prevention during continuous VDT work. The present findings may provide a new work/rest strategy.